U.S. patent application number 11/454359 was filed with the patent office on 2007-07-05 for robotic surgical systems with fluid flow control for irrigation, aspiration, and blowing.
This patent application is currently assigned to Intuitive Surgical INC.. Invention is credited to David Bailey, Salvatore Brogna, Gary Guthart, Dean Hoornaert, David Q. Larkin, John Magnasco, Paul Millman, David Stephen Mintz, Nitish Swarup.
Application Number | 20070156121 11/454359 |
Document ID | / |
Family ID | 37662587 |
Filed Date | 2007-07-05 |
United States Patent
Application |
20070156121 |
Kind Code |
A1 |
Millman; Paul ; et
al. |
July 5, 2007 |
Robotic surgical systems with fluid flow control for irrigation,
aspiration, and blowing
Abstract
In one embodiment of the invention, a robotic surgical system is
provided including a master control console and a surgical
manipulator. The master control console generates control signals
to cause one or more fluids to flow into or out of a surgical site.
The surgical manipulator is coupled to the console to receive the
control signals and includes at least one robotic arm and a
surgical instrument coupled thereto. The surgical manipulator
controls the surgical instrument in response to the control signals
to control the flow of the one or more fluids into or out of the
surgical site. The surgical instrument has a first robotically
controlled valve that is responsive to the surgical manipulator and
a hollow tube having a first end coupled to the first robotically
controlled valve with an opening at a second end to direct the flow
of one or more fluids.
Inventors: |
Millman; Paul; (San Jose,
CA) ; Bailey; David; (Redwood City, CA) ;
Hoornaert; Dean; (San Jose, CA) ; Mintz; David
Stephen; (Sunnyvale, CA) ; Larkin; David Q.;
(Menlo Park, CA) ; Magnasco; John; (San Jose,
CA) ; Guthart; Gary; (Mountain View, CA) ;
Swarup; Nitish; (Sunnyvale, CA) ; Brogna;
Salvatore; (Pleasanton, CA) |
Correspondence
Address: |
PATENT DEPT;INTUITIVE SURGICAL, INC
1266 KIFER RD
BUILDING 101
SUNNYVALE
CA
94086
US
|
Assignee: |
Intuitive Surgical INC.
Sunnyvale
CA
94086
|
Family ID: |
37662587 |
Appl. No.: |
11/454359 |
Filed: |
June 15, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60696482 |
Jun 30, 2005 |
|
|
|
Current U.S.
Class: |
606/1 |
Current CPC
Class: |
A61B 2034/305 20160201;
A61M 1/0035 20140204; A61B 34/37 20160201; A61B 2017/00203
20130101; A61B 34/30 20160201; A61B 2217/005 20130101; A61M
2039/2473 20130101; A61M 1/0058 20130101; A61B 34/74 20160201; A61M
1/0039 20130101; A61B 2017/00477 20130101; A61B 2090/506 20160201;
A61B 2217/007 20130101; A61M 13/003 20130101; A61B 34/71
20160201 |
Class at
Publication: |
606/001 |
International
Class: |
A61B 17/00 20060101
A61B017/00 |
Claims
1. A robotic surgical system comprising: a master control console
to generate control signals to cause one or more fluids to flow
into or out of a surgical site; a surgical manipulator coupled to
the master control console to receive the control signals, the
surgical manipulator including at least one robotic arm to
manipulate at least one surgical instrument, and a surgical
instrument coupled to the robotic arm, the surgical manipulator to
control the surgical instrument in response to the control signals
to control the flow of the one or more fluids into or out of the
surgical site, the surgical instrument having a first robotically
controlled valve responsive to the surgical manipulator, the first
robotically controlled valve having a first port and a second port,
and a hollow tube having a first end coupled to the second port of
the first robotically controlled valve, the hollow tube having an
opening at a second end to direct the flow of one or more fluids
into or out of the surgical site; a first pump having a pump port,
the first pump to pump a first fluid into or out of the surgical
site; and a first hose having a first end coupled to the first port
of the first robotically controlled valve and a second end coupled
to the pump port of the pump, the first hose to transport a first
fluid between the first robotically controlled valve and the
pump.
2. The system of claim 1, wherein the first pump is a suction pump
to create a vacuum in the first hose as the first fluid to aspirate
the surgical site in response to opening the first robotically
controlled valve.
3. The system of claim 1, wherein the first pump is a fluid pump to
pressurize a liquid in the first hose as the first fluid to
irrigate the surgical site in response to opening the first
robotically controlled valve.
4. The system of claim 1, wherein the first pump is a compressor to
pressurize a gas in the first hose as the first fluid to blow a
pressurized gas in the surgical site in response to opening the
first robotically controlled valve.
5. The system of claim 1, wherein the first robotically controlled
valve is responsive to the control signals from the master control
console, and the master control console includes at least one foot
pedal to generate the control signals to control the first
robotically controlled valve.
6. The system of claim 1, wherein the first robotically controlled
valve is responsive to the control signals from the master control
console, and the master control console includes a touch sensing
handle to generate the control signals to control the first
robotically controlled valve.
7. The system of claim 1, wherein the first robotically controlled
valve is responsive to the control signals from the master control
console, and the master control console includes a voice
recognition system to recognize commands to generate the control
signals to control the first robotically controlled valve.
8. The system of claim 1, wherein the first robotically controlled
valve is a three-way valve having a third port; and, the system
further comprises a second hose having a first end coupled to the
third port of the first robotically controlled valve; and a second
pump having a port coupled to a second end of the second hose.
9. The system of claim 8, wherein the first pump is a suction pump
to create a vacuum in the first hose and to aspirate the surgical
site in response to opening the first robotically controlled valve
to couple the first port and the second port together, and the
second pump is a fluid pump to pressurize a fluid in the second
hose to irrigate the surgical site in response to opening the first
robotically controlled valve to couple the first port and the third
port together.
10. The system of claim 8, wherein the first pump is a gas
compressor to create a gas pressure in the first hose and to blow a
pressurized gas in the surgical site in response to opening the
first robotically controlled valve to couple the first port and the
second port together, and the second pump is a fluid pump to
pressurize a fluid in the second hose to irrigate the surgical site
in response to opening the first robotically controlled valve to
couple the first port and the third port together.
11. The system of claim 1, wherein the first robotically controlled
valve is a four-way valve having a third port and a fourth port;
and, the system further comprises a second hose having a first end
coupled to the third port of the first robotically controlled
valve; a third hose having a first end coupled to the fourth port
of the first robotically controlled valve; a second pump having a
port coupled to a second end of the second hose; and a third pump
having a port coupled to a second end of the third hose.
12. The system of claim 11, wherein the first pump is a suction
pump to create a vacuum in the first hose and to aspirate the
surgical site in response to opening the first robotically
controlled valve to couple the first port and the second port
together, the second pump is a fluid pump to pressurize a fluid in
the second hose to irrigate the surgical site in response to
opening the first robotically controlled valve to couple the first
port and the third port together, and the third pump is a gas
compressor to create a gas pressure in the first hose and to blow a
pressurized gas in the surgical site in response to opening the
first robotically controlled valve to couple the first port and the
fourth port together.
13. The system of claim 1, wherein the surgical instrument further
has a second robotically controlled valve having a first port and a
second port, a third robotically controlled valve having a first
port and a second port, and a four-way coupler coupled between the
second ports of the first, second, and third robotically controlled
valves and the first end of the hollow tube; and, the system
further comprises a second hose having a first end coupled to the
first port of the second robotically controlled valve; a third hose
having a first end coupled to the first port of the third
robotically controlled valve; a second pump having a port coupled
to a second end of the second hose; and a third pump having a port
coupled to a second end of the third hose.
14. The system of claim 13, wherein the first pump is a suction
pump to create a vacuum in the first hose and to aspirate the
surgical site in response to opening the first robotically
controlled valve to couple the first port and the second port
together, the second pump is a fluid pump to pressurize a fluid in
the second hose to irrigate the surgical site in response to
opening the first robotically controlled valve to couple the first
port and the third port together, and the third pump is a gas
compressor to create a gas pressure in the first hose and to blow a
pressurized gas in the surgical site in response to opening the
first robotically controlled valve to couple the first port and the
fourth port together.
15. A robotic surgical system comprising: a master control console
to generate control signals to cause one or more fluids to flow
into or out of a surgical site; a surgical manipulator coupled to
the master control console to receive the control signals, the
surgical manipulator including at least one robotic arm to
manipulate at least one surgical instrument, and a surgical
instrument coupled to the robotic arm, the surgical manipulator to
control the surgical instrument in response to the control signals
to control the flow of one or more fluids into or out of the
surgical site, the surgical instrument having a first robotically
controlled valve having a first port and a second port, the first
robotically controlled valve responsive to the surgical manipulator
to control the flow of a first fluid, a second robotically
controlled valve having a first port and a second port, the second
robotically controlled valve responsive to the surgical manipulator
to control the flow of a second fluid, a hollow tube having a first
end and a second end with an opening to direct the flow of a
plurality of fluids into or out of the surgical site, and a
three-way coupler coupled between the second ports of the first and
second robotically controlled valves and the first end of the
hollow tube, the three way coupler to couple a plurality of fluids
between the hollow tube and the first and second robotically
controlled valves.
16. The system of claim 15, further comprising: a first pump having
a first pump port, the first pump to pump the first fluid into or
out of the surgical site; a second pump having a second pump port,
the second pump to pump the second fluid into or out of the
surgical site; a first hose having a first end coupled to the first
port of the first robotically controlled valve and a second end
coupled to the first pump port of the first pump, the first hose to
transport the first fluid between the first robotically controlled
valve and the first pump; and a second hose having a first end
coupled to the first port of the second robotically controlled
valve and a second end coupled to the second pump port of the
second pump; the second hose to transport the second fluid between
the second robotically controlled valve and the second pump.
17. The system of claim 16, wherein the first pump is a suction
pump to create a vacuum in the first hose and to aspirate the
surgical site in response to opening the first robotically
controlled valve, and the second pump is a fluid pump to pressurize
a fluid in the second hose to irrigate the surgical site in
response to opening the second robotically controlled valve.
18. The system of claim 15, wherein the first robotically
controlled valve and the second robotically controlled valve are
responsive to the control signals from the master control console,
and the master control console includes at least one foot pedal to
generate the control signals to control the first robotically
controlled valve and the second robotically controlled valve.
19. The system of claim 15, wherein the first robotically
controlled valve and the second robotically controlled valve are
responsive to the control signals from the master control console,
and the master control console includes at least one touch sensing
handle to generate the control signals to control the first
robotically controlled valve and the second robotically controlled
valve.
20. The system of claim 15, wherein the first robotically
controlled valve and the second robotically controlled valve are
responsive to the control signals from the master control console,
and the master control console includes a voice recognition system
to recognize commands to generate the control signals to control
the first robotically controlled valve and the second robotically
controlled valve.
21. A robotic surgical system comprising: a master control console
to generate control signals to cause a fluid to flow into or out of
a surgical site; a surgical manipulator coupled to the master
control console to receive the control signals, the surgical
manipulator including at least one robotic arm to manipulate at
least one surgical instrument, and a surgical instrument coupled to
the robotic arm, the surgical instrument to control the flow of the
fluid into or out of the surgical site, the surgical instrument
having a first hose having a first end and a second end, the first
hose being flexible; a first robotically controlled pinch valve to
receive the first hose, the first robotically controlled pinch
valve to squeeze and pinch closed the first hose and to release and
open the first hose, and a hollow tube having a first end to couple
to the first end of the first hose; and a first pump having a port
coupled to the second end of the first hose.
22. The system of claim 21, wherein the first pump is a suction
pump to create a vacuum in the first hose and to aspirate the
surgical site at a second end of the hollow tube in response to
releasing the first robotically controlled pinch valve.
23. The system of claim 21, wherein the first pump is a fluid pump
to pressurize a fluid in the first hose to irrigate the surgical
site at a second end of the hollow tube in response to releasing
the first robotically controlled pinch valve.
24. The system of claim 21, wherein the first pump is a compressor
to pressurize a gas in the first hose to blow a pressurized gas in
the surgical site in response to opening the robotically controlled
pinch valve.
25. The system of claim 21, wherein the surgical instrument further
has a second robotically controlled pinch valve having a first port
and a second port, and a three-way coupler coupled between the
second ports of the first and second robotically controlled pinch
valves and the first end of the hollow tube; and, the system
further comprises a second hose having a first end coupled to the
first port of the second robotically controlled pinch valve; and a
second pump having a port coupled to a second end of the second
hose.
26. The system of claim 25, wherein the first pump is a suction
pump to create a vacuum in the first hose and to aspirate the
surgical site in response to opening the first robotically
controlled pinch valve, and the second pump is a fluid pump to
pressurize a fluid in the second hose to irrigate the surgical site
in response to opening the second robotically controlled pinch
valve.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This non-provisional United States (U.S.) patent application
claims the benefit of U.S. provisional patent Application No.
60/696,482 entitled "IRRIGATION, ASPIRATION, AND BLOWING FOR
ROBOTIC SURGERY" filed on Jun. 30, 2005 by inventors Paul Millman
et al.
FIELD
[0002] The embodiments of the invention relate generally to
surgical instruments for robotic surgery. More particularly, the
embodiments of the invention relate to
irrigation/aspiration/blowing devices for surgery.
BACKGROUND
[0003] During surgery on a patient, it is often desirable to
irrigate a surgical site with a fluid, such as water, to clean or
clear away blood, tissue, or other items obscuring the vision of a
surgeon in the surgical site. Suction or aspiration in the surgical
site may also be used to vacuum away blood, tissue, or other items
obscuring the vision of the surgeon in the surgical site.
[0004] Hand held surgical instruments have typically been used to
provide irrigation and/or aspiration. The surgeon typically does
not operate the hand held surgical instrument that provides
irrigation and/or aspiration. An assistant surgeon or nurse
handling such instruments may provide irrigation and/or aspiration
of the surgical site. The surgeon gives verbal instructions to the
assistant surgeon or nurse to provide irrigation and/or aspiration
of the surgical site. If the surgeon could both control the
surgical instruments and the irrigation and aspiration of the
surgical site, verbal instructions could be reduced and surgical
procedures may be more efficient.
BRIEF SUMMARY
[0005] The embodiments of the invention are summarized by the
claims that follow below.
BRIEF DESCRIPTIONS OF THE DRAWINGS
[0006] FIG. 1 is a block diagram of a robotic surgery system to
perform minimally invasive robotic surgical procedures using an
irrigation/aspiration/blowing robotic surgical tool.
[0007] FIG. 2A is a perspective view of a robotic surgical
manipulator with a plurality of robotic surgical arms at least one
of which includes an irrigation/aspiration/blowing robotic surgical
tool.
[0008] FIG. 2B is a perspective view of the robotic surgical arm
including the irrigation/aspiration/blowing robotic surgical tool
mounted thereto.
[0009] FIG. 2C illustrates mounting of the
irrigation/aspiration/blowing robotic surgical tool to an adapter
of the robotic surgical arm of FIG. 2B.
[0010] FIG. 2D illustrates a top view of the adapter of the robotic
surgical arm of FIG. 2C to which the irrigation/aspiration/blowing
robotic surgical tool may be mounted.
[0011] FIG. 3A is a perspective view of a robotic surgical master
control console.
[0012] FIG. 3B is a perspective view of an exemplary gimbaled
device pivotally supporting a touch sensitive handle for the
robotic surgical master control console of FIG. 3A to control
robotic surgical tools including an irrigation/aspiration/blowing
robotic surgical tool.
[0013] FIG. 3C is a cross-sectional view schematically illustrating
mounting of the touch sensitive handle of FIG. 3B with sensors to
sense gripping and rotation of the handle to control robotic
surgical tools, including an irrigation/aspiration/blowing robotic
surgical tool.
[0014] FIG. 4A is a perspective view of an
irrigation/aspiration/blowing robotic surgical tool.
[0015] FIG. 4B is a back side view of a portion of the
irrigation/aspiration/blowing robotic surgical tool of FIG. 4A.
[0016] FIG. 5A is a schematic flow diagram of an
irrigation/aspiration robotic surgical tool using two-way
two-position valves.
[0017] FIG. 5B is a schematic flow diagram of an
irrigation/aspiration robotic surgical tool using a three-way
three-position valve.
[0018] FIG. 5C is a schematic flow diagram of an
irrigation/aspiration/blowing robotic surgical tool using a
four-way four-position valve.
