U.S. patent application number 10/008964 was filed with the patent office on 2002-09-12 for surgical instrument.
Invention is credited to Brock, David L., Lee, Woojin.
Application Number | 20020128661 10/008964 |
Document ID | / |
Family ID | 57821529 |
Filed Date | 2002-09-12 |
United States Patent
Application |
20020128661 |
Kind Code |
A1 |
Brock, David L. ; et
al. |
September 12, 2002 |
Surgical instrument
Abstract
A disposable surgical instrument apparatus comprising: a
disposable elongated tube having a tool mounted at a distal end of
the tube; one or more disposable cables drivably interconnected
between the tool and a drive unit, the one or more disposable
cables extending through the disposable tube between the tool and a
proximal end of the disposable tube. The apparatus typically
include a disposable mechanically drivable interface mounted at a
proximal end of the disposable tube, the tool being drivably
intercoupled to a drive unit via the disposable mechanically
drivable interface.
Inventors: |
Brock, David L.; (Natick,
MA) ; Lee, Woojin; (Hopkinton, MA) |
Correspondence
Address: |
Finnegan, Henderson, Farabow,
Garrett & Dunner, L.L.P.
1300 I Street, N.W.
Washington
DC
20005-3315
US
|
Family ID: |
57821529 |
Appl. No.: |
10/008964 |
Filed: |
November 16, 2001 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10008964 |
Nov 16, 2001 |
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09827503 |
Apr 6, 2001 |
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09827503 |
Apr 6, 2001 |
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09746853 |
Dec 21, 2000 |
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09746853 |
Dec 21, 2000 |
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09375666 |
Aug 17, 1999 |
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6197017 |
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09375666 |
Aug 17, 1999 |
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09028550 |
Feb 24, 1998 |
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10008964 |
Nov 16, 2001 |
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09783637 |
Feb 14, 2001 |
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09783637 |
Feb 14, 2001 |
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PCT/US00/12553 |
May 9, 2000 |
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10008964 |
Nov 16, 2001 |
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PCT/US01/11376 |
Apr 6, 2001 |
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10008964 |
Nov 16, 2001 |
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09746853 |
Dec 21, 2000 |
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10008964 |
Nov 16, 2001 |
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09827503 |
Apr 6, 2001 |
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10008964 |
Nov 16, 2001 |
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09827643 |
Apr 6, 2001 |
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10008964 |
Nov 16, 2001 |
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PCT/US00/12553 |
May 9, 2000 |
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60133407 |
May 10, 1999 |
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60257869 |
Dec 21, 2000 |
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60195264 |
Apr 7, 2000 |
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60293346 |
May 24, 2001 |
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60279087 |
Mar 27, 2001 |
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60313496 |
Aug 21, 2001 |
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60313497 |
Aug 21, 2001 |
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60313495 |
Aug 21, 2001 |
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60269203 |
Feb 15, 2001 |
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60269200 |
Feb 15, 2001 |
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60276151 |
Mar 15, 2001 |
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60276217 |
Mar 15, 2001 |
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60276086 |
Mar 15, 2001 |
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60276152 |
Mar 15, 2001 |
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60257816 |
Dec 21, 2000 |
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60257868 |
Dec 21, 2000 |
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60257867 |
Dec 21, 2000 |
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60257869 |
Dec 21, 2000 |
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Current U.S.
Class: |
606/130 |
Current CPC
Class: |
A61B 34/37 20160201;
A61B 2017/00026 20130101; A61B 2090/506 20160201; A61B 17/00234
20130101; A61B 2017/2939 20130101; A61B 17/00 20130101; A61B 5/4893
20130101; A61B 2017/00323 20130101; A61B 2090/365 20160201; A61B
34/35 20160201; A61B 2090/378 20160201; A61B 17/29 20130101; A61B
90/36 20160201; B25J 9/104 20130101; A61B 5/015 20130101; A61B
34/30 20160201; A61B 2017/003 20130101; A61B 2017/00477 20130101;
A61B 2034/2051 20160201; A61B 2034/2059 20160201; A61B 2034/301
20160201; A61B 17/3462 20130101; A61B 34/72 20160201; A61B 2034/744
20160201; B25J 3/04 20130101; A61B 17/0469 20130101; A61B 17/3421
20130101; A61B 34/10 20160201; A61B 34/70 20160201; A61B 2017/00088
20130101; A61B 90/361 20160201; A61B 34/71 20160201; A61B 5/0084
20130101; A61B 17/0483 20130101; A61B 2017/00331 20130101; A61B
34/77 20160201; A61B 34/20 20160201; A61B 2017/2927 20130101; A61B
2034/742 20160201; A61B 2034/305 20160201; A61B 2034/715
20160201 |
Class at
Publication: |
606/130 |
International
Class: |
A61B 019/00 |
Claims
1. A medical procedure instrument comprising: a disposable
implement including a disposable elongated shaft having a tool at
its distal end and a disposable mechanically drivable mechanism
drivably interconnected to the tool: a mounting mechanism
interconnected to a drive mechanism, the mechanically drivable
mechanism being removably mountable on the mounting mechanism for
drivable interconnection to the drive mechanism; and the shaft
being insertable into a patient along a select length of the shaft
to position the tool at a target site in the patient.
2. The medical procedure instrument of claim 1 wherein the drive
mechanism is drivably interconnected to the mounting mechanism, at
a first interface which is remote from a second interface at which
the mechanically drivable mechanism is mounted to the mounting
mechanism.
3. The medical procedure instrument of claim 1 wherein the drive
mechanism comprises a plurality of motors, each motor and the drive
mechanism is attachable and detachable from the mounting
mechanism.
4. The medical procedure instrument of claim 1 wherein the mounting
mechanism includes a guide tube through which the shaft is inserted
into the patient.
5. The medical procedure instrument of claim 1 wherein the mounting
mechanism includes a drivable mechanism for mechanically driving
the guide tube.
6. The medical procedure instrument of claim 1 wherein the mounting
mechanism includes a first removable interface to the drive
mechanism and a second removable interface to the mechanically
drivable mechanism of the disposable instrument, wherein the
disposable instrument can be removed from the mounting mechanism
and discarded after use and the mounting mechanism can be removed
from the drive mechanism and sterilized for reuse.
7. The medical procedure instrument of claim 1 wherein the
disposable implement is remote controllably drivable by a user via
a manually controllable mechanism which is electrically
interconnected to the drive mechanism through an electrical drive
control mechanism.
8. The medical procedure instrument of claim 1 wherein the
mechanically drivable mechanism provides at least two degree of
freedom movement to the tool.
9. The medical procedure instrument of claim 1 wherein the mounting
mechanism and the disposable implement are manually portable in a
sterile field.
10. The medical procedure instrument of claim 9 wherein the drive
mechanism is outside the sterile fields.
11. A medical procedure instrument comprising: a disposable
implement which is readily drivably interconnectable to and
disconnectable from a drive mechanism; the disposable implement
including a mechanically drivable interface drivably interconnected
through a shaft to a tool; the mechanically drivable interface
being readily drivably engageable with and readily disengageable
from a second drive interface which is drivably interconnected to
the drive mechanism.
12. The medical procedure instrument of claim 11 wherein the
mechanically drivable interface and the shaft are an integral
disposable unit.
13. The medical procedure instrument of claim 11 wherein the
disposable implement is remote controllably drivable by a user via
a manually controllable mechanism which is electrically
interconnected to the drive mechanism through an electrical drive
control mechanism.
14. The medical procedure instrument of claim 11 wherein the second
drive interface is manually portable in a sterile field.
15. The medical procedure instrument of claim 14 wherein the drive
mechanism is outside the sterile field.
16. The medical procedure instrument of claim 14 wherein the second
drive interface is reusable following sterilization.
17. A surgical instrument system positionable within an anatomic
body structure and controllable by an operator, said system
comprising: a guide member having a proximal end and a distal end;
a support for the guide member so as to position the guide member
with the proximal end outside of the anatomic body structure and
the distal end within the anatomic body structure adjacent an
operative site; and an integral instrument member, disposable as a
unit, including a mechanical drivable element, a stem section, and
a distal tool; said instrument member being readily removably
engageable with said guide member.
18. A surgical instrument system as set forth in claim 17 wherein
said instrument member has a coupler at a proximal end thereof
which removably engages with a coupler of the guide member to drive
the mechanical drivable element of the instrument member.
19. A surgical instrument system as set forth in claim 18 including
at least one motor remote from said guide and instrument members
and mechanical cabling from said motor to the guide member coupler,
via the instrument member coupler, to provide at least one degree
of freedom of the instrument member.
20. A surgical instrument system as set forth in claim 19 wherein
each of said couplers includes at least one inter-engageable
wheel.
21. A surgical instrument system as set forth in claim 19 wherein
said guide member coupler is pivotal to facilitate the removable
engagement of the guide member and instrument member.
22. A surgical instrument system as set forth in claim 19 wherein
said guide member includes a base piece, and a guide tube extending
from the base piece, and wherein said coupler is pivotably
supported from said base piece.
23. A surgical instrument system as set forth in claim 19 wherein
said instrument member stem section has mechanical cabling
extending therethrough from the instrument member coupler to the
distal tool.
24. A surgical instrument system as set forth in claim 23 wherein
said stem section includes section with differing amounts of flex
ability.
25. A surgical instrument system as set forth in claim 22 wherein
said guide tube includes a straight section and a more distal
curved section.
26. A surgical instrument system as set forth in claim 25 wherein,
when the instrument member is engaged with the guide member, a more
flexible stem section is disposed in the guide tube curved
section.
27. A surgical instrument system as set forth in claim 17 further
including an electro-mechanical drive member remote from said guide
and instrument members and having only mechanical coupling to said
guide and instrument members.
28. A surgical instrument system as set forth in claim 27 wherein
the guide member includes a guide tube and the mechanical coupling
controls rotation of the guide tube.
29. A surgical instrument system as set forth in claim 28 wherein
the instrument stem section is disposable in the guide tube and the
mechanical coupling controls rotation of the instrument stem within
the guide tube.
30. An article comprising: a disposable integral medical instrument
including: a disposable mechanical coupler at a proximal end of the
instrument for receiving mechanical drive from a drive unit; a
disposable elongated stem extending from said mechanical coupler; a
tool disposed at a distal end of said elongated stem and drivably
interconnected via said elongated stem to said mechanical coupler;
said elongated stem enabling removable insertion in an instrument
holder to position the tool at a target site in a patient for
performing a medical procedure.
31. A disposable medical instrument as set forth in claim 30
attachable to and detachable from an instrument holder to couple
mechanical drive from a remote drive unit.
32. A disposable medical instrument as set forth in claim 31
wherein said mechanical coupler includes at least one interlocking
wheel for coupling to the instrument holder.
33. A disposable medical instrument as set forth in claim 30 the
mechanical coupler includes mechanical cabling extending to said
tool.
34. A disposable medical instrument as set forth in claim 30
wherein the stem is mounted to enable rotation of the stem relative
to the mechanical coupler.
35. A disposable medical instrument as set forth in claim 33
wherein said stem is hollow and said mechanical cabling extends
through the hollow stem to the tool.
36. A disposable medical instrument as set forth in claim 30
including a wrist joint at the distal end of said stem coupling to
the tool.
37. A disposable medical instrument as set forth in claim 30
wherein said elongated stem also has a more distal flexible
section.
38. A disposable medical instrument as set forth in claim 30
wherein said mechanical coupler includes a plurality of drive
wheels and mechanical cabling for driving the tool.
39. A disposable medical instrument as set forth in claim 38
wherein said mechanical cabling controls at least two
degrees-of-freedom of the tool.
40. A disposable medical instrument as set forth in claim 30
including means for registering the mechanical coupler with an
instrument holder.
41. A disposable surgical instrument comprising: a disposable
elongated tube having a tool mounted at a distal end of the tube;
one or more disposable cables drivably interconnected between the
tool and a drive unit, the one or more disposable cables extending
through the disposable tube between the tool and a proximal end of
the disposable tube.
42. The disposable surgical instrument of claim 41 further
comprising: a guide tube having an open distal end, the guide tube
being readily manually insertable through an incision in a subject
to position the distal end at an operative site within the subject,
the disposable elongated tube being readily insertable through the
guide tube to position the tool through the open distal end of the
guide tube.
43. The disposable surgical instrument of claim 42 further
comprising: a manually portable support readily fixedly attachable
to and detachable from a stationary structure on or relative to
which the subject is mounted, the guide tube being readily fixedly
interconnectable to and disconnectable from the support for fixedly
positioning the distal end of the guide tube at the operative
site.
44. The disposable surgical instrument of claim 41 wherein the
drive unit is mounted remotely from the operative site and is
drivably interconnected to the one or more cables extending through
the disposable tube by one or more cables extending between the
drive unit and the proximal end of the disposable elongated
tube.
45. A disposable surgical instrument comprising: a disposable
elongated tube having a tool mounted at a distal end of the tube; a
disposable mechanically drivable interface mounted at a proximal
end of the disposable tube, the tool being drivably intercoupled to
a drive unit via the disposable mechanically drivable
interface.
46. The disposable surgical instrument of claim 45 further
comprising: a guide tube having an open distal end, the guide tube
being readily manually insertable through an incision in a subject
to position the distal end of the guide tube at an operative site
within the subject, the disposable elongated tube being readily
insertable through the guide tube to position the tool through the
open distal end of the guide tube at the operative site.
47. The disposable surgical instrument of claim 46 further
comprising: a manually portable support readily fixedly attachable
to and detachable from a stationary structure on or relative to
which the subject is mounted, the guide tube being readily fixedly
interconnectable to and disconnectable from the support for readily
fixedly positioning the distal end of the guide tube at the
operative site.
48. The disposable surgical instrument of claim 45 wherein the
drive unit is mounted remotely from the operative site and is
drivably interconnected to the mechanically drivable interface by
one or more cables extending between the drive unit and the
mechanically drivable interface.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation-in-part of and claims the
benefit of priority from U.S. application Ser. No. 09/827,503,
filed Apr. 6, 2001, which is a continuation of U.S. application
Ser. No. 09/746,853, filed Dec. 21, 2000, which is a divisional of
U.S. application Ser. No. 09/375,666, now U.S. Pat. No. 6,197,017,
filed Aug. 17, 1999, which is a continuation of U.S. application
Ser. No. 09/028,550 filed Feb. 24, 1998, now abandoned. This
application is also a continuation-in-part of and claims the
benefit of priority from U.S. application Ser. No. 09/783,637,
filed Feb. 14, 2001, which is a continuation of PCT/US00/12553
filed May 9, 2000, which claims the benefit of priority of U.S.
provisional patent application Serial No. 60/133,407, filed May 10,
1999, now abandoned. This application is also a
continuation-in-part of and claims the benefit of priority from
PCT/US01/11376 filed Apr. 6, 2001 which claims priority to U.S.
application Ser. Nos. 09/746,853 filed Dec. 21, 2000 and 09/827,503
filed Apr. 6, 2001. This application is also a continuation-in-part
of and claims the benefit of priority from U.S. application Ser.
Nos. 09/746,853 filed Dec. 21, 2000 and 09/827,503 filed Apr. 6,
2001. This application is also a continuation-in-part of and claims
the benefit of priority from U.S. application Ser. No. 09/827,643
filed Apr. 6, 2001 which claims priority to, inter alia, U.S.
provisional application serial No. 60/257,869 filed Dec. 21, 2000
and U.S. provisional application serial No. 60/195,264 filed Apr.
7, 2000 and is also a continuation-in-part of PCT/US00/12553 filed
May 9, 2000 from which U.S. application Ser. No. 09/783,637 filed
Feb. 14, 2001 claims priority.
[0002] This application also claims the benefit of priority under
35 U.S.C. .sctn..sctn.119 and 120 to U.S. Provisional Application
Serial No. 60/293,346 filed May 24, 2001, U.S. Provisional
Application Serial No. 60/279,087, filed Mar. 27, 2001, U.S.
Provisional Application Serial No. 60/313,496 filed Aug. 21, 2001,
U.S. Provisional Application Serial No. 60/313,497 filed Aug. 21,
2001, U.S. Provisional Application Serial No. 60/313,495 filed Aug.
21, 2001, U.S. Provisional Application Serial No. 60/269,203 filed
Feb. 15, 2001, U.S. Provisional Application Serial No. 60/269,200
filed Feb. 15, 2001, U.S. Provisional Application Serial No.
60/276,151 filed Mar. 15, 2001, U.S. Provisional Application Serial
No. 60/276,217 filed Mar. 15, 2001, U.S. Provisional Application
Serial No. 60/276,086 filed Mar. 15, 2001, U.S. Provisional
Application Serial No. 60/276,152 filed Mar. 15, 2001, U.S.
Provisional Application Serial No. 60/257,816 filed Dec. 21, 2000,
U.S. Provisional Application Serial No. 60/257,868 filed Dec. 21,
2000, U.S. Provisional Application Serial No. 60/257,867 filed Dec.
21, 2000, U.S. Provisional Application Serial No. 60/257,869 filed
Dec. 21, 2000.
[0003] The disclosures of all of the foregoing applications and
U.S. Pat. No. 6,197,017 are all incorporated herein by reference in
their entirety.
[0004] This application further incorporates by reference in its
entirety the disclosures of the following U.S. Patent applications
which are being filed concurrently on the same date herewith,
having the following titles and docket numbers:
08491.7013--Surgical Instrument; 08491.7014--Surgical Instrument;
08491.7015--Surgical Instrument; 08491.7016--Surgical Instrument;
08491.7017--Surgical Instrument; 08491.7018--Surgical Instrument;
08491.7019--Surgical Instrument; 08491.0006--Flexible Instrument;
08491.0006--Flexible Instrument; 08491.0007--Flexible Instrument;
08491.0008--Flexible Instrument; 08491.0009--Flexible Instrument;
08491.0010--Flexible Instrument; and 08491.0011--Flexible
Instrument.
BACKGROUND OF THE INVENTION
[0005] The present invention relates to surgical instruments and
more particularly to surgical instruments which are remotely
controlled by electronic control signals generated by a user which
are sent to a drive unit which drives mechanically drivable
components of a mechanical apparatus which support a surgical
instrument.
SUMMARY OF THE INVENTION
[0006] Instrument Support and Mounting
[0007] One aspect of the present invention relates to a support
member for holding a medical procedure instrument holder in a fixed
position relative to a patient.
[0008] In one embodiment, a medical procedure instrument is
provided, including an instrument holder, an instrument insert, and
a support. The instrument holder includes an elongated guide member
for receiving the instrument insert. The insert carries on its
distal end a medical tool for executing the medical procedure. The
instrument holder is manually insertable into a patient so as to
dispose a distal end of the guide member into a target site in
which the procedure is to be executed. The support holds the
instrument holder fixed in position relative to the patient. The
instrument holder is held in fixed position in an incision in the
patient between changes of instrument inserts during the course of
a procedure such that trauma or damage which can result from
withdrawal and re-insertion of another or the same instrument is
minimized or eliminated. The distal end of the elongated guide
member is preferably curved and at least the distal end of the
instrument insert is flexible to enable the insert to slide through
the curved distal end of the guide member.
[0009] The instrument insert typically includes an elongated shaft
having a proximal end, a distal end and a selected length between
the two ends. One or more portions of the elongated shaft along its
length, and most typically a distal end portion, may comprise a
mechanically and controllably deformable material such that the
portion of the selected lengths of the shaft which are deformable
are controllably bendable or flexible in any one or more of an X, Y
and Z axis direction relative to the axis of the shaft thus
providing an additional three degrees of freedom of movement
control. Flexible cables, rods or the like which are connected at
one end to a deformable or flexible portion of a shaft and are
drivably intercoupled to a controllably drivable drive unit are
typically included for effecting control of the bending or
flexing.
[0010] In one embodiment, the support includes a bracket that holds
an instrument holder to the support at a fixed reference point. The
instrument holder is then pivotally supported at this reference
point from the bracket.
[0011] In various embodiments, the instrument insert is manually
engageable and disengageable with the instrument holder. Generally,
the instrument holder is inserted into the patient first, and then
the insert is engaged to the holder, such that the medical tool at
the distal end of the insert extends beyond the distal end of the
guide member at the target site. One advantage is to maintain the
guide member with its distal end at the target site upon withdrawal
of the instrument insert. This enables exchange of instrument
inserts during the procedure and facilitates ease of placement of
the next instrument insert.
[0012] The instrument insert preferably includes a mechanically
drivable mechanism for operating the medical tool. The instrument
holder also includes a mechanical drive mechanism such that the
drive and drivable mechanisms are engageable and disengageable with
one another, in order to enable engagement and disengagement
between the insert and holder. Preferably, a drive unit for
controlling the instrument insert and holder is disposed remote
from the insert and holder, outside of a sterile field which may be
defined by the area above the operating table.
[0013] In another embodiment, a medical procedure instrument is
provided which includes an instrument holder, an instrument insert,
and a support. The instrument holder includes an elongated guide
member for receiving the insert, the insert carrying at its distal
end a medical tool for executing a medical procedure. The support
holds the instrument holder with a distal end of the guide member
at a target site internal of the patient. The insert is adapted for
ready insertion and withdrawal by way of the guide member, while
the guide member is held at the target site. Again, this
facilitates ready exchange of instrument inserts during a medical
procedure. The instrument inserts are preferably disposable, so
they can be discarded after a single insertion and withdrawal from
the patient.
[0014] In a further embodiment, a remote controlled instrument
system is provided which includes a user interface, an instrument,
a support, and a controller. The user interface allows an operator
to manually control an input device. The instrument has at its
distal end a tool for carrying out a procedure, the instrument
being manually inserted into a patient so as to dispose the tool at
a target site at which the procedure is to be executed. The support
holds a part of the instrument fixed in position relative to the
patient. A controller coupled between the user interface and the
instrument is responsive to a remote control by the operator for
controlling the instrument at the target site.
[0015] Another embodiment is a method for remotely controlling an
instrument having multiple degrees-of-freedom. The instrument is
manually inserted into a patient so as to dispose its distal end at
a target site at which a procedure is to be executed. An instrument
holder, that receives the instrument, is supported stationary
relative to the patient during the procedure so as to maintain the
instrument distal end at the target site. A user input device is
used to remotely control the motion of the instrument distal end in
executing the procedure at the target site.
[0016] In a further method embodiment for remotely controlling an
instrument, an instrument holder is provided for removably
receiving and supporting a disposable instrument insert. The
instrument holder is inserted into a patient so as Lo dispose its
distal end at an operative site at which the procedure is to be
executed. The instrument insert is received in the holder so as to
dispose a tool at the distal end of the insert so that it extends
from the holder and is positioned at the operative site. A user
input device remotely controls motion of the insert in executing
the procedure at the operative site. Preferably, the instrument
holder is maintained at the operative site as the insert is
withdrawn, enabling ready exchange of one instrument insert for
another.
[0017] The invention also provides a medical apparatus for
exchanging surgical instruments having a selected tool to be
positioned at an operative site of a subject, the apparatus
comprising: a guide tube having an open distal end inserted through
an incision of the subject, the guide tube being fixedly positioned
relative to the subject such that the distal end of the guide tube
is fixedly positioned at the operative site, the guide tube being
readily manually insertable through the incision; one or more
surgical instruments each having a selected tool mounted at a
distal end of the instrument; wherein the one or more surgical
instruments are readily insertable through the fixedly positioned
guide tube such that the selected tool of an instrument is disposed
through the open distal end of the guide tube at the operative site
upon full insertion of the surgical instrument, the guide tube
having a first mounting interface and the surgical instruments
having a second mounting interface, the first and second mounting
interfaces being readily engageable with each other to fixedly
mount the surgical instruments within the guide tube upon full
insertion of the surgical instrument. Such a medical apparatus may
further comprise a readily manually portable support for fixedly
positioning the guide tube in a selected location and orientation
relative to the subject, the manually portable support being
readily fixedly attachable to and detachable from a stationary
structure on or relative to which the subject is mounted.