[0019] FIG. 5D is a schematic flow diagram of an
irrigation/aspiration/blowing robotic surgical tool using two-way
two-position valves.
[0020] FIGS. 6A-6C are top views of rotationally actuated rotatable
valves for use with the irrigation/aspiration/blowing robotic
surgical tool and the robotic surgical arm.
[0021] FIGS. 7A-7C are cross-sections of linearly actuated linear
valves for use with the irrigation/aspiration/blowing robotic
surgical tool and the robotic surgical arm.
[0022] FIG. 8 is a top view of exemplary linear actuation of a
rotatable valve for use with the irrigation/aspiration/blowing
robotic surgical tool and the robotic surgical arm.
[0023] FIG. 9A is a top view of exemplary rotational actuation of a
linear valve for use with the irrigation/aspiration/blowing robotic
surgical tool and the robotic surgical arm with an optional manual
push arm.
[0024] FIG. 9B is a top view of exemplary rotational actuation of a
linear valve for use with the irrigation/aspiration/blowing robotic
surgical tool and the robotic surgical arm with an optional manual
push side-arm.
[0025] FIG. 10A is a top view to illustrate rotational actuation of
a rotatable pinch valve for use with the
irrigation/aspiration/blowing robotic surgical tool and the robotic
surgical arm.
[0026] FIG. 10B is a side view to illustrate linear actuation of a
linear pinch valve for use with the irrigation/aspiration/blowing
robotic surgical tool and the robotic surgical arm.
[0027] FIG. 11A is a top perspective view of an
irrigation/aspiration/blowing robotic surgical tool with cover
removed to show a solid valve body.
[0028] FIG. 11B is a bottom exploded of the
irrigation/aspiration/blowing robotic surgical tool of FIG. 11A
with the solid valve body.
[0029] FIG. 11C is a cross sectional view of the valve assembly
with the solid valve body in a closed position for the
irrigation/aspiration/blowing robotic surgical tool of FIG.
11A.
[0030] FIG. 11D is a cross sectional view of the valve assembly
with the solid valve body in an open position for the
irrigation/aspiration/blowing robotic surgical tool of FIG.
11A.
[0031] FIG. 11E is a top perspective view of an
irrigation/aspiration/blowing robotic surgical tool with a solid
valve body including robotically actuated valves and manually
actuated valves.
[0032] FIG. 12 is a top perspective view of an
irrigation/aspiration/blowing robotic surgical tool with cover
removed to show the replaceable valves.
[0033] FIG. 13A is a top perspective view of an
irrigation/aspiration/blowing robotic surgical tool with cover
removed to show rotatable pinch valves.
[0034] FIG. 13B is a top perspective view of the
irrigation/aspiration/blowing robotic surgical tool of FIG. 13A
with cover in place to show manual handles and a cleaning position
of the handles.
[0035] FIG. 14 is a top view of an irrigation/aspiration/blowing
robotic surgical tool with cover removed to show the pinch valves
and replaceable tubing.
[0036] FIGS. 15A-15B are top views of irrigation/aspiration/blowing
robotic surgical tools with covers removed to respectively show
three-way and four-way couplers and replaceable tubing coupled
thereto.
[0037] FIG. 16A is a side view of the touch sensitive handle of the
diagram of the touch sensitive handle illustrated in FIG. 3B for
the robotic surgical master control console of FIG. 3A.
[0038] FIGS. 16B-16D are side views of grip positions of the touch
sensitive handle to control the irrigation/aspiration/blowing
robotic surgical tool in a surgical site.
[0039] FIG. 17 is a graph showing exemplary control of irrigation
and aspiration using grip control of the touch sensitive handle
corresponding to the side views of the touch sensitive handle
illustrated in FIGS. 16B-16D.
[0040] FIG. 18A is a top perspective view of the
irrigation/aspiration/blowing robotic surgical tool with light
emitting diodes at the distal end to provide user feedback.
[0041] FIG. 18B is a top perspective view of the
irrigation/aspiration/blowing robotic surgical tool with a light
pipe along side the flow tube that is coupled to a light emitting
diode at the proximal end to provide user feedback.
[0042] FIG. 18C is a top perspective view of the
irrigation/aspiration/blowing robotic surgical tool with a sliding
sleeve around the flow tube that is moved to reveal a scale at the
distal end to provide user feedback by mechanical means.
[0043] FIG. 18D is a top perspective view of the
irrigation/aspiration/blowing robotic surgical tool with a
rotational sleeve around the flow tube that rotates to reveal a
scale at the distal end and provide user feedback by mechanical
means.
[0044] FIG. 18E is a perspective view of a first tip for the
irrigation/aspiration/blowing robotic surgical tool of FIG. 18D
with a rotational sleeve around the flow tube that rotates to
reveal a scale and provide user feedback.
[0045] FIG. 18F is a perspective view of a second tip for the
irrigation/aspiration/blowing robotic surgical tool of FIG. 18D
with a rotational sleeve around the flow tube that rotates to
reveal a scale and provide user feedback.
[0046] FIG. 18G is a perspective view of a third tip for the
irrigation/aspiration/blowing robotic surgical tool of FIG. 18D
with a rotational sleeve around the flow tube that rotates to
reveal a scale and provide user feedback.
[0047] FIG. 19 is a viewer of the robotic surgical master control
console of FIG. 3A with an icon overlaid onto the displayed images
to provide user feedback as to the control of the
irrigation/aspiration/blowing robotic surgical tool.
[0048] FIG. 20A illustrates a viewer of the master control console
of FIG. 3A with an icon overlay in a single side to provide user
feedback as to the control of the irrigation/aspiration/blowing
robotic surgical tool.
[0049] FIG. 20B illustrates a viewer of the master control console
of FIG. 3A with an icon overlay in both left and right sides to
provide three-dimensional user feedback as to the control of the
irrigation/aspiration/blowing robotic surgical tool.
DETAILED DESCRIPTION
[0050] In the following detailed description of the embodiments of
the invention, numerous specific details are set forth in order to
provide a thorough understanding of the embodiments of the
invention. However, it will be obvious to one skilled in the art
that the embodiments of the invention may be practiced without
these specific details. In other instances well known methods,
procedures, components, and circuits have not been described in
detail so as not to unnecessarily obscure aspects of the
embodiments of the invention.
[0051] The embodiments of the invention include a method,
apparatus, and system for robotically controlled
irrigation/aspiration/blowing of an internal or external surgical
area or site where robotic surgery is being performed. Aspiration
may also be referred to as suction.
[0052] In one embodiment of the invention a robotic surgical system
is provided including a master control console, a surgical
manipulator, a first hose, and a first pump. The master control
console is used to generate control signals to cause one or more
fluids to flow into or out of a surgical site. The surgical
manipulator is coupled to the master control console to receive the
control signals. The surgical manipulator includes at least one
robotic arm to manipulate at least one robotic surgical instrument,
and a surgical instrument coupled to the robotic arm. The surgical
manipulator controls the surgical instrument in response to the
control signals to control the flow of the one or more fluids into
or out of the surgical site. The surgical instrument has a first
robotically controlled valve responsive to the surgical manipulator
and a hollow tube having an opening at one end to direct the flow
of one or more fluids in the surgical site. The first robotically
controlled valve has a first port and a second port and the hollow
tube has a first end coupled to the second port of the first
robotically controlled valve. The first hose has a first end
coupled to the first port of the first robotically controlled
valve. The first hose transports a first fluid to the first
robotically controlled valve. The first pump has a port coupled to
a second end of the first hose. The first pump pumps a first fluid
through the first hose to the first robotically controlled valve of
the surgical instrument.
[0053] In another embodiment of the invention, a robotic surgical
system is provided including a master control console, a surgical
manipulator, and a first pump. The master control console generates
control signals to cause a fluid to flow into or out of a surgical
site. The surgical manipulator is coupled to the master control
console to receive the control signals. The surgical manipulator
includes at least one robotic arm to manipulate at least one
surgical instrument. A surgical instrument is coupled to the
robotic arm to control the flow of a fluid into or out of the
surgical site. The surgical instrument has a first hose, a first
robotically controlled pinch valve, and a hollow tube. The first
hose is flexible and has a first end and a second end. The first
robotically controlled pinch valve receives the first hose. The
first robotically controlled pinch valve squeezes and pinches
closed the first hose and releases and opens the first hose. The
hollow tube has a first end to couple to the first end of the first
hose. The first pump has a port coupled to the second end of the
first hose.
[0054] In another embodiment of the invention, a method is
provided. The method includes generating a first control signal to
control a robotic surgical instrument; coupling the first control
signal into the robotic surgical instrument; and opening a first
valve in the robotic surgical instrument to flow a first fluid over
a surgical site in response to the first control signal.
[0055] In another embodiment of the invention, another method is
provided. The method includes mounting an irrigation-aspiration
robotic surgical instrument to a robotic arm of a robotic surgical
manipulator; coupling at least one hose from the
irrigation-aspiration robotic surgical instrument to at least one
pump; inserting a tip of a hollow tube of the irrigation-aspiration
robotic surgical instrument into a patient near a surgical site;
controlling a flow of a fluid between the surgical site and the
irrigation-aspiration robotic surgical instrument; and monitoring a
level of the flow of the fluid between the surgical site and the
irrigation-aspiration robotic surgical instrument.
[0056] In yet another embodiment of the invention, a robotic
surgical instrument is provided for the control of flows of one or
more fluids into and out of a surgical site. The robotic surgical
instrument includes a housing, a flow control system mounted in the
housing, a hollow tube having a first end mounted in the housing,
and one or more hose fittings having a first end coupled to the
flow control system. The housing can couple the robotic surgical
instrument to a robotic arm. The flow control system includes one
or more controlled valves to control the flow of one or more fluids
through the robotic surgical instrument. The first end of the
hollow tube couples to the flow control system. The one or more
hose fittings have a second end to respectively couple to one or
more hoses.
[0057] In still another embodiment of the invention, another
robotic surgical instrument is provided for the control of flows of
one or more fluids into and out of a surgical site.
[0058] The robotic surgical instrument includes an interface base,
a hollow tube having a proximal end mounted to the interface base,
a three-way coupler having a first port coupled to the proximal end
of the hollow tube, a first robotically controlled valve coupled to
the interface base, and a second robotically controlled valve
coupled to the interface base. The interface base can mechanically
and electrically couple to an end of a robotic arm. The hollow tube
further has a distal end for placement in a surgical site to allow
the flow of fluids into and out of a surgical site. The three-way
coupler further has a second port and a third port to couple the
first port, the second port, and the third port together to flow
fluids there-between. The first robotically controlled valve having
a first port to couple to a first hose and a second port coupled to
the second port of the three-way coupler. The first robotically
controlled valve controls the flows of a first fluid. The second
robotically controlled valve having a first port to couple to a
second hose and a second port coupled to the third port of the
three-way coupler. The second robotically controlled valve controls
the flows of a second fluid.
[0059] Robotic surgery generally involves the use of a robot
manipulator that has multiple robotic manipulator arms. One or more
of the robotic manipulator arms often support a surgical tool which
may be articulated (such as jaws, scissors, graspers, needle
holders, micro dissectors, staple appliers, tackers,
suction/irrigation tools, clip appliers, or the like) or
non-articulated (such as cutting blades, cautery probes,
irrigators, catheters, suction orifices, or the like). One or more
of the robotic manipulator arms are often used to support a
surgical image capture device such as an endoscope (which may be
any of a variety of structures such as a laparoscope, an
arthroscope, a hysteroscope, or the like), or, optionally, some
other imaging modality (such as ultrasound, fluoroscopy, magnetic
resonance imaging, or the like). Typically, the arms will support
at least two surgical tools corresponding to the two hands of a
surgeon and one image capture device.
[0060] Robotic surgery may be used to perform a wide variety of
surgical procedures, including but not limited to open surgery,
neurosurgical procedures (such as stereotaxy), endoscopic
procedures (such as laparoscopy, arthroscopy, thoracoscopy), and
the like.
Robotic Surgical System
[0061] Referring now to FIG. 1, a block diagram of a robotic
surgery system 100 is illustrated to perform minimally invasive
robotic surgical procedures using an irrigation/aspiration/blowing
(IAB) robotic surgical tool 101A. The irrigation/aspiration/blowing
robotic surgical tool 101A is a robotic endoscopic surgical
instrument that is manipulated by a slaved robotic manipulator and
remotely controlled by control signals received from a master
control console. In contrast, manual endoscopic surgical
instruments are directly controlled by hand.
[0062] A user or operator O (generally a surgeon) performs a
minimally invasive surgical procedure on patient P by manipulating
input devices at a master control console 150. A computer 151 of
the console 150 directs movement of robotically controlled
endoscopic surgical instruments (generally numbered 101), effecting
movement of the instruments using a robotic surgical manipulator
152. The robotic surgical manipulator 152 may also be referred to
as robotic patient-side cart system or simply as a cart. The
robotic surgical manipulator 152 has one or more robotic arms 153.
Typically, the robotic surgical manipulator 152 includes at least
three robotic manipulator arms 153 supported by linkages, with a
central arm supporting an endoscopic camera and the robotic arms
153 to left and right of center supporting tissue manipulation
tools and the irrigation/aspiration/blowing robotic surgical tool
101A such as the robotic manipulator arm 153C.
[0063] An assistant A may assist in pre-positioning of the robotic
surgical manipulator 152 relative to patient P as well as swapping
tools or instruments 101 for alternative tool structures, and the
like, while viewing the internal surgical site via an assistant's
display 154. The image of the internal surgical site shown to A by
the assistant's display 154 and operator O by surgeon's console 150
is provided by one of the surgical instruments 101 supported by the
robotic surgical manipulator 152.
[0064] Generally, the robotic arms 153 of robotic surgical
manipulator 152 include a positioning portion and a driven portion.
The positioning portion of the robotic surgical manipulator 152
remains in a fixed configuration during surgery while manipulating
tissue. The driven portion of the robotic surgical manipulator 152
is actively articulated under the direction of the operator O
generating control signals at the surgeon's console 150 during
surgery. The actively driven portion of the arms 153 is herein
referred to as an end effector 158. The positioning portion of the
robotic arms 153 that are in a fixed configuration during surgery
may be referred to as positioning linkage and/or "set-up joint" 56,
56'.
[0065] To support the irrigation/aspiration/blowing robotic
surgical tool 101A, the robotic surgical system may further include
one or more pumps 102A-102C, one or more inline filters 104A-104C,
and one or more hoses 106A-106C. For irrigation, the pump 102A is a
sterile fluid pump and may be an intravenous (IV) pump with an
input port or inlet coupled to an IV bag 108 through a hose 106D.
The output port or outlet of the pump 102A may couple to the
robotic surgical instrument 101A directly or through the inline
filter 104A. The IV bag 108 may have a pressure cuff. For
aspiration, the pump 102B is a vacuum pump 102B with an output port
110 exhausting to atmosphere and an input port coupling to a
suction canister 105 through the inline filter 104B. In an
alternate embodiment of the invention, suction may be provided to
rooms at a wall inlet to isolate the noise of the vacuum pump 102B.
For blowing, the pump 102C is a gas compressor with an input port
coupled to a source of gas 111, such as oxygen or air, and an
output port coupled to the instrument 101A through the inline
filter 104C.
[0066] The one or more hoses 106A-106C may be joined together along
a portion of their length and into one end to couple to the
instrument 101A for ease of coupling and to readily manage a
plurality of hoses as one unit at the robotic manipulator 152.
Towards the opposite end, the one or more hoses 106A-106C may
separate to couple to the inline filters, the pumps, the canister
105, or other pipe fittings as the case may be.
[0067] In one embodiment of the invention, the master control
console 150 may control the one or more pumps 102A-102C and any
valves thereat in order to control fluid flow between the pumps and
the instrument 101A into and out of the surgical site. One or more
control signal lines 109A-109C may couple between the computer 151
and the one or more pumps 102A-102C and any valves thereat in order
that they may be controlled by control signals from the master
control console 150. In which case, the hoses 106A-106C may simply
couple to a coupler within the instrument 101A as is discussed
further below with reference to FIGS. 15A-15B.