[0018] These and other embodiments of the instrument, system and
method are more particularly described in the later detailed
description section.
[0019] Ready Attachability Couplability and Mountability
[0020] Another aspect of the invention is to provide a drive unit
or motor assembly which is attachable and detachable from a medical
instrument assembly in order to provide one or more of the features
of, positioning the motor assembly outside a sterile field in which
a medical procedure takes place, increasing portability of the
instrument assembly for ease of positioning with respect to the
patient and ease of access to the patient during the procedure,
e.g., avoiding bulky and unnecessary electromechanical equipment in
the sterile field of the procedure so as to increase ease of access
to the patient, enabling detachment, sterilization and reusability
of certain components of the instrument assembly and/or detachment
and disposability of certain other portions of the instrument
assembly.
[0021] In the first embodiment, a medical procedure instrument is
provided. including a medical implement and a drive unit. The
medical implement includes a mechanically drivable mechanism
intercoupled with the tool used in executing a medical procedure. A
drive unit, disposed remote from the medical implement, is used for
mechanically driving the implement. The implement is initially
decoupled from the drive unit and manually insertable into a
patient so as to dispose the tool at an operative site within the
patient. The medical implement is attachable and detachable with
the drive unit for coupling and decoupling the mechanically
drivable mechanism with the drive unit.
[0022] In various preferred embodiments, the medical implement
includes a holder and an instrument insert, the holder receiving
the insert and the insert carries the mechanically drivable
mechanism. Preferably, the insert is an integral disposable unit,
including a stem section with the tool at its distal end and the
mechanically drivable mechanism at its proximal end.
[0023] The drive unit may be an electromechanical unit, and
mechanical cabling may intercouple the drive unit with the
mechanically drivable mechanism. Mechanical cabling may be provided
to control motion for both the instrument holder, and the
instrument insert. The medical implement may be remotely
controllable by a user, manipulating a manually controllable
device, which device is connected to the drive unit through an
electrical drive control element.
[0024] In another embodiment, a slave station of a robotic surgery
system is provided in which manipulations by a surgeon control
motion of a surgical instrument at a slave station. The slave
station includes a support, mechanical cabling, and a plurality of
motors. The support is manually portable and is provided to hold
the surgical instrument at a position over an operating table so
that the instrument may be readily disposed at an operative site.
Mechanical cabling is coupled to the instrument for controlling
movement of the instrument. The plurality of motors are controlled,
by way of a computer interface, and by surgeon manipulations for
driving the mechanical cabling. The mechanical cabling is driven by
the plurality of motors in a manner so as to be attachable and
detachable from the plurality of motors.
[0025] In a preferred embodiment, a two section housing is
provided, one housing section accommodating the ends of the
mechanical cabling and the other housing section accommodating the
plurality of motors. The two housing sections are respectively
attachable and detachable. A plurality of coupler spindles
supported by the one housing section receive cables of the
mechanical cabling. The plurality of coupler spindles and plurality
motors are disposed in aligned arrays. A plurality of coupler disks
of the other housing section are provided, one associated with and
supported by each motor by the plurality of motors. The housing
sections support the coupler spindles and the coupler disks in
aligned engagement. An engagement element may lock the coupler
spindles and disks against relative rotation.
[0026] In a further embodiment, a robotic surgery system is
provided, including an instrument, a support, mechanical cabling,
an array of actuators, and an engagement member. The support is
manually portable and holds the instrument over an operating table
so that the instrument may be disposed at an operative site in a
patient for remote control thereof via a computer interface. The
mechanical cabling is coupled to the instrument for controlling
movement of the instrument. An array of electrically driven
actuators is controlled by the computer interface for driving the
mechanical cabling. An engagement member intercouples between the
mechanical cabling and the array of actuators so that the
mechanical cabling is readily attachable to and detachable from the
array of actuators.
[0027] In another aspect of the invention, there is provided a
robotic surgery apparatus comprising: a mechanically drivable
surgical instrument for use at an internal operative site of a
subject; an electrically driven drive unit for driving the surgical
instrument; mechanical cabling drivably intercoupled to the
surgical instrument at one end of the cabling; the mechanical
cabling having another end which is readily drivably couplable to
and decouplable from the drive unit.
[0028] In another aspect of the invention, there is provided a
robotic surgery apparatus comprising: a surgical instrument for use
at an internal operative site of a subject; a mechanically drivable
mounting unit on which the surgical instrument is mounted, the
mounting unit being drivably movable outside the operative site of
the subject; an electrically driven drive unit for driving movement
of the mounting unit; mechanical cabling drivably intercoupled to
the mounting unit at one end of the cabling; the mechanical cabling
having another end which is readily drivably couplable to and
decouplable from the drive unit.
[0029] In another aspect of the invention there is provided a
robotic surgery apparatus comprising: a mechanically drivable
surgical instrument for use at an internal operative site of a
subject; an electrically driven drive unit for driving the surgical
instrument; mechanical cabling drivably intercoupled to the
surgical instrument at one end of the cabling; the drive unit being
readily manually portable and readily attachable to and detachable
from a fixed support on or relative to which the subject is
mounted.
[0030] These and other embodiments are described in the following
detailed description section.
[0031] Disposability
[0032] Another aspect of the invention is to provide a disposable
medical procedure instrument which includes a mechanically drivable
mechanism for driving a tool.
[0033] Disposable or disposability generally means that a device or
mechanism is used or intended for a single use without a re-use of
the device/mechanism and/or without the necessity or intention of a
use of the device followed by sterilization of the device for an
intended re-use. In practice, a device which is intended for one
time or single use may be re-used by the user/physician but such
re-use more than once, twice or a very limited number of times is
not intended for a disposable device or mechanism.
[0034] In one embodiment, a medical procedure instrument is
provided including a disposable implement and a mounting mechanism
interconnected to a drive mechanism. The disposable implement
includes a shaft having a tool at its distal end and a mechanically
drivable mechanism drivably interconnected to the tool. A mounting
mechanism, interconnected to the drive mechanism, enables the
mechanically drivable mechanism of the implement to be removably
mounted on the mounting mechanism for drivable interconnection to
the drive mechanism. The shaft is insertable into a patient along a
select length of the shaft to position the tool at a target site in
the patient. The shaft together with the mechanically drivable
mechanism is disposable.
[0035] At various embodiments, the drive mechanism is drivably
interconnected to the mounting mechanism at a first interface which
is remote from a second interface at which the mechanically
drivable mechanism is mounted to the mounting mechanism. The drive
mechanism may include a plurality of motors, and the mounting
mechanism is preferably attachable and detachable from the drive
mechanism. The mounting mechanism may include a guide tube, through
which the shaft is inserted into the patient, and wherein the
mounting mechanism includes a drivable mechanism for mechanically
driving the guide tube.
[0036] Preferably, the disposable instrument can be removed from
the mounting mechanism and discarded after use, while the mounting
mechanism can be removed from the drive mechanism and sterilized
for reuse.
[0037] The disposable implement is preferably remote controllably
drivable by a user via a manually controllable mechanism which is
electrically connected to the drive mechanism through an electrical
drive control mechanism.
[0038] Preferably, the mounting mechanism and the disposable
implement are manually portable in a sterile field, while the drive
mechanism is outside the sterile field.
[0039] In another embodiment, a medical procedure instrument is
provided which is a disposable instrument, drivably
interconnectable to and disconnectable from a drive mechanism, the
disposable instrument including a mechanically drivable interface,
drivably interconnected through a shaft to a tool, the mechanically
drivably interface being drivably engageable with and disengageable
from a second drive interface which is drivably interconnected to
the drive mechanism. Preferably, the mechanically drivable
interface and the shaft are an integral disposable unit. The
disposable implement may be remote controllably drivable by a user
via a manually controllable mechanism which is electrically
interconnected to the drive mechanism through an electrical drive
control mechanism. The second drive interface may be manually
portable in a sterile field. After use, the second drive interface
is sterilized for reuse. The drive mechanism is outside the sterile
field.
[0040] In yet another embodiment, a surgical instrument system is
provided positionable within an anatomic body structure and
controllable by an operator. The system contains a guide member, a
support, and an integral instrument member. The guide member has a
proximal end and a distal end. The support positions the guide
member with the proximal end outside the anatomic body structure
and the distal end within the anatomic body structure adjacent to
the operative site. An integral instrument member, disposable as a
unit, includes a mechanical drivable element, a stem section and a
distal tool. The instrument member is removably engageable with the
guide member.
[0041] In various embodiments, each of the instrument member and
guide member has a coupler, the couplers being removably engageable
in order to drive the mechanical drivable element of the instrument
member. At least one motor is provided remote from the guide member
and instrument member, and mechanical cabling is provided from the
motor to the instrument member coupler via the guide member coupler
to provide at least 1 degree-of-freedom of motion of the instrument
member. The couplers may include interengageable wheels. The guide
member coupler is pivotal to facilitate the removable engagement of
the guide member and instrument member.
[0042] In one embodiment, the guide member includes a base piece,
and a guide tube extending from the base piece, wherein the coupler
is pivotally supported from the base piece. The instrument member
stem section has a mechanical cabling extending therethrough from
the instrument member coupler to the distal tool. The instrument
member stem section may include sections with different amounts of
flexibility. The guide tube includes a straight section, and a more
distal curved section. When the instrument member engages with the
guide member, the more flexible stem section is disposed in the
guide tube curved section. An electromechanical drive member may be
provided remote from the guide tube and instrument member, having
only mechanical coupling to the guide tube and instrument member.
The mechanical coupling may control rotation of the guide tube as
well as rotation of the instrument stem within the guide tube.
[0043] In another embodiment, a disposable integral medical
instrument is provided including a mechanical coupler, an elongated
stem, and a tool. The mechanical coupler is at the proximal end of
instrument for receiving mechanical drive from a drive unit. The
elongated stem extends from the mechanical coupler. The tool is
disposed at the distal end of the elongated stem and is
interconnected, via the elongated stem, to the mechanical coupler.
The elongated stem enables removable insertion in an instrument
holder to position a tool at a target site inside a patient for
performing a medical procedure.
[0044] Preferably, the disposable integral medical instrument is
attachable to and detachable from an instrument holder in order to
couple mechanical drive from a remote drive unit. The mechanical
coupler includes at least one interlocking wheel for coupling with
the instrument holder. The mechanical coupler includes mechanical
cabling extending to the tool. The stem is mounted to enable
rotation of the stem relative to the mechanical coupler. A wrist
joint may be provided at the distal end of the stem, coupling to
the tool. The elongated stem may have a more distal flexible
section. The instrument may have a means for registering the
mechanical coupler with an instrument holder.
[0045] In another aspect of the invention, there is provided a
disposable surgical instrument comprising: a disposable elongated
tube having a tool mounted at a distal end of the tube; one or more
disposable cables drivably interconnected between the tool and a
drive unit, the one or more disposable cables extending through the
disposable tube between the tool and a proximal end of the
disposable tube. The apparatus preferably includes a guide tube
having an open distal end, the guide tube being readily manually
insertable through an incision in a subject to position the distal
end at an operative site within the subject, the disposable
elongated tube being readily insertable through the guide tube to
position the tool through the open distal end of the guide tube.
The apparatus preferably also includes a manually portable support
readily fixedly attachable to and detachable from a stationary
structure on or relative to which the subject is mounted, the guide
tube being readily fixedly interconnectable to and disconnectable
from the support for fixedly positioning the distal end of the
guide tube at the operative site. The drive unit is preferably
mounted remotely from the operative site and is drivably
interconnected to the one or more cables extending through the
disposable tube by one or more cables extending between the drive
unit and the proximal end of the disposable elongated tube.
[0046] In another embodiment of the invention there is provided a
disposable surgical instrument comprising: a disposable elongated
tube having a tool mounted at a distal end of the tube; a
disposable mechanically drivable interface mounted at a proximal
end of the disposable tube, the tool being drivably intercoupled to
a drive unit via the disposable mechanically drivable
interface.
[0047] These and other features of the invention are set forth more
fully in the following detailed description.
[0048] Translation and Other Movement Capability
[0049] Another aspect of the invention relates to controlled
movement of a surgical instrument system having a distal end
positionable within a patient. More specifically, the controlled
movement may be limited to translation in a predetermined plane.
This controlled movement specifies certain degrees-of-freedom of
the surgical instrument, including a guide tube that receives an
instrument member having a tool at its distal end. Such movement
may be remotely controlled via computer control in response to
movements by a surgeon at an input interface.
[0050] In one embodiment, a surgical instrument system is provided
that is adapted to be inserted through an incision of a patient for
operation by a surgeon from outside the patient. The system
includes an arm member, a support for the arm member and an
instrument member. The arm member has a proximal end disposed
outside the patient and a distal end internal of the patient. A
support for the arm member provides controlled translation of the
arm member with a proximal end thereof moving substantially only in
a predetermined plane. The instrument member is carried by the arm
member and includes a tool disposed at the distal end of the arm
member.
[0051] In a preferred embodiment, a controller responsive to a
surgeon manipulation controls movement of the arm member and of the
tool. The surgeon may be positioned at a master station having an
input interface, at which the surgeon manipulates an input device.
The controller may allow a number of degrees-of-freedom of the tool
and of the arm member. In one embodiment, the tool has 4
degrees-of-freedom, while the arm member has 3 degrees-of-freedom.
More specifically, the arm member may have one degree-of-freedom in
the predetermined plane. The arm member may have another
degree-of-freedom that is rotation of the arm member about a
longitudinal axis of the arm member. The arm member may have a
further degree-of-freedom that is linear movement of the arm member
along the longitudinal axis of the arm member. The tool may have
one degree-of-freedom that is rotation of the instrument member
about a longitudinal axis of the instrument member. The tool may
have another degree-of-freedom that is pivotal in a second plane
orthogonal to the first plane. The tool may have jaws and a further
degree-of-freedom may be provided enabling opening and closing of
the jaws.
[0052] The support for the arm member may include a support post
for positioning the arm member over an operating table upon which a
patient is placed. Preferably, the support post positions the arm
member at an acute angle to the operating table. The arm member may
include a guide tube that receives the instrument member.
[0053] In another embodiment, a surgical instrument system is
provided adapted to be inserted through an incision in a patient
for operation by a surgeon from outside the patient. The system may
include an instrument member having a tool at its distal end. The
guide member has a guide tube with a proximal end disposed outside
the patient and a distal end internal of the patient. The guide
tube has an elongated portion with a central access of rotation and
a distal portion having an end which is positioned a radial
distance away from the central access. The support for the guide
member provides controlled translation of the guide member with the
proximal end thereof moving substantially only in a predetermined
plane.
[0054] In various embodiments, a drive unit is coupled to the guide
tube for rotating the guide tube and thereby displacing the tool
with respect to the central access. Preferably, the distal portion
of the guide tube is curved so as to displace the end thereof the
radial distance away from the central access. When combined with
translation in the plane, the rotation of the guide tube enables
three-dimensional placement of the instrument tool.
[0055] The instrument member may include a coupler for engaging the
instrument member to the guide member, and an elongated section
that is, at least, partially flexible for insertion into the guide
tube. The instrument member may include in its distal end at least
two adjacent link members intercoupled by way of at least one
joint, and at least one cable extending along at least one of the
link members for operating the adjacent link member. Separate cable
sections may be coupled to opposite sides of the adjacent link
members for enabling pivoting in either direction of the adjacent
link member relative to the at least one link member.
[0056] The instrument member can be readily engageable and
disengageable with the guide a member and constructed to enable
exchange with other instrument members. The instrument member may
be disposable.
[0057] The instrument member may be couplable to and decouplable
from a drive unit, the drive unit being controlled by a controller
for operating the instrument member. The drive unit may be disposed
remote from a sterile field in which the patient and instrument
member are disposed.
[0058] In another embodiment, an instrument system is provided,
including a user interface, an instrument, a support, a controller,
and a drive unit. A surgeon may manipulate an input device at the
user interface. The instrument has a distal end internal of the
patient and carrying at its distal end a tool used in executing a
procedure at an operative site of the patient. The support for the
instrument includes a pivot at the proximal end of the instrument
that limits motion of the proximal end of the instrument
substantially only in one plane. The controller receives commands
from the user interface for controlling movement of the instrument.
A drive unit intercouples with the controller and the
instrument.
[0059] In a preferred embodiment, the instrument includes an
adapter and an instrument insert. The adapter may have a guide tube
with an elongated portion having a longitudinal access of rotation
and a distal end that is positioned a radial distance away from the
longitudinal access. When the distal end of the guide tube is
curved, the distal end will orbit about the longitudinal access as
the guide tube is rotated under control from the user interface.
The insert may be removably couplable with the adapter and include
an elongated stem having a tool at its distal end. The adapter and
insert may each include a coupler for lateral relative coupling and
decoupling of the adapter and insert. The instrument coupler may
include a series of wheels that engage with a series of wheels on
the adapter coupler.
[0060] The instrument insert may have an elongated stem which
includes a more flexible stem section disposed distally of a less
flexible stem section. Alternatively, the full length of the
elongated stem may be flexible. A wrist link, intercoupling a more
flexible stem section with the tool, provides one degree-of-freedom
of the tool.
[0061] In another embodiment of the invention there is provided a
remotely controlled surgical instrument system that is adapted to
be inserted through an incision of a patient for operation by a
surgeon from outside the patient in a remote location, the system
comprising: an elongate tube having a proximal end disposed outside
the patient and a distal end internal of the patient; a support for
the elongate tube that provides controlled translation of said
elongate tube with the proximal end thereof moving substantially
only in a predetermined plane; and the elongate tube having an axis
and a tool mounted on a distal end of the tube, the elongate tube
being curved along a distal length of the elongate tube and
controllably rotatable around the axis such that the tool is
movable in a circle or an additional two degrees of freedom
internal of the patient by rotation of the arm member.
[0062] These and other features of the invention are described in
the following detailed description.
[0063] Portability
[0064] Another aspect of the invention is to provide readily
manually portable components positionable in close proximity to a
patient within the sterile field, without unduly reducing access to
the patient or otherwise interfering with the procedure.
[0065] In one embodiment, a portable remotely controllable surgical
instrument is provided including a shaft, a mounting mechanism and
a drive unit. A manually portable elongated shaft is provided
having a proximal end and a distal end manually positionable at an
operative site within a subject upon insertion of the shaft through
an incision in the subject. A manually portable mounting mechanism
is readily manually mountable in a fixed position outside the
patient through the incision, the proximal end of the portable
shaft being mounted thereon. A manually portable drive unit is
drivably interconnected through the mounting mechanism to a tool
mounted at the distal end of the portable shaft. The drive unit is
readily manually positionable at a selected position outside the
patient.
[0066] In various embodiments, the drive unit is controllably
drivable by a computer. The proximal end of the portable shaft is
readily manually mountable on the portable mounting mechanism for
enabling readily drivable intercoupling of the tool to the drive
unit. The portable shaft may be disposable. The drive unit may be
readily manually mountable at a position remote from the
incision.
[0067] In another embodiment, there is provided a portable remotely
controllable surgical apparatus comprising: a manually portable
elongated shaft having a proximal end and a distal end manually
positionable at an operative site within a subject upon insertion
of the shaft through an incision in the subject; a manually
portable mounting mechanism being readily manually mountable in a
fixed position outside the patient near the incision, the proximal
end of the portable elongated shaft being mounted thereon; a
manually portable support for fixedly positioning the manually
portable mounting mechanism in a selected location relative to the
subject, the manually portable support being readily fixedly
attachable to and detachable from a stationary structure on or
relative to which the subject is mounted. A portable drive unit is
preferably drivably intercoupled through the mounting mechanism to
a tool mounted at the distal end of the portable shaft; wherein the
drive unit is readily positionable at a selected position outside
and remote from the incision. The surgical instrument may include
one or more mechanically drivable components drivably intercoupled
to a drive unit, the apparatus further comprising mechanical
cabling drivably coupled to the one or more components at one end
of the cabling, the mechanical cabling being readily drivably
couplable to and decouplable from the drive unit at another end of
the mechanical cabling.
[0068] In another embodiment there is provided a portable remotely
controllable surgical apparatus comprising: a manually portable
elongated shaft having a proximal end and a distal end manually
positionable at an operative site within a subject upon insertion
of the shaft through an incision in the subject; a manually
portable mounting mechanism being readily manually mountable in a
fixed position outside the patient near the incision, the proximal
end of the portable elongated shaft being mounted thereon; a
portable drive unit drivably interconnected to the portable
elongated shaft through the mounting mechanism; mechanical cabling
drivably coupled to the mounting mechanism at one end of the
cabling and readily drivably couplable to and decouplable from the
portable drive unit at another end of the cabling. The mounting
mechanism typically includes one or more mechanically drivable
components for moving the mounting mechanism outside the subject,
the one or more mechanically drivable components being drivably
interconnected to the drive unit through the mechanical
cabling.
[0069] These and other features of the invention are set forth in
greater detail in the following detailed description section.
[0070] User Control Apparatus
[0071] Another aspect of the invention is to provide, in a
master/slave surgery system, a master station which includes upper
and lower positioner assemblies, movably connected, including an
arm assembly with a distal hand assembly for engagement by the
surgeon's hand.
[0072] In one embodiment, a master station is adapted to be
manually manipulated by a surgeon to, in turn, control motion to a
slave station at which is disposed a surgical instrument. The
master station includes a lower positioner assembly, an upper
positioner assembly and an arm assembly. The upper positioner
assembly is supported over and in rotational engagement with the
lower positioner assembly to enable a lateral side-to-side surgical
manipulation. An arm assembly has at its distal end a hand assembly
for engagement by a surgeon's hand, and a proximal end pivotally
supported from the upper positioner assembly to enable an
orthogonal forward and back surgeon manipulation in a direction
substantially orthogonal to the lateral surgeon manipulation.
[0073] In various preferred embodiments, the arm assembly includes
a proximal arm member and a distal arm member joined by a
rotational joint. A position encoder is disposed at a rotational
joint detects rotation of the distal arm member. A pivotal joint
connects the hand assembly to the distal end of the distal arm
member, this movement being responsive to a pivotal movement of a
surgeon's wrist.
[0074] The hand assembly may include a base piece with a pair of
holders coupled with a base piece. One of these holder is adapted
to receive a thumb and the other adapted to hold a forefinger. Each
holder may comprise a metal bar positioned along the thumb or
forefinger and a Velcro loop for attaching the thumb or finger to
the bar. The hand assembly may further include a pair of rotating
element pivotally supported from opposite ends of the base piece.
One of these holders is secured to one of the rotating elements so
that the surgeon can move one holder toward and away from the other
holder. The pivotal joint that connects the hand assembly to the
distal end of the distal arm is connected to the other rotating
element, to account for rotational motion at the surgeon's
wrist.
[0075] In another embodiment, a master station of a master/slave
surgery system includes a base, an arm assembly pivotally supported
from the base, and a hand assembly pivotally supported from the arm
assembly, wherein the hand assembly includes a finger holder and a
thumb holder and wherein the holders are supported for relative
movement therebetween. The hand assembly may include a base piece
for the holders, wherein the thumb holder is fixed in position
relative to a base piece and the finger holder rotates from the
base piece.
[0076] In another embodiment, a master station of a master/slave
surgery system includes a base, an arm assembly pivotally supported
from the base, and a hand assembly pivotally supported from the arm
assembly, the hand assembly including a guide shaft adapted to be
grasped by the surgeon, an actuator on the guide shaft, and a
multiple rotation joint attaching the guide shaft to the arm
assembly.
[0077] In yet another embodiment, a template is provided secured to
the support which holds the surgical instrument, for locating the
position of the support and subsequently the position of the
surgical instrument, relative to the incision point of the patient.
This enables an accurate placement of the instrument at an
operative site internal to the patient.
[0078] These and other features of the present invention are
described in greater detail in the following detailed description
section.
[0079] Electronic Controls and Methodology
[0080] The invention also provides a method of controlling a
surgical instrument that is inserted in a patient for facilitating
a surgical procedure and controlled remotely from an input device
manipulated by a surgeon at a user interface, the method comprising
the steps of: initializing the position of the surgical instrument
without calculating its original position, and the position of the
input device under electronic control; the initializing including
establishing an initial reference position for the input device and
an initial reference position for the surgical instrument;
calculating the current absolute position of the input device as it
is manipulated by the surgeon; determining the desired position of
the surgical instrument based upon: the current position of the
input device, the reference position of the input device, and the
reference position of the surgical instrument, and moving the
surgical instrument to the desired position so that the position of
the surgical instrument corresponds to that of the input device.
The input device typically has position sensors, and the step of
initializing includes initializing these position sensors. The
initializing is preferably to zero. The method may include
computing an initial reference orientation for the input device,
computing a desired orientation for the surgical instrument and/or
computing a desired position for the surgical instrument. The
initializing step may include performing a forward kinematic
computation from the input device. The method may include reading
position sensor values and current time. The calculating step may
include calculating both the position and orientation of the input
device. The method may further include calculating the current
orientation of the input device. The step of determining may
include performing an inverse kinematic computation and/or a
transformation into an earth coordinate system From the
transformation determined joint angles and drive motor angles for
the surgical instrument orientation may be determined.
[0081] In another embodiment, there is provided a method of
controlling a tool of a surgical instrument that is inserted in a
patient for carrying out a surgical procedure and is controlled
remotely by way of a controller from an input device at a user
interface, the method comprising the steps of: the input device at
an initial reference configuration and under controller control;
setting the surgical instrument in the patient at an initial
predefined reference configuration without controller control;
calculating the current absolute position of the input device;
determining the desired location of the tool by a kinematic
computation that accounts for at least the initial reference
configuration of the input device and the current absolute position
of the input device; and moving the surgical instrument to the
desired position so that the location of the tool corresponds to
that of the input device. The step of determining may also be based
upon the initial reference configuration of the tool.
[0082] In another embodiment, there is provided a system for
controlling an instrument that is inserted in a patient to enable a
surgical procedure and controlled remotely from an input device
controlled by a surgeon at a user interface, the system comprising:
a base; a first link rotatably connected to the base; an elbow
joint for rotatably connecting the second link to the first link; a
handle; a wrist member connecting the handle to the distal end of
the second link; and a controller coupled to at least the base and
links and for receiving signals representative of: a rotational
position of the base, a rotational position of the first link
relative to the base, and a rotational position of the second link
relative to the first link.
[0083] In another embodiment, there is provided a control system
for an instrument that is controlled remotely from an input device,
the system comprising: a forward kinematics block for computing the
position of the input device; an initialization block for storing
an initial reference position of the input device; an inverse
kinematics block coupled from the forward kinematics block and the
initialization block for receiving information from the forward
kinetics block of the current input device position; and a
controller block coupled from the inverse kinematics block for
controlling the position of the instrument in response to
manipulations at the input device. Such a control system may
include a scaling block coupled between the forward kinematics
block and the inverse kinematics block for scaling motions imparted
at the input device. The system may also include an output from the
forward kinematics block directly to the inverse kinematics block
representative of current input device orientation. The system may
also include a combining device coupled from the forward kinematics
block and the initialization block to the scaling block for
providing a signal to the inverse kinematics block representative
of desired instrument position. The input device typically includes
a wrist and a handle and the position of the wrist is expressed in
x, y and z coordinates. The orientation of the handle is typically
determined by a series of coordinate transformations. Such system
may include a transformation matrix for the handle coordinate frame
with respect to a reference coordinate frame, a transformation
matrix R.sub.wh for the wrist joint coordinate with respect to a
reference coordinate, and a transformation matrix R.sub.hwh for the
handle coordinate with respect to the wrist coordinate. The
transformation matrix R.sub.h for the handle coordinate with
respect to the reference coordinate may be
R.sub.h=R.sub.whR.sub.hwh.
[0084] In another embodiment there is provided a method of
controlling a medical implement remotely from an input device that
is controlled by an operator, the method comprising the steps of:
positioning the medical implement at an initial start position at
an operative site for the purpose of facilitating a medical
procedure; establishing a fixed position reference coordinate
representative of the initial start position of the medical
implement based upon a base point of the implement and an active
point of the implement being in a known relative dimensional
configuration, positioning the input device at an initial start
position; establishing a fixed position reference coordinate
representative of the initial start position of the input device;
calculating the current position of the input device as it is
controlled; determining the desired position of the medical
implement based upon; the current position of the input device, the
fixed position reference coordinate of the input device, and the
fixed position reference coordinate of the medical implement, and
moving the medical implement to the desired position so that the
position of the medical implement corresponds to that of the input
device.
[0085] In another embodiment there is provided a method of
controlling a surgical instrument remotely from an input device and
by way of an electronic controller, the method comprising the steps
of: inserting the surgical instrument through an incision in the
patient so as to dispose the distal end of the instrument at an
initial start position; establishing a fixed position reference
coordinate system corresponding to a fixed known position on the
surgical instrument at the initial start position of the surgical
instrument; positioning the input device at an initial start
position; establishing a fixed position reference coordinate system
representative of the initial start position of the input device;
calculating the current absolute position of the input device as it
is controlled; determining the desired position of the surgical
instrument based upon the current absolute position of the input
device, and the fixed position reference coordinate system for the
respective surgical instrument and input device; and moving the
surgical instrument to the desired position so that the position of
the surgical instrument corresponds to that of the input
device.
[0086] The invention also provides a program of instructions for
the processor which include: receiving an insertion length of a
medical instrument inserted in a patient; and determining a distal
end location of the instrument at a target site in the patient from
the insertion length. The instrument typically has a straight
proximal portion and curved distal portion, lies in a single plane
and is a rigid guide member. The instrument is typically inserted
and then fixed at a pivot axis outside the patient. The pivot axis
is generally aligned with an insertion point at which the
instrument is inserted into the patient. The program of
instructions may include determining a subsequent location of the
distal end associated with pivoting about the pivot axis. The
program of instructions may include determining a subsequent
location of the distal end associated with axial rotation of the
instrument, determining a subsequent location of the distal end
associated with linear translation along a length axis of the
instrument and/or determining a subsequent movement of the distal
end in a single plane about the pivot axis. The pivotal axis is
typically a reference point used by the program of instructions in
determining subsequent movement of the distal end.
[0087] The invention also provides a processor and a memory device
containing a program of instructions for the processor which
include: receiving a coordinate representative of the desired
location of the distal end of a medical instrument at a target site
in a patient; and determining from the coordinate an insertion
length for the medical instrument so as to locate the distal end at
the target site.
[0088] These and other features of the present invention are
described in greater detail in the following detailed description
section.
DESCRIPTION OF DRAWINGS
[0089] FIG. 1 is a perspective view illustrating one embodiment of
the robotic system of the present invention;
[0090] FIGS. 1A-1C are three views of a flexible cannula for use
with the embodiment of FIG. 1;
[0091] FIG. 2A is a schematic diagram illustrating the
degrees-of-freedom associated with the master station;
[0092] FIG. 2B is a schematic diagram illustrating the
degrees-of-freedom associated with the slave station;
[0093] FIG. 2C shows a functional schematic diagram of the surgical
adapter component of the system of FIG. 1;
[0094] FIG. 2D shows a functional schematic diagram of the
instrument insert component of the system of FIG. 1;
[0095] FIG. 3 is a perspective view of the positioner assembly at
the master station;
[0096] FIG. 4 is an exploded perspective view also of the
positioner assembly at the master station;
[0097] FIG. 5 is a partially exploded view of the hand assembly
portion associated with the positioner assembly;
[0098] FIG. 6 is a cross-sectional view of the hand assembly as
taken along line 6-6 of FIG. 3;
[0099] FIG. 7 is a cross-sectional view at the master station as
taken along lines 7-7 of FIG. 3;
[0100] FIG. 7A is a schematic perspective view of the yoke assembly
portion of the positioner assembly;
[0101] FIG. 8 is a perspective view of the slave station;
[0102] FIG. 8A is a perspective view of an alternative adjustable
clamp member at the slave station;
[0103] FIG. 8B is a top plan view of the clamp of FIG. 8A;
[0104] FIG. 8C is a side view of the clamp of FIGS. 8A and 8B as
taken along line 8C-8C of FIG. 8B;
[0105] FIG. 8D is a perspective view of a template used with this
embodiment;
[0106] FIG. 8E is a schematic cabling diagram illustrating one
cable arrangement used to operate a tool;
[0107] FIG. 8F is an exploded perspective view of another version
of the cable drive mechanism and tool in accordance with the
present invention;
[0108] FIG. 8G is a schematic perspective view similar to that
illustrated in FIG. 8F but specifically showing the cabling
construction;
[0109] FIG. 8H is a partially broken away front elevational view as
taken along line 8H-8H of FIG. 8F;
[0110] FIG. 8I is a top plan cross-sectional view taken along line
8I-8I of FIG. 8H;
[0111] FIG. 8J is a further cross-sectional top plan view as taken
along line 8J-8J of FIG. 8H,
[0112] FIG. 8K is a cross-sectional side view as taken along line
8K-8K of FIG. 8H;
[0113] FIG. 8L is a cross-sectional rear view of the coupler
spindle and disk as taken along line 8L-8L of FIG. 8K.
[0114] FIG. 9 is a view at the slave station taken along line 9-9
of FIG. 8;
[0115] FIG. 10 is a side elevation view at the slave station taken
along line 10-10 of FIG. 9;
[0116] FIG. 11 is a perspective view at the slave station;
[0117] FIG. 11A is a cross-sectional view as taken along line
11A-11A of FIG. 11;
[0118] FIG. 11B is a cross-sectional view as taken along line
11B-11B of FIG. 11A;
[0119] FIG. 11C is a cross-sectional view as taken along line
11C-11C of FIG. 11A;
[0120] FIG. 12 is a cross-sectional view as taken along line 12-12
of FIG. 11;
[0121] FIG. 13 is a cross-sectional view as taken along line 13-13
of FIG. 12;
[0122] FIG. 14 is a cross-sectional view as taken along line 14-14
of FIG. 12;
[0123] FIG. 15 is a perspective view at the slave station showing
the instrument insert being removed from the adapter;
[0124] FIG. 15A is a top plan view of the instrument insert
itself;
[0125] FIG. 16A is a perspective view at the tool as viewed along
line 16A-16A of FIG. 11; to FIG. 16B is an exploded perspective
view of the tool of FIG. 16A;
[0126] FIG. 16C is a fragmentary perspective view of an alternative
tool referred to as a needle driver;
[0127] FIG. 16D is a side elevation view of the needle driver of
FIG. 16C;
[0128] FIG. 16E is a perspective view of an alternate embodiment of
the tool and wrist construction;
[0129] FIG. 16F is an exploded perspective view of the construction
illustrated in FIG. 16E;
[0130] FIG. 16G is a fragmentary perspective view showing a portion
of the bending section;
[0131] FIG. 16H is a plan view of the flexible wrist member
associated with the construction of FIGS. 16E-16G.
[0132] FIG. 16I is a perspective view of still another embodiment
of a flexible end tool;
[0133] FIG. 16J is an exploded perspective view of the construction
illustrated in FIG. 16I;
[0134] FIG. 16K is a fragmentary perspective view showing further
details of the bending section;
[0135] FIG. 17 is a perspective view of the drive unit at the slave
station;
[0136] FIG. 17A is a schematic front view of the drive unit at the
slave station;
[0137] FIG. 18 is a schematic perspective view of an alternative
hand piece for use at the master station;
[0138] FIGS. 19A-19D are schematic diagrams showing alternate
positions of the guide tube of the adapter;
[0139] FIG. 20 is a block diagram of the controller used with the
robotic system of this embodiment;
[0140] FIG. 21 is a block diagram of further details of the
controller, including the module board;
[0141] FIG. 22 is a block diagram of a control algorithm in
accordance with the present embodiment; and
[0142] FIGS. 23-28 are a series of schematic diagrams of the input
device position and resulting instrument position relating to the
algorithm control of the present embodiment.
DETAILED DESCRIPTION
[0143] A. Overview of Surgical Robotic System (FIGS. 1-2)
[0144] An embodiment of a surgical robotic system of the present
invention is illustrated in the accompanying drawings. The
described embodiment is preferably used to perform minimally
invasive surgery, but may also be used for other procedures such as
endoscopic or open surgical procedures.
[0145] FIG. 1 illustrates a surgical instrument system 10 that
includes a master station M at which a surgeon 2 manipulates a pair
of input devices 3, and a slave station S at which is disposed a
pair of surgical instruments 14. The surgeon is seated in a
comfortable chair 4 with his forearms resting upon armrests 5. His
hands manipulate the input devices 3 which cause a responsive
movement of the surgical instruments 14.
[0146] A master assembly 7 is associated with the master station M
and a slave assembly 8 is associated with the slave station S.
Assemblies 7 and 8 are interconnected by cabling 6 to a controller
9. Controller 9 has one or more display screens enabling the
surgeon to view a target operative site, at which is disposed a
pair of tools 18. The controller further includes a keyboard for
inputting commands or data.
[0147] As shown in FIG. 1, the slave assembly 8, also referred to
as a drive unit, is remote from the operative site and is
positioned outside of the sterile field. In this embodiment, the
sterile field is defined above the plane of the top surface of the
operating table T, on which is placed the patient P. The drive unit
8 is controlled by a computer system, part of the controller 9. The
master station M may also be referred to as a user interface,
whereby commands issued at the user interface are translated by the
computer into an electrical signal received by drive unit 8. Each
surgical instrument 14, which is tethered to the drive unit 8
through mechanical cabling, produces a desired responsive
motion.
[0148] Thus, the controller 9 couples the master station M and the
slave station S and is operated in accordance with a computer
program or algorithm, described in further detail later. The
controller receives a command from the input device 3 and controls
the movement of the surgical instrument in a manner responsive to
the input manipulation.
[0149] With further reference to FIG. 1, associated with the
patient P are two separate surgical instruments 14, one on either
side of an endoscope 13. The endoscope includes a camera mounted on
its distal end to remotely view the operative site. The dashed line
circle in FIG. 2B, labeled OS, is an example of the operative
site). A second camera may be positioned away from the site to
provide an additional perspective on the medical procedure or
surgical operation. It may be desirable to provide the endoscope
through an orifice or incision other than the one used by the
surgical instrument. Here three separate incisions are shown, two
for the surgical instruments 14, 14 and a centrally disposed
incision for the viewing endoscope 13. A drape over the patient has
a single opening for the three incisions.
[0150] Each of the two surgical instruments 14 is generally
comprised of two basic components, an adaptor or guide member 15
and an instrument insert or member 16. The adaptor 15 is a
mechanical device, driven by an attached cable array from drive
unit 8. The insert 16 extends through the adaptor 15 and carries at
its distal end the surgical tool 18. Detailed descriptions of the
adapter and insert are found in later drawings.
[0151] Although reference is made to "surgical instrument" it is
contemplated that this invention also applies to other medical
instruments, not necessarily for surgery. These would include, but
are not limited to catheters and other diagnostic and therapeutic
instruments and implements.
[0152] In FIG. 1 there is illustrated cabling 12 coupling the
instrument 14 to the drive unit 8. The cabling 12 is readily
attachable and detachable from the drive unit 8. The surgical
adaptor 15, which supports the instrument at a fixed reference
point is of relatively simple construction and may be designed for
a particular surgical application such as abdominal, cardiac,
spinal, arthroscopic, sinus, neural, etc. As indicated previously,
the instrument insert 16 is couplable and decouplable to the
adaptor 15, and provides a means for exchanging instrument inserts,
with then attached tools. The tools may include, for example,
forceps, scissors, needle drivers, electrocautery, etc.
[0153] Referring again to FIG. 1, the overall system 10 includes a
surgeon's interface 11, computer system or controller 9, drive unit
8 and surgical instruments 14. Each surgical instrument 14 is
comprised of an instrument insert 16 extending through adapter 15.
During use, a surgeon manipulates the input device 3 at the
surgeon's interface 11, which manipulation is interpreted by
controller 9 to effect a desired motion of the tool 18 within the
patient.
[0154] Each surgical instrument 14 is mounted on a separate rigid
support post 19 which is illustrated in FIG. 1 as removably affixed
to the side of the surgical table T. This mounting arrangement
permits the instrument to remain fixed relative to the patient even
if the table is repositioned. Although two instruments 14 are shown
here, the invention can be practiced with more or with only a
single surgical instrument.
[0155] Each surgical instrument 14 is connected to the drive unit 8
by two mechanical cabling (cable-in-conduit) bundles 21 and 22.
These bundles 21 and 22 terminate at connection modules,
illustrated in FIG. 8F, which are removably attachable to the drive
unit 8. Although two cable bundles are used here, more or fewer
cable bundles may be used. Also, the drive unit 8 is preferably
located outside the sterile field as shown here, although in other
embodiments the drive unit may be draped with a sterile barrier so
that it may be located within the sterile field.
[0156] In a preferred technique for setting up the system, a distal
end of the surgical instrument 14 is manually inserted into the
patient through an incision or opening. The instrument 14 is then
mounted to the rigid post 19 using a mounting bracket 25. The cable
bundles 21 and 22 are then passed away from the operative area to
the drive unit 8. The connection modules of the cable bundles are
then engaged to the drive unit 8. One or more instrument inserts 16
may then be passed through the surgical adaptor 15, while the
adapter remains fixed in position at the operative site. The
surgical instrument 14 provides a number of independent motions, or
degrees-of-freedom, to the tool 18. These degrees-of-freedom are
provided by both the surgical adaptor 15 and the instrument insert
16.
[0157] The surgeon's interface 11 is in electrical communication
with the controller 9. This electrical control is primarily by way
of the cabling 6 illustrated in FIG. 1 coupling from the master
assembly 7. Cabling 6 also couples from the controller 9 to the
drive unit 8. The cabling 6 is electrical cabling. The drive unit 8
however, is in mechanical communication with the instruments 14 in
mechanical cabling 21, 22. The mechanical communication with the
instrument allows the electromechanical components to be removed
from the operative region, and preferably from the sterile
field.
[0158] FIG. 2A illustrates the various movements (J1-J7) that occur
at the master station M while FIG. 2B illustrates various movements
(J1-J7) that occur at the slave station S. More specific details
regarding FIGS. 2A and 2B are contained in a later discussion of
FIGS. 3-4 (with regard to the master station of FIG. 2A) and FIGS.
8-9 (with regard to the slave station of FIG. 2B).
[0159] FIG. 2C is a simplified representation of adaptor 15 of the
slave station, useful in illustrating the three degrees-of-freedom
enabled by the adapter. The adapter as shown in FIG. 2C comprises a
generally rigid outer guide tube 200 (corresponding to guide tube
17 in FIG. 2B) through which an inner flexible shaft, carrying a
tool 18 at its distal end, is inserted into the patient. The
adapter provides three degrees-of-freedom by way of a pivotal joint
J1, a linear joint J2, and a rotary joint J3. From a fixed mounting
point 23 shown schematically at the top of FIG. 2C, the pivotal
joint J1 allows the guide tube 200 to pivot about a fixed vertical
axis 204, while maintaining the tube (both the proximal straight
portion 208 and distal curved portion 202) in a single plane,
transverse to pivot axis 204, in which lies central horizontal tube
axis 201. The linear joint J2, moves the rigid guide tube 200 along
this same axis 201. The rotary joint J3 rotates the guide tube 200
about the tube axis 201. The guide tube 200 has a fixed curve or
bend 202 at its distal end 203; as a result the distal end 203 will
orbit in a circle about the axis 201 when the straight portion 208
of the guide tube 200 is rotated about its axis 201. Alternatively,
the three degrees-of-freedom can be achieved by a structure other
than a curve 202, such as by means of a joint or angular end
section. The point is to have the distal end 203 of the tube 200 at
a location spaced away from the tube axis 201.
[0160] FIG. 2C thus shows a schematic view of the three degrees of
freedom of the rigid curved guide tube 200. In summary, via the
pivot 205 the guide tube 200 may rotate in a direction J1 about an
axis 204. The guide tube 200 may also slide in an axial direction
J2 along proximal tube axis 201 (via the linear slider) and rotate
in a direction J3 about the proximal tube axis 201 (via a rotatable
mounting at the guide tube housing). It is intended that the point
205 at which the axes of linear movement and rotation 201 and 204
intersect, be in linear alignment (along axis 204) with the
incision point illustrated in dotted outline at 207, at which the
guide tube enters the patient. Positioning the incision 207 in
substantially vertical linear alignment with point 205 results in
less trauma to the patient in the area around the incision, because
movement of the guide tube 17 near the point 205 is limited.
[0161] In addition to the three degrees-of-freedom provided by the
guide tube 17, the tool 18 may have three additional
degrees-of-freedom. This is illustrated schematically in FIG. 2D
which shows an inner flexible shaft 309, fixed at its proximal end
300, having a straight proximal portion 301 and having a curved
distal portion 302 with a tool 18 mounted at the distal end. The
shaft 309 has a wrist joint that rotates about axis 306. A pair of
pinchers 304, 305 independently rotate as shown (J6 and J7) about
horizontal axis 308 to open and close (e.g., to grasp objects).
Still further, the inner shaft can be rotated (J4) about the
central axis of proximal portion 301.
[0162] In practice, an instrument insert 16 (carrying the inner
shaft 309) is positioned within the adaptor 15 (including guide
tube 17), so that the movements of the insert are added to those of
the adaptor. The tool 18 at the distal end of insert 16 has two end
grips 304 and 305, which are rotatably coupled to wrist link 303,
by two rotary joints J6 and J7. The axis 308 of the joints J6 and
J7 are essentially collinear. The wrist link 303 is coupled to a
flexible inner shaft 302 through a rotary joint J5, whose axis 306
is essentially orthogonal to the axis 308 of joints J6 and J7. The
inner shaft 309 may have portions of differing flexibility, with
distal shaft portion 302 being more flexible than proximal shaft
portion 301. The more rigid shaft portion 301 is rotatably coupled
by joint J4 to the instrument insert base 300. The axis of joint J4
is essentially co-axial with the rigid shaft 301. Alternatively,
the portions 301 and 302 may both be flexible.
[0163] Through the combination of movements J1-J3 shown in FIG. 2C,
the adaptor 15 can position the curved distal end 203 of guide tube
200 to any desired position in three-dimensional space. By using
only a single pivotal motion (J1), the motion of the adaptor 15 is
limited to a single plane. Furthermore, the fixed pivot axis 204
and the longitudinal axis 201 intersect at a fixed point 205. At
this fixed point 205, the lateral motion of the guide tube 200 is
minimal, thus minimizing trauma to the patient at the aligned
incision point 207.
[0164] The combination of joints J4-J7 shown in FIG. 2D allow the
instrument insert 16 to be actuated with four degrees-of-freedom.