[0068] Referring now to FIG. 2A, a perspective view of the robotic
surgical manipulator 152 is illustrated. The robotic surgical
manipulator 152 has one or more robotic surgical arms 153. The
robotic arm 153C includes an irrigation/aspiration/blowing robotic
surgical tool 101A coupled thereto at the end effector 158. The
robotic surgical manipulator 152 further includes a base 202 from
which the robotic surgical instruments 101 may be supported. More
specifically, the robotic surgical instruments 101 are each
supported by the positioning linkage 156 and the end effector 158
of the arms 153. It should be noted that these linkage structures
are here illustrated with protective covers 206,208 extending over
much of the robotic arms. It should be understood that these
protective covers 206,208 are optional, and may be limited in size
or entirely eliminated in some embodiments to minimize the inertia
that is manipulated by the servomechanism, and to limit the overall
weight of robotic surgical manipulator 152.
[0069] The robotic surgical manipulator 152 generally has
dimensions suitable for transporting between operating rooms. It
typically can fit through standard operating room doors and onto
standard hospital elevators. The robotic surgical manipulator 152
may have a weight and a wheel (or other transportation) system that
allows the cart to be positioned adjacent an operating table by a
single attendant. The robotic surgical manipulator 152 may be
sufficient stable during transport to avoid tipping, and to easily
withstand overturning moments that may be imposed at the ends of
the robotic arms during use.
[0070] Referring now to FIG. 2B, a perspective view of the robotic
surgical arm 153C is illustrated including the
irrigation/aspiration/blowing robotic surgical tool 101A mounted
thereto. Each of the robotic manipulating arms 153 preferably
includes a linkage 212 that constrains the movement of the surgical
tool 101 mounted thereto. More specifically, linkage 212 includes
rigid links coupled together by rotational joints in a
parallelogram arrangement so that the robotic surgical tool 101A
rotates around a point 215 in space. At the point 215, the robotic
arm can pivot the robotic surgical tool 101A about a pitch axis
215A and a yaw axis 215B. The pitch and yaw axes intersect at the
point 215, which is aligned along a shaft 216 of robotic surgical
tool 101A. In the case of the IAB robotic surgical tool 101A, the
shaft is a hollow tube as is further discussed below.
[0071] The robotic arm provides further degrees of freedom of
movement to the robotic surgical tool 101A. Along an insertion axis
215C, parallel to the central axis of the shaft 216 of the robotic
surgical tool 101A, the robotic surgical tool 101A may slide into
and out from a surgical site. The robotic surgical tool 101A can
also rotate about the insertion axis 215C. As the robotic surgical
tool 101A slides along or rotates about the insertion axis 215C,
the center point 215 is relatively fixed with respect to the base
218. That is, the entire robotic arm is generally moved in order to
maintain or re-position back to the center point 215.
[0072] The linkage 212 of the robotic arm 153 is driven by a series
of motors 217 therein in response to commands from a processor or
computer. The motors 217 in the robotic arm are also used to rotate
and/or pivot the robotic surgical tool 101A at the point 215 around
the axes 215A-215C. If a robotic surgical tool 101 further has end
effectors to be articulated or actuated, still other motors 217 in
the robotic arm may be used to do so. A flow control system in the
IAB robotic surgical tool 101A may be actuated by these other
motors in the robotic arm 153. However, alternative means may also
be used to actuate or control the flow control system in the IAB
robotic surgical tool 101A. Additionally, the motion provided by
the motors 217 may be mechanically transferred to a different
location such as by using pulleys, cables, gears, links, cams, cam
followers, and the like or other known means of transfer, such as
pneumatics, hydraulics, or electronics.
[0073] For endoscopic surgical procedures, the end effector 158 of
the robotic arm 153 is often fitted with a hollow cannula 219. The
shaft or tube of the robotic surgical tool 101 may be inserted into
the hollow cannula 219. The cannula 219, which may be releasably
coupled to the robotic arm 153, supports the shaft or tube of the
robotic surgical tool 101, preferably allowing the tool to rotate
around the axis 215C and move axially through the central bore of
the cannula along the axis 215C.
[0074] The robotic surgical tools 101 are generally sterile
structures, often being sterilizable and/or being provided in
hermetically sealed packages for use. As the robotic surgical tools
101 will be removed and replaced repeatedly during many procedures,
a tool holder could potentially be exposed to contamination if the
interface directly engages the tool holder. To avoid contamination
to a tool holder and possible cross contamination between patients,
an adaptor for coupling to robotic surgical tools 101 is provided
in a robotic arm of the robotic surgical manipulator.
[0075] Referring now to FIGS. 2C, 2D, and 4B, the mounting of the
irrigation/aspiration/blowing robotic surgical tool 101A to an
adapter 228 of the robotic surgical arm is now briefly
described.
[0076] The robotic surgical arm 153 may include an adapter 228 to
which the IAB robotic surgical tool 101A or other surgical tool 101
may be mounted. FIG. 2D illustrates a front side of an exemplary
adapter 228. The front side of the adaptor 128 is generally
referred to as a tool side 230 and the opposite side is generally
referred to as a holder side (not shown).
[0077] FIG. 4B illustrates a back side of an exemplary IAB robotic
surgical tool 400 as the IAB surgical robotic tool 101A. The
robotic surgical tool 400 includes an exemplary mountable housing
401 including an interface base 412 that can be coupled to the
adapter 228. The interface base 412 and the adapter 228 may be
electrically and mechanically coupled together to actuate the flow
control system of the IAB robotic surgical tool 101A. Rotatably
coupled to the interface base 412 are one or more rotatable
receiving members 418. Each of the one or more rotatable receiving
members 418 includes a pair of pins 422A and 422B generally
referred to as pins 422. Pin 422A is located closer to the center
of each rotatable receive member 418 than pin 422B. The one or more
rotatable receiving members 418 can mechanically couple
respectively to one or more rotatable drivers 234 of the adapter
228. The robotic surgical tool 101A may further include release
levers 416 to release it from the adapter 228.
[0078] The interface base 412 may further include one or more
electrical contacts or pins 424 to electrically couple to
electrical connector 242 of the adapter 228. The interface base 412
may further include a printed circuit board 425 and one or more
integrated circuits 426 coupled thereto and to the one or more pins
424. The one or more integrated circuits 426 may be used to
identify the type of robotic surgical tool coupled to the robotic
arm, so that it may be properly controlled by the master control
console 150.
[0079] The adapter 228 includes one or more rotatable drivers 234
rotatably coupled to a floating plate 236. The rotatable drivers
234 are resiliently mounted to the floating plate 236 by resilient
radial members which extend into a circumferential indentation
about the rotatable drivers. The rotatable drivers 234 can move
axially relative to floating plate 236 by deflection of these
resilient structures.
[0080] The floating plate 236 has a limited range of movement
relative to the surrounding adaptor structure normal to the major
surfaces of the adaptor. Axial movement of the floating plate helps
decouple the rotatable drivers 234 from a robotic surgical tool 101
when its release levers 416 are actuated.
[0081] The one or more rotatable drivers 234 of the adapter 228 may
mechanically couple to a part of the surgical tools 101. Each of
the rotatable drivers 234 may include one or more openings 240 to
receive protrusions or pins 422 of rotatable receiving members 418
of the robotic surgical tools 101. The openings 240 in the
rotatable drivers 234 are configured to accurately align with the
rotatable receiving elements 418 of the surgical tools 101.
[0082] The inner pins 422A and the outer pins 422B of the rotatable
receiving elements 418 respectively align with the opening 240A and
the opening 240B in each rotatable driver. The pins 422A and
openings 240A are at differing distances from the axis of rotation
than the pins 422B and openings 240B so as to ensure that rotatable
drivers 234 and the rotatable receiving elements 418 are not
aligned 180 degrees out of phase from their intended position.
Additionally, each of the openings 240 in the rotatable drivers may
be slightly radially elongated so as to fittingly receive the pins
in the circumferential orientation. This allows the pins 422 to
slide radially within the openings 240 and accommodate some axial
misalignment between the tool and the adapter 228, while minimizing
any angular misalignment and backlash between the rotatable drivers
234 and the rotatable receiving elements 418. Additionally, the
interaction between pins 422 and openings 240 helps restrain the
robotic surgical tool 101 in the engaged position with the adapter
228 until the release levers 416 along the sides of the housing 401
push on the floating plate 236 axially from the interface so as to
release the tool 101.
[0083] When disposed in a first axial position (away from the tool
side 230) the rotatable drivers are free to rotate without angular
limitation. The one or more rotatable drivers 234 may rotate
clockwise or counter-clockwise to further actuate the systems and
tools of the robotic surgical instruments 101. However, as the
rotatable drivers move axially toward the tool side 230, tabs
(extending radially from the rotatable drivers) may laterally
engage detents on the floating plates so as to limit the angular
rotation of the rotatable drivers about their axes. This limited
rotation can be used to help engage the rotatable drivers the
rotating members of the tool as the pins 422 may push the rotatable
bodies into the limited rotation position until the pins are
aligned with (and slide into) the openings 140 in the rotatable
drivers.
[0084] While rotatable drivers 234 are described here, other types
of drivers or actuators may be provided in the adapter 228 to
actuate systems or tools of the robotic surgical instruments 101.
The adapter 228 further includes an electrical connector 242 to
electrically couple to surgical instruments 101.
[0085] The mounting of robotic surgical tool 101A to the adapter
228 generally includes inserting the tip or distal end of the shaft
or hollow tube of the robotic surgical tool through the cannula 219
and sliding the interface base 412 into engagement with the adapter
228, as illustrated in FIG. 2C. A lip 232 on the tool side 130 of
the adaptor 128 slidably receives the laterally extending portions
of the interface base 412 of the robotic surgical tool. A catch 244
of adapter 228 may latch onto the back end of the interface base
412 to hold the tool 101A in position. The protrusions or pins 422
extending from the one or more rotatable members 418 of the robotic
surgical tool couple into the holes 240 in the rotatable drivers
234 of the adapter 228.
[0086] The range of motion of the rotatable receiving elements 418
in the robotic surgical tool may be limited. To complete the
mechanical coupling between the rotatable drivers of the adapter
and the rotatable receiving elements 418, the operator O at the
surgical master control console 150 may turn the rotatable drivers
in one direction from center, turn the rotatable drivers in a
second direction opposite the first, and then return the rotatable
drivers to center. Further, to ensure that the pins 422 enter
openings 240 of adapter 228, the adapter 228 and tool 101A mounted
thereto may be moved along the axis 215C. The adapter 228 and tool
101A mounted thereto may be moved to an initial position so that
the tip or distal end of the shaft or hollow tube is disposed
within the cannula 219.
[0087] To dismount and remove the robotic surgical tool 101A, the
release levers 416 may be squeezed pushing out on the mountable
housing 401 to release the pins 422 from the holes 240 and the
catch 244 from the back end of the interface base. The mountable
housing 401 is then pulled up to slide the interface base 412 up
and out from the adapter 228. The mountable housing 401 is
continually pulled up to remove the tip or distal end of the shaft
or hollow tube out from the cannula 219. After the robotic surgical
tool 101A is dismounted, another robotic surgical tool may be
mounted in its place, including a new or freshly sterilized IAB
robotic surgical tool 101A.
[0088] As previously discussed, the robotic surgical tool 101A may
include one or more integrated circuits 426 to identify the type of
robotic surgical tool coupled to the robotic arm, such that it may
be properly controlled by the master control console 150. However,
the robotic surgical system may determine whether or not the
robotic surgical tool is compatible or not, prior to its use.
[0089] The system verifies that the tool is of the type which may
be used with the robotic surgical system 100. The one or more
integrated circuits 426 may signal to the computer 151 in the
master control console 150 data regarding compatibility and
tool-type to determine compatibility as well as control
information. One of the integrated circuits 426 may include a
non-volatile memory to store and read out data regarding system
compatibility, the tool-type and the control information. In an
exemplary embodiment, the data read from the memory includes a
character string indicating tool compatibility with the robotic
surgical system 100. Additionally, the data from the tool memory
will often include a tool-type to signal to the master control
console how it is to be controlled. In some cases, the data will
also include tool calibration information. The data may be provided
in response to a request signal from the computer 151.
[0090] Tool-type data will generally indicate what kind of tool has
been attached in a tool change operation. For example, the
tool-type data might indicate that an IAB robotic surgical
instrument 101A has been mounted to the robotic arm. The tool-type
data may include information on wrist axis geometries, tool
strengths, grip force, the range of motion of each joint,
singularities in the joint motion space, the maximum force to be
applied via the rotatable receiving elements 418, the tool
transmission system characteristics including information regarding
the coupling of rotatable receiving elements 418 to actuation or
articulation of a system within the robotic surgical
instrument.
[0091] Instead of storing all of the tool-type date in the one or
more integrated circuits 426, most of the tool-type data may
optionally be stored in memory or a hard drive of the computer 151
in the robotic surgical system 100. An identifier may be stored in
the one or more integrated circuits 426 to signal the computer 151
to read the relevant portions of data in a look up table store in
the memory or the hard drive of the computer. The tool-type data in
the look-up table may be loaded into a memory of computer 151 by
the manufacturer of the robotic surgical system 100. The look-up
table may be stored in a flash memory, EEPROM, or other type of
non-volatile memory. As a new tool-type is provided, the
manufacturer can revise the look-up table to accommodate the new
tool-specific information. It should be recognized that the use of
tools which are not compatible with the robotic surgery system, for
example, which do not have the appropriate tool-type data in an
information table, could result in inadequate robotic control over
robotic surgical tool by the computer 151 and the operator O.
[0092] In addition to the tool-type data, tool specific information
may be stored in the integrated circuit 426, such as for
reconfiguring the programming of computer 151 to control the tool.
There may be calibration information, such an offset, to correct a
misalignment in the robotic surgical tool. The calibration
information may be factored into the overall control of the robotic
surgical tool. The storing of such calibration information can be
used to overcome minor mechanical inconsistencies between tools of
a single type. For example, the tool-type data including the
tool-specific data may be used to generate appropriate coordinate
transformations and servo drive signals to manipulate the robotic
arm and rotate the rotatable drivers 234.
[0093] Additionally, some robotic surgical tools have a limited
life span. Tool life and cumulative tool use information may also
be stored on the tool memory and used by the computer to determine
if the tool is still safe for use. Total tool life may be measured
by clock time, by procedure, by the number of times the tool has
been loaded onto a holder, and in other ways specific to the type
of tool. Tool life data is preferably stored in the memory of the
tool using an irreversible writing process.
[0094] Referring now to FIG. 3A, a perspective view of a robotic
surgical master control console 150 is illustrated. The master
control console 150 of the robotic surgical system 100 includes the
computer 151, a binocular viewer 312, an arm support 314, a
microphone 315, a pair of control input wrists and control input
arms in a workspace 316, a speech recognizer 317, foot pedals 318
(including foot pedals 318A-318B), and a viewing sensor 320.
[0095] The computer 151 may include one or microprocessors 302 to
execute instructions and a storage device 304 to store software
with executable instructions that may be used to generate control
signals to control the robotic surgical system 100. The master
control console 150 generates the control signals to control the
fluid flows through the embodiments of the IAB robotic surgical
instruments into and out of a surgical site.
[0096] The viewer 312 has at least one display where images of a
surgical site may be viewed to perform minimally invasive surgery.
As discussed further below, the viewer 312 may be used to provide
user-feedback to the operator O as to the control of the fluid flow
through the IAB robotic surgical instruments into and out of a
surgical site
[0097] The arm support 14 can be used to rest the elbows or
forearms of the operator O (typically a surgeon) while gripping
touch sensitive handles 325 (see FIGS. 3B-3C), one in each hand, of
the pair of control input wrists 352 in the workspace 316 to
generate control signals. The touch sensitive handles 325 are
positioned in the workspace 316 disposed beyond the arm support 314
and below the viewer 312.
[0098] When using the master control console, the operator O
typically sits in a chair, moves his or her head into alignment
with the binocular viewer 312, and grips the touch sensitive
handles 325 of the control input wrists 352, one in each hand,
while resting their forearms against the arm support 314. This
allows the touch sensitive handles to be moved easily in the
control space 316 in both position and orientation to generate
control signals.
[0099] Additionally, the operator O can use his feet to control the
foot-pedals to change the configuration of the surgical system and
generate additional control signals to control robotic surgical
instruments.
[0100] To ensure that the operator is viewing the surgical site
when controlling the robotic surgical tools 101, the master control
console 150 may include the viewing sensor 320 disposed adjacent
the binocular display 312. When the system operator aligns his or
her eyes with the binocular eye pieces of the display 312 to view a
stereoscopic image of the surgical worksite, the operator's head
sets off the viewing sensor 320 to enable the control of the
robotic surgical tools 101. When the operator's head is removed the
area of the display 312, the viewing sensor 320 can disable or stop
generating new control signals in response to movements of the
touch sensitive handles in order to hold the state of the robotic
surgical tools.
[0101] The computer 151 with its microprocessors 302 interprets
movements and actuation of the touch sensitive handles 325 (and
other inputs from the operator O or other personnel) to generate
control signals to control the robotic surgical instruments 101 in
the surgical worksite. In one embodiment of the invention, the
computer 151 and the viewer 312 map the surgical worksite into the
controller workspace 316 so it feels and appears to the operator
that the touch sensitive handles 325 are working over surgical
worksite.
[0102] Referring now to FIG. 3B, a perspective view of a control
input wrist 352 with a touch sensitive handle 325 is illustrated.
The control input wrist 352 is a gimbaled device that pivotally
supports the touch sensitive handle 325 of the master control
console 150 to generate control signals that are used to control
the robotic surgical manipulator 152 and the robotic surgical tools
101, including an IAB robotic surgical tool 101A. A pair of control
input wrists 352 are supported by a pair of control input arms in
the workspace 316 of the master control console 150.
[0103] The control input wrist 352 includes first, second, and
third gimbal members 362, 364, and 366. The third gimbal member is
rotationally mounted to a control input arm (not shown).
[0104] The touch sensitive handle 325 includes a tubular support
structure 351, a first grip 350A, and a second grip 350B. The first
grip and the second grip are supported at one end by the structure
351. The touch sensitive handle 325 can be rotated about axis G
illustrated in FIGS. 3B-3C. The grips 350A, 350B can be squeezed or
pinched together about the tubular structure 351. The "pinching" or
grasping degree of freedom in the grips is indicated by arrows
Ha,Hb in FIG. 3B and arrows H in FIG. 3C.
[0105] The touch sensitive handle 325 is rotatably supported by the
first gimbal member 362 by means of a rotational joint 356g. The
first gimbal member 362 is in turn, rotatably supported by the
second gimbal member 364 by means of the rotational joint 356f.
Similarly, the second gimbal member 364 is rotatably supported by
the third gimbal member 366 using a rotational joint 356d. In this
manner, the control wrist allows the touch sensitive handle 325 to
be moved and oriented in the workspace 316 using three degrees of
freedom.
[0106] The movements in the gimbals of the control wrist 352 to
reorient the touch sensitive handle in space can be translated into
control signals to control the robotic surgical manipulator 152 and
the robotic surgical tools 101. In particular, the rotational
motion of the touch sensitive handle 325 about axis G in FIGS.
3B-3C may be used to control the flow of fluids through the IAB
robotic surgical tools.
[0107] The movements in the grips 350A,350B of the touch sensitive
handle 325 can also be translated into control signals to control
the robotic surgical manipulator 152 and the robotic surgical tools
101. In particular, the squeezing motion of the grips 350A,350B
over their freedom of movement indicated by arrows Ha,Hb or H, may
be used to control the flow of fluids through the IAB robotic
surgical tools.
[0108] In embodiments of the invention, one or a combination of
both the rotational motion of the touch sensitive handle 325 and
the squeezing motion of the grips 350A,350B may be used to control
the flow of fluids through the IAB robotic surgical tools. For
example, the rotational motion of the touch sensitive handle 325
may be used for the control of irrigation while the squeezing
motion of the grips 350A,350B may be used for controlling suction
in a surgical site.
[0109] To sense the movements in the touch sensitive handle and
generate controls signals for the IAB robotic surgical tool,
sensors can be mounted in the handle 325 as well as the gimbal
member 362 of the control input wrist 352. Exemplary sensors may be
a Hall effect transducer, a potentiometer, an encoder, or the
like.
[0110] Referring now to FIG. 3C, a cross-sectional view of the
touch sensitive handle 325 and gimbal member 362 of the control
input wrist 352 is illustrated. FIG. 3C provides an example as to
how the touch sensitive handle 325 can be mounted to the control
input wrist 352 to sense the gripping and rotation of the handle to
control robotic surgical tools 101, including IAB robotic surgical
tools 101A.
[0111] As illustrated in FIG. 3C, the exemplary gimbal member 362
includes beveled gears 368a, 368b which can couple the rotational
motion of the touch sensitive handle 325 to a roll sensor 370. The
roll sensor 370 may use a potentiometer or encoder 370b included in
a roll motor 370a to sense the rotation. Alternatively, a separate
roll sensor, such as a potentiometer, may be directly coupled to
the shaft 380 to sense the rotation of the touch sensitive handle.
In any case, a roll sensor senses the roll motion of the touch
sensitive handle 325 and generates control signals in response
thereto to control the robotic surgical tools 101. The control of
IAB robotic surgical tools 101A using the roll motion of the touch
sensitive handle 325 is discussed below with reference to FIG.
16A.
[0112] To sense a squeezing motion in the grips 350A,350B of the
touch sensitive handle 325, a remote sensing assembly 386 may be
included by the gimbal member 362. The first and second grips
350A,350B are adapted to be squeezed together by a hand of an
operator O so as to define a variable grip separation. The grip
separation may be determined as a function of a variable grip angle
with an axis or as a function of a variable grip separation
distance, or the like. Alternative handle actuations, such as
movement of a thumbwheel or knob may also be provided in the handle
to control the robotic surgical instruments 101.
[0113] In the exemplary embodiment, the remote sensor assembly 386
includes a circuit board 394 on which a first and a second Hall
effect sensors, HE1, HE2 are mounted. A magnet 396 is disposed
distally beyond the circuit board 394 and the Hall effect sensors.
A magnetic mass 398 is axially coupled to the proximally oriented
surface 390 of a push rod 84. Thus, the magnetic mass 398 moves (as
shown by Arrow J) with the push rod 384 and varies the magnetic
field at the Hall effect sensors in response actuation of the grips
350A,350B.
[0114] To translate the squeezing action of the grips 350A,350B to
the sensor 386, the gimbal member 362 includes a push rod 384
within the tubular handle structure 351. Each of the grips 350A,
350B pivot about a respective pivot 334a, 334b in the tubular
handle structure 351. Urging links 335a, 335b respectively couple
between the grips 350A,350B and a first end of the push rod 384.
The squeezing action of the grips 350A,350B is translated into a
linear motion on the push rod 384 by means of urging links
335a,335b as shown by arrow A in FIG. 3C. A second end of the push
rod 384 couples to the sensor 386. As discussed previously, the
magnetic mass 398 is axially coupled to the surface 390 of the push
rod 384 in order to sense the linear motion in the push rod and the
squeezing motion of the grips 350A,350B.
[0115] A biasing mechanism such as spring 392 applies a force
against the squeezing motion of the grips to return them to full
open when the grips are released. The biasing spring 392 may be a
linear or non-linear elastic device biasing against the depression
of grips 350A, 350B, e.g., a single or multiple element assembly
including springs or other elastic members. For example, spring 392
may comprise a concentric dual spring assembly whereby one spring
provides a "softer" bias response as the grips 350A, 350B are
initially depressed, and a second spring provides a superimposed
"firm" bias response as the grips 350A, 350B approach a fully
depressed state. Such a non-linear bias may provide a pseudo
force-feedback to the operator.
[0116] It should be noted that a wide variety of alternative
sensing arrangements may be used to translate the mechanical
actuation of the touch sensitive handle and control input wrist
into control signals. While Hall effect sensors are included in the
exemplary embodiment, alternative embodiments may include encoders,
potentiometers, or a variety of alternative optical, electrical,
magnetic, or other sensing structures.
Irrigation/Aspiration/Blowing Robotic Surgical Instrument
[0117] A number of embodiments of irrigation/aspiration/blowing
(IAB) robotic surgical tools that can be mounted to a robotic arm
in a robotic surgical system are now described.
[0118] Referring to FIGS. 4A-4B, an irrigation/aspiration/blowing
(IAB) robotic surgical tool or instrument 400 is illustrated in
greater detail than that of instrument 101A. In one embodiment of
the invention, the IAB robotic surgical instrument 400 has an
interface that is backward compatible to the adapter 228 that is
typically used for other types of robotic surgical instruments. In
yet another embodiment of the invention, the IAB robotic surgical
instrument 400 has a reusable instrument housing with modular valve
components that are disposable. In yet another embodiment of the
invention, the entire IAB robotic surgical instrument 400 is
disposable.
[0119] The IAB robotic surgical instrument 400 includes a mountable
housing 401 at a proximal end and a hollow tube 404 coupled
together as shown in FIG. 4A. The mountable housing 401 maybe a
reusable housing including some reusable components therein. The
mountable housing 401 is backward compatible and includes an
interface base 412 that can couple to the adapter 228 to which
other surgical tools may also couple. The mountable housing 401 may
further include one or more tube fittings 410A-410C, a cover 414,
and one or more release levers 416.
[0120] The hollow tube 404 is elongated and has an opening 424 at
its tip 406, the distal end of the instrument 400. The hollow tube
404 may also be referred to as a hollow instrument shaft or a
hollow probe. The hollow tube 404 may be reusable or disposable.
The hollow tube 404 maybe coupled to the interface base 412 for
additional support. Alternative, the hollow tube 404 may couple
directly to a modular disposable valve subassembly and avoid
coupling to the interface base such that it too is disposable.
[0121] In one embodiment of the invention, the hollow tube 404 is a
hollow circular cylindrical shape. Fluids (e.g., gas, liquid, with
or without solids) may flow in the hollow tube 404 and into or out
from a surgical site through the opening 424 at the tip 406. The
hollow tube 404 may further include one or more smaller openings
422 around its circumference substantially near the tip 406 to
further allow fluid to flow into and out of a surgical site. The
diameter of the opening 424 may be substantially same as the inner
diameter of the tube 404. In one embodiment of the invention, the
diameter of the hollow tube 404 may be between 5 mm and 8 mm. The
hollow tube 404 may be formed out of metal, plastic or other rigid
material that can be hollow to allow fluid to flow therein while
being positioned within a patient's body at a surgical site or over
a surgical area.
[0122] The interface base 412 is used to mount the instrument 400
to a robotic arm of a surgical robotic manipulator. The interface
base 412 both mechanically and electrically couples the IAB robotic
surgical instrument 400 to a robotic arm of the surgical robotic
manipulator 152. The release levers 416 are located at the sides of
the mountable housing and may be used to release the robotic
surgical instrument 400 from a robotic arm.
[0123] A first end of the one or more tube fittings 410A-410C may
respectively couple to the one or more hoses 106A-106C,
respectively. The one or more tube fittings 410A-410C may be barb
fittings, luer fittings, or other types of hose or tube fittings. A
second end of the one or more tube fittings 410A-410C couples to a
flow control system 417 within the mountable housing 401. In some
embodiments of the invention, the one or more hoses 106A-106C may
directly couple to the flow control system without the one or more
tube fittings 410A-410C. The end of the hollow tube 404 opposite
the tip 406, also couples to the flow control system 417.
[0124] The flow control system 417 controls the flow of fluids,
including any solids that may be transported by the fluid, between
the surgical site and the one or more hoses 106A-106C through the
IAB robotic surgical instrument 400. The flow control system 417
may include one or more valves of a valve subassembly to control
the flow of fluids and any solids that may be transported by the
fluid. Note that a fluid may be a liquid, a gas, a vacuum, or any
combination thereof. The flow control system 417 may be controlled
by control signals generated by an operator O at the master control
console 150 to control the fluid flow through the IAB robotic
surgical instrument 400. In addition to robotic control, a number
of embodiments of the invention include an optional manual
actuation of the valves of the IAB robotic surgical instrument 400.
In which case, either an assistant A can manually operate the flow
control system 417 and control the fluid flow or the operator O at
the master control console 150 may robotically operate the flow
control system 417 to control the fluid flow through the IAB
robotic surgical instrument 400. The operator O at the master
control console 150 can position the IAB robotic surgical
instrument 400 where the operator wants it within the surgical
site. Then, to free up the operator's hands to perform some other
task at the master control console, the IAB robotic surgical
instrument 400 may be controlled manually by an assistant,
remaining attached to a robotic arm. The operator can then give
verbal instructions to the assistant to manually control the
irrigation/suction/blowing in the surgical site selected by the
operator.
[0125] The cover 414 covers over to protect the flow control system
417 such as a valve subassembly from damage and to maintain a
sterile surgical environment during surgery. As the surgical
instrument 400 is used during an operation or surgery at a surgical
site of human patient, it is important that its components be
sterilized.
[0126] As body fluids of a human patient will be flowing through
the surgical instrument 400 during use, it may be desirable to
re-sterilize the IAB robotic surgical tool for reuse. However, it
may be difficult to re-sterilize portions of the flow control
system 417, such as valves, within the IAB robotic surgical tool
400. Thus, portions of the flow control system 417 may be replaced
instead of sterilized after usage. If components forming the IAB
robotic surgical instrument 400 are relatively inexpensive, the IAB
robotic surgical instrument 400 may be discarded in its entirety
instead of re-sterilzing or replacing components.
[0127] FIG. 4B illustrates a back side view of a portion of the IAB
robotic surgical tool 400, some elements of which were previously
discussed. In particular, the interface base 412 is illustrated
with rotatable receiving elements 418 rotatably coupled thereto.
The rotatable receiving elements 418 provide a mechanical coupling
to the rotatable drivers 234 and drive motors mounted of the
robotic surgical manipulator 152. Each of the rotatable receiving
elements 418 include a pair of pins 422 extending from a surface
thereof. An inner pin 422A is closer to an axis of rotation of each
rotatable receiving elements 418 than an outer pin 422B, which
helps to ensure positive angular alignment of the rotatable
receiving elements 418. In one embodiment of the invention, the
rotatable receiving elements 418 are disk shaped and may be
referred to as rotatable disks.
[0128] The interface base 412 further includes an array of
electrical connecting pins 424 and one or more integrated circuits
426 coupled to a printed circuit board 425 within the mountable
housing 401. As the interface base 412 is backward compatible to
the adapter 228, it maybe mechanically actuated by pre-existing
driver motors found in the robotic surgical manipulator 152. While
the interface base 412 has been described herein with reference to
mechanical and electrical coupling elements, it should be
understood that other modalities maybe used, including infrared
coupling, magnetic coupling, inductive coupling, or the like.
[0129] Referring now to FIGS. 5A-5D, schematic flow diagrams of
robotic surgical tools 500A-500D are respectively illustrated to
provide irrigation, suction, blowing, or any combination thereof
within a surgical site.
[0130] FIG. 5A is a schematic flow diagram of an
irrigation/aspiration robotic surgical tool 500A that uses a pair
of valves mounted within a housing 501A. The tool 500A includes the
hollow tube 504, a valve subassembly 506, a three-way coupler 508,
and tube fittings 509A-509B. The tube fittings 509A-509B may have
an irrigation hose 106A and a suction hose 106B respectively
coupled thereto.
[0131] The valve subassembly 506 includes a first two-way
two-position valve 510A and a second two-way two-position valve
510B. After use, the valve subassembly 506 may be removed and
replaced by a new sterilized valve subassembly for reuse of the
tool 500A. The valves are a component of the tool that is more
difficult to clean and sterilize for reuse.
[0132] Each of the two way valves 510A-510B includes two ports. A
first port couples to the three-way coupler 508 while a second port
couples to the fittings 509A or 509B, respectively. A three-way
coupler 508 includes three ports one of which is coupled to the
hollow tube 504. The second port of the three-way coupler couples
to a port of the valve 510A. A third port of the three-way coupler
508 couples to a port of the valve 510B.
[0133] A fluid may flow in or out of the hollow tube 504 as
illustrated by the double-headed arrow near the tip. Either valve
510A or 510B may be open so that a fluid may flow through the
hollow tube 504. With valve 510B open and valve 510A substantially
closed, a suction may be applied near the tip of the surgical
instrument 500A so that a surgical site may be aspirated. With
valve 510B substantially closed and valve 510A open, a liquid may
flow through the surgical instrument 500A out through the hollow
tube 504 into a surgical site so that it may be irrigated. The
liquid is coupled to the surgical instrument 500A by the hose
106A.
[0134] FIG. 5B is a schematic flow diagram of an
irrigation/aspiration robotic surgical tool 500B that uses a single
valve mounted within a housing 501B to provide irrigation, or
aspiration. The surgical instrument 500B includes a single
three-way valve 516 with three ports, the hollow tube 504, and the
tube fittings 509A-509B. The three way coupler 508 is not
needed.