When coupled to the adaptor 15, the insert and adaptor provide the
instrument 14 with seven degrees-of-freedom. Although four
degrees-of-freedom are described here for the insert 16, it is
understood that greater and fewer numbers of degrees-of-freedom are
possible with different instrument inserts. For example an
energized insert with only one gripper may be useful for
electro-surgery applications, while an insert with an additional
linear motion may provide stapling capability.
[0165] FIG. 2B shows in dotted outline a cannula 487, through which
the guide tube 17 is inserted at the incision point. Further
details of the cannula are illustrated in FIGS. 1A-1C. FIG. 1A is a
longitudinal cross-sectional view showing a cannula 180 in position
relative to, for example, an abdominal wall 190 of the patient.
FIG. 1B is a schematic view of the guide tube 17 being inserted
through the flexible cannula 180. FIG. 1C is a schematic view of
the guide tube inserted so that the proximal straight section of
the tube is positioned at the incision point within the cannula,
with the curved distal end of the guide tube and tool 18 disposed
at a target or operative site.
[0166] The cannula 180 includes a rigid base 182 and a flexible end
or stem 184. The base may be constructed of a rigid plastic or
metal material, while the stem may be constructed of a flexible
plastic material having a fluted effect as illustrated in FIGS.
1A-1C. The length of the base is short enough that the curve in the
guide tube can easily pass through a center passage or bore 186 in
the base 182. The bore 186 has a larger diameter than the outer
diameter of the guide tube 17 to facilitate passage of the guide
tube through the cannula 180. A diaphragm or valve 188 seals the
guide tube 17 within the cannula 180.
[0167] FIG. 1A shows a cap 192 secured to the proximal end of the
base 182 by one or more o-rings 194. Before the guide tube 17 is
inserted in cannula 180, a plug 196 may be inserted to seal the
proximal end of the base 182. The plug 196 is secured by a tether
198 to base 182.
[0168] In the context of an insertable instrument system, there may
generally be distinguished two types of systems, flexible and
rigid. A flexible system would use a flexible shaft, which may be
defined as a shaft atraumatically insertable in a body orifice or
vessel which is sufficiently pliable that it can follow the
contours of the body orifice or vessel without causing significant
damage to the orifice or vessel. The shaft may have transitions of
stiffness along its length, either due to the inherent
characteristics of the material comprising the shaft, or by
providing controllable bending points along the shaft. For example,
it may be desirable to induce a bend at some point along the length
of the shaft to make it easier to negotiate a turn in the body
orifice. A mechanical bending of the tube may be caused by
providing one or more mechanically activatable elements along the
shaft at the desired bending point, which a user remotely operates
to induce the bending upon demand. The flexible tube may also be
caused to bend by engagement with a body portion of greater
stiffness, which may, for example, cause the tube to bend or loop
around when it contacts the more stiffer body portion. Another way
to introduce a bend in the flexible shaft is to provide a
mechanical joint, such as the wrist joint provided adjacent to tool
18 as previously described, which, as discussed further, is
mechanically actuated by mechanical cabling extending from a drive
unit to the wrist joint.
[0169] One potential difficulty with flexible shafts or tubes as
just described is that it can be difficult to determine the
location of any specific portion or the distal end of such shaft or
tube within the patient. In contrast, what is referred to as a
rigid system may utilize a rigid guide tube 17 as previously
described, for which the position of the distal end is more easily
determined, simply based upon knowing the relevant dimensions of
the tube. Thus, in the system previously described, a fixed pivot
point (205 in FIG. 2C) is aligned with an incision point 207. One
can determine the position of the rigid guide tube 17, knowing the
length from the fixed point to the distal end of the guide tube,
which is fixed and predetermined based upon the rigid nature of the
guide tube, and the known curvature of the distal end of the guide
tube. The point of entry or incision point serves as a pivot point,
for which rotation J1 of the guide tube about the fixed axes 204 is
limited to maintaining the proximal end of the guide tube in a
single plane.
[0170] Furthermore, by inserting the more flexible shaft, carrying
a tool 18 at its distal end, within the rigid guide tube, the rigid
guide tube in effect defines a location of the flexible shaft and
its distal end location tool 18.
[0171] Also relevant to the present invention is the use of the
term "telerobotic" instrument system, in which a physician or
medical operator is manually manipulating some type of hand tool,
such as a joy stick, and at the same time is looking at the effect
of such manual manipulation on a tool which is shown on a display
screen, such as a television or a video display screen, accessible
to the operator. The operator then can adjust his manual movements
in response to visual feedback he receives by viewing the resulting
effect on the tool, shaft guide tube, or the like, shown on the
display screen. It is understood that the translation of the
doctor's manual movement, via a computer processor which feeds a
drive unit for the inserted instrument, is not limited to a
proportional movement, rather, the movement may be scaled by
various amounts, either in a linear fashion or a nonlinear fashion.
The scaling factor may depend on where the instrument is located or
where a specific portion of the instrument is located, or upon the
relative rate of movement by the operator. The computer controlled
movement of the guide tube or insert shaft in accordance with the
present invention, enables a higher precision or finer control over
the movement of the instrument components within the patient.
[0172] In practice, the physician, surgeon or medical operator
would make an incision point, inserting the flexible cannula
previously shown. He would then manually insert the rigid curved
guide tube until the distal point of the guide tube was positioned
at the operative site. With the guide tube aligned in a single
plane, the operator would clamp the guide tube at the support
bracket 25 on post 19, to establish the fixed reference pivot
point, (205 in FIG. 2C), with the incision point axially aligned
under the fixed pivot point. The operator would then manually
insert the instrument insert through the guide tube until the tool
18 is extended out from the distal end of the guide tube. The wrist
joint on the inner insert shaft is then positioned at a known
point, based upon the known length and curvature of the rigid guide
tube and distance along that length at which the incision point is
disposed. Then, a physician, surgeon or medical operator located at
the master station can manually adjust the hand assembly to cause a
responsive movement of the inserted instrument. The computer
control decides what the responsive movement at the instrument is,
including one or more of movement of the guide tube, the whole
instrument 14, or the flexible inner shaft or the tool at its
distal end. A pivotal movement J1 will rotate the proximal end of
the guide tube, causing pivoting of the whole instrument 14. An
axial movement J2 of the whole instrument 14 will reposition the
instrument in the single plane. A rotational movement J3 of just
the guide tube results in the end of the guide tube and end of the
inner shaft being taken out of the plane, following a circular path
or orbit in accordance with rotation of the guide tube shaft. These
three movements J1, J2 and J3 are defined as setting the position
of the wrist joint 303 of the tool.
[0173] The other three movements J4-J7, are defined as setting the
orientation of the instrument insert, and more specifically, a
direction at which the tool is disposed with respect to the wrist
joint. Central mechanical cables in the inner shaft cause motions
J5-J7, J5 being the wrist movement and J6-J7 being the jaw movement
of the tool. The J4 movement is for rotation of the inner shaft by
its proximal axis, within the guide tube. These relative movements,
and the position and orientation of the instrument insert, will be
further described in a later discussion of an example of the
computer algorithm for translating the movement at the master
station to a movement at the slave station.
[0174] B. The Master Station M (FIGS. 3-7)
[0175] At the master station M illustrated in FIG. 1 and shown in
further detail in FIG. 3, there are two sets of identical hand
controls, one associated with each hand of the surgeon. The outputs
of both controls are fed to assembly 7, which is secured to the
surgeon's chair 4 by a cross-brace 40. In FIG. 3, the brace 40 is
shown secured to the chair frame 42 by means of adaptor plate 44
and bolts 45. Additional bolts 46, with associated nuts and washers
secure the cross-brace 40 in a desired lateral alignment (see
double headed arrow) along the adaptor plate 44. Additional bolts
49 (see FIG. 4) are used for securing the cross-brace 40 with a
base piece 48. The base piece 48 supports lower and upper
positioner assemblies, as will now be described.
[0176] A lower positioner assembly 50 is supported from the base
piece 48. An upper positioner assembly 60 is supported above and in
rotational engagement (see arrow J1 in FIGS. 2A and 4), in a
substantially horizontal plane with the lower positioner assembly.
This rotational movement J1 enables a lateral or side-to-side
manipulation by the surgeon. An arm assembly 90, having a lower
proximal end 90A, is pivotally supported (J2) from the upper
positioner assembly 60 about a substantially horizontal axis 60A
(see FIGS. 2A and 3) to enable substantially vertical surgeon
manipulation. The arm assembly 90 has an upper distal end 90B (FIG.
3), carrying a hand assembly 110.
[0177] As shown in FIG. 4, the lower positioner assembly 50
includes a base member 51 that is secured to the base piece 48 by
bolts 52. It also includes a bracket 53 that is secured to the base
member 51 by means of bolts 54. The bracket 53 supports a
motor/encoder 55. A vertical shaft 56 that extends from the upper
positioner assembly 60 to the base member 51, extends through a
passage in the base member 51 and is secured to a pulley 57
disposed under the base member 51. A belt 58 engages with pulley 57
and with a further pulley 62 supported from the bracket 53. This
further pulley 62 is on a shaft that engages a pulley 59. A further
belt 61 intercouples pulley 59 to the shaft of the motor/encoder
55.
[0178] In FIGS. 3 and 4, the base member 51 and bracket 53 are
stationary; however, upon rotation about J1, drive is applied to
the pulleys 57 and 59 thus applying drive to the motor/encoder 55.
This detects the position and movement from one position to another
of the upper positioner assembly 60 relative to the lower
positioner assembly 50.
[0179] The upper positioner assembly 60 has a main support bracket
63, supporting on either side thereof side support brackets 64 and
66. Side bracket 64 supports a pulley 65, while side bracket 66
supports a pulley 67. Above pulley 65 is another pulley 70, while
above pulley 67 is another pulley 72. Pulley 70 is supported on
shaft 71, while pulley 72 is supported on shaft 73.
[0180] Also supported from side support bracket 64 is another
motor/encoder 74, disposed on one side of the main support bracket
63. On the other side of bracket 63 is another motor/encoder 76,
supported from side support bracket 66. Motor/encoder 74 is coupled
to the shaft 71 by pulleys 65 and 70 and associated belts, such as
the belt 75 disposed about pulley 65. Similarly, motor/encoder 76
detects rotation of the shaft 73 through pulleys 67 and 72 by way
of two other belts. The pulley 65 is also supported on a shaft
coupling to pulley 70 supported by side support bracket 64. A
further belt goes about pulley 70 so there is continuity of
rotation from the shaft 71 to the motor/encoder 74. These various
belts and pulleys provide a movement reduction ratio of, for
example, 15 to 1. This is desirable so that any substantial
movements at the master station are translated as only slight
movements at the slave station, thereby providing a fine and
controlled action by the surgeon.
[0181] Extending upwardly from main support bracket 63, is arm
assembly 90 which includes a pair of substantially parallel and
spaced apart upright proximal arms 91 and 92, forming two sides of
a parallelogram. Arm 91 is the main vertical arm, while arm 92 is a
tandem or secondary arm. The bottoms of arms 91 and 92 are captured
between side plates 78 and 79. The secondary arm 92 is pivotally
supported by pin 81 (see FIG. 4) from the forward end of the side
plates 78 and 79. The main arm 91 is also pivotally supported
between the side plates 78 and 79, but is adapted to rotate with
the shaft 71. Thus, any forward and back pivoting J2 of the arm 91
is sensed through the shaft 71 down to the motor/encoder 74. This
movement J2 in FIGS. 2A and 4 translates the forward and rearward
motion at the surgeon's shoulder.
[0182] The side plates 78 and 79 pivot on an axis defined by shafts
71 and 73. However, the rotation of the plates 78 and 79 are
coupled only to the shaft 73 so that pivotal rotation, in unison,
of the side plates 78 and 79 is detected by motor/encoder 76. This
action is schematically illustrated in FIGS. 2A and 4 by J3.
Movement J3 represents an up and down motion of the surgeon's
elbow. A counterweight 80 is secured to the more rear end of the
side plates 78 and 79, to counter-balance the weight and force of
the arm assembly 90.
[0183] As depicted in FIGS. 3 and 4, the tops of the arms 91 and 92
are pivotally supported in a bracket 94 by two pivot pins 89. The
bracket 94 also supports a distal arm 96 of the arm assembly 90.
The rotation of distal arm 96 is sensed by an encoder 88. Thus, the
distal arm 96 is free to rotate J4 about its longitudinal axis,
relative to the arms 91 and 92. This rotation J4 translates the
rotation of the surgeon's forearm.
[0184] The distal end of distal arm 96 is forked, as indicated at
95 in FIG. 4. The forked end 95 supports disc 97 in a fixed
position on shaft 98. The disc 97 is fixed in position while the
shaft 98 rotates therein; bearings 93 support this rotation. The
shaft 98 also supports one end of pivot member 100, which is part
of hand assembly 110. The pivot member 100 has at its proximal end
a disc 101 that is supported co-axially with the disc 97, but that
rotates relative to the fixed disc 97 (see FIGS. 5 and 6). This
rotation is sensed by an encoder 99 associated with shaft 98. The
disc end 101 of the pivot member 100 defines the rotation J5 in
FIG. 4, which translates the wrist action of the surgeon,
particularly the up and down wrist action.
[0185] The pivot member 100 has at its other end a disc 103 that
rotates co-axially with a disc end 104 of hand piece 105. There is
relative rotation between disc 103 and disc 104 about a pivot pin
106 (see FIGS. 4 and 6). This relative rotation between the pivot
member 100 and the hand piece 105 is detected by a further encoder
109 associated with discs 103 and 104. This action translates
lateral or side to side (left and right) action of the surgeon's
hand.
[0186] At the very distal end of the master station is a forefinger
member 112 that rotates relative to end 114 of the hand piece 105.
As indicated in FIG. 3, the forefinger piece 112 has a Velcro loop
116 for holding the surgeon's forefinger to the piece 112. Also
extending from the hand piece 105 is a fixed position thumb piece
118, with an associated Velcro loop 120. In FIG. 3, motion J7
represents the opening and closing between the surgeon's forefinger
and thumb.
[0187] Reference is now made to FIG. 5, which shows expanded
details of the distal end of the arm assembly. One end of the
distal arm 96 couples to the fork 95; fork 95 supports one end of
the pivot member 100. The encoder 99 detects the position of the
pivot member 100 relative to the distal arm 96. The encoder 109
couples to a shaft adapter 119 and detects relative displacement
between the pivot member 100 and the hand piece 105. The thumb
piece 118 is secured to the side piece 125 which, in turn, is
secured as part of the hand piece 105. Bolts 126 secure the finger
piece 112 to the rotating disc 130. The distal end encoder 132,
with encoding disc 134, detects the relative movement between the
surgeon's thumb and forefinger pieces.
[0188] FIG. 6 shows further details of the distal end of the arm
assembly. Pivot member 100 is attached to the distal arm 96 and the
hand piece 105. Further details are shown relating to the encoder
132 and the encoder disc 134. A shaft 140, intercoupling hand piece
105 and disc 130, is supported by a bearing 142. The shaft 106 is
also supported by a bearing 144.
[0189] The detailed cross-sectional view of FIG. 7 is taken along
lines 7-7 of FIG. 3. This illustrates the base member 51 with the
pulley 57 supported thereunder by means of the shaft 56. Also
illustrated are bearings 147 about shaft 56 which permit the main
support bracket 63 to pivot (J1). Pulley 57 rotates therewith and
its rotation is coupled to the encoder 55 for detecting the J1
rotation. FIG. 7 also illustrates the motor/encoder 76, where the
separate dashed portions identify motor 76A and encoder 76B.
[0190] FIG. 7 also shows further details of the belt and pulley
arrangement. For simplicity, only the pulley 67 and its associated
support is disclosed. Substantially the same construction is used
on the other side of the main support bracket 63 for the mounting
of the opposite pulley 65. A belt 149 about pulley 72 also engages
with pulley 153 fixedly supported on the shaft 155. The shaft 155
rotates relative to the fixed side support bracket 66, by way of
bearings 154. The shaft 155 supports the pulley 67. A toothed belt
150 is disposed about pulley 67 to the smaller pulley 152. The
pulley 152 is supported on the shaft of the motor/encoder 76. For
the most part all pulleys and belts disclosed herein are toothed so
that there is positive engagement and no slippage therebetween.
[0191] In order to provide adjustment of the belts 149 and 150,
adjusting screws are provided. One set of adjusting screws is shown
at 157 for adjusting the position of the side support bracket 66
and thus the belt 149. Also, there are belt adjusting screws 158
associated with support plate 159 for adjusting the position of the
encoder and thus adjusting the belt 150.
[0192] FIG. 7 also illustrates the pulleys 70 and 72 with their
respective support shafts 71 and 73. FIG. 7A shows details of the
pulleys 70 and 72 and their support structure. The pulley 70 is
associated with motion J2. The pulley 72 is associated with motion
J3. The pulley 70 and its associated shaft 71 rotate with the
vertical main shaft or arm 91. The pulley 72 and its associated
shaft 73 rotate independent of the arm 91 and instead rotate with
the rotation of the side plates 78 and 79. One end of shaft 71 is
secured with the pulley 70. The other end of the shaft 71 engages a
clamp 161, which clamps the other end of the shaft to the support
piece 162 of the main vertical arm 91. The shaft 71 is supported
for rotation relative to the main support bracket 63 and the side
plates 78,79 by means of bearings 164.
[0193] The opposite pulley 72 and its shaft 73 are supported so
that the pulley 72 rotates with rotation of the yoke formed by side
plates 78 and 79. A clamp 166 clamps the shaft 73 to the side plate
and thus to the rotating yoke. This yoke actually rotates with the
pin of shaft 73. For further support of the shaft 73, there are
also provided bearings 168, one associated with the support bracket
63 and another associated with support piece 162.
[0194] Regarding the yoke formed by side plates 78 and 79, at one
end thereof is a counterweight 80, as illustrated in FIGS. 4 and
7A. The other end supports a rotating block 170 (see FIG. 4) that
supports the lower end of arm 92 and has oppositely disposed ends
of pin 81 rotatably engaged with that end of the yoke (side plates
78 and 79). Bushings or bearings may be provided to allow free
rotation of the bottom end of the arm 92 in the yoke that captures
this arm.
[0195] In practice, the following sequence of operations occur at
master station M. After the instrument 14 has been placed at the
proper operative site, the surgeon is seated at the console and
presses an activation button, such as the "enter" button on the
keyboard 31 on console 9. This causes the arms at the master
station to move to a predetermined position where the surgeon can
engage thumb and forefinger grips. FIG. 1 shows such an initial
location where the arm assemblies 3 are essentially pointed
forward. This automatic initialization movement is activated by the
motors in unit 7 at the master station. This corresponds, in FIG.
2A, to upper arm 96 being essentially horizontal and lower arm 92
being essentially vertical.
[0196] While observing the position of the tools on the video
display screen 30, the surgeon now positions his hand or hands
where they appear to match the position of the respective tool 18
at the operative site (OS in FIG. 2B). Then, the surgeon may again
hit the "enter" key. This establishes a reference location for both
the slave instrument and the master controls. This reference
location is discussed later with details of controller 9 and an
algorithm for controlling the operations between the master and
slave stations. This reference location is also essentially
identified as a fixed position relative to the wrist joint at the
distal end of distal arm 96 at pin 98 in FIG. 4 (axis 98A in FIG.
2A). This is the initial predefined configuration at the master
station, definable with three dimensional coordinates.
[0197] Now when the surgeon is ready to carry out the procedure, a
third keystroke occurs, which may also be a selection of the
"enter" key. When that occurs the motors are activated in the drive
unit 8 so that any further movement by the surgeon will initiate a
corresponding movement at the slave end of the system.
[0198] Reference is now made to FIG. 18 which is a schematic
perspective view of an alternate embodiment of an input device or
hand assembly 860A. Rather than providing separate thumb and
forefinger members, as illustrated previously, the surgeon's hand
is holding a guide shaft 861A. On the shaft 861 there is provided a
push-button 866A that activates an encoder 868A. The guide shaft
861A may be considered more similar to an actual surgical
instrument intended to be handled directly by the surgeon in
performing unassisted nonrobotic surgery. Thus, the hand piece 860A
illustrated in FIG. 18 may be more advantageous to use for some
types of operative procedures.
[0199] FIG. 18 illustrates, in addition to the encoder 868A, three
other encoder blocks, 862A, 863A and 864A. These are schematically
illustrated as being intercoupled by joints 870A and 871A. All four
of these encoders would provide the same joint movements depicted
previously in connection with joints J4-J7. For example, the button
866A may be activated by the surgeon to open and close the
jaws.
[0200] C. The Slave Station S
[0201] C1--Slave Overview (FIGS. 8-8D)
[0202] Reference is now made to FIG. 8 which is a perspective view
illustrating the present embodiment of the slave station S. A
section of the surgical tabletop T is shown, from which extends the
rigid angled post 19 that supports the surgical instrument 14 at
mounting bracket 25. The drive unit 8 is also supported from the
side of the tabletop by an L-shaped brace 210 that carries an
attaching member 212. The brace is suitably secured to the table T
and the drive unit 8 is secured to the attaching member 212 by
means of a clamp 214. A lower vertical arm 19A of the rigid support
rod 19 is secured to the attaching member 212 by another clamping
mechanism 216, which mechanism 216 permits vertical adjustment of
the rigid support 19 and attached instrument 14. Horizontal
adjustment of the surgical instrument is possible by sliding the
mounting bracket 25 along an upper horizontal arm 19B of the
support rod 19. One embodiment of the drive unit 8 is described in
further detail in FIG. 17. A preferred embodiment is illustrated in
FIGS. 8F-8L.
[0203] The clamping bracket 216 has a knob 213 that can be loosened
to reposition the support rod 19 and tightened to hold the support
rod 19 in the desired position. The support rod 19, at its vertical
arm 19A, essentially moves up and down through the clamp 216.
Similarly, the mounting bracket 25 can move along the horizontal
arm 19B of the support rod 19, and be secured at different
positions therealong. The clamp 214, which supports the drive unit
8 on the operating table, also has a knob 215 which can be loosened
to enable the drive unit to be moved to different positions along
the attaching member 212.
[0204] FIG. 8 also shows the cable-in-conduit bundles 21 and 22.
The cables in the bundle 21 primarily control the action of the
adapter or guide member 15. The cables in bundle 22 primarily
control the tool 18, all described in further detail below.
[0205] FIG. 8 also illustrates a support yoke 220 to which is
secured the mounting bracket 25, a pivot piece 222, and support
rails 224 for a carriage 226. Piece 222 pivots relative to the
support yoke 220 about pivot pin 225.
[0206] FIG. 2B is a schematic representation of the joint movements
associated with the slave station S. The first joint movement J1
represents a pivoting of the instrument 14 about pivot pin 225 at
axis 225A. The second joint movement J2 is a transition of the
carriage 226 on the rails 224, which essentially moves the carriage
and instrument 14 supported therefrom, in the direction indicated
by the arrow 227. This is a movement toward and away from the
operative site OS. Both of these movements J1 and J2 are controlled
by cabling in bundle 21 in order to place the distal end of the
guide tube 17 at the operative site. The operative site is defined
as the general area in proximity to where movement of the tool 18
occurs, usually in the viewing area of the endoscope and away from
the incision.
[0207] FIG. 8 also shows a coupler 230 pivotally coupled from a
base piece 234 by means of a pivot pin 232. The coupler 230 is for
engaging with and supporting the proximal end of the instrument
insert 16.