[0135] The three-way valve 516 has three ports. A first port of the
three-way valve couples to the proximal end of the hollow tube 504.
A second port couples to the tube fitting 509A that may couple to
the hose 106A. A third port of the valve 516 couples to the tube
fitting 509B that may in turn couple to hose 106B.
[0136] The three-way valve 516 has three-positions of operation. In
a closed position, the valve is completely shut off so that no
fluid flows through the hollow tube 504. In a second position
suction is shut off, the first port and the second port of the
valve couple together such that the surgical site may be irrigated
by a liquid flowing through valve 516 and into the hollow tube 504.
In a third position irrigation is shut off, the first port and the
third port of the valve couple together such that a vacuum or a
suction may flow through valve 516 and a surgical site may be
aspirated at the tip of the hollow tube 504.
[0137] FIG. 5C is a schematic flow diagram of an
irrigation/aspiration/blowing robotic surgical tool 500C that uses
a single valve mounted within a housing 501C to provide irrigation,
aspiration or blowing. The surgical instrument 500C includes a
single four-way four position valve 526, the hollow tube 504, and
the tube fittings 509A-509B coupled together as illustrated in the
mountable housing 501C. A four way coupler 508 is not needed.
[0138] The single four-way valve 526 includes four ports. A first
port of the four-way valve 526 couples to the proximal end of the
hollow tube 504. A second port of the valve 526 couples to one end
of the tube fitting 509A. A third port of the valve 526 couples to
an end of the tube fitting 509B. A fourth port of the valve 526
couples to an end of the tube fitting 509C. Hoses 106A-106C may
respectively couple to the tube fittings 509A-509C. In this manner
three of the four ports of valve 526 may receive a liquid for
irrigation, a vacuum for suction and a pressurized gas for blowing,
respectively.
[0139] The four-way valve 526 has four positions of operation. In a
closed position, the valve is completely shut off so that no fluid
flows through the hollow tube 504. In a second position
suction/blowing are shut off, the first port and the second port of
the valve couple together such that the surgical site may be
irrigated by a liquid flowing through valve 526 and into the hollow
tube 504. In a third position irrigation/suction are shut off, the
first port and the third port of the valve couple together such
that a pressurized gas may flow through valve 516 and out through
the tip of the hollow tube 504 to blow a surgical site with a
pressurized gas. In a fourth position irrigation/blowing are shut
off, the first port and the fourth port of the valve couple
together such that a vacuum may provide suction through the valve
516 and the hollow tube 504 to a surgical site to remove fluids and
solids transported therein at the tip of the hollow tube 504.
[0140] FIG. 5D is a schematic flow diagram of an
irrigation/aspiration/blowing robotic surgical tool 500D that uses
three two-way valves in a valve subassembly mounted within a
housing 501D to provide irrigation, aspiration or blowing. The
robotic surgical instrument 500D includes a valve subassembly 536,
a four-way coupler 538, the hollow tube 504, and the tube fittings
509A-509C. The tube fittings 509A-509C may couple to the hoses
106A-106C, respectively.
[0141] In place of the four-way valve 526 illustrated in FIG. 5C,
the valve subassembly 536 includes three two-way two-position
valves 510A-510C of a valve subassembly 536 in conjunction with a
four-way coupler 538. In comparison with the tool 500A of FIG. 5A,
a third two-way valve 510C is provided so that a third fluid may
flow into and out of the hollow tube 504. In this case, a
pressurized gas may be supplied by hose 106C, flow through valve
510C when opened, flow through the four way coupler 538, and into
the hollow tube 504 to blow a pressurized gas near the surgical
site.
[0142] Each of the two way two position valves 510A-510C includes
two ports. A first port of each couples to respective ports of the
four-way coupler 538 while a second port of each couples to the
fittings 509A, 509B or 509C, respectively. The four-way coupler 538
includes four ports one of which is coupled to the hollow tube 504.
The second port of the four-way coupler 538 couples to a port of
the valve 510A. A third port of the four-way coupler 538 couples to
a port of the valve 510B. A fourth port of the four-way coupler 538
couples to a port of the valve 510C.
[0143] Valve subassembly 536 may be replaceable with a sterile
component while the other elements mounted in the housing 501D may
be separately sterilized and reused with a new valve subassembly
536.
[0144] Various types of valves may be used as part of the flow
control system 417 in the IAB robotic surgical instrument 400, 101A
to control the flow of fluids to provide irrigation, aspiration, or
blowing. For example, a linear motion type of valve ("linear
valve") may be used such as a spool-type valve, a trumpet-type
valve, a piston-type valve, a poppet-type valve, or a
sliding-plate-type valve. Alternatively, a rotational motion type
of valve ("rotatable valve") may be used such as a ball-type valve,
a screw-type valve, a gate-type valve, a disc-type valve, a
cock-type valve, a globe-type valve, or a rotary-plate-type valve.
Additionally, the various types of valves within the IAB robotic
surgical instrument may be actuated in different ways by the
robotic surgical manipulator 152. While three-way and two-way
valves have been separately shown and described, any mixed
combination of one or more two-way valves and one or more three-way
valves, or other multi-port valve, may be used within an IAB
robotic surgical instrument with different types of couplers to
provide a flow control system therein. For example, an IAB robotic
surgical instrument may include a three-way valve 516 for gas
pressure and suction and a two-way valve 510A for irrigation by a
liquid coupled to a three-way coupler 508, which is in turn coupled
to the tube 504.
[0145] Moreover, the valves used in the flow control system may be
automatically returned to a closed position so that no fluid flows
through the IAB robotic surgical tool when it is dismounted from
the robotic arm or when the modular valve assembly is not mounted
in the housing of the tool. That is, the valves may be spring
loaded by a spring to return to a closed or fully off position when
they are not actuated.
[0146] FIGS. 6A-6C, 7A-7C, 8, 9 and 10A-10B illustrate some of the
various types of valves, various types of actuation means, and
various types of automatic return means that may be used to control
the flow of fluids through the robotic surgical instrument and into
the surgical site. It is understood that other types of valves,
actuation means, and automatic return means may be used to provide
flow control for a flow control system of an IAB robotic surgical
tool.
[0147] Referring now to FIGS. 6A-6C, rotational actuators to
actuate rotatable valves are illustrated for use with the
irrigation/aspiration/blowing robotic surgical tool and the robotic
surgical arm.
[0148] In FIG. 6A, the rotatable receiving element 418A is directly
coupled to the rotatable valve 604A. As the rotatable receiving
element 418A is rotated, a shaft of the rotatable valve rotates to
a different position in order to open or close the valve and
control the flow of fluids. For actuation, the rotatable receiving
element 418A couples to the rotatable driver 234 of the adapter 228
in the robotic arm. The pins 422A-422B of the rotatable receiving
element 418A couple into the respective openings 240A-240B of the
adapter 228. A coil spring 606 may be used to return the rotatable
valve 604A to a closed or shut off position when the robotic
surgical tool 101A is dismounted from the robotic arm.
[0149] In FIG. 6B, a rotatable receiving element 418B rotatably
couples to the rotatable valve 604B through a gearing provided by
the gears 610-611. The rotatable receiving element 418B similarly
couples to the rotatable driver 234. The rotatable receiving
element 418B includes the gear 610 which also may be referred to as
a driving gear 610. Valve 604B includes the pinion gear 611 coupled
to a shaft 602 of the rotatable valve in order to rotate the valve
from one position to another. The gearing may be use to reduce or
increase the rotation in the driver gear 610 to rotate the valve.
The rotatable receiving element 418B may further include the coil
spring 606 to return the three-way four position valve 604B to a
shut off position. The rotatable valve 604B is a three-way valve
including three ports and has three positions.
[0150] In FIG. 6C, the rotatable receiving element 418C is linked
to the rotatable valve 604C by means of a linkage 620. The
rotatable receiving element 418C includes a drive wheel with a
notch 622 to receive a distal end of the linkage 620. The rotatable
valve 604C is a three-way three position valve. The rotatable
receiving element 418C may move the valve 604C into one of three
positions. In position 620A, the valve may be shut off so that no
fluid flows through the robotic surgical tool 101A, 400. In
position 620B, a first fluid may flow between a first port and a
second port. In position 620C, a second fluid may flow between the
first port and a third port.
[0151] To change positions of the valve using the linkage 620, the
rotatable receiving element 418C may be moved counter clockwise,
while the valve rotates clockwise. If the rotatable receiving
element 418C moves clockwise, the linkage 620 causes the valve to
rotate counter clockwise. To actuate the rotatable valve, the
rotatable receiving element 418C couples to the rotatable driver
234 by means of the pins 422A-422B coupling into the opening
240A-240B respectively.
[0152] FIGS. 7A-7C illustrate the linear actuation of linear motion
valves that may be used in the flow control system 417 of IAB
robotic surgical tools. The dashed lines shown in FIGS. 7A-7C
illustrate a dividing line between the robotic surgical tool 400,
101A and actuation in the robotic surgical arm 153.
[0153] In FIG. 7A, a push rod 702 is linearly actuated in the
robotic arm 153. One end of the push rod 702 pushes on a button 703
of a linear motion trumpet valve 704A to move a plunger 705
therein. The trumpet valve 704A is a two-way two-position valve.
The plunger 705 in its closed position blocks the first and second
ports of the trumpet valve 704A. When the valve is linearly pushed
open, a spring 706 is compressed and the plunger moves to a
position 705' such that the first and second ports are open to pass
a fluid.
[0154] The push rod 702 may be linearly actuated in robotic arm in
a number of ways including, but not limited to, pneumatically,
hydraulically, electromechanically, or electrically. For example, a
solenoid 701 may be used to linearly actuate the push rod 702 to
linearly move the valve 704A to an open position. When the push rod
702 is not actuated, the force of the spring 706 may push back on
the push rod 702 and return the plunger of the valve to a closed
plunger position 705 to shut off the first and second ports and
stop a flow of a fluid. The spring 706 may also retain the plunger
of the valve in a closed plunger position 705 to shut off the first
and second ports when the IAB robotic surgical tool is
dismounted.
[0155] In FIG. 7B, a spool valve 704B linearly moves in response to
a magnetic force generated by the electromagnet 710 in the robotic
arm 153. The electromagnet 710 may be formed out of coil of wire
711 wrapped around a magnetic core 712. When no electromagnetic
field is generated by the electromagnet 710, a spring 706 keeps the
spool 715 in a closed position blocking the first and second ports
of the spool valve 704B. To actuate the spool valve, the
electromagnet 710 is actuated to pull the spool 715 in a linear
motion into position 715' so that the center hourglass portion of
the spool 715 is coincident with the first and second ports to
allow fluid to flow through the valve 704B. Spring 706 is
compressed with the spool in position 715' such that when the
electromagnetic force of the electromagnet 710 is released the
spring 706 pushes back on the spool 715 to close off the valve
704B.
[0156] In FIG. 7C, a three-way spool valve 704C is electrically
actuated by the robotic arm 153 to move the spool 725 with a linear
motion. Electrical contacts 242 in the robotic arm 153 couple to
the pins 424 of the robotic surgical tool 400, 101A. The three-way
valve 704C includes the spool 725, three ports, a first spring 706A
at a first end, and a second spring 706B at a second end, a first
wire coil 710A at the first end, and a second wire coil 710B at the
second end. A current in the wires 721A may flow through the coil
710A to attract the spool 725 towards the first end of the valve so
that the ports 726 and 728 of the valve are coincident with the
center hourglass portion of the spool to allow fluid to flow
there-between. To shut off the valve, the current flow in the wires
721A is turned off and the spool 725 is pushed back into the closed
position by the force of spring 706A. Springs 706A-706B maintain
the spool in the center position shutting off the three ports in
the valve from each other. By providing a current in the wires 721B
and the coil 720B, the spool 725 is moved towards the second end
and compresses the spring 706B. This allows the center hourglass
portion of the spool 725 to coincide with the second port 727 and
the third port 728 to allow a fluid to flow there-between. To shut
off the valve, the current flow in the wires 721B is turned off and
the spring 706B pushes the spool 725 back to its closed
position.
[0157] Referring now to FIG. 8, a linear actuation is transformed
into a rotational actuation for a rotatable valve by a rack and
pinion gear system. When activated, a push rod 702 linearly pushes
against a button 803 of the rack 801 in order to linearly move its
teeth 810 and provide the initial linear actuation. The teeth 810
of the rack 801 are meshed with the pinion gear 811 to transform
the initial linear actuation of the push rod into a rotational
actuation. The pinion gear is coupled to a shaft 802 of the
rotatable valve 804. As the teeth of the rack 801 linearly move,
the pinion gear 811 transforms the linear motion into a rotational
motion in order to rotate the rotatable valve 804 between open and
closed positions to control the fluid flow.
[0158] A spring may be coupled between an end of the rack 801 and a
stop in order to linearly push on the rack and rotate and maintain
the valve in a closed position when the IAB robotic surgical tool
is dismounted.
[0159] In addition to being robotically controlled from the master
control console 150, the valves of the flow control system 417 of
the IAB robotic surgical tools may also be manually controlled.
Manual actuators may be provided that extend external to the
housing so that a user's hand may open and/or close the valves.
[0160] Referring now to FIGS. 9A-9B, a rotational actuation is
transformed into linear actuation by a cam and cam follower system
for actuation of a linear motion trumpet valve 704A. Trumpet valve
704A illustrated in FIGS. 9A-9B operates similarly to trumpet valve
704A of FIG. 7A but with a cam follower 903 in place of the button
703 to better couple to the rotating cam 902. Additionally, the cam
follower 903 of FIG. 9A may further include a manual push arm 913
that may extend for a top side of a housing of the IAB robotic
surgical tools for manual operation of the trumpet valve 704A. The
cam follower 903 of FIG. 9B may further include a manual push side
arm 923 that may extend for a side of a housing of the IAB robotic
surgical tools for manual operation of the trumpet valve 704A.
[0161] The rotatable receiving element 418D of the IAB robotic
surgical tools is coupled to the cam 902. For robotic control from
the master control console 150, the rotatable receiving element
418D couples to the rotatable driver 234 by means of the pins
422A-422B within the openings 240A-240B, respectively.
[0162] The cam 902 includes a cam lobe 904 that pushes on the cam
follower 903 to a position 903' so that the plunger 705 is moved to
an open position 705'. In the open position 705', the plunger
allows the first and second ports to couple together and allow a
fluid to flow there-between. As the cam rotates to move the cam
lobe to a different position so that the cam follower can move back
to its original position 903, the spring 706 pushes on the plunger
705 to move it back into the closed position to close the valve
704A.
[0163] The cam 902 may rotate clockwise or counterclockwise so that
the cam follower transforms a rotational motion into a linear
motion to open and close the valve 704A. In this manner, a
rotational actuation within the robotic surgical tool 400, 101A may
be converted to linear actuation and actuate a linear motion valve,
such as the trumpet valve 704A. A coil spring may be coupled around
the shaft of the cam 901 in order to rotate it so that the valve
can close when the IAB robotic surgical tool is dismounted.
[0164] With the cam 902 rotated to a position so that the valve
704A is closed, the valve may be manually operated. To manually
operate valve 704A, a user pushes on the manual push arms 913,923
extending from the housing. With the manual push arms 913,923 being
coupled to the cam follower 903, the force applied thereto manually
forces open the valve 704A. This decouples the cam follower 903
from the cam 902. To close the valve 704A, a user releases the
force applied to the manual push arms 913,923 which allows the
spring 706 to push back out the plunger 705 into a closed position
and shut off the valve.
[0165] Referring now to FIGS. 10A-10B, pinch valves 1004A-1004B for
use in the flow control system of IAB robotic surgical tools are
illustrated. The pinch valves 1004A-1004B are used to pinch closed
a hose 1002,1002' to control the flow of fluids.
[0166] In FIG. 10A, a rotary pinch valve 1004A is illustrated to
pinch closed a hose 1002 and can be rotated to release and open the
hose 1002. Without the hose 1002 pinched off, a fluid is allowed to
flow therein and through the IAB robotic surgical tools. The rotary
pinch valve 1004A pinches the hose 1002 closed against a backstop
1005 to shut off the flow of fluids. The hose 1002 may be a silicon
rubber hose that is flexible in order that it may be readily
pinched off and stop the fluid flow therein and flex back when
released.
[0167] The rotary pinch valve 1004A is coupled to a shaft of the
rotatable receiving element 418E to receive a rotational actuation.
The rotatable receiving element 418E may couple to the rotatable
driver 234 in a similar fashion as previously described with pins
422A-422B inserted into the respective openings 240A-240B.
[0168] The rotary pinch valve 1004A includes a rotatable pinch arm
1020 and a pinch roller 1022 coupled to the distal end of the
rotatable pinch arm 1020. The rotary pinch valve 1004A may further
include a spring 1006 coupled to the rotatable receiving element
418E in order to bias the pinch valve to a closed position and
pinch off the hose when the surgical tool 101A, 400 is
dismounted.
[0169] In the closed position, the pinch roller 1022 pinches off
the hose 1002 against the backstop 1005. In rotating the pinch
valve 1004A and the rotatable pinch arm from the closed position to
a position 1020', the pressure against the hose 1002 is released
such that it flexes open and allows fluid to flow therein.
[0170] In FIG. 10B, a linear pinch valve 1004B is illustrated to
pinch closed a hose 1002'. The linear pinch valve 1004B can be
moved linearly to release and open the hose 1002'. Without the hose
1002' pinched off, a fluid is allowed to flow therein and through
the IAB robotic surgical tools. The linear pinch valve 1004B
pinches the hose 1002' closed against a backstop 1015 to shut off
the flow of fluids. The hose 1002' may be a silicon rubber hose
that is flexible in order that it may be readily pinched off and
stop the fluid flow therein and flex back when released.
[0171] A push rod 702 may be provided in the robotic arm 153 to
provide linear actuation of the linear pinch valve 1004B. The push
rod 702 pushes on a button 1013 to a position 1013'', compressing a
spring 1016, and linearly moving the linear pinch valve 1004B and a
linear pinch arm 1030 to position 1030' to release the hose 1002
from the backstop 1015. With the linear pinch arm 1030 in the open
position 1030', the linear pinch valve is open and fluid can flow
within the hose 1002'. Upon releasing the linear force provided by
the push rod 702 within the robotic arm 153, the spring 1016 forces
back the linear pinch arm 1030 of the linear pinch valve 1030 to
squeeze the hose 1002 against the backstop 1015. In this manner, a
linear actuating motion of the push rod 702 can activate a linear
pinch valve 1004B.
[0172] FIGS. 11A-15B illustrate exemplary embodiments of IAB
robotic surgical tools including varying types of flow control
systems.
[0173] Referring now to FIGS. 11A-11E,
irrigation/aspiration/blowing robotic surgical tools having a flow
control system with a solid valve body are now discussed.
[0174] FIG. 11A illustrates a top perspective view of an IAB
robotic surgical tool 1100 with its cover removed to show the flow
control system 417 therein. The IAB robotic surgical tool 1100
employs a solid valve body 1101. The solid valve body 1101 is a
three-dimensional solid body that includes hollow passages with
open ports therein and a pair of valve openings to receive a pair
of rotatable valves 1104A-1104B. In one embodiment of the
invention, the solid valve body 1101 is a polyhedron shaped solid
body.
[0175] With a solid valve body, the flow control system 417 of the
IAB robotic surgical tool 1100 is relatively inexpensive to
manufacture such that the flow control system 417 may be discarded
after use, instead of cleaned or sterilized. The remaining
components of the tool 1100 may be cleaned and re-sterilized.
Alternatively, the IAB robotic surgical tool 1100 is also
relatively inexpensive to manufacture such that it may be discarded
in its entirety after usage.
[0176] A first port of the solid valve body 1101 couples to the
proximal end of the hollow tube 404. Second and third ports of the
solid valve body 1101 may couple to the hose fittings 410A-410B.
The hose fittings 410A-410B may respectively couple to hoses
106A-106B. The solid valve body 1101 includes a three-way passage
1106 coupled between the proximal end of the hollow tube 404 and
first ports of rotatable valves 1104A-1104B. The solid valve body
1101 further includes passages 1108A-1108B coupled between second
ports of the rotatable valves 1104A-1104B and the hose fittings
410A-410B, respectively. The rotatable valves 1104A-1104B are
two-way two-position valves and each have an open flow channel that
can be rotated and switched open or closed between the ports to the
respective passages 1108A-1108B and the ports to the three-way
passage 1106.
[0177] Although a third valve and a third set of passages are not
illustrated in FIG. 11A, it is understood that it may be provided
to provide flow control for a third type of fluid.
[0178] The hollow tube 404 is mechanically supported in the
mountable housing by having an end coupled into the first port of
the solid valve body 1101. The hollow tube 404 maybe further
supported mechanically by being inserted into a bushing that is
supported within the collar 1102 of the interface base 412. As
previously discussed, the hollow tube 404 has an opening 424 at its
tip 406. The hollow tube 404 may further have openings around its
circumference near its tip 406.
[0179] The solid valve body 1101 may be fitted to the interface
base 412 so that it is readily replaceable. The hollow tube 404 may
be fitted with a quick release fitting to the solid valve body 1101
so that it can be readily re-sterilized and reused.
[0180] Referring now to FIG. 11B, a bottom exploded view of the IAB
robotic surgical tool 1100 is illustrated. As illustrated by FIG.
11B, the solid valve body 1101 includes valve openings 1109A-1109B
to receive the rotatable valves 1104A-1104B, respectively. The
valve openings 1109A-1109B in the solid valve body may include
threads or rings to allow the rotatable valves 1104A-1104B to
rotate in a fixed axial position with respect to the passages 1106,
and 1108A-1108B.
[0181] Coupled to one end of a cylindrical shaft 1105 of each of
the rotatable valves 1104A-1104B is a rotatable receiving element
418 with pins 422A-422B. The rotatable receiving element 418 of the
rotatable valves 1104A-1104B may further include a tab 1114 to abut
against a stop within the interface base 412.
[0182] Elements of the rotatable valves 1104A-1104B may be molded
together as one piece to further lower the cost of manufacture of
the flow control system. As valves 1104A-1104B are substantially
similar, a further detailed description of valve 1104A is only
provided with valves 1104A-1104B being collectively referred to as
valves 1104.
[0183] In the cylindrical shaft 1105 of the valves 1104 is the flow
channel 1110. The flow channel 1110 of the rotatable valves 1104
may be a slanted opening through the cylindrical shaft. The flow
channel 1110 of the rotatable valves 1104 may be a slanted opening
through the cylindrical shaft. Wrapped around the cylindrical shaft
are one or more seals 1112 to seal off the flow channel 1110 within
the valve body 1101. A slanted seal 1113 may be provided above the
slanted opening of the flow channel 1110. In an alternate
embodiment of the invention, an additional slanted seal 1113 may be
provided below the slanted opening of the flow channel 1110. The
cylindrical shaft 1105 has circumferential channels to respectively
receive a portion of the one or more seals 1112. The cylindrical
shaft 1105 has one or more slanted channels in its cylindrical
surface to respectively receive a portion of the one or more
slanted seals 1113. The channels in the shaft 1105 keep the seals
in position as the valve is moved.
[0184] Referring now to FIG. 11C, a cross section of one of the
rotatable valves 1104 is illustrated in a closed position. As
discussed previously, the rotatable valve 1104 includes the
cylindrical shaft 1105 coupled at one end to the rotatable
receiving element 418.
[0185] The cylindrical shaft 1105 includes the flow channel 1110.
The flow channel 1110 has a first port 1110A at one end and a
second port 1110B at a second end. As discussed previously, the
flow channel 1110 may be slanted from the first port 1110A to the
second port 1110B. As valve 1104 is in a closed position in FIG.
11C, neither the first port 1110A nor the second port 1110B of the
flow channel 1110 matches the ports into the passages 1106 or
1108A, 1108B. The cylindrical shaft 1105 further includes one or
more seals 1112 near top and bottom portions to seal off the flow
channel 1110 in the solid body 1101. The cylindrical shaft 1105
further includes the slanted seal 1113 between a top seal 1112 and
the slanted flow channel 1110 to further seal the rotatable valve
within the solid body 1101.
[0186] The slanted seal 1113 around the cylindrical shaft 1105
allows for relaxed tolerances between the rotatable valve 1104 and
the solid valve body 1101. In particular, the slanted seal 1113
allows for a larger radial gap between the cylindrical shaft 1105
of the valve 1104 and the solid valve body 1101 while maintaining a
leak-less seal. While the top and bottom seals 1112 seal the valve
1404 with respect to the valve body, the slanted seal 1113 seals
the flow of fluids through the channel 1110. The slanted seal 1113
seals the flow of fluids through the channel 1110 over the range of
positions of the valve 1104, from a fully closed position to a
fully open position. The slanted seal 1113 particularly prevents
leakage when the valve 1104 is in the closed position.
[0187] In an alternate embodiment of the invention, the channel
1110 in the cylindrical shaft 1105 is replaced by narrowing the
center diameter portion of the cylindrical shaft 1105 between the
slanted seal 1113 and the bottom seal 1112, such as into an hour
glass shape, to form a channel for fluid flow when the valve 1104
is moved from a closed position. In this case, the slanted seal
1113 forms an end portion of the channel.
[0188] The hollow tube 404 couples to a port of the three-way
passage 1106. The hose fittings 410A, 410B couple to the passages
1108A, 1108B, respectively. The hose fittings 410A, 410B and the
hollow tube 404 may be press fitted into the solid valve body 1101
or have threads to be screwed into and mate with threads in
passages 1106, 1108A, 1108B of the solid valve body 1101.
[0189] Referring now to FIG. 11D, a cross section of one of the
rotatable valves 1104 is illustrated in an open position. With the
rotatable valve 1104 in an open position, a fluid can flow between
the hollow tube 404 and one of the hose fittings 410A, 410B by way
of the passages in the solid valve body 1101 and the flow channel
1110.
[0190] In comparison with FIG. 11C, the flow channel 1110 in the
cylindrical shaft 1105 is reoriented to a position where its first
port 1110A matches a port of the three-way passage 1106 and its
second port 1110B matches a port of the passage 1108A, 1108B. In
this manner, a fluid can flow from the hollow tube into the three
way passage 1106, through the flow channel 1110, into the passage
1108A,1108B and out of the hose fitting 410A,410B. Alternatively, a
fluid can flow from the hose fitting 410A,410B, into the passage
1108A, 1108B, through the flow channel 1110, into the three way
passage 1106 and out from the hollow tube 404.
[0191] FIGS. 11C-11D illustrate one or more seals 1112 near top and
bottom portions of the shaft 1105 and the slanted seal 1113 in
parallel with the slanted flow channel 1110 to seal the rotatable
valves 1004A-1104B in the solid body 1101.
[0192] The rotatable valves 1104A and 1104B may operate in the same
rotational direction or in opposite rotational directions. That is,
each rotatable valve may operate to open in a clockwise direction
or a counterclockwise direction. Alternatively, rotatable valve
1104A may open using a counterclockwise rotation while rotatable
valve 1104B opens using a clockwise rotation, for example.
[0193] With a solid valve body 1101 and one piece rotatable valves
1104, the flow control system 417 can be made relatively
inexpensive such that it can be readily discarded with or without
other components of the surgical tool 1100.
[0194] As discussed previously, the valves of the flow control
system 417 of the IAB robotic surgical tools may also be manually
controlled with manual actuators. Additional manually controlled
valves may also be provided in parallel with robotically controlled
valves in the flow control system in order to both manually and
robotically control the fluid flows through an IAB robotic surgical
instrument. Manual actuators are coupled to the manually controlled
valves to extend external to the housing of the IAB robotic
surgical tools so that a user's hand may open and/or close the
valves.
[0195] Referring now to FIG. 11E, the solid valve body 1101 has
been modified to solid valve body 1101' that includes manually
controlled valves 1124A-1124B in parallel with the respective
robotically controlled valves 1104A-1104B in order that the fluid
flows through the IAB robotic surgical instrument 1100B may be
controlled manually by hand and robotically from a master control
console 150. The manually controlled valves 1124A-1124B are trumpet
valves, a type of valve such as illustrated in FIG. 7A and
previously described. The valves 1124A-1124B each include a button
1125 on top that extends out from the housing 401 through the cover
414 (not illustrated in FIG. 11E), such as illustrated in FIG. 13B.
However, the trumpet valves 1124A-1124B are two-way two position
valves that are linearly actuated by a finger or hand pushing on
the button to open the valve and allow fluid to flow. As in valve
704A, each of the manually controlled valves 1124A-1124B includes a
spring 706 to return the valve to a closed position when the force
is released from the button 1125. (see FIG. 7A). The button 1125 is
similar to the button 703 of the valve 704A illustrated in FIG.
7A.
[0196] To support the valves 1124A-1124B, the two way passages
1108A-1108B and the three way passage 1106 in the solid valve body
1101 illustrated in FIG. 11A are modified respectively into three
way passages 1108A'-1108B' and a five way passage 1106' of the
solid valve body 1101' illustrated in FIG. 11E. The five way
passage 1106' includes one or more parallel passages 1126 to a port
of the valves 1124A-1124B. That is, the five way passage 1106' has
a first port to couple to the tube 404, a second port and a third
port to respectively couple to valves 1104A, 1104B, and a fourth
port and a fifth port to respectively couple to the valves
1124A-1124B. The three way passages 1108A'-1108B' each include a
side passage 1128 to a port of the valves 1124A-1124B. The three
way passage 1108A' has a first port to couple to the valve 1104A, a
second port to couple to the valve 1124A, and a third port to
couple to the hose fitting 410A. The three way passage 1108B' has a
first port to couple to the valve 1104B, a second port to couple to
the valve 1124B, and a third port to couple to the hose fitting
4101B. The solid valve body 1101' further includes an additional
pair of valve openings to receive the spring 706 and the plunger
705 of the trumpet valve 704A. Additional seals may be provided
around the shaft between the plunger 705 and the buttons
703,1125.
[0197] Otherwise, the modified solid valve body 1101', including
the structure and function of the valves 1104A-1104B, is similar to
that of the solid valve body 1101 illustrated by FIGS. 11A-11D and
described previously.
[0198] Referring now to FIG. 12, a top perspective view of an IAB
robotic surgical tool 1200 is illustrated with its cover over the
mountable housing removed. The IAB robotic surgical tool 1200
includes a modular valve subassembly 1201. After being used once,
the modular valve assembly 1201 and coupling hoses 1208A-1208B are
readily replaceable with new used components. The remaining portion
of the tool 1200 may be re-sterilized and then reused with a new
modular valve assembly 1201 and coupling hoses 1208A-1028B. The
modular valve subassembly 1201 is mountable to and dismountable
from the interface base 412. A base 1211 of the modular valve
subassembly 1201 may press fit into place to mount the valve
subassembly to the interface base 412. The base 1211 of the modular
valve subassembly 1201 includes recesses for rigid attachment of
the ports of the valves 1204A-1204B and the ports of the hose
fittings 410A-410B. Hoses 106A-106B may be coupled to ends of the
hose fittings 410A-410B. The control and actuation of the rotatable
valves 1204A-1204B was previously described with reference to FIG.
6A and the rotatable valve 604A.
[0199] The modular valve subassembly includes a first rotatable
valve 1204A and a second rotatable valve 1204B. Each of the valves
1204A-1204B are two-way, two-position valves having a pair of
ports. The valves 104A-104B may be trumpet valves, ball cock style
valves, or other rotatable type of valve used to control the flow
of gases or fluids. Coupled to the first ports of each valve
1204A-1204B are the hose fittings 410A-410B, respectively. Coupled
to a second port of each of the valves 1204A-1204B are first ends
of the respective coupling hoses 1208A-1208B. Second ends of the
hoses 1208A-1208B respectively couple to a pair of ports of a
three-way coupler 1206. A third port of the coupler 1206 couples to
the hollow tube 404.
[0200] Shafts of the valves 1204A-1204B can be coupled to and
decoupled from a pair of rotatable receiving elements 418. The
modular valve subassembly 1201 is replaceable. After being used,
the modular valve subassembly 1201 is dismounted from the interface
base with shafts of the used valves 1204A-1204B being decoupled
from the rotatable receiving elements 418. Similarly, shafts of new
unused valves 1204A-1204B may be coupled to the rotatable receiving
elements 418 when mounting a new modular valve subassembly to the
interface base.