[0208] Reference is now made to FIGS. 8A, 8B and 8C which are
perspective views of a preferred clamping arrangement which allows
a limited amount of pivoting of the mounting bracket 25 (which
supports instrument 14). The mounting bracket 25 includes a
securing knob 450 that clamps the mounting bracket 25 to a base
452. The mounting bracket is basically two pieces 455 and 457. A
bottom piece 457 is adapted to receive the upper arm of rigid
supporting rod 19 (see FIG. 8B) and is secured thereto by a bolt
458. A top piece 455 is pivotably adjustable relative to the bottom
piece 457 by means of slots 460 that engage with bolts 462. When
bolts 462 are loosened, the top piece 455 may be rotated relative
to the bottom piece 457 so that the instrument 14 may be held in
different positions. The bolts 462 may then be tightened when the
instrument 14 is in a desired angular position.
[0209] An adjustable bracket 25 and support post 19 may be provided
at each side of the table for mounting a surgical instrument 14 on
both the left and the right sides of the table. Depending upon the
particular surgical procedure, it may be desirable to orient a pair
of guide tubes on the left and right sides in different
arrangements. In the arrangement of FIG. 1, the guide tubes 17, 17
are arranged so that the respective tools 18, 18 face each other.
However, for other procedures it may be desirable to dispose the
guides in different positions, allowed by the adjustability of
brackets 25, 25 on their respective support posts 19, 19.
[0210] FIG. 8D shows a template 470 useful in a preferred procedure
for positioning the guide tube. In this procedure, when the support
post 19 is initially positioned, the mounting bracket 25 holds the
template 470 (rather than the instrument 14). The template 470 has
a right angle arm 472 with a locating ball 474 at the end thereof.
The arm 472 extends a distance that is substantially the same as
the lateral displacement of the guide tube 200 from pivot point 205
above the incision point 207 in FIG. 2C (see also the trocar 487 at
the incision point 485 in FIG. 2B). The mounting bracket 25 is
adjusted on the support post 19 so that the ball 474 coincides with
the intended incision point of the patient. Thereafter, the
template is removed and when the instrument 14 is then clamped to
the mounting bracket, the guide tube 17 will be in the proper
position vis--vis the patient's incision. Thus, the template 470 is
used to essentially position the bracket 25 where it is desired to
be located with the ball 474 coinciding with the incision point.
Once the template is removed and the instrument is secured, the
guide tube 17 will be in the proper position relative to the
incision.
[0211] In connection with the operation of the present system, once
the patient is on the table, the drive unit 8 is clamped to the
table. It's position can be adjusted along the table by means of
the attaching member 212. The lower arm 19A of the rigid support
rod 19 is secured to the table by the bracket 216. The surgeon
determines where the incision is to be made. The mounting bracket
on the rigid rod 19 is adjusted and the template 470 is secured to
the clamp 25. The ball 474 on the template is lined up with the
incision so as to position the securing rod 19 and clamp 25 in the
proper position. At that time the rigid rod 19 and the securing
clamp 25 are fixed in position. Then the template is removed and
the instrument 14 is positioned on the clamp 25. The incision has
been made and the guide tube 17 is inserted through the incision
into the patient and the instrument 14 is secured at the fixed
position of mounting bracket 25.
[0212] With regard to the incision point, reference is made to FIG.
2B which shows the incision point along the dashed line 485. Also
shown at that point is the cannula 487. In some surgical procedures
it is common to use a cannula in combination with a trocar that may
be used to pierce the skin at the incision. The guide tube 17 may
then be inserted through the flexible cannula so that the tool is
at the operative site. The cannula typically has a port at which a
gas such as carbon dioxide enters for insufflating the patient, and
a switch that can be actuated to desufflate. The cannula may
typically include a valve mechanism for preventing the escape of
the gas.
[0213] C2--Slave Cabling and Decoupling (FIGS. 8E-8L)
[0214] FIG. 8E illustrates a mechanical cabling sequence at the
slave station from the drive unit 8, through adaptor 15 and insert
16, to the tool 18. Reference will again be made to FIG. 8E after a
description of further details of the slave station.
[0215] In the present embodiment the cable conduits 21 and 22 are
detachable from the drive unit 8. This is illustrated in FIG. 8F
wherein the drive unit includes separable housing sections 855 and
856. The instrument 14 along with the attached cable conduits 21
and 22 and housing section 856 are, as a unit, of relatively light
weight and easily maneuverable (portable) to enable insertion of
the instrument 14 into the patient prior to attachment to the
bracket 25 on support post 19.
[0216] FIG. 8F is an exploded perspective view of the cable drive
mechanism and instrument illustrating the de-coupling concepts of
the present embodiment at the slave station S. A section of the
surgical tabletop T which supports the rigid post 19 is shown. The
drive unit 8 is supported from the side of the tabletop by an
L-shaped brace 210 that carries an attaching member 212. The brace
210 is suitably secured to the table T. The drive unit 8 is secured
to the attaching member 212 by means of a clamp 214. Similarly, the
rigid support rod 19 is secured to the attaching member 212 by
means of another clamping mechanism 216.
[0217] Also in FIG. 8F the instrument 14 is shown detached from (or
not yet attached to) support post 19 at bracket 25. The instrument
14 along with cables 21 and 22 and lightweight housing section 856
provide a relatively small and lightweight decoupleable slave unit
that is readily manually engageable (insertable) into the patient
at the guide tube 17.
[0218] After insertion, the instrument assembly, with attached
cables 21, 22 and housing 856, is attached to the support post 19
by means of the krob 26 engaging a threaded hole in base 452 of
adapter 15. At the other end of the support post 19, bracket 216
has a knob 213 that is tightened when the support rod 19 is in the
desired position. The support rod 19, at its vertical arm 19A,
essentially moves up and down through the clamp 216. Similarly, the
mounting bracket 25 can move along the horizontal arm 19B of the
support rod to be secured at different positions therealong. A
further clamp 214 enables the drive unit 8 to be moved to different
positions along the attaching member 212.
[0219] FIG. 8F also shows the coupler 230 which is pivotally
coupled from base piece 234 by means of the pivot pin 232. The
coupler 230 is for engaging with and supporting the proximal end of
the instrument insert 16.
[0220] Reference is now made to FIG. 8G which illustrates the
mechanical cabling sequence at the slave station. The cabling
extends from a motor 800 (of the drive unit 8), via adaptor 15, and
via the instrument insert 16 to the tool 18. The adapter 15 and
insert 16 are intercoupled by their associated interlocking wheels
324 and 334. Cables 606 and 607, which in reality, are a
single-looped cable, extend between the interlocking wheel 334 and
the tool 18. These cables 606, 607 are used for pivoting the
wrist-joint mechanism (at the tool 18), in the direction of arrow
J5 illustrated in FIG. 8G.
[0221] FIG. 8G also illustrates an idler pulley 344 on the insert
16, as well as a pair of pulleys 317 associated with the wheel 324
on the adapter 15. Cabling 315 extends from interlocking wheel 324
about the pulleys 317, about an idler pulley 318 and through
sheathing 319 to conduit turn buckles 892. The cables 323 extending
from the turn buckles 892 are wrapped about a coupler spindle 860.
Associated with the coupler spindle 860 is a coupler disk 862
secured to an output shaft of one of the motors 800 of drive unit
8.
[0222] Reference is now made to further cross-sectional views
illustrated in FIGS. 8H-8L. FIG. 8H is a partially broken away
front-elevational view as taken along line 8H-8H of FIG. 8F. FIGS.
8I and 8J are cross-sectional views taken respectively along lines
8I-8I and 8J-8J of FIG. 8H. FIG. 8K is a cross-sectional side view
taken along line 8K-8K of FIG. 8H. Lastly, FIG. 8L is a
cross-sectional view as taken along line 8L-8L of FIG. 8K.
[0223] These cross-sectional views illustrate a series of seven
motors 800, one for each of an associated mechanical cabling
assembly. In, FIG. 8K, there is illustrated one of the motors 800
with its output shaft 865 extending therefrom. The motor 800 is
secured to a housing wall 866 (also shown in FIG. 8F). FIG. 8K also
shows the angle iron 868 that is used to support the housing
section 855 from the bracket 214 (see FIG. 8F).
[0224] A coupler disk 862 is illustrated in FIGS. 8J and 8K,
secured to the shaft 865 by a set screw 869. The coupler disk 862
also supports a registration pin 871 that is adapted to be received
in slots 873 of the coupler spindle 860. FIGS. 8K and 8L illustrate
the pin 871 in one of the slots 873. The registration pin 871 is
biased outwardly from the coupler disk by means of a coil spring
874.
[0225] The first housing section 855 also carries oppositely
disposed thumb screws 875 (see FIG. 8H). These may be threaded
through flanges 876 as illustrated in FIG. 8J. When loosened, these
set screws enable the second housing section 856 to engage with the
first housing section 855. For this purpose, there is provided a
slot 878 illustrated in FIG. 8F. Once the second housing section
856 is engaged with the first housing section 855, then the thumb
screws 875 may be tightened to hold the two housing sections
together, at the same time facilitating engagement between the
coupler disks 862 and the coupler spindles 860.
[0226] The cross-sectional view of FIG. 8K shows that at the end of
coupler disk 862 where it is adapted to engage with the coupler
spindle 860, the coupler disk is tapered as illustrated at 879.
This facilitates engagement between the coupler disk and the
coupler spindle.
[0227] As illustrated in FIG. 8F, the two housing sections 855 and
856 are separable from each other so that the relatively compact
slave unit can be engaged and disengaged from the motor array,
particularly from the first housing section 855 that contains the
motors 800. The first housing section 855, as described previously,
contains the motors 800 and their corresponding coupler disks 862.
In FIG. 8F, the second housing section 856 primarily accommodates
and supports the coupler spindles 860 and the cabling extending
from each of the spindles to the cable bundles 21 and 22 depicted
in FIG. 8F.
[0228] FIGS. 8J and 8K illustrate one of the coupler spindles 860
supported within a pair of bearings 881. The cable associated with
the coupler spindle is secured to the coupler spindle by means of a
cable clamp screw 883. FIGS. 8J and 8K illustrate the cable
extending about the coupler spindle, and secured by the cable clamp
screw 883. The particular cable illustrated in FIGS. 8J about
spindle 860 is identified as cable D.
[0229] In FIGS. 8H-8K, the cabling is identified by cables A-G.
This represents seven separate cables that are illustrated, for
example, in FIG. 8H as extending into the second housing section
856 with a flexible boot 885 (see the top of FIGS. 8H and 8K)
extending thereabout.
[0230] At the top of the second housing section 856 there is
provided a conduit stop or retainer 888 that is secured in place at
the top of the housing section in an appropriate manner. The
conduit retainer 888 has through slots 890, one for accommodating
each of the cables A-G (see FIG. 8I). Refer in particular to FIGS.
8H and 8K illustrating the cables A-G extending through the
retainer 888 in the slots thereof. Each of the cables may also be
provided with a turnbuckle 892 that is useful in tensioning the
cables. Each turnbuckle 892 screws into an accommodating threaded
passage in the retainer 888, as illustrated in FIG. 8K.
[0231] In FIG. 8H the coupler spindles are all disposed in a linear
array. To properly accommodate the cabling, the spindles are of
varying diameter, commencing at the top of the second housing
section 856 with the smallest diameter spindle and progressing in
slightly larger diameter spindles down to the bottom of the second
housing section 856 where there is disposed the largest diameter
coupler spindle.
[0232] The detachability of the two housing sections 855 and 856
enables the cleaning of certain components which are disposed above
the plane of the operating table, here referred to as the sterile
field. More specifically, the detachable housing 856 with attached
cables 21 and 22 and instrument 14, needs to be sterilized after
use, except for the instrument insert 16 which is an integral
disposal unit. The sterilization of the designated components may
include a mechanical cleaning with brushes or the like in a sink,
followed by placement in a tray and autoclave in which the
components are subjected to superheated steam to sterilize the
same. In this manner, the adapter 15 is reusable. Also, the
engagement between the adapter 15 and insert 16 is such that the
disposable insert element may have holes, which are relatively hard
to clean, whereas the recleanable adapter element has a minimum
number of corresponding projections, which are relatively easier to
clean than the holes. By disposable, it is meant that the unit,
here the insert 16, is intended for a single use as sold in the
marketplace. The disposable insert interfaces with an adapter 15
which is intended to be recleaned (sterilized) between repeated
uses. Preferably, the disposable unit, here the insert 16, can be
made of relatively lower cost polymers and materials which, for
example, can be molded by low-cost injection molding. In addition,
the disposable instrument insert 16 is designed to require a
relatively minimal effort by the operator or other assistant who is
required to attach the insert to the adapter 15. More specifically,
the operator is not required to rethread any of the multiple
mechanical cabling assemblies.
[0233] C3--Slave Instrument Assembly (FIGS. 9-16)
[0234] Further details of the detachable and portable slave unit
are shown in FIGS. 9-16. For example, FIG. 11 shows the carriage
226 which extends from the mounting bracket 25 on support post 19.
Below carriage 226, a base piece 234 is supported from the carriage
226 by a rectangular post 228. The post 228 supports the entire
instrument assembly, including the adaptor 15 and the instrument
insert 16 once engaged.
[0235] As indicated previously, a support yoke 220 is supported in
a fixed position from the mounting bracket 25 via base 452. Cabling
21 extends into the support yoke 220. The support yoke 220 may be
considered as having an upper leg 236 and a lower leg 238 (see FIG.
12). In the opening 239 between these legs 236, 238 there is
arranged the pivot piece 222 with its attached base 240. Below the
base 240 and supported by the pivot pin 225 is a circular disc 242
that is stationary relative to the yoke legs 236, 238. A bearing
235 in leg 236, a bearing 237 in leg 238, and a bearing 233 in disc
242, allow rotation of these members relative to the pivot pin
225.
[0236] Disposed within a recess in the support yoke 220, as
illustrated in FIG. 13, is a capstan 244 about which cables 245 and
246 extend and are coupled to opposite sides of the arcuate segment
248 of pivot piece 222. The ends of cables 245 and 246 are secured
in holes at opposite sides of arcuate segment 248. The cables 245
and 246 operate in conjunction with each other. At their other
ends, these cables connect to a motor. Depending upon the direction
of rotation of the motor, either cable 245 or cable 246 will be
pulled, causing the pivot price 232 to rotate in a direction
indicated by J1.
[0237] The base 240 of pivot piece 222 also has at one end thereof
an end piece 241 into which are partially supported the ends of
rails 224 (see FIG. 13). The other ends of the rails are supported
by an end piece 251, which also has cabling 257, 258 for the
carriage 226 extending therethrough, such as illustrated in FIG.
14. A capstan 253 is supported from a lower surface of the base
240. Another capstan 256 is supported within the support yoke 220.
The cables 257 and 258 extend about the capstan 256, about disc 242
(which may be grooved to receive the cables), to the carriage 226,
and from there about another capstan 260 disposed within end member
262 (see FIG. 11). End member 262 supports the other ends of the
rails 224, upon which the carriage 226 transitions. The ends of the
cables 257 and 258 are secured appropriately within the carriage.
FIG. 11 illustrates by the arrow 227 the forward and backward
motion of the carriage 226, and thus of the attached actuator 15
toward and away from the operative site.
[0238] Now, reference is made to FIG. 15 illustrating a portion of
the slave unit with the instrument insert 16 partially removed and
rotated from the base piece 234. FIG. 15 shows a portion of the
carriage mechanism, including the carriage 226 supported on rails
224. As indicated previously, below the carriage 226 there is a
support post 228 that supports the base piece 234. It is at the
base piece 234, that cabling 22 from the drive unit 8 is
received.
[0239] Also extending from the base piece 234 is the guide tube 17
of adapter 15. The guide tube 17 accommodates, through its center
axial passage, the instrument insert 16. Also, supported from the
base piece 234, at pivot pin 232, is the adaptor coupler 230. The
adaptor coupler 230 pivots out of the way so that the instrument
insert 16 can be inserted into the adaptor 15. FIG. 15 shows the
instrument insert 16 partially withdrawn from the adaptor 15. The
pivot pin 232 may be longer than the distance between the two
parallel bars 270 and 272 carried by base piece 234, so that the
pin not only allows rotation, but can also slide relative to bars
270 and 272. This permits the coupler 230 to not only pivot, but
also to move laterally to enable better access of the instrument
insert 16 into the base piece 234. The instrument insert 16 has a
base (coupler) 300 that in essence is a companion coupler to the
adapter coupler 230.
[0240] With further reference to FIG. 15, the instrument insert 16
is comprised of a coupler 300 at the proximal end, and at the
distal end an elongated shaft or stem, which in this embodiment has
a more rigid proximal stem section 301 and a flexible distal stem
section 302 (see FIG. 15A). The distal stem section 302 carries the
tool 18 at its distal end. The instrument coupler 300 includes one
or more wheels 339 which laterally engage complimentary wheels 329
of the coupler 230 on adaptor 15. The instrument coupler 300 also
includes an axial wheel 306 at its distal end through which the
stem 301 extends, and which also engages a wheel on the adaptor, as
to be described below in further detail. The axial engagement wheel
306 is fixed to the more rigid stem section 301, and is used to
rotate the tool 18 axially at the distal end of the flexible stem
section 302 (as shown by arrow J4 in FIG. 213).
[0241] The base piece 234 has secured thereto two parallel
spaced-apart bars 270 and 272. It is between these bars 270 and 272
that is disposed the pivot pin 232. The pivot pin 232 may be
supported at either end in bearings in the bars 270 and 272, and as
previously mentioned, has limited sliding capability so as to move
the adapter coupler 230 away from base piece 234 to enable
insertion of the instrument insert 16. A leg 275 is secured to the
pivot pin 232. The leg 275 extends from the coupler 230 and
provides for pivoting of coupler 230 with respect to base piece
234. Thus, the combination of pivot pin 232 and the leg 275 permits
a free rotation of the coupler 230 from a position where it is
clear to insert the instrument insert 16 to a position where the
coupler 230 intercouples with the base 300 of the instrument insert
16. As depicted in FIG. 15, the bars 270 and 272 also accommodate
therethrough cabling from cable bundles 271.
[0242] The base piece 234 also rotatably supports the rigid tube 17
(illustrated by arrow J3 in FIG. 2B). As indicated previously, it
is the connection to the carriage 226 via post 228 that enables the
actuator 15 to move toward and away from the operative site. The
rotation of the tube 17 is carried out by rotation of pulley 277
(see FIG. 15). A pair of cables from the bundle 271 extend about
the pulley 277 and can rotate the pulley in either direction
depending upon which cable is activated. To carry out this action,
the tube 17 is actually supported on bearings within the base piece
234. Also, the proximal end of the tube 17 is fixed to the pulley
277 so that the guide tube 17 rotates with the pulley 277.
[0243] Also supported from the very proximal end of the tube 17, is
a second pulley 279 that is supported for rotation about the
actuator tube 17. For this purpose a bearing is disposed between
the pulley 279 and the actuator tube. The pulley 279 is operated
from another pair of cables in the bundle 271 that operate in the
same manner. The cabling is such that two cables couple to the
pulley 279 for operation of the pulley in opposite directions.
Also, as depicted in FIG. 15, the pulley 279 has a detent at 280
that is adapted to mate with a tab 281 on the axial wheel 306 of
instrument coupler 300. Thus, as the pulley 279 is rotated, this
causes a rotation of the axial wheel 306 and a corresponding
rotation of flexible and rigid sections 301, 302 of the instrument
insert 16, including the tool 18.
[0244] Again referring to FIG. 15, a block 310 is secured to one
side of the coupler 230. The block 310 is next to the leg 275 and
contains a series of small, preferably plastic, pulleys that
accommodate cabling 315. These cables extend to other pulleys 317
disposed along the length of the coupler 230. Refer also to the
cabling diagram of FIG. 8E.
[0245] In this embodiment, the coupler 230 includes wheels 320, 322
and 324. Each of these wheels is provided with a center pivot 325
to enable rotation of the wheels in the coupler 230. The knob 327
is used to secure together the adapter coupler 230 and the base
coupler 300 of the instrument insert 16.
[0246] For the three wheels, 320, 322 and 324, there are six
corresponding pulleys 317, two pulleys being associated with each
wheel (see FIGS. 8E and 11B). Similarly, there are six pulleys in
the block 310. Thus, for cabling bundle 315 there are six separate
cable conduits for the six separate cables that couple to the
wheels 320, 322 and 324. Two cables connect to each wheel for
controlling respective opposite directions of rotation thereof.
[0247] Each of the wheels 320, 322 and 324 have a half-moon portion
with a flat side 329. Similarly, the instrument base 300 has
companion wheels 330, 332 and 334 with complimentary half-moon
construction for engagement with the wheels 320, 322 and 324. The
wheel 320 controls one of the jaws of the tool 18 (motion J6 in
FIG. 2B). The wheel 324 controls the other jaw of the tool 18
(motion J7 in FIG. 2B). The middle wheel 322 controls the wrist
pivoting of the tool 18 (motion J5 in FIG. 2B). Also refer to FIG.
8E showing cabling for controlling tool movement.
[0248] The coupler 300 of insert 16 has three wheels 330, 332 and
334, each with a pivot pin 331, and which mate with the
corresponding wheels 320, 322 and 324, respectively of the adaptor
coupler. In FIG. 15 the instrument base piece 300 is shown rotated
from its normal position for proper viewing of the wheels.
Normally, it is rotated through 180.degree. so that the half-moon
wheels 330, 332 and 334 engage with the corresponding coupler
wheels 320, 322 and 324. Also illustrated in FIG. 15 are capstans
or idler pulleys 340, 342 and 344 associated, respectively, with
wheels 330, 332 and 334.
[0249] As shown in FIG. 15A, each wheel of the instrument coupler
300 has two cables 376 that are affixed to the wheel (e.g., wheel
334 in FIG. 8E) and wrapped about opposite sides at its base. The
lower cable rides over one of the idler pulleys or capstans (e.g.,
capstan 34 in FIG. 8E), which routes the cables toward the center
of the instrument stem 301. It is desirable to maintain the cables
near the center of the instrument stem. The closer the cables are
to the central axis of the stem, the less disturbance motion on the
cables when the insert stem is rotated. The cables may then be
routed through fixed-length plastic tubes that are affixed to the
proximal end of the stem section 301 and the distal end of the stem
section 302. The tubes maintain constant length pathways for the
cables as they move within the instrument stem.
[0250] The instrument coupler 300 is also provided with a
registration slot 350 at its distal end. The slot 350 engages with
a registration pin 352 supported between the bars 270 and 272 of
base piece 234. The coupler 300 is also provided with a clamping
slot 355 on its proximal end for accommodating the threaded portion
of the clamping knob 327 (on adapter coupler 230). The knob 327
affirmatively engages and interconnects the couplers 230 and
300.
[0251] In operation, once the surgeon has selected a particular
instrument insert 16, it is inserted into the adapter 15. The
proximal stem 301, having the distal stem 302 and the tool 18 at
the distal end, extend through the adapter guide tube 17. FIG. 8
shows the tool 18 extending out of the guide tube 17 when the
surgical instrument 16 is fully inserted into the adaptor 15. When
it is fully inserted, the tab 281 on the axial wheel 306 engages
with the mating detent 280 in pulley 279. Also, the registration
slot 350 engages with the registration pin 352. Then the coupler
230 is pivoted over the base 300 of the instrument insert 16. As
this pivoting occurs, the respective wheels of the coupler 230 and
the coupler 300 interengage so that drive can occur from the
coupler 230 to the insert 16. The knob 327 is secured down so that
the two couplers 230 and 300 remain in fixed relative
positions.
[0252] Reference is also now made to detailed cross-sectional views
of FIGS. 11A, 11B and 11C. FIG. 11A is a cross sectional view taken
along line 11A-11A of FIG. 11. FIG. 11B is a cross-sectional view
taken along line 11B-11B of FIG. 11A. FIG. 11C is a further
cross-sectional view taken through FIG. 1A along line 11C-11C.
[0253] The base piece 234 of adapter 15 rotatably supports the
guide tube 17, allowing rotation J3 shown in FIG. 2B. As noted in
FIG. 11A, there are a pair of bearings 360 disposed at each end
within the axial passage 362 in the base piece 234. The rotation of
the guide tube 17 is carried out by rotation of the first pulley
277. In FIG. 11A there is a set screw 364 that secures the pulley
277 to the guide tube 17. Nylon spacers 366 separate various
components, such as the base piece 234 and the pulley 277, the two
pulleys 277 and 279, and base 300 and wheel 306.
[0254] A nylon bearing 368 is also provided between the second
pulley 279 and the guide tube 17. FIG. 11A also shows the proximal
stem section 301 of the insert 16 inside of the guide tube 17. A
nylon bearing 370 is supported within the Front block 372 of the
insert 16.
[0255] In FIG. 11A, the second pulley 279 is supported from the
proximal end of the tube 17. The bearing 368 is disposed between
the pulley 279 and the tube 17. The pulley 279 has a detent 280
that is adapted to mate with a tab 281 on the axial wheel 306.
Thus, when the pulley 279 is rotated by cabling 271 (see FIG. 11C),
this causes a rotation of the axial wheel 306, and a corresponding
rotation (motion J4 in FIG. 2B) of the sections 301, 302 of the
instrument insert 16, including the tool 18. The very proximal end
of the section 301 is illustrated in FIG. 11A as being rotatable
relative to the bearing 370.
[0256] FIG. 1A also shows the intercoupling of the instrument and
adapter couplers 230 and 300. Here wheel 324 is shown interlocked
with wheel 334. FIGS. 11A and 11C also show cabling at 376. This
cabling includes six separate cables that extend through the length
of the stem 301, 302 of the instrument. The cabling is illustrated
connecting about an idler pulley 344. The cabling associated with
wheel 334 is secured by the cable clamping screw 378. For further
details of the cabling, refer to FIG. 8E.
[0257] FIG. 11B is a cross-sectional view taken along 11B-1B of
FIG. 11A which again shows the cooperating wheels 324 and 334. Also
illustrated is a cable clamping set screw 380 that is used to
secure the cabling 376 to wheel 324. A cable guide rail 382 is
attached and forms part of the base of the adapter coupler 230. The
cable guide rail 382 contains six idler pulleys 317, one of which
is illustrated in FIG. 11B. It is noted that cabling 376 extends
about this pulley to the cable idler block 310 where conduits 315
are coupled. The cable guide idler block 310 includes a series of
six idler pulleys shown in dotted outline in FIG. 11B at 386.
[0258] FIG. 11C is a cross-sectional view taken along line 11C-11C
of FIG. 11A, which shows further details at the pulley 279. Also
illustrated is post 228 supporting the base piece 234 of the
instrument insert, and cabling 376 extending through the
instrument.
[0259] FIGS. 16A and 16B illustrate the construction of one form of
a tool. FIG. 16A is a perspective view and FIG. 16B is an exploded
view. The tool 18 is comprised of four members including a base
600, link 601, upper grip or jaw 602 and lower grip or jaw 603. The
base 600 is affixed to the flexible stem section 302 (see FIG.
15A). The flexible stem may be constructed of a ribbed plastic.
This flexible section is used so that the instrument will readily
bend through the curved part of the guide tube 17.
[0260] The link 601 is rotatably connected to the base 600 about
axis 604. FIG. 16B illustrates a pivot pin 620 at axis 604. The
upper and lower jaws 602 and 603 are rotatably connected by pivot
pin 624 to the link 601 about axis 605, where axis 605 is
essentially perpendicular to axis 604.
[0261] Six cables 606-611 actuate the four members 600-603 of the
tool. Cable 606 travels through the insert stem (section 302) and
through a hole in the base 600, wraps around curved surface 626 on
link 601, and then attaches on link 601 at 630. Tension on cable
606 rotates the link 601, and attached upper and lower grips 602
and 603, about axis 604 (motion J5 in FIG. 2B). Cable 607 provides
the opposing action to cable 606, and goes through the same routing
pathway, but on the opposite sides of the insert. Cable 607 may
also attach to link 601 generally at 630.
[0262] Cables 608 and 610 also travel through the stem 301, 302 and
though holes in the base 600. The cables 608 and 610 then pass
between two fixed posts 612. These posts constrain the cables to
pass substantially through the axis 604, which defines rotation of
the link 601. This construction essentially allows free rotation of
the link 601 with minimal length changes in cables 608-611. In
other words, the cables 608-611, which actuate the jaws 602 and
603, are essentially decoupled from the motion of link 601. Cables
608 and 610 pass over rounded sections and terminate on jaws 602
and 603, respectively. Tension on cables 608 and 610 rotate jaws
602 and 603 counter-clockwise about axis 605. Finally, as shown in
FIG. 16B, the cables 609 and 611 pass through the same routing
pathway as cables 608 and 610, but on the opposite side of the
instrument. These cables 609 and 611 provide the clockwise motion
to jaws 602 and 603, respectively. At the jaws 602 and 603, as
depicted in FIG. 16B, the ends of cables 608-611 may be secured at
635, for example by the use of an adhesive such as epoxy glue, or
the cables could be crimped to the jaws.
[0263] To review the allowed movements of the various components of
the slave unit, the instrument insert 16 slides through the guide
tube 17 of adaptor 15, and laterally engages the adaptor coupler
230. The adaptor coupler 230 is pivotally mounted to the base piece
234. The base piece 234 rotationally mounts the guide tube 17
(motion J3). The base piece 234 is affixed to the linear slider or
carriage assembly (motion J2). The carriage assembly in turn is
pivotally mounted at the pivot 225 (motion J1).
[0264] Reference is now made to FIGS. 16C and 16D. FIG. 16C is a
fragmentary perspective view of an alternate set of jaws, referred
to as needle drivers. FIG. 16D is a side elevation view of the
needle drivers. This embodiment employs an over-center camming
arrangement so that the jaw is not only closed, but also at a
forced closure.
[0265] In FIGS. 16C and 16D, similar reference characters are
employed with respect to the embodiment of FIGS. 16A and 16B. Thus,
there is provided a base 600, a link 601, an upper jaw 650 and a
lower jaw 652. The base 600 is affixed to the flexible stem section
302. Cabling 608-611 operate the end jaws. Linkages 654 and 656
provide the over-center camming operation.
[0266] The two embodiments of FIGS. 16A-16D employ a fixed wrist
pivot. An alternate construction is illustrated in FIGS. 16E-16H in
which there is provided, in place of a wrist pivot, a flexible or
bending section. In FIGS. 16E-16H, similar reference characters are
used for many of the parts, as they correspond to elements found in
FIGS. 16A-16D.
[0267] In the embodiment of FIGS. 16E-16H, the tool 18 is comprised
of an upper grip or jaw 602 and a lower grip or jaw 603, supported
from a link 601. Each of the jaws 602, 603, as well as the link
601, may be constructed of metal, or alternatively, the link 601
may be constructed of a hard plastic. The link 601 is engaged with
the distal end of the flexible stem section 302. In this regard
reference may also be made to FIG. 15A that shows the ribbed,
plastic construction of the flexible stem section 302. FIG. 16E
shows only the very distal end of the stem section 302, terminating
in a bending or flexing section 660. The flexible stem section 302
is constructed so as to be flexible and thus has a substantial
length of a ribbed surface as illustrated in FIG. 15A. Also, at the
flexible section 660, flexibility and bending is enhanced by means
of diametrically-disposed slots 662 that define therebetween ribs
664. The flexible section 660 also has a longitudinally extending
wall 665, through which cabling extends, particularly for operation
of the tool jaws. The very distal end of the bending section 660
terminates with an opening 666 for receiving the end 668 of the
link 601. The cabling 608-611 is preferably at the center of the
flex section at wall 665 so as to effectively decouple flex or
bending motions from tool motions.
[0268] Regarding the operation of the tool, reference is made to
the cables 608, 609, 610, and 611. All of these extend through the
flexible stem section and also through the wall 665 such as
illustrated in FIG. 16G. The cables extend to the respective jaws
602, 603 for controlling operation thereof in a manner similar to
that described previously in connection with FIGS. 16A-16D. FIGS.
16E-16H also illustrate the cables 606 and 607 which couple through
the bending section 660 and terminate at ball ends 606A and 607A,
respectively. Again, refer to FIG. 16G that shows these cables.
FIGS. 16F and 16H also show the cables 606, 607 with the ball ends
606A, 607A, respectively. These ball ends are adapted to urge
against the very end of the bendable section in opening 666. When
these cables are pulled individually, they can cause a bending of
the wrist at the bending or flexing section 660. FIG. 16H
illustrates the cable 607 having been pulled in the direction of
arrow 670 so as to flex the section 660 in the manner illustrated
in FIG. 16H. Pulling on the other cable 606 causes a bending in the
opposite direction.
[0269] By virtue of the slots 662 forming the ribs 664, there is
provided a structure that bends quite readily, essentially bending
the wall 665 by compressing at the slots such as in the manner
illustrated in FIG. 16H. This construction eliminates the need for
a wrist pin or hinge.
[0270] The embodiment illustrated in FIG. 16F has a separate link
601. However, in an alternate embodiment, this link 601 may be
fabricated integrally with, and as part of, the bending section
660. For this purpose the link 601 would then be constructed of a
relatively hard plastic rather than the metal link as illustrated
in FIG. 16F and would be integral with section 660.
[0271] In another embodiment, the bending or flexing section 660
can be constructed so as to have orthogonal bending by using four
cables separated at 90.degree. intervals and by providing a center
support with ribs and slots about the entire periphery. This
embodiment is shown in FIGS. 16I-16K. The bending section 613 is at
the end of flexible stem section 302. The cables 608, 609, 610 and
611 are for actuation of the jaws 602 and 603 in the same manner as
for earlier embodiments. The link 601 couples the bending section
613 to the jaws 602 and 603.
[0272] The bending section has a center support wall 614 supporting
ribs 618 separated by slots 619. This version enables bending in
orthogonal directions by means of four cables 606, 607, 616 and
617, instead of the single degree-of-freedom of FIG. 16E. The
operation of cables 606 and 607 provides flexing in one
degree-of-freedom, while an added degree-of-freedom is provided by
operation of cables 616 and 617.
[0273] Mention has also been made of various forms of tools that
can be used. The tool may comprise a variety of articulated tools
such as: jaws, scissors, graspers, needle holders, micro
dissectors, staple appliers, tackers, suction irrigation tools and
clip appliers. In addition, the tool may comprise a non-articulated
instrument such as: a cutting blade, probe, irrigator, catheter or
suction orifice.
[0274] C4--Slave Drive Unit (FIGS. 17-17A)
[0275] Reference is now made to the perspective view of the drive
unit 8, previously illustrated in FIG. 8. FIG. 17 illustrates the
drive unit 8 with the cover removed. The drive unit is adjustably
positionable along rail 212 by an angle brace 210 that is attached
to the operating table. Within the drive unit 8 are seven separate
motors 800, corresponding to the seven separate controls at the
slave station, and more particularly, to motions JI-J7 previously
described in reference to FIG. 2B.
[0276] The drive unit includes a support plate 805 to which there
is secured a holder 808 for receiving and clamping the cabling
conduits 835. The motors 800 are each supported from the support
plate 805. FIG. 17 also illustrates the electrical interface at
810, with one or more electrical connectors 812.
[0277] Regarding support for the motors 800 there is provided,
associated with each motor, a pair of opposed adjusting slots 814
and adjusting screws 815. This permits a certain degree of
positional adjustment of the motors, relative to their associated
idler pulleys 820. The seven idler pulleys are supported for
rotation by means of a support bar 825. FIG. 17 also shows the
cabling coming 830 from each of the idler pulleys. With seven
motors, and two cables coming off of each motor for opposite
direction control, there are a total of fourteen separate cables
conduits at the bundle 835. The cables move within the conduits in
a known manner. The conduits themselves are fixedly supported and
extend from the holder 808 to the adapter 15. Again, reference may
be made to FIG. 8 showing the conduit bundles at 21 and 22.
[0278] The seven motors in this embodiment control (1) one jaw of
the tool J6, (2) the pivoting of the wrist at the tool J5, (3) the
other jaw of the tool J7, (4) rotation of the insert J4, (5)
rotation of the adaptor J3, (6) linear carriage motion J2 and (7)
pivoting of the adaptor J1. Of course, fewer or lesser numbers of
motors may be provided in other embodiments and the sequence of the
controls may be different.
[0279] FIG. 17A illustrates another aspect of the invention--a
feedback system that feeds force information from the slave station
back to the master station where the surgeon is manipulating the
input device. For example, if the surgeon is moving his arm to the
left and this causes some resistance at the slave station, the
resistance is detected at the slave station and coupled back to one
of the motors at the master station to drive the input device, such
as the hand assembly illustrated herein, back in the opposite
direction. This provides an increased resistance to the surgeon's
movements which occurs substantially instantaneously.
[0280] FIG. 17A illustrates schematically a load cell 840 that is
adapted to sense cable tension. FIG. 17A shows one of the pulleys
842 associated with one of the motors 800, and cables 845 and 847
disposed about a sensing pulley 850. The sensing pulley 850 is
coupled to the piezoelectric load cell 840. The load cell 840 may
be disposed in a Wheatstone bridge arrangement.
[0281] Thus, if one of the motors is operating under tension, this
is sensed by the load cell 840 and an electrical signal is coupled
from the slave station, by way of the controller 9, to the master
station to control one of the master station motors. When tension
is sensed, this drives the master station motor in the opposite
direction (to the direction of movement of the surgeon) to indicate
to the surgeon that a barrier or some other obstacle has been
encountered by the element of the slave unit being driven by the
surgeon's movements.
[0282] The cabling scheme is important as it permits the motors to
be located in a position remote from the adaptor and insert.
Furthermore, it does not require the motor to be supported on any
moving arms or the like. Several prior systems employing motor
control have motors supported on moveable arms. Here the motors are
separated from the active instrument area (and sterile field) and
furthermore are maintained fixed in position. This is illustrated
in FIG. 8E by the motor 800. FIG. 8E also illustrates a typical
cabling sequence from the motor 800 through to the tool 18. Both
ends of cabling 315 are secured to the motor at 842 and the motor
is adapted to rotate either clockwise or counterclockwise, in order
to pull the cabling in either one direction or the other. The pair
of cabling operates in unison so that as one cable is pulled
inwardly toward the motor, the other cable pulls outwardly. As
illustrated in FIG. 8E, the cables extend over pulley 820 to other
pulleys, such as the pair of pulleys 317 and control wheel 324
associated with coupler 230. From there, the mechanical drive is
transferred to the control wheel 334 of the instrument insert 300,
which is coupled to wheel 334 and to the output cables 606 and 607
which drive wrist rotation of the tool 18, identified in FIG. 5E by
the motion J5.
[0283] Another important aspect is the use of inter-mating wheels,
such as the wheels 324 and 334 illustrated in FIG. 5E. This permits
essentially a physical interruption of the mechanical cables, but
at the same time a mechanical drive coupling between the cables.
This permits the use of an instrument insert 16 that is readily
engageable with the adaptor, as well as disengagable from the
adaptor 15. This makes the instrument insert 16 easily replacable
and also, due to the simplicity of the instrument insert 16, it can
be made disposable. Refer again to FIG. 15A which shows the
complete instrument insert and its relatively simple construction,
but which still provides an effective coupling between the drive
motor and the tool.
[0284] C5--Slave Guide Tube (FIGS. 19-19D)
[0285] Reference is now made to FIG. 19, a schematic diagram
illustrating different placements of the guide tube 17. FIG. 19A
illustrates left and right guide tubes substantially in the same
position as illustrated in FIG. 1. For some surgical procedures, it
may be advantageous to orient the tubes so that the curvatures are
in the same direction. FIG. 19B shows the ends of the tubes
pointing to the right, while FIG. 19C shows the ends of the tubes
pointing to the left. Lastly, in FIG. 19D the ends of the tubes are
shown converging but in a downwardly directed position. Regarding
the different placements shown in FIG. 19, the adjustable clamp 25,
illustrated in FIGS. 8A-8C may be useful, as this provides some
added level of flexibility in supporting the positioning of the
guide tubes on both the left and right side.
[0286] C6--Slave Motor Control (FIGS. 20-28)
[0287] FIGS. 20 and 21 are block diagrams of the motor control
system of the present embodiment. In the system of FIG. 1, there
are two instruments supported on either side of the operating
table. Thus, there are in actuality two separate drive units 8. One
of these is considered a left hand (LH) station and the other is
considered a right hand (RH) station. Similarly, at the master
station, on either side of the chair, as depicted in FIG. 1, there
are left hand and right hand master station assemblies.
Accordingly, there are a total of 28 (7.times.4) separate actions
that are either sensed or controlled. This relates to seven
separate degrees-of-motion at both the master and slave, as well as
at left hand and right stations. In other embodiments there may be
only a single station, such as either a left hand station or a
right hand station. Also, other embodiments may employ fewer or
greater numbers of degrees-of-motion as identified herein.
[0288] Regarding the master station side, there is at least one
position encoder associated with each of degree-of-motion or
degree-of-freedom. Also, as previously described, some of the
described motions of the active joints have a combination of motor
and encoder on a common shaft. With regard to the master station,
all of the rotations represented by J1, J2 and J3 (see FIG. 2A)
have associated therewith, not only encoders but also individual
motors. At the hand assembly previously described, there are only
encoders. However, the block diagram system of FIGS. 20 and 21
illustrates a combination with motor and encoder. If a motor is not
used at a master station, then only the encoder signal is coupled
to the system.
[0289] FIGS. 20 and 21 illustrate a multi-axis, high performance
motor control system which may support anywhere from 8 to 64 axes,
simultaneously, using either eight-bit parallel or pulse width
modulated (PWM) signals. The motors themselves may be direct
current, direct current brushless or stepper motors with a
programmable digital filter/commutater. Each motor accommodates a
standard incremental optical encoder.
[0290] The block diagram of FIG. 20 represents the basic components
of the system. This includes a host computer 700, connected by a
digital bus 702 to an interface board 704. The interface board 704
may be a conventional interface board for coupling signals between
the digital bus and the eight individual module boards 706. The set
of module boards is referred to as the motor control sub unit.
Communication cables 708 intercouple the interface board 704 to
eight separate module boards 706. The host computer 700 may be an
Intel microprocessor based personal computer (PC) at a control
station preferably running a Windows NT program communicating with
the interface board 704 by way of a high-speed PCI bus 702 (5.0 KHz
for eight channels to 700 Hz for 64 channels).
[0291] FIG. 21 shows one of the module boards 706. Each board 706
includes four motion control circuits 710. Each of the blocks 710
may be a Hewlett-Packard motion control integrated circuit. For
example, each of these may be an IC identified as HCTL1100. Also
depicted in FIG. 21 is a power amplifier sub unit 712. The power
amplifier sub unit is based on National Semiconductor's H-bridge
power amplifier integrated circuits for providing PWM motor command
signals. The power amplifier 712 associated with each of the blocks
710 couples to a motor X. Associated with motor X is encoder Y.
Also note the connection back from each encoder to the block 710.
In FIG. 21, although the connections are not specifically set
forth, it is understood that signals intercouple between the block
710 and the interface board 704, as well as via bus 702 to the host
computer 700.
[0292] The motor control system may be implemented for example, in
two ways. In a first method the user utilizes the motor control
subunit 706 to effect four control modes: positional control,
proportional velocity control, trapezoidal profile control and
integral velocity control. Using any one of these modes means
specifying desired positions or velocities for each motor, and the
necessary control actions are computed by the motion control IC 710
of the motor control subunit, thereby greatly reducing the
complexity of the control system software. However, in the case
where none of the on-board control modes are appropriate for the
application, the user may choose a second method in which a servo
motor control software is implemented at the PC control station.
Appropriate voltage signal outputs for each motor are computed by
the PC control station and sent to the motor control/power
amplifier unit (706, 712). Although the computation load is mostly
placed on the control station's CPU in this case, there are
available high performance computers and high speed PCI buses for
data transfer which can accommodate this load.
[0293] D. Master--Slave Positioning and Orientation (FIGS.
22-28)
[0294] FIG. 22 provides an overview of control algorithm for the
present embodiment. Its primary function is to move the instrument
tool 18 in such a way that the motions of the instrument tool are
precisely mapped to that of the surgeon interface device 3 in three
dimensional space, thereby creating the feel of the tool being an
extension of the surgeon's own hands. The control algorithm assumes
that both the surgeon's input interface as well as the instrument
system always start at predefined positions and orientations, and
once the system is started, it repeats a series of steps at every
sampling period. The predefined positions and orientations, relate
to the initial positioning of the master and slave stations.
[0295] First, the joint sensors (box 435), which are optical
encoders in the present embodiment, of the surgeon's interface
system are read, and via forward kinematics (box 410) analysis, the
current position (see line 429) and orientation (see line 427) of
the input interface handle are determined. The translational motion
of the surgeon's hand motion is scaled (box 425), whereas the
orientation is not scaled, resulting in a desired position (see
line 432) and orientation (see line 434) for the instrument tool.
The results are then inputted into the inverse kinematics
algorithms (box 415) for the instrument tool, and finally the
necessary joint angles and insertion length of the instrument
system are determined. The motor command positions are sent to the
instrument motor controller (box 420) for commending the
corresponding motors to positions such that the desired joint
angles and insertion length are achieved.
[0296] With further reference to FIG. 22, it is noted that there is
also provided an initial start position for the input device,
indicated at box 440. The output of box 440 couples to a summation
device 430. The output of device 430 couples to scale box 425. The
initial handle (or hand assembly) position as indicated previously
is established by first positioning of the handle at the master
station so as to establish an initial master station handle
orientation in three dimensional space. This is compared to the
current handle position at device 430. This is then scaled by box
425 to provide the desired tool position on line 432 to the
instrument inverse kinematics box 415.
[0297] The following is an analysis of the kinematic computations
for both box 410 and box 415 in FIG. 22.
[0298] Kinematic Computations
[0299] The present embodiment provides a surgeon with the feel of
an instrument as being an extension of his own hand. The position
and orientation of the instrument tool is mapped to that of the
surgeon input interface device, and this mapping process is
referred to as kinematic computations. The kinematic calculations
can be divided into two sub-processes: forward kinematic
computation of the surgeon user interface device, and inverse
kinematic computation of the instrument tool.
[0300] Forward Kinematic Computation
[0301] Based on the information provided by the joint angle
sensors, which are optical encoders of the surgeon interface
system, the forward kinematic computation determines the position
and orientation of the handle in three dimensional space.
[0302] 1. Position
[0303] The position of the surgeon's wrist in three dimensional
space is determined by simple geometric calculations. Referring to
FIG. 23, the x, y, z directional positions of the wrist with
respect to the reference coordinate are
X.sub.p=(L.sub.3 sin .theta..sub.3+L.sub.2 cos .theta..sub.2a) cos
.theta..sub.bp-L.sub.2
Y.sub.p=-(L.sub.3 cos .theta..sub.3+L.sub.2 sin
.theta..sub.2a)-L.sub.3
Z.sub.p=(L.sub.3 sin .theta..sub.3+L.sub.2 cos .theta..sub.2a) sin
.theta..sub.bp
[0304] where X.sub.p, Y.sub.p, Z.sub.p are wrist positions in the
x, y, z directions, respectively.