[0201] Coil springs may be wrapped around the shafts of the valves
1204A-1204B and coupled to the pair of rotatable receiving elements
418 in order to spring load the valves 1204A-1204B to automatically
close so that neither suction nor irrigation are activated when the
instrument housing is not mounted onto the robotic arm, or modular
valve subassembly is not mounted to the interface base 412 in the
mountable housing 401.
[0202] The hollow tube 404 is supported by the interface base. A
bushing 1202 may be inserted over the hollow tube 404 and pressed
into the collar 1102 of the interface base 412.
[0203] The printed circuit board 425 may also be mounted to the
interface base 412. Electrical pins 424 may couple to the printed
circuit board 425 to provide an electrical connection to the
adaptor 228. The integrated circuit 426 is mounted to the printed
circuit board may be reprogrammed to indicate that the tool 1200
has been re-sterilized and its components replaced.
[0204] In order to reuse the IAB robotic surgical tool 1200, the
modular valve subassembly 1201 and the coupling hoses 1208A-1208B
are removed and discarded. A new valve subassembly 1201 and new
hoses 1208A-1208B are installed and mounted in the robotic surgical
tool. The remaining components including the interface base 412,
the three-way coupler 1206 and the hollow tube 404 are
re-sterilized prior to fitting a new modular valve subassembly 1201
and new hoses 1208A-1208B.
[0205] After re-sterilization, the integrated circuit 426 may be
programmed to indicate that the tool 1200 has been re-sterilized
and its components replaced.
[0206] Referring now to FIGS. 13A-13B, an IAB robotic surgical tool
1300 to control the flow of fluids into and out from a surgical
site is illustrated. FIG. 13A illustrates the IAB robotic surgical
tool 1300 with its cover removed to show that the IAB robotic
surgical tool 1300 includes a flow control system that utilizes
rotatable pinch valves 1304A-1304B.
[0207] To control the flow of fluids through the robotic surgical
tool 1300, a pair of flexible coupling hoses 1302A-1302B are
coupled to a pair of hose fittings 410A-410B at a first end and a
pair of ports of a three-way coupler 1206 at a second end. The
third port of the three-way coupler 1206 is coupled to the proximal
end of the hollow tubing 404. To pinch off hoses 1302A-1302B, the
tool 1300 includes a rotatable pinch valves 1304A-1304B rotatably
mounted to the interface base 412. Each of the pinch valves
1304A-1304B is coupled to a rotatable receiving element 418. As
discussed previously, the rotatable receiving element 418 may
couple to a rotatable driver 234.
[0208] Each of the rotatable pinch valves 1304A-1304B may include a
coil spring 1306, a rotatable pinch arm 1320, a pinch wheel 1322
coupled to the end of the rotatable pinch arm 1320, a tab 1324, and
a handle 1330. In FIG. 13A, the pinch valve 1304A is illustrated as
being open and allowing the flow of fluid through the tool 1300.
Rotatable pinch valve 1304B is illustrated as being closed to pinch
off hose 1302B at a pinch point 1302B'.
[0209] At a pinch point 1302B', a pinch wheel 1322 presses the hose
1302B against the backstop 1315B of bulkhead 1310. The hose 1302B
collapses to a diameter of zero so that no fluid can flow through
it at the pinch point 1302B'. The rotatable pinch valve 1304A may
utilize the backstop 1315A of bulkhead 1310 to close and pinch off
hose 1302A. The operation of a rotatable pinch valve is further
discussed herein with reference to FIG. 10A. When being opened from
the closed position, the tab 1324 may be used to limit the rotation
of each rotatable pinch valve 1304A-1304B to a stop 1325.
[0210] In order to readily collapse and pinch off the flow of
fluids, the hoses 1302A-1302B may be silicon hoses that are
flexible with the capability of expanding to an open non-collapsed
diameter from a collapsed state at the pinch point in response to
opening the rotatable pinch valves. The pinch wheel 1322 rotates
along the hose as its being pinched off so as to avoid damaging the
hose and cause leeks.
[0211] The coil spring 1306 wrapped around the shafts of the pinch
valves 1304A-1304B may be used to spring load the valves
1204A-1204B to automatically close and pinch off the hoses
1302A-1302B when the instrument housing is dismounted from the
robotic arm or otherwise not being actuated.
[0212] While the IAB robotic surgical tool 1300 is typically under
control of the master control console 150, the handles 1330A-1330B
allow for manual use of the IAB robot surgical tool 1300 when it is
not mounted to a robotic arm. The handles 1330A-1330B are
respectively coupled to the shafts 1330A-1330B of the rotatable
pinch valves 1304A-1304B in order to manually rotate them open and
closed by hand. When the IAB robot surgical tool 1300 is not
mounted to a robotic arm so that the rotatable receiving elements
418 are not engaged with the rotatable drivers 234, the assistant
surgeon or nurse may manually operate the IAB robotic surgical tool
1300 to control the fluid flows by using the handles 1330A-1330B.
Furthermore, the handles 1330A-1330B allow for cleaning the flow
control system as is described further below.
[0213] Referring now to FIG. 13B, the IAB robotic surgical tool
1300 is illustrated with its cover 1350 coupled to the interface
base 412. The cover 1350 provides protection to the flow control
system 417 including the rotatable pinch valves in the hoses. The
handles 1330A-1330B extend through the cover 1350 so that they are
accessible to manually control the pinch valves.
[0214] Additionally, the handle 1330A includes a clip 1332 that may
be swung around and fitted into a groove 1334 of the handle 1305B.
With the clip 1332 within the groove 1334, both handles 1330A-1330B
are open such that neither hose 1302A nor hose 1302B is pinched
closed. The handles are clipped together in the open position
during a cleaning of the flow control system of the robotic
surgical tool 1300 and to ease replacement of the hoses.
[0215] To clip the handles together, the handle is rotated to the
open position and the clip 1332 is swung to position 1332'. The
handle 1330B is rotated to position 1330B' so that the clip 1332'
may be inserted into its groove 1334. In this position, the pinch
valves are both open and the hoses 1302A-1302B are not pinched off
but are open so that they can be cleaned.
[0216] Referring now to FIG. 14, a top view of a IAB robotic
surgical tool 1400 is illustrated with its cover removed to show
the pinch valves and replaceable tubing. The tool 1400 is
substantially similar to tool 1300 previously described but for use
of the coupling hoses 1302A-1302B to control the flow of fluids
within the tool. Tool 1400 eliminates the hose fittings 410A-410B
and the short coupling hoses 1302A-1302B between the hose fittings
410A-410B and the three-way coupler 1206. Instead, the tool 1400
includes replaceable hoses 106B-106A directly coupled to the ports
of the three-way coupler 1206, as is illustrated in FIG. 14. The
replaceable hoses 106B-106A extend beyond the robotic surgical tool
in order to couple externally to sources of fluids.
[0217] In contrast, the coupling hoses 1302A-1302B of the tool 1300
require cleaning and sterilization after each use of the tool 1300
in order for it to be reused. In tool 1400, the hoses 106A-106B are
not cleaned, but replaced after each usage with new sterile hoses
so that the tool 1400 may be reused. With the rotatable pinch
valves open, the interface base 412 is formed with bulkhead 1410 to
allow the hoses 106A-106B to be readily replaceable and coupled to
the three-way coupled 1206.
[0218] The tool 1400 includes the rotatable pinch valves
1304A-1304B with their pinch arms 1320 and pinch rollers 1322
coupled thereto to pinch off the hoses 106A-106B and stop the flow
of fluids. The rotatable pinch valves are rotatably mounted to the
interface base 412. The shaft of each rotatable valve is coupled to
the rotatable receiving element 418.
[0219] In FIG. 14, rotatable pinch valve 1304A is open such that
hose 106A may allow a fluid to flow therein. Rotatable pinch valve
1304B is closed to pinch off hose 106B at point 1402B. Thus, with
pinch valve 1304B closed, a fluid will not flow through hose 106B.
Bulkhead 1410 is provided so that the hoses 106A-106B may be
readily replaced when the rotatable pinch valves 1304A-1304B are
held in their open positions. The bulkhead 1410 includes backstops
1415A and 1415B against which the rotatable pinch valves
1304A-1304B may pinch off the respective hoses 106A-106B. Hoses
106A-106B may be formed of a silicon rubber compound so that they
are flexible and can be readily collapsed and expanded in response
to the opening and closing of the rotatable pinch valves.
[0220] As discussed previously, the replaceable hoses 106B-106A are
directly coupled to two of the three ports of the three-way coupler
1206. The third port of the three-way coupler 1206 is coupled to
the proximal end of the hollow tube 404. The hollow tube 404 may be
further supported by the interface base 412 by inserting a the
hollow tube into a bushing mounted in the collar 1102.
[0221] The IAB robotic surgical tools, including tool 1400, may
further include the printed circuit board 425 with one or more pins
424 and one or more interrelated circuits 426 coupled thereto to
indicate its tool type, whether its new or refurbished, and if
refurbished, the number of prior uses.
[0222] Referring now to FIGS. 15A-15B, IAB robotic surgical tools
1500A-1500B are respectively illustrated without their covers. The
tools 1500A-1500B do not internally control the flow of fluids into
and out of a surgical site. Instead, the control of the flow of
fluids into and out of a surgical site is externally controlled
away from the surgical tool. As previously discussed with reference
to FIG. 1, the control of fluids may be provided at the respective
fluid pumps by the computer system 151 in the surgeons master
control console 150 under the control of the operator O.
[0223] Even though fluid flow is externally controlled, the IAB
robotic surgical tools 1500A-1500B are mounted to a robotic arm of
the robotic surgical manipulator 152 and can facilitate the flow of
fluids into and out of a surgical site through couplers and the
hollow tube 404.
[0224] In FIG. 15A, the IAB robotic surgical tool 1500A includes a
three-way coupler 1206 mounted to the interface base 412. A
proximal end of the hollow tube 404 couples to a first port of the
three-way coupler 1206. Replaceable hoses 106A-106B respectively
couple to a second and a third port of the three-way coupler 1206.
The tool 1500A may further include the printed circuit board 425
with the electrical pins 424 in one or more interrelated circuits
426 coupled thereto to indicate the tool type and that external
fluid control is to be utilized.
[0225] In FIG. 15B, the IAB robotic surgical tool 1500B includes a
four-way coupler 1506 with a first port coupled to the hollow tube
404, a second port coupled to an end of a first hose 106A, a third
port coupled to an end of a second hose 106B, and a fourth port
coupled to an end of a third hose 106C. Tool 1500B may also include
the printed circuit board 425 with the electrical pins 424 and the
one or more integrated circuits 426 coupled thereto to indicate the
tool type and that external fluid control is to be utilized to
control the flow of fluids flow in the hoses 106A-106C.
[0226] Cleaning and sterilization of the IAB robotic surgical tools
1500A-1500B is fairly easy as there are no valves. To reuse the
tools 1500A-1500B, used hoses 106A-106C are removed. The remaining
portions of the tools 1500A and 1500B, such as the couplers and the
hollow tube 404, are then sterilized and then fitted with new
sterile hoses 106A-106C so that they may be reused.
[0227] While IAB robotic surgical tools 1500A-1500B have been shown
and described to include couplers 1206, 1506, respectively, the
couplers can be removed and provided externally to the surgical
tools 1500A-1500B. In which case, a single hose would be routed
from the external coupler to the IAB robotic surgical tool. The
single hose may couple to a hose fitting, that in turn would be
coupled to the hollow tube 404. Alternatively, the proximal end of
the hollow tube could be formed as a hose fitting and directly
couple to an end of the hose. In this manner, reuse of the IAB
robotic surgical tool may further simplified with fewer components
to sterilize and a single hose to replace.
User Control
[0228] Typically, irrigation and aspiration of a surgical site are
manually controlled by an assisting surgeon or nurse using manual
surgical tools. By allowing tele-operated or remote control and
actuation of an IA or IAB robotic surgical instrument, the primary
surgeon can now control irrigation and aspiration of a surgical
site.
[0229] The flow control system of the IAB robotic surgical
instrument may be controlled by the operator O seated at the
robotic surgical master control console 150 in a number of ways.
For example, master axes of movement in a control handle that is
normally used for controlling a wristed robotic surgical instrument
may be used to activate irrigation, aspiration, and or blowing
through an IAB robotic surgical instrument over a surgical site. As
previously discussed, one or a combination of both the rotational
motion of the touch sensitive handle 325 and the squeezing motion
of the grips 350A,350B may be used to control the flow of fluids
through the IAB robotic surgical tools. For example, the rotational
motion of the touch sensitive handle 325 may be used for the
control of irrigation while the squeezing motion of the grips
350A,350B may be used for controlling suction in a surgical
site.
[0230] FIG. 16A is a side view of the touch sensitive handle 325 of
the robotic surgical master control console 150. The touch
sensitive handle 325 may be used by the operator O to control the
fluid flow in IAB robotic surgical instruments. In one embodiment
of the invention, a rotational motion R ("roll") of the touch
sensitive handle may control the irrigation, aspiration, and/or
blowing through IAB surgical instruments 101A, 400. For example,
the handle may rotated clockwise to open a first valve to have a
fluid flow through the IAB surgical instrument into or out of a
surgical site. The handle may then be rotated counter-clockwise to
close the first valve and stop the flow of fluid through the IAB
surgical instrument and into or out of the surgical site. A center
detent point D of rotation in the touch sensitive handle 325 may be
used to switch over from one type of fluid flow to another. In
which case, the handle may rotated counter-clockwise to open a
second valve or switch open the first valve to a different position
to have a second fluid flow through the IAB surgical instrument and
into or out of a surgical site. The handle 325 may then be rotated
clockwise to the center detent point D to close the second valve
and stop the flow of fluid through the IAB surgical instrument and
into or out of the surgical site.
[0231] The rotational motion of the handle 325 may typically
control wrist motors in the robotic surgical manipulator 152 to
control a wrist motion of a robotic surgical tool. In this case,
the wrist motors in the robotic surgical manipulator 152 may be
adapted for use to control one or move valves in the IAB robotic
surgical instruments in response to the rotational motion of the
handle 325.
[0232] In another embodiment of the invention, a gripping or
squeezing motion ("master grip") on the grips 350A-350B of the
touch sensitive handle 325 may be used to control the flow of
fluids through IAB robotic surgical instruments. For example,
squeezing the grip of touch sensitive handle may be used to turn on
the suction of the I/A/B surgical instrument and the grip released
to turn off the suction. In which case, the touch sensitive handle
may include one or more springs 306A-306C to provide differing
spring constants or a single spring 306 with a progressive rate
spring constant as the positions of the grips 350A-350B change. An
explanation as to how the touch sensitive handle 325 functions was
previously describe with reference to FIG. 3C. By using the grip of
the touch sensitive handle 325 to control the IAB robotic surgical
instrument, the rotational motion of the handle may be used for
further movement or control of the instrument.
[0233] The position of the grips 350A-350B can vary over a range of
positions in order to control suction, blowing and irrigation of a
surgical site such as from a fully released or fully open position
to a fully squeezed or fully closed position.
[0234] FIGS. 16B-16D illustrate different positions of the grips
350A-350B of the touch sensitive handle 325 when squeezed by a hand
H of the operator O to control the IAB robotic surgical tool at a
surgical site. FIG. 16B illustrates a fully open grip position
without any squeezing by the hand H. FIG. 16C illustrates the hand
H squeezing the grips 350A-350B to a half-way closed position. To
provide force feedback to a user, a first spring rate may be used
over a range of positions, such as from the fully open to the
half-way closed position. FIG. 16D illustrates the hand H squeezing
the grips 350A-350B to a fully closed position. To provide force
feedback to a user, a second spring rate somewhat greater than the
first may be used over a range of positions, such as from the
half-way closed position to the fully closed position.
[0235] FIG. 17 is a graph showing exemplary control of irrigation
and aspiration using the grip control of the touch sensitive handle
325. The open, half, and closed positions along the X-axis of the
graph correspond to the different positions of the grips 350A-350B
of the touch sensitive handle 325 illustrated in FIGS. 16B-16D.
Curve 1701 illustrates a flow of vacuum or a percentage of suction.
Curve 1710 illustrates a flow of irrigation fluid through the tool
and into a surgical site.
[0236] With the grips 350A-350B in the fully released or fully open
position, both suction and irrigation are turned off. As the grip
is initially squeezed, suction is turned on and irrigation remains
turned off. As the grip position changes from fully-open to
half-way closed, curve 1701 illustrates the flow of vacuum change
from zero to one hundred percent. As the grip reaches half way,
suction may be fully turned on with a negligible amount of
irrigation. As the operator O squeezes further still, past the
half-way closed position, the vacuum flow tapers off toward zero
and the irrigation begins from zero around the three-fourths closed
position, as is illustrated by curves 1701 and 1710.