[0305] These equations for X.sub.p, Y.sub.p, and Z.sub.p represent
respective magnitudes as measured from the initial reference
coordination location, which is the location in FIG. 23 when
.theta..sub.3 and .theta..sub.2a are both zero degrees. This
corresponds to the position wherein arm L2 is at right angles to
arm L3, i.e., arm L2 is essentially horizontal and arm L3 is
essentially vertical. That location is identified in FIG. 23 as
coordinate location P' where X.sub.p=Y.sub.p=Z.sub.p=0. Deviations
from this reference are calculated to determine the current
position P.
[0306] The reference coordinates for both the master and the slave
are established with respect to a base location for each. In FIG.
23 it is location BM that corresponds structurally to the axis 60A
in FIG. 2A. In FIG. 25 it is the location BS that corresponds
structurally to the axis 225A in FIG. 2B. Because both the master
and slave structures have predefined configurations when they are
initialized, the locations of the master wrist 60A and the slave
pivot 225A are known by the known dimensions of the respective
structures. The predefined configuration of the master in the
illustrated embodiment, per FIG. 23, relates to known lengths of
arms L2 and L3, corresponding to arm 91 or arm 92, and arm 96
respectively. The predefined configuration of the slave is
similarly defined, per FIG. 25, by dimensions of arms L.sub.s and
L.sub.b and by initializing the slave unit with the guide tube 17
flat in one plane (dimension Y=O) and the arm L.sub.s in line with
the Z axis.
[0307] 2. Orientation
[0308] The orientation of the surgeon interface handle in three
dimensional space is determined by a series of coordinate
transformations for each joint angle. As shown in FIG. 24, the
coordinate frame at the wrist joint is rotated with respect to the
reference coordinate frame by joint movements .theta..sub.bp,
.theta..sub.2, .theta..sub.3 and .theta..sub.ax. Specifically, the
wrist joint coordinate frame is rotated (-.theta..sub.bp) about the
y axis, (-.theta..sub.2a) about the z axis and .theta..sub.ax about
the x axis where .theta..sub.2a is .theta..sub.2-.theta..sub.3. The
resulting transformation matrix R.sub.wh for the wrist joint
coordinate frame with respect to the reference coordinate is then 1
R w h = [ R w h11 R w h12 R w h13 R w h21 R w h22 R w h23 R w h31 R
w h32 R w h33 ]
[0309] where R.sub.wh11=cos .theta..sub.bp1 cos .theta..sub.2a
R.sub.wh12=cos .theta..sub.bp1 sin .theta..sub.2a cos
.theta..sub.ax-sin .theta..sub.bp1 sin .theta..sub.ax
R.sub.wh13=-cos .theta..sub.bp1 sin .theta..sub.2a sin
.theta..sub.ax-sin .theta..sub.bp1 cos .theta..sub.ax
R.sub.wh21=-sin .theta..sub.2a
R.sub.wh22=cos .theta..sub.2a cos .theta..sub.ax
R.sub.wh23=-cos .theta..sub.2a sin .theta..sub.ax
R.sub.wh31=sin .theta..sub.bp1 cos .theta..sub.2a
R.sub.wh32=sin .theta..sub.bp1 sin .theta..sub.2a cos
.theta..sub.ax+cos .theta..sub.bp1 sin .theta..sub.ax
R.sub.wh33=-sin .theta..sub.bp1 sin .theta..sub.2a sin
.theta..sub.ax+cos .theta..sub.bp1 cos .theta..sub.ax
[0310] Similarly, the handle coordinate frame rotates joint angles
.PHI.and (-.theta..sub.h) about the z and y axes with respect to
the wrist coordinate frame. The transformation matrix R.sub.hwh for
handle coordinate frame with respect to the wrist coordinate is
then 2 R h w h = [ R h w h11 R h w h12 R h w h13 R h w h21 R h w
h22 R h w h23 R h w h31 R h w h32 R h w h33 ]
[0311] where
R.sub.hwh11cos .PHI. cos .theta..sub.h
R.sub.hwh12=-sin .PHI.
R.sub.hwh13=-cos .PHI. sin .theta..sub.h
R.sub.hwh21=sin .PHI. cos .theta..sub.h
R.sub.hwh22=cos .PHI.
R.sub.hwh23=-sin .PHI. sin .theta..sub.h
R.sub.hwh31=sin .theta..sub.h
R.sub.hwh32=0
R.sub.hwh33=cos .theta..sub.h
[0312] Therefore, the transformation matrix R.sub.h for handle
coordinate frame with respect to the reference coordinate is
R.sub.h=R.sub.whR.sub.hwh
[0313] Inverse Kinematic Computation
[0314] Once the position and orientation of the surgeon interface
handle are computed, the instrument tool is to be moved in such a
way that the position of the tool's wrist joint in three
dimensional space X.sub.w, Y.sub.w, Z.sub.w with respect to the
insertion point are proportional to the interface handle's
positions by a scaling factor .alpha.
(X.sub.w-X.sub.w.sub..sub.--.sub.ref)=.alpha.X.sub.p
(Y.sub.w-Y.sub.w.sub..sub.--.sub.ref)=.alpha.Y.sub.p
(Z.sub.w-Z.sub.w.sub..sub.--.sub.ref)=.alpha.Z.sub.p
[0315] where X.sub.w.sub..sub.--.sub.ref,
Y.sub.w.sub..sub.--.sub.ref, Z.sub.w.sub..sub.--.sub.ref are the
initial reference positions of the wrist joint. The orientations
could be scaled as well, but in the current embodiment, are kept
identical to that of the interface handle.
[0316] When
X.sub.w.sub..sub.--.sub.ref,=Y.sub.w.sub..sub.--.sub.ref,
=Z.sub.w.sub..sub.--.sub.ref=0 the foregoing equations simplify
to:
X.sub.w=.alpha.X.sub.p
Y.sub.w=.alpha.Y.sub.p
Z.sub.w=.alpha.Z.sub.p
[0317] where (X.sub.w, Y.sub.w, Z.sub.w,), (X.sub.p, Y.sub.p,
X.sub.p,) and .alpha. are the desired absolute position of the
instrument, current position of the interface handle and scaling
factor, respectively.
[0318] 1. Position
[0319] The next task is to determine the joint angles .omega.,
.PSI. and the insertion length L.sub.s of the instrument, as shown
in FIG. 25, necessary to achieve the desired positions of the
tool's wrist joint. Given Y.sub.w, the angle .omega. is 3 = arcsin
( Y w L b s ) = sin - 1 ( Y w / L b s )
[0320] or,
[0321] where L.sub.bs=L.sub.b sin .theta..sub.b.
[0322] Referring to FIG. 26, the sine rule is used to determine the
insertion length L.sub.s of the instrument. Given the desired
position of the tool's wrist joint, the distance from the insertion
point to the wrist joint, L.sub.ws is simply
L.sub.w={square root}{square root over
(X.sub.w.sup.2+Y.sub.w.sup.2+Z.sub.- w.sup.2)}
[0323] Then by the sine rule, the angle .theta..sub.a is 4 a =
arcsin ( L b L w sin b ) , and L s = L w ( sin c sin b ) where c =
b - a
[0324] Having determined .omega. and L.sub.s, the last joint angle
.PSI. can be found from the projection of the instrument on the x-z
plane as shown in FIG. 27.
.PSI.=.theta..sub.L'.sub..sub.w-.theta..sub..DELTA.
[0325] where 5 = arccos ( L s + L b cos b L w ' ) , L w ' = arcsin
( X w 0 L w ' ) ,
L.sub.w.sup.r={square root}{square root over
(X.sub.w.sup.2+Z.sub.w.sup.2)- }
[0326] and X.sub.wo is the x-axis wrist position in reference
coordinate frame.
[0327] 2. Orientation
[0328] The last step in kinematic computation for controlling the
instrument is determining the appropriate joint angles of the tool
such that its orientation is identical to that of the surgeon's
interface handle. In other words, the transformation matrix of the
tool must be identical to the transformation matrix of the
interface handle, R.sub.h.
[0329] The orientation of the tool is determined by pitch
(.theta..sub.f), yaw (.theta..sub.wf) and roll (.theta..sub.af)
joint angles as well as the joint angles .omega. and .PSI., as
shown in FIG. 28. First, the starting coordinate is rotated
(.theta..sub.b-.pi./2) about the y-axis to be aligned with the
reference coordinate, represented by the transformation matrix
R.sub.o 6 R o = [ sin b 0 ( - cos b ) 0 1 0 cos b 0 sin b ]
[0330] The wrist joint coordinate is then rotated about the
reference coordinate by angles (-.PSI.) about the y-axis and
.omega. about the z-axis, resulting in the transformation matrix
R.sub.w'f, 7 R w ' f = [ cos cos ( - cos sin ) ( - sin ) sin cos 0
sin cos ( - sin sin ) cos ]
[0331] followed by rotation of (.pi./2-.theta..sub.b) about the
y-axis, represented by R.sub.wfw'f. 8 R w f w ' f = [ sin b 0 cos b
0 1 0 - cos b 0 sin b ]
[0332] which is equal to R.sub.o.sup.T.
[0333] Finally, the tool rolls (-.theta..sub.af) about the x-axis,
yaws .theta..sub.wf about the z-axis and pitches (-.theta..sub.f)
about the y-axis with respect to the wrist coordinate, are
calculated resulting in transformation matrix R.sub.fwf 9 R f w f =
[ R f w f11 R f w f12 R f w f13 R f w f21 R f w f22 R f w f23 R f w
f31 R f w f32 R f w f33 ]
[0334] where
R.sub.fwf11=cos .theta..sub.wf cos .theta..sub.f
R.sub.fwf12=-sin .theta..sub.wf
R.sub.fwf13=-cos .theta..sub.wf sin .theta..sub.f
R.sub.fwf21=cos .theta..sub.af sin .theta..sub.wf cos
.theta..sub.f+sin .theta..sub.af sin .theta..sub.f
R.sub.fwf22=cos .theta..sub.af cos .theta..sub.wf
R.sub.fwf23=-cos .theta..sub.af sin .theta..sub.wf sin
.theta..sub.f+sin .theta..sub.af cos .theta..sub.f
R.sub.fwf31=-sin .theta..sub.af sin .theta..sub.wf cos
.theta..sub.f+cos .theta..sub.f sin .theta..sub.f
R.sub.fwf32=-sin .theta..sub.af cos .theta..sub.wf
R.sub.fwf33=sin .theta..sub.af sin .theta..sub.wf sin
.theta..sub.f+cos .theta..sub.af cos .theta..sub.f
[0335] Therefore the transformation matrix of the tool R.sub.f with
respect to the original coordinate is
R.sub.f=R.sub.oR.sub.wf'R.sub.o.sup.TR.sub.fwf.
[0336] Since R.sub.f is identical to R.sub.h of the interface
handle, R.sub.fwf can be defined by
R.sub.fwf=R.sub.oR.sub.wf'.sup.TR.sub.o.sup.TR.sub.h=R.sub.c
[0337] 10 R f w f = R o R w f T R o T R h = R c = [ R c11 R c12 R
c13 R c21 R c22 R c23 R c31 R c32 R c33 ]
[0338] where the matrix R.sub.c can be fully computed with known
values. Using the computed values of R.sub.c and comparing to the
elements of R.sub.fwf, we can finally determine the necessary joint
angles of the tool. 11 w f = arcsin ( - R c12 ) , f = arccos ( R
c11 cos w f ) = arcsin ( - R c13 cos w f ) w f = arccos ( R c22 cos
w f ) = arcsin ( - R c32 cos w f )
[0339] The actuators, which are motors in the current embodiment,
are then instructed to move to positions such that the determined
joint angles and insertion length are achieved.
[0340] Now reference is made to the following algorithm that is
used in association with the system of the present invention. First
are presented certain definitions.
[0341] Variable Definitions: (RH--Right Hand, LH--Left Hand)
[0342] s_Ls_RH Linear slider joint for RH slave
[0343] s_Xi_RH Lateral motion joint for RH slave (big disk in front
of slider)
[0344] s_Omega_RH Up/down motion joint for RH slave (rotates curved
tube)
[0345] s_Ax1_RH Axial rotation joint for RH slave (rotates
instrument insert along its axis)
[0346] s_f1_RH Finger 1 for RH slave
[0347] s_f2_RH Finger 2 for RH slave
[0348] s_wrist_RH Wrist joint for RH slave
[0349] m_base_RH Base rotation joint for RH master
[0350] m_shoulder_RH Shoulder joint for RH master
[0351] m_elbow_RH Elbow joint for RH master
[0352] m_Ax1_RH Axial rotation joint for RH master
[0353] m_f1_RH Finger 1 for RH master
[0354] m_f2_RH Finger 2 for RH master
[0355] m_wrist_RH Wrist joint for RH master
[0356] GRadian[i] Motor axle angle for joint no. i with i being one
of above joints
[0357] Des_Rad[i] Desired motor axle angle for joint no. i
[0358] Des_Vel[i] Desired motor axle angular velocity for joint no.
i
[0359] Mout_[i] Motor command output for joint no. i
[0360] Thetabp1_m_RH Angle of base rotation joint for RH master
[0361] Theta2_m_RH Angle of elbow joint for RH master
[0362] Theta3_m_RH Angle of shoulder joint for RH master
[0363] Xw_m_RH Position of RH master handle in X-axis
[0364] Yw_m_RH Position of RH master handle in Y-axis
[0365] Zw_m_RH Position of RH master handle in Z-axis
[0366] Xwref_m_RH Reference position of RH master handle in
X-axis
[0367] Ywref_m_RH Reference position of RH master handle in
Y-axis
[0368] Zwref_m_RH Reference position of RH master handle in
Z-axis
[0369] Phi_f_m_RH Angle of wrist joint for RH master
[0370] Theta_f1_m_RH Angle of finger 1 for RH master
[0371] Theta_f2_m_RH Angle of finger 2 for RH master
[0372] ThetaAx1_m_RH Angle of axial rotation joint for RH
master
[0373] Theta_h_m_RH Angle of mid line of fingers for RH master
[0374] Theta_f_m_RH Angle of fingers from the mid line for RH
master
[0375] Xw_s_RH Position of RH slave in X-axis
[0376] Yw_s_RH Position of RH slave in Y-axis
[0377] Zw_s_RH Position of RH slave in Z-axis
[0378] Xwref_s_RH Reference position of RH slave in X-axis
[0379] Ywref_s_RH Reference position of RH slave in Y-axis
[0380] Zwref_s_RH Reference position of RH slave in Z-axis
[0381] alpha Master-to-slave motion scaling factor
[0382] Xw_s_b1_RH Motion boundary 1 of RH slave in X-axis
[0383] Xw_s_b2_RH Motion boundary 2 of RH slave in X-axis
[0384] Yw_s_b1_RH Motion boundary 1 of RH slave in Y-axis
[0385] Yw_s_b2_RH Motion boundary 2 of RH slave in Y-axis
[0386] Note the motion boundaries of the slave are used to define
the virtual boundaries for the master system, and do not directly
impose boundaries on the slave system.
[0387] The following represents the steps through which the
algorithm proceeds.
[0388] 1. The system is started, and the position encoders are
initialized to zero. This ASSUMES that the system started in
predefined configuration.
1 /* Preset Encoder Position for all axis */ for(i=0; i<32; ++i)
{ SetEncoder[i]=0; } /* Convert encoder count to radian */
for(i=0;i<32;i++) { Radian[i] = Enc_to_Rad(Encoder[i]); }
[0389] 2. Bring the system to operating positions, Des_Rad[i], and
hold the positions until the operator hits the keyboard, in which
case the program proceeds to next step.
2 While(!kbhit()) { for(i=0; i<14; i++) /* compute motorout for
slave robots*/ { Des_Vel[i] = 0.0; Err_Rad[i] = Des_Rad[i] -
Radian[i]; Err_Vel[i] = Des_Vel[i] - Velocity[i]; kpcmd =
Kp[i]*Err_Rad[i]; kdcmd = (Kp[i]*Td[i])*Err_Vel[i]; Mout_f[i] =
kpcmd + kdcmd;/* Command output to motor */ } for(i=14;i<28;i++)
/* compute motorout for master robot */ { Des_Vel[i] = 0.0;
Err_Rad[i] = Des_Rad[i] - Radian[i]; Err_Vel[i] = Des_Vel[i] -
Velocity[i]; kpcmd = Kp[i]*Err_Rad[i]; kdcmd =
(Kp[i]*Td[i])*Err_Vel[i]; Mout_f[i] = kpcmd + kdcmd;/* Command
output to motor */ } }
[0390] 3. Based on the assumption that the system started at the
predefined configuration, the forward kinematic computations are
performed respectively for the master and the slave systems to find
the initial positions/orientations of handles/tools.
[0391] /* Compute Initial Positions of Wist for Right Hand Master
*/
[0392] Thetabp1o_m_RH=-Radian[m_base_RH]/PR_bp1;
[0393] Theta3o_m_RH=-Radian[m_shoulder_RH]/PR.sub.--3;
[0394] Thetabp1_m_RH=Thetabp1o_m_RH;
[0395] Theta3_m_RH=Theta3o_m_RH;
[0396] Theta2o_m_RH=Theta3o_m_RH-Radian[m_elbow_RH]/PR.sub.--2;
[0397] Theta2_m_RH=Theta2o_m_RH;
[0398] Theta2A_m_RH=(Theta2_m_RH-Theta3_m_RH);
[0399] Theta2A_eff_m_RH=Theta2A_m_RH+Theta_OS_m;
[0400] L_m_RH=(L3_m*sin (Theta3o_m_RH)+L2_eff_m*cos
(Theta2A_eff_m_RH));
[0401] Xwo_m_RH=L_m_RH*cos (Thetabp1o_m_RH);
[0402] Ywo_m_RH=-(L3_m+L2_eff_m*sin (Theta2A_eff_m_RH));
[0403] Zwo_m_RH=L_m_RH*sin (Thetabp1o_m_RH);
[0404] /* Set these initial positions as the reference positions.
*/
[0405] Xwre_m_RH=Xwo_m_RH=L2 (FIG. 23)
[0406] Ywref_m_RH=Ywo_m_RH=L3
[0407] Zwref_m_RH=Zwo_m_RH=0
[0408] /* Initial Position of the Wrist for Right Hand Slave based
on predefined configurations */
[0409] Ls_RH=Ls;
[0410] Xwo_s_RH=Lbs=Xref_s_RH
[0411] Ywo_s_RH=0.0=Yref_s_RH
[0412] Zwo_s_RH=-(Ls_RH+Lbc)=Zref_s_RH
[0413] /* Compute Initial Orientations for Right Hand Handle */
[0414] Phi_f_m_RH=Radian[m_wrist_RH];
[0415] Theta_f1_m_RH=Radian[m_f1_RH];
[0416] Theta_f2_m_RH=-Radian[m_f2_RH]-Theta_f1_m_RH;
[0417] ThetaAx1_m_RH=Radian[m_Ax1_RH];
[0418] Theta_h_m_RH=(Theta_f1_m_RH-Theta_f2_m_RH)/2.0; /* angle of
midline
[0419] Theta_f_m_RH=(Theta_f1_m_RH+Theta_f_m_RH)/2.0; /* angle of
fingers from mid line */
[0420] /* Repeat for Left Hand Handle and Slave Instrument */
[0421] 4. Repeat the procedure of computing initial
positions/orientations of handle and tool of left hand based on
predefined configurations.
[0422] 5. Read starting time
[0423] /* Read starting time: init_time */
[0424] QueryPerformanceCounter(&hirescount);
[0425]
dCounter=(double)hirescount.LowPart+(double)hirescount.HighPart *
(double)(4294967296);
[0426] QueryPerformanceFrequency(&freq);
[0427] init_time=(double)(dCounter/freq.LowPart);
[0428] prev_time=0.0;
[0429] 6. Read encoder values of master/slave system, and current
time
3 /* Read encoder counters */ for(i=1; i<9; ++i) {
Read_Encoder(i); } /* Convert encoder counts to radian */
for(i=0;i<32;i++) { Radian[i] = Enc_to_Rad(Encoder[i]); } /* Get
current time */ QueryPerformanceCounter(&hirescount); dCounter
= (double)hirescount.LowPart+(double)hirescount.HighPart *
(double)(4294967296); time_now = (double)(dCounter/freq.LowPart) -
init_time; delta_time3 = delta_time2; delta_time2 = delta_time1;
delta_time1 = time_now - prev_time; prev_time = time_now;
[0430] 7. Compute current positions/orientations of master handle
for Right Hand /* Compute master handle's position for right hand
*/
[0431] Thetabp1_m_RH=-Radian[m_base_RH]/PR_bp1;
[0432] Theta3_m_RH=-Radian[m_shoulder_RH]/PR.sub.--3;
[0433] Theta2_m_RH=Theta3_m_RH-Radian[m_elbow_RH]/PR.sub.--2;
[0434] Theta2A_m_RH=(Theta2_m_RH-Theta3_m_RH);
[0435] Theta2A_eff_m_RH=Theta2A_m_RH+Theta_OS_m;
[0436] L_m_RH=(L3_m*sin_Theta3_m+L2_eff_m*cos_Theta2A_eff_m);
[0437] Xw_m_RH=L_m_RH*cos_Thetabp1_m;
[0438] Yw_m_RH=-(L3_m*cos_Theta3_m+L2_eff_m*sin_Theta2A_eff_m);
[0439] Zw_m_RH=L_m_RH*sin_Thetabp1_m;
[0440] /* Compute master handle's orientation for right hand */
[0441] Phi_f_m_RH=Radian[m_wrist_RH];
[0442] Theta_f1_m_RH=Radian[m_f1_RH];
[0443] Theta_f2_m_RH=-Radian[m_f2_RH]-Theta_f1_m_RH;
[0444] ThetaAx1_m_RH=Radian[m_Ax1_RH];
[0445] Theta_h_m_RH=(Theta_f1_m_RH-Theta_f2_m_RH)/2.0; /* angle of
midline
[0446] Theta_f_m_RH=(Theta_f1_m_RH+Theta_f2_m_RH)/2.0; /* angle of
fingers from mid line */
[0447] /* Perform coordinate transformation to handle's coordinate
*/
[0448] Rwh11=cos_Thetabp1_m*cos_Theta2A_m;
[0449]
Rwh12=-sin_Thetabp1_m*sin_ThetaAx1_m+cos_Thetabp1_m*sin_Theta2A_m*c-
os_ThetaAx1_m;
[0450]
Rwh13=-sin_Thetabp1m*cos_ThetaAx1_m-cos_Thetabp1_m*sin_Theta2A_m*si-
n_ThetaAx1_m;
[0451] Rwh21=-sin_Theta2A_m;
[0452] Rwh22=cos_Theta2A_m*cos_ThetaAx1_m;
[0453] Rwh23=-cos_Theta2A_m*sin_ThetaAx1_m;
[0454] Rwh31=sin_Thetabp1_m*cos_Theta2A_m;
[0455]
Rwh32=cos_Thetabp1_m*sin_ThetaAx1_m+sin_Thetabp1_m*sin_Theta2A_m*co-
s_ThetaAx1_m;
[0456]
Rwh33=cos_Thetabp1_m*cos_ThetaAx1_m-sin_Thetabp1_m*sin_Theta2A_m*si-
n_ThetaAx1_m;
[0457] Rhr11=cos_Phi_f_m*cos_Theta_h_m;
[0458] Rhr12=-sin_Phi_f_m;
[0459] Rhr13=-cos_Phi_f_m*sin_Theta_h_m;
[0460] Rhr21 =sin_Phi_f_m*cos_Theta_h_m;
[0461] Rhr22=cos_Phi_f_m;
[0462] Rhr23=-sin_Phi_f_m*sin_Theta_h_m;
[0463] Rhr31=sin_Theta_h_m;
[0464] Rhr=0.0;
[0465] Rhr33=cos_Theta_h_m;
[0466] Rh11=Rwh11*Rhr11+Rwh12*Rhr21+Rwh13*Rhr31;
[0467] Rh12=Rwh11*Rhr12+Rwh12*Rhr22+Rwh13*Rhr32;
[0468] Rh13=Rwh11*Rhr13+Rwh12*Rhr23+Rwh13*Rhr33;
[0469] Rh21=Rwh21*Rhr11+Rwh22*Rhr21+Rwh23*Rhr31;
[0470] Rh22=Rwh21*Rhr12+Rwh22*Rwhr22+Rwh23*Rhr32;
[0471] Rh23=Rwh21*Rhr13+Rwh22*Rhr23+Rwh23*Rhr33;
[0472] Rh31=Rwh31*Rhr11+Rwh32*Rthr21+Rwh33*Rhr31;
[0473] Rh32=Rwh31*Rhr12+Rwh32*Rhr22+Rwh33*Rhr32;
[0474] Rh33=Rwh31*Rhr13+Rwh32*Rhr23+Rwh33*Rhr33;
[0475] 8. Desired tool position is computed for right hand
[0476] /* Movement of master handle is scaled by alpha for tool
position */
[0477] Xw_s_RH=alpha*(Xw_m_RH-Xwref_m_RH)+Xwref_s_RH;
[0478] Yw_s_RH=alpha*(Yw_m_RH-Ywref_m_RH)+Ywref_s_RH;
[0479] Zw_s_RH=alpha*(Zw_m_RH-Zwref_m_RH)+Zwref_s_RH;
[0480] /* The next step is to perform a coordinate transformation
from the wrist coordinate (refer to FIG. 25 and coordinate Xwf, Ywf
and Zwf) to a coordinate aligned with the tube arm Ls. This is
basically a fixed 45.degree. transformation (refer in FIG. 25 to
.theta..sub.b) involving the sin and cos of .theta..sub.b as
expressed below. */
[0481] Xwo_s_RH=Xw_s_RH*sin_Theta_b+Zw_s_RH*cos_Theta_b;
[0482] Ywo_s_RH=Yw_s_RH;
[0483] Zwo_s_RH=-Xw_s_RH*cos_Theta_b+Zw_s_RH*sin_Theta_b;
[0484] 9. Perform inverse kinematic computation for the right hand
to obtain necessary joint angles of the slave system such that tool
position/orientation matches that of master handle.
[0485] Omega_RH=a sin (Ywo_s_RH/Lbs);
[0486]
Lw=sqrt(pow(Xwo_s_RH,2)+pow(Ywo_s_RH,2)+pow(Zwo_s_RH,2));
[0487] Theta_a=a sin (Lb/Lw*sin_Theta_b);
[0488] Theta_c=Theta_b-Theta_a;
[0489] Ls_RH=Lw*(sin(Theta_c)/sin_Theta_b);
[0490] Lwp=sqrt(pow(Lw,2)-pow(Ywo_s_RH,2));
[0491] Theta_Lwp=a sin (Xwo_s_RH/Lwp);
[0492] Xi_RH=Theta_Lwp-Theta_delta;
[0493] sin_Omega=sin(Omega_RH);
[0494] cos_Omega=cos(Omega_RH);
[0495] sin_Xi=sin(Xi_RH);
[0496] cos_Xi=cos(Xi_RH);
[0497] Ra11=cos_Xi*cos_Omega*sin_Theta_b+sin_Xi*cos_Theta_b;
[0498] Ra12=sin_Omega*sin_Theta_b;
[0499] Ra13=sin_Xi*cos_Omega*sin Theta_b-cos_Xi*cos_Theta_b;
[0500] Ra21=-cos_Xi*sin_Omega;
[0501] Ra22=cos_Omega;
[0502] Ra23=-sin_Xi*sin_Omega;
[0503] Ra31=cos_Xi*cos_Omega*cos_Theta_b-sin_Xi*sin_Theta_b;
[0504] Ra32=sin_Omega*cos_Theta_b;
[0505] Ra33=sin_Xi*cos_Omega*cos_Theta_b+cos_Xi*sin_Theta_b;
[0506] Rb11=Ra11*sin_Theta_b_Ra13*cos_Theta_b;
[0507] Rb12=Ra12;
[0508] Rb13=Ra11*cos_Theta_b+Ra13*sin_Theta_b;
[0509] Rb21=Ra21*sin_Theta_b-Ra2.3*cos_Theta_b;
[0510] Rb22=Ra22;
[0511] Rb23=Ra21*cos_Theta_b+Ra23*sin_Theta_b;
[0512] Rb31=Ra31*sin_Theta_b-Ra33*cos_Theta_b;
[0513] Rb32=Ra32;
[0514] Rb33=Ra31*cos_Theta_b+Ra33*sin_Theta_b;
[0515] Rc11=Rb11*Rh11+Rb12*Rh21+Rb13*Rh31;
[0516] Rc12=Rb11*Rh12+Rb12*Rh22+Rb13*Rh32;
[0517] Rc13=Rb11*Rh13+Rb12*Rb23+Rb13*Rh33;
[0518] Rc2=Rb21*Rh1+Rb22*Rh21+Rb23*Rh31;
[0519] Rc22=Rb21*Rh12+Rb22*Rh22+Rb23*Rh32;
[0520] Rc23=Rb21*Rh13+Rb22*Rh23+Rb23*Rh33;
[0521] Rc31=Rb31*Rh11+Rb32*Rh21+Rb33*Rh31;
[0522] Rc32=Rb31*Rh12+Rb32*Rh22+Rb33*Rb32;
[0523] Rc33=Rb31*Rh13+Rb32*Rh23+Rb33*Rh33;
[0524] sin_Theta_wf_s=-Rc12;
[0525] Theta_wf_s_RH=asin(sin_Theta_wf_s);
[0526] cos_Theta_wf_s=cos(Theta_wf_s_RH);
[0527] /* Compute Theta_f_s_RH */
[0528] var1=Rc11/cos_Theta_wf_s;
[0529] var2=-Rc13/cos_Theta_wf_s;
[0530] Theta_f_s_RH=asin(var2) or acos (var1) depending or
region;
[0531] /* Compute ThetaAx1_s_RH */
[0532] var1=Rc22/cos_Theta_wf_s;
[0533] var2=-Re32/cos_Theta_wf_s;
[0534] ThetaAx1_s_RH=asin(var2) or acos(var1) depending or
region;
[0535] 10. Repeat steps 7-9 for left hand system
[0536] 11. Determine motor axle angles necessary to achieve desired
positions/orientations of the slave systems, and command the motors
to the determined positions.
4 Des_Rad[s_Ls_RH] = 63.04*(Ls_RH-Ls_init_RH -
0.75*(Xi_RH-Xi_init_RH)); Des_Rad[s_Xi_RH] =
-126.08*(Xi_RH-Xi_init_RH); Des_Rad[s_Omega_RH] =
-23.64*(Omega_RH-Omega_init_RH); Des_Rad[s_Axl_RH] =
-23.64*1.3333*(ThetaAxl_s_RH + Omega_RH- Omega_init_RH);
Des_Rad[s_wrist_RH] = 18.9*Theta_wf_s_RH; Des_Rad[s_f1_RH] =
18.9*(Theta_f_s_RH + Theta_f_m_RH); Des_Rad[s_f2_RH] =
18.9*(-Theta_f_s_RH + Theta_f_m_RH); Des_Rad[s_Ls_LH] =
-63.04*(Ls_LH-Ls_init_LH - 0.75*(Xi_LH-Xi_init_LH));
Des_Rad[s_Xi_LH] = 126.08*(Xi_LH-Xi_init_LH); Des_Rad[s_Omega_LH] =
-23.64*(Omega_LH-Omega_init_LH); Des_Rad[s_Axl_LH] =
-23.64*1.3333*(ThetaAxl_s_LH + Omega_LH- Omega_init_LH);
Des_Rad[s_wrist_LH] = 18.9*Theta_wf_s_LH; Des_Rad[s_f1_LH] =
-18.9*(-Theta_f_s_LH - Theta_f_m_LH); Des_Rad[s_f2_LH] =
-18.9*(Theta_f_s_LH - Theta_f_m_LH); /* Compute motor output for
slave systems */ for(i=0;i<14;i++) { Des_Vel[i] = 0.0;
Err_Rad[i] = Des_Rad[i] - Radian[i]; Err_Vel[i] = Des_Vel[i] -
Velocity[i]; kpcmd = Kp[i]*Err_Rad[i]; kdcmd =
(Kp[i]*Td[i])*Err_Vel[i]; Mout_f[i] = kpcmd + kdcmd; } /* Virtual
boundaries for master handles */ if (Xwo_s_RH>=Xw_s_b1_RH) {
Fx_RH = 3.0*k_master*(Xwo_s_RH-Xw_s_b1_RH); Mout_f[m_base_RH] =
Fx_RH*cos(0.7854-(Radian[m_base_RH]/14.8)); Mout_f[m_shoulder_RH] =
Fx_RH*sin(0.7854- (Radian[m_base_RH]/14.8))-
1.0*Radian[m_shoulder_RH]; } else if(Xwo_s_RH<=Xw_s_b2- _RH) {
Fx_RH = k_master*(Xwo_s_RH-Xw_s_bw_RH); Mout_f[m_base_RH] =
Fx_RH*cos(0.7854-(Radian[m_base_RH]/14.8)); Mout_f[m_shoulder_RH] =
Fx_RH*sin(0.7854- (Radian[m_base_RH]/14.8)- )-
1.0*Radian[m_shoulder_RH]; } else { Mout_f[m_base_RH]=0.0;
Mout_f[m_shoulder_RH]=-1.0*Radian[m_should- er_RH]; } if
(Ywo_s_RH>=Yw_s_b2_RH) { Mout_f[m_elbow_RH] =
-k_master*(Ywo_s_RH-Yw_s_b2_RH); } else if
(Ywo_s_RH<=Yw_s_b1_RH) { Mont_f[m_elbow_RH] =
-k_master*(Ywo_s_RH-Yw_s_b1_RH); } else Mout_f[m_elbow_RH]=0.0; /*
Repeat for left master handle */
[0537] 12. Go back to step 6 and repeat.
[0538] Previously there has been described an algorithm for
providing controlled operation between the master and slave units.
The following description relates this operation to the system of
FIGS. 1-2.
[0539] The controller 9 receives input signals from the input
device 3 that represent the relative positions of the different
portions of the input device. These relative positions are then
used to drive the instrument 14 to a corresponding set of relative
positions. For example, the input device includes a base 50 (FIG.
2A) to which a first link 90 is rotatably connected. A second link
96 is rotatably connected to the first link at an elbow joint 94.
Connected to the second link 96 opposite the elbow joint 94 is a
wrist joint 98A and two fingers. A surgeon may attach a thumb and
forefinger to the two fingers and move the input device to drive
the instrument 14.
[0540] As the surgeon operates the input device, rotational
position of the base (Thetabp1_m_RH), the rotational position of
the first link relative to the base (Theta3_m_RH), the rotational
position of the second link relative to the first link
(Theta2_m_RH), the angle of the wrist joint relative to the second
link (PHI_f_m_RH, i.e., the angle the wrist joint is rotated about
an axis perpendicular to the length of the second link), the rotary
angle of the wrist joint relative to the second link
(ThetaAx1_m_RH, i.e., the angle the wrist joint is rotate about an
axis parallel to the length of the second link), and the angles of
the fingers (Theta_f1_m_RH and Theta_f2_m_RH) are provided to the
controller.
[0541] When the surgical instrument is first started, the
controller initializes all of the position encoders in the
instrument 14 and the input device 3, assuming that the system has
been started in a desired initial configuration. See Sections 1-3
of the algorithm. The initial position of the input device, e.g.,
Xwo_m_RH, Ywo_m_RH, and Zwo_m_RH, is then used to establish a
reference position for the input device, Xwref_in_RH, Ywref_m_RH,
and Zwref_m_RH. See Section 3 of the algorithm. Initial positions
are also established for the instrument 14 based on the dimensions
of the instrument 14. See Section 3 of the algorithm.
[0542] With reference to Section 3 of the algorithm, it is noted
that there is an assignment of the initial position of the wrist
for the slave, and that this is not a forward kinematics
calculation based upon joint angles, but rather is a number based
upon the predefined configuration of the slave unit. The coordinate
of the slave relates to fixed physical dimensions of the instrument
and instrument holder.
[0543] As the surgeon moves the input device 3, the encoder values
for the input device are read and used to compute the current
absolute position of the input device, i.e., Xw_m_RH Yw_m_RH, and
Zw_m_RH. See Sections 6 and 7 of the algorithm. The controller then
determines the desired position of the tool 18 (Xw_s_RH, Yw_s_RH,
and Zw_s_RH) based on the current position of the input device
(Xw_m_RH Yw_m_RH, and Zw_m_RH), the reference position for the
input device (Xwref_m_RH, Ywref_m_RH, and Zwref_m_RH) and the
reference position for the instrument 14 (Xwref_m_RH, Ywref_s_RH,
and Zwref_s_RH). See Section 8 of the algorithm. The desired
position of the tool 18 (Xw_s_RH, Yw_s_RH, and Zw_s_RH) is then
transformed by a 45.degree. coordinate transformation giving the
desired position (Xwo_s_RH, Ywo_S_RH, Zwo_s_RH) which is used to
determine joint angles and drive motor angles for the instrument 14
orientation to match that of the input device. See Sections 8-11 of
the algorithm. Thus, movement of the surgical instrument 14 is
determined based on the current absolute position of the input
device, as well as the initial positions of the input device and
the instrument at the time of system start-up.
[0544] E. Select Features of Described Embodiment
[0545] The control in accordance with the present embodiment, as
exemplified by the foregoing description and algorithm, provides an
improvement in structure and operation while operating in a
relatively simple manner. For example, the control employs a
technique whereby the absolute position of the surgeon input device
is translated into control signals to move the instrument to a
corresponding absolute position. This technique is possible at
least in part because of the particular construction of the
instrument and controllable instrument holder, which essentially
replace the cumbersome prior art multi-arm structures including one
or more passive joints. Here there is initialized an all active
joint construction, including primarily only a single instrument
holder having a well-defined configuration with respect to the
inserted instrument.
[0546] Some prior-art systems rely upon passive joints to initially
position the distal tip of the surgical instrument. Because the
positions of the passive joints are initially unknown, the position
of the distal tip of the surgical instrument with respect to the
robot (instrument holder) is also unknown. Therefore, these systems
require an initial calculation procedure. This involves the reading
of joint angles and the computation of the forward kinematics of
all elements constituting the slave. This step is necessary because
the joint positions of the slave are essentially unknown at the
beginning of the procedure.
[0547] On the other hand, in accordance with the present invention
it is not necessary to read an initial position of joint angles in
order to determine an initial position of the distal tip of the
surgical instrument. The system of the present invention, which
preferably employs no passive joints, has the initial position of
the distal tip of the surgical instrument known with respect to the
base of the instrument. The instrument is constructed with known
dimensions, such as between base pivot 225 and the wrist (303 at
axis 306 in FIG. 2D) of the tool 18. Further, the instrument is
initially inserted by the surgeon in a known configuration, such as
illustrated in FIGS. 9 and 10, where the dimensions and
orientations of the instrument insert and adaptor guide tube are
known with respect to the base (pivot 225). Therefore, an initial
position of the surgical instrument distal tip need not be
calculated before the system is used.
[0548] The system of the present embodiment is fixed to the end of
a static mount (bracket 25 on post 19) which is manually maneuvered
over the patient, such as illustrated in FIG. 1. Since the initial
position of the surgical instrument tip (tool 18) with respect to
the base (pivot 225) of the articulate mechanism is invariant, the
joint positions are neither read nor is the forward kinematics
computed during the initial setup. Thus, the initial position of
the surgical instrument tip is neither computed nor calculated. In
addition, because the base of the system in accordance with the
present embodiment is not necessarily fixed directly to the
surgical table, but rather movable during a surgical procedure, the
initial position of the surgical instrument in a world coordinate
system is not knowable.
[0549] Another advantage of the present system is that the
instrument does not use the incision in the patient to define a
pivot point of the instrument. Rather, the pivot point of the
instrument is defined by the kinematics of the mechanism,
independent of the patient incision, the patient himself, or the
procedure. Actually, the pivot point in the present system is
defined even before the instrument enters the patient, because it
is a pivot point of the instrument itself. This arrangement limits
trauma to the patient in an area around the incision.
[0550] From an illustrative standpoint, the base of the instrument
may be considered as pivot 225 (FIG. 8), and the wrist may be the
pivot location 604 (axis) depicted in FIG. 16B (or axis 306 in FIG.
2D). The guide tube 17 has known dimensions and because there are
no other joints (active or passive) between the pivot 225 and wrist
joint, all of the intervening dimensions are known. Also, the
instrument when placed in position has a predefined configuration
such as that illustrated in FIGS. 1, 9 and 10 with the guide tube
flat is one plane.
[0551] The guide tube 17 may also have an alignment mark therealong
essentially in line with the pivot 225, as shown in FIG. 9. This
marks the location where the guide tube 17 is at the patient
incision point. The result is minimal trauma to the patient
occasioned by any pivoting action about pivot 225.
[0552] Another advantage is the decoupling nature of the present
system. This decoupling enables the slave unit to be readily
portable. Here the instrument, drive unit and controller are
decouplable. A sterilized adaptor 15 is inserted into a patient,
then coupled to a non-sterile drive unit 8 (outside the sterile
field). Instrument inserts 16 are then removably attached to the
surgical adaptor to perform the surgical procedure. The system of
the present embodiment separates the drive unit 8 from the
instruments 16. In this way, the instruments can be maintained as
sterile, but the drive unit need not be sterilized. Furthermore, at
the time of insertion, the adaptor 15 is preferably decoupled from
the drive unit 8 so it can be readily manually maneuvered to
achieve the proper position of the instrument relative to the
patient and the patient's incision.
[0553] In accordance with the present embodiment, the instrument
inserts 16 are not connected to the controller 9 by way of any
input/output port configuration. Rather, the present system employs
an exclusively mechanical arrangement that is effected remotely and
includes mechanical cables and flexible conduits coupling to a
remote motor drive unit 8. This provides the advantage that the
instrument is purely mechanical and does not need to be contained
within a sterile barrier. The instrument may be autoclaved, gas
sterilized or disposed in total or in part.
[0554] The present system also provides an instrument that is far
less complex than prior art robotic system. The instrument is far
smaller than that of a typical prior art robotic system, because
the actuators (motors) are not housed in the articulate structure
in the present system. Because the actuators are remote, they may
be placed under the operating table or in another convenient
location and out of the sterile field. Because the drive unit is
fixed and stationary, the motors may be of arbitrary size and
configuration, without effecting the articulated mechanics.
Finally, the design allows multiple, specialized instruments to be
coupled to the remote motors. This allows one to design an
instrument for particular surgical disciplines including, but not
limited to, such disciplines as cardiac, spinal, thoracic,
abdominal, and arthroscopic.
[0555] A further important aspect is the ability to make the
instrument disposable. The disposable element is preferably the
instrument insert 16 such as illustrated in FIG. 15A. This
disposable unit may be considered as comprising a disposable,
mechanically drivable mechanism such as the coupler 300
interconnected to a disposable tool 18 through a disposable
elongated tube such as the stem section 301, 302 of the instrument
insert. This disposable implement is mounted so that the
mechanically drivable mechanism may be connectable to and drivable
from a drive mechanism. In the illustrated embodiment the drive
mechanism may include the coupler 230 and the associated drive
motors. The disposable elongate tube 301, 302 is inserted into an
incision or orifice of a patient along a selected length of the
disposable elongated tube.
[0556] The aforementioned disposable implement is purely mechanical
and can be constructed relatively inexpensively, thus lending
itself readily to being disposable. Another factor that lends
itself to disposability is the simplicity of the instrument distal
end tool (and wrist) construction. Prior tool constructions,
whether graspers or other types, are relatively complex in that
they usually have multiple pulleys at the wrist location for
operation of different degrees-of-freedom there, making the
structure quite intricate and relatively expensive to manufacture.
On the other hand, in accordance with the present invention, no
pulleys are required and the mechanism in the location of the wrist
and tool is simple in construction and can be manufactured at far
less expense, thus readily lending itself to disposability. One of
the aspects of the invention that has enabled elimination of the
pulleys, or the like, is the decoupling of tool action relative to
wrist action by passing the tool actuation cables essentially
through the center axis (604 in FIGS. 16A and 16B) of the wrist
joint. This construction allows proper wrist action without any
significant action being conveyed to the tool cables, and
furthermore allows for a very simple and inexpensive construction
at the distal end of the implement.
[0557] Another aspect is the relative simplicity of the system,
both in its construction and use. This provides an instrument
system that is far less complex than prior robotic systems.
Furthermore, by enabling a decoupling of the slave unit at the
motor array, there is provided a readily portable and readily
manually insertable slave unit that can be handled quite
effectively by the surgeon or assistant when the slave unit is to
be engaged through a patient incision or orifice. This enables the
slave unit to be positioned through the incision or orifice so as
to dispose the distal end at a target or operative site. A support
is then preferably provided so as to hold a base of the slave unit
fixed in position relative to the patient at least during a
procedure that is to be carried out. This initial positioning of
the slave unit with a predefined configuration immediately
establishes an initial reference position for the instrument from
which control occurs via a controller and user interface.
[0558] This portable nature of the slave unit comes about by virtue
of providing a relatively simple surgical instrument insert in
combination with an adaptor for the insert that is of relatively
small configuration, particularly compared with prior large
articulated robotic arm(s) structures. Because the slave unit is
purely mechanical, and is decouplable from the drive unit, the
slave unit can be readily positioned by the operator. Once in
position, the unit is then secured to the support and the
mechanical cables are coupled with the drive unit. This makes the
slave unit both portable and easy to position in place for use.
[0559] Another advantage of the system is the ability to position
the holder or adaptor for the instrument with its distal end at the
operative site and maintained at the operative site even during
instrument exchange. By way of example, and with reference to FIG.
2B, the instrument holder is represented by the guide tube 17
extending to the operative site OS. When instruments are to be
exchanged, the distal end of the guide tube 17 essentially remains
in place and the appropriate instruments are simply inserted and/or
withdrawn depending on the particular procedure that is being
carried out.
[0560] Accordingly, one of the advantages is the ease of exchanging
instruments. In a particular operation procedure, there may be a
multitude of instrument exchanges and the present system is readily
adapted for quick and easy instrument exchange. Because the holder
or adaptor is maintained in position, the surgeon does not have to
be as careful each and every time that he reintroduces an
instrument into the patient. In previous systems, the instrument is
only supported through a cannula at the area of the incision and
when an instrument exchange is to occur, these systems require
removal of the entire assembly. This means that each time a new
instrument is introduced, great care is required to reposition the
distal end of the instrument so as to avoid internal tissue or
organ damage. On the other hand, in accordance with the present
invention, because the holder or adaptor is maintained in position
at the operative site, even during instrument exchange, the surgeon
does not have to be as careful as the insert simply slides through
the rigid tube adaptor. This also essentially eliminates any chance
of tissue or organ damage during this instrument exchange.
[0561] Having now described a limited number of embodiments of the
present invention, it should be apparent to those skilled in the
art that numerous other embodiments and modifications thereof are
contemplated as falling within the scope of the present
invention.
* * * * *