[0237] In another embodiment of the invention, both the rotational
motion of the touch sensitive handle 325 and the squeezing motion
of the grips 350A,350B may be used to control the flow of fluids
through the IAB robotic surgical tools.
[0238] In addition to the touch sensitive handle 325 and its grips
350A-350B, foot pedals 18 of the surgeons master control console
150, as illustrated in FIG. 3A, may be used to further control the
IAB robotic surgical tools. For example, one of the foot pedals 18
may be used to switch from suction control to blow control in order
to blow a pressurized gas over the surgical site. In which case, a
gripping squeezing motion of the touch sensitive handle can also
control the blowing provided by the I/A/B surgical instrument.
[0239] Alternatively, the touch sensitive handle 325 may be
modified to include buttons to activate irrigation, aspiration, and
or blowing when an IAB robotic surgical tool is mounted to the
robotic surgical manipulator 152
[0240] To avoid using a touch sensitive handle, the foot pedals 18
of the surgeons master control console 150 may be used to fully
control the suction and irrigation provided by an IAB robotic
surgical tool. In one embodiment of the invention, a first foot
pedal 18A may be used to control suction and a second foot pedal
18B may be used to control the irrigation provided by an IA or IAB
surgical instrument.
[0241] With knowledge of other surgical instruments that are to be
controlled by some of the foot pedals, foot pedals on the right
side of the footrest may be used, for example. Two pedals and a
toggle switch on the master control console or the control handle
may be used to control a variety of actuations in a plurality of
surgical instruments knowing the context of the robotic surgical
system in advance. Additionally, foot pedals normally used for
cautery (or another energy device) may be switched to activate
irrigation, aspiration, and or blowing when an IAB robotic surgical
tool is mounted to the robotic surgical manipulator 152.
[0242] To avoid any use of hands or feet in controlling the I/A
surgical instrument, voice activation may be used to activate
irrigation, aspiration, and or blowing when an IAB robotic surgical
tool is mounted to the robotic surgical manipulator 152. In this
case, an operator's voice or speech may be used to control the
suction, irrigation, and or blowing provided by an IA or IAB
surgical instrument. For example, spoken voice commands such as
"suction ON", "suction OFF", "suction lightly", "irrigation ON",
"irrigation OFF", and "irrigate lightly" may be used to control the
suction and irrigation provided by the IA or IAB surgical
instrument.
[0243] To recognize the voice commands, the master control console
150 includes a microphone 315 and a speech recognizer 317. The
speech recognizer 317 may generate the control signals that are
provided to the IA or IAB surgical instrument.
[0244] While various control means have been individually described
here, two or more of these control means may be combined in order
to control the flow of fluids through an IAB robotic surgical tool.
For example, the rotational motion of the touch sensitive handle
325 may be used for the control of irrigation while the squeezing
motion of the grips 350A,350B may be used for controlling suction
in a surgical site.
User Feedback
[0245] Within a surgical site it may be difficult to determine if a
valve is open and providing suction, blowing, or irrigation. User
feedback may be provided to the surgeon at the console to provide
information to him/her such as suction is on and at what
level--high, medium, low, or otherwise off. User feedback
information may also be provided regarding blowing and
irrigation--whether its off or on, and if on at what level--high,
medium, or low. However, it typically is easier to visually
determine when a liquid is flowing for irrigation than when suction
is provided for aspiration or a pressurized gas for blowing.
[0246] Referring now to FIGS. 18A-18G, various types of user
feedback may be provided to the IAB robotic surgical tools.
[0247] In FIG. 18A, the irrigation/aspiration/blowing robotic
surgical tool 400A includes a pair of light emitting diodes (LEDs)
1801-1802 near the tip 406 of the hollow tube 404 in order provide
visible feedback to an operator O that a fluid is flowing through
the tool. One or more wires 1804 may couple between the light
emitting diodes 1801-1802 and the printed circuit board 425 within
the mountable housing 401. Electrical signals can be transmitted
towards the light emitting diodes from the printed circuit board to
turn them on during the flow of fluids and off when no fluid flow
occurs. The integrated circuit 426 may generate the electrical
signals to control the light emitting diodes. In this manner, the
light emitting diode 1801-1802 may be activated by control signals
received over the one or more wires 1804 from the master control
console 150. Additional light emitting diodes may be provided near
the tip 406 of the hollow tube 404 in order provide additional
visible feedback for additional fluid flows. Moreover, the light
emitting diodes 1801-1802, including any additional LEDs, may emit
photons of different wavelengths in order that different colors can
be provided corresponding to different types of fluid flow (e.g.,
suction, irrigation, gas pressure).
[0248] In FIG. 18B, the IAB robotic surgical tool 400B includes a
light pipe 1812 mounted externally to the hollow tube 404 to
provide visible user feedback to the operator O that fluids are
flowing into or out of the surgical site. The light pipe 1812 maybe
a side lighting fiber optic cable with one end optically coupled to
one or more light emitting diodes 1811 to receive photons. The
light emitting diodes 1811 may emit photons of different
wavelengths in order that different colors can be provided
corresponding to different types of fluid flow (e.g., suction,
irrigation, gas pressure). One or more wires 1814 may couple
between the one or more light emitting diodes 1811 and the printed
circuit board 425 mounted within the housing 401. An integrated
circuit, such as integrated circuit 426, may be used to drive the
one or more light emitting diodes 1811 to turn them on or off.
Alternatively when fluids flow, the one or more light emitting
diodes 1811 may be activated directly by control signals received
over the one or more wires 1814 from the master control console 150
or from the integrated circuit 426. More than one light pipe 1812
may be provide along the circumference of the hollow tube 404 so
that the side light may be visible at different viewing angles and
positions of the IAB robotic surgical instrument.
[0249] In comparison with the light emitting diodes 1801-1802 at
the tip, the light pipe 1812 provides a light that maybe visible
along the entire length of the hollow tube 404 so that it can be
seen, regardless of the position of the tip. Additionally, the
light emitting diode 1811 is protected under the cover of the
mountable housing 401.
[0250] Referring now to FIG. 18C, an IAB robotic surgical tool 400C
is illustrated. In tools 400A-400B previously described, user
feedback was provided by electro-optic means. In contrast, the user
feedback provided by the tool 400C is provided mechanically. The
IAB robotic surgical tool 400C includes a sliding sleeve 1820 and a
visible scale 1824 coupled to the hollow tube 404. The sliding
sleeve 1820 is coaxial with the hollow tube 404 and covers over the
scale 1824 when no fluid is flowing through the tool. The sliding
sleeve 1820 can be slid along the hollow tube 404 and into the
housing 401 to reveal the visible scale 1824 as fluids flow through
the tool 400C. The visible scale 1824 maybe different colored bands
to indicate the level of fluid flow within the tool 400C.
Alternatively, the visible scale 1824 maybe bands of different
thickness to reveal the amount of fluid flow within the tool 400C.
The sliding sleeve 1820 can be gradually received into the hosing
401 to reveal the appropriate scale in proportion to the amount of
fluid flow in the tool 400C.
[0251] Without any flow of fluids within the tool 400C, a tip 1822
of the sliding sleeve 1820 may completely cover over the visible
scale 1824. With maximum fluid flow in the tool 400C, the sliding
sleeve 1820 may be slid into the housing 401 such that its tip
moves to a position 1822' to fully reveal the visible scale 1824.
The opposite end 1823 of the sliding sleeve 1820 moves inward to
position 1823'. In this manner, the level of fluid flow in the tool
400C maybe provided to a user by mechanical means.
[0252] The sliding sleeve 1820 may be pulled into the housing 401
and pushed back out in a variety of ways. A spring may used to
apply a force against the retraction of the sliding sleeve 1820
into the housing so that it can push it back out after the pulling
force is released. A cable with one end coupled to and wrapped
around a take up drum may be coupled to the sleeve 1820 through a
pulley in order to pull the sleeve into the housing 401. A gearing
system may alternatively be used. A pinion gear may couple to a
rotatable receiving element 418 and to a rack coupled to the sleeve
1820. Alternatively, a ball screw and a lead screw may be used. A
slider with a crank or lever arm may be used. An electrical means
may also be used, such as a solenoid to pull in on the sliding
sleeve 1820.
[0253] Referring now to FIGS. 18D-18G, an IAB robotic surgical tool
400D includes another mechanical structure to provide user
feedback. However instead of a sliding sleeve, the IAB robotic
surgical tool 400D includes a rotating sleeve 1820' coaxial with
the hollow tube 404. FIGS. 18E-18G illustrate various types of tips
406 and sleeves 1820A'-1820C' that may be used to provide user
feedback.
[0254] In FIG. 18D, the IAB robotic surgical tool 400D includes the
hollow tube coupled to the solid valve body 1101,1101' mounted to
the interface base 412. The tool 400D further includes the hollow
rotatable sleeve 1820' coaxial around the hollow tube 404. The
rotatable sleeve 1820' couples to a bearing assembly 1852 mounted
to the collar 1102 to rotatably mount to the interface base
412.
[0255] For rotational purposes, the rotatable sleeve 1820' includes
a drum 1854 that extends from the bearing assembly 1852 into the
housing 401. There are a number of ways to couple a rotational
movement from the surgical manipulator to the rotatable sleeve
1820'. In one embodiment of the invention, the tool 400D is
backward compatible and includes a spool 1830 rotatably mounted to
the interface base 412. A rotatable receiving element 418 of the
IAB robotic surgical tool is coupled to the spool 1830. For robotic
control from the master control console 150, the rotatable
receiving element 418 couples to the rotatable driver 234 by means
of the pins 422A-422B within the openings 240A-240B,
respectively.
[0256] Coupled between the spool 1830 and the drum 1854 of the
rotatable sleeve are a top cable 1832 and a bottom cable 1834. One
end of each cable couples to the spool 1830. The opposite end of
each cable couples to the drum 2854. Alternatively, a single cable
may be used by appropriately wrapping it around the drum 2834 and
the spool 1830. The top cable and the bottom cable wrap different
from each other around the spool. They also wrap different from
each other around the drum 1854. In this manner, one cable is being
let out while the other cable is being taken in by the rotation of
the spool. 1854. If the spool 1854 is turning clockwise as
indicated by arrow F2, the cable 1832 is taken in, the cable 1834
is let out, and the sleeve 1820' rotates counter clockwise as
illustrated by the letter G2. If the spool 1854 is turning
counter-clockwise as indicated by arrow F1, the cable 1832 is let
out, the cable 1834 is let out, and the sleeve 1820' rotates
clockwise as illustrated by the letter G1.
[0257] There rotational movement of the receiving element 418 may
be transmitted by other means to the rotatable sleeve 1820'. For
example, a gear system may be used. In which case, a first worm
gear may be used in place of the spool 1830 and a second worm gear
coupling to the first may be used in place of the drum 1854.
[0258] The flow control system provided by the solid valve bodies
1101,1101' and their valves was previously described with reference
to FIGS. 11A-11E and is incorporated here by reference.
[0259] Referring now to FIG. 18E, the hollow rotatable sleeve
1820A' includes a plurality of narrow openings 1840 located around
a circumference of a distal end of the sleeve 1820A'. This way, the
scale may be seen from different angles. The narrow window openings
1840 may be oval shaped as illustrated or rectangularly shaped. The
hollow tube 404 includes a plurality of curved color stripes 1842
around its circumference that may be rectangularly shaped as
illustrated by the dashed lines in FIG. 18E. As the sleeve 1820A'
rotates, the stripes 1842 are positioned on the hollow tube 404 to
be substantially aligned with the window openings 1840.
[0260] In one position of the sleeve 1820A', no color stripe or a
color stripe representative of fluid flow being completely shut off
is located within a window opening 1840. This corresponds to all
the valves being closed to shut off the fluid flow through the IAB
robotic surgical tool. Rotating the sleeve 1820A' from a shut off
position, a first or second color stripe may begin to be revealed,
such as illustrated in FIGS. 18E-18G, representative of a first
fluid flow in an IAB robotic surgical instrument. The level of
fluid flow can be indicated by the amount of color stripe 1842 that
is exposed in the window opening 1840. With the color stripe 1842
being completely exposed by the window opening 1840, the
corresponding valve of the flow control system may be fully open.
With the sleeve 1820A' being rotated still further, a second or
third color stripe may begin to be exposed by the window opening
1840. In which case, the prior fluid flow may be substantially shut
off and another valve opened to allow another fluid to flow through
the IAB robotic surgical tool.
[0261] The different color stripes 1842 indicate the flow of
different fluids through the IAB robotic surgical. For example, a
red color stripe may indicate that all fluid flows are fully shut
off. A green color stripe may indicate pressurized gas flow. A blue
color stripe may indicate irrigation, An orange color stripe may
indicate suction or aspiration.
[0262] Referring now to FIG. 18F, the tool 400D includes the
rotatable sleeve 1820B' that is similar to the rotatable sleeve
1820A' but has triangular shaped window openings 1850 instead. The
hollow tube 404 includes the plurality of color stripes 1842. But
for the shape of the window openings, the sleeve 1820'B operates
substantially similar to that of sleeve 1820A' described
previously.
[0263] Referring now to FIG. 18G, the hollow rotatable sleeve
1820C' includes a plurality of narrow rectangular openings 1860
located around a circumference of a distal end. With the plurality
of openings 1860, the scale may be seen from different angles and
positions of the tool. The narrow window openings 1860 are
rectangularly shaped. However, the hollow tube 404 includes a
plurality of triangle stripes 1842 curving around its circumference
as illustrated by the dashed lines in FIG. 18G. The colored
triangle stripes 1862 are positioned on the hollow tube 404 to be
substantially aligned with the window openings 186, as the sleeve
1820C' rotates,
[0264] As the sleeve 1820C' rotates, the level of fluid flow can be
indicated by the amount of color triangular stripe 1862 that is
exposed in the window opening 1860. As discussed previously, the
type of fluid flow may be indicated by the different colors.
[0265] The type of user feedback previously disclosed was
implemented by the IAB robotic surgical tool. Alternatively, user
feedback may be provided by the master control console 150, such as
through an electronic visual display of a graphical icon or
image.
[0266] Referring now to FIG. 19, a simulated 3D image of a surgical
site in a viewer 312 of the master control console 150 is
illustrated when the operators eyes are in the viewer 312. As
illustrated in FIGS. 20A-20B, stereo optic images of a left image
1900L and a right image 1900R are provided at the viewer 312, in
order to provide a three-dimensional image when viewed by the
operator O. In the left and right views, the IAB robotic surgical
tool 400 is located within the surgical site. To provide user
feedback as to the fluid flow in the tool 400, icons 1902 are
overlaid onto the images displayed in one or both of the displays
1900L, 1900R. The icons may use different colors overlaid on the
image in order to display the function of the tool 400. A scale
maybe provided in the viewer to display the level of the fluid flow
in the tool 400. Alternatively abbreviated letters maybe used to
indicate the type of fluid flow (e.g., S--suction or A--aspiration,
I--irrigation, B--blowing) in the tool 400 as well as its level,
such as L, M, and H.
[0267] Referring now to FIG. 20A, a viewer 312A of the master
control console 150 is illustrated. To provide a three-dimensional
perspective, the viewer 312A includes stereo images for each eye
including left image 400L of the tool 400 and surgical site and a
right image 400R of the tool 400 and surgical site. One or more
icons 2010R may be overlaid onto the images in the right viewfinder
2001R to indicate the functionality and the level of fluid flow in
the IAB robotic surgical tool 400. The images 400R and 400L in the
viewfinders maybe provided by a right liquid crystal display 2002R
and a left liquid crystal display 2002L, respectively.
[0268] As the one or more icons 2010R in the viewer 312A are
provided in a single viewfinder of the stereo viewer, they are
displayed as two-dimensional icons. However, three dimensional
images of the icons maybe provided and overlaid onto stereo left
and right images of the surgical site.
[0269] In FIG. 20B, one or more icons to provide user feedback of
the control of the IAB robotic surgical tool are overlaid onto both
the left image 400L and right image 40R of the surgical site. In
the right viewfinder 2001R, a right icon image 2010R is overlaid
onto the right image 400R being displayed by the liquid crystal
display 2002R. In the left viewfinder 2001L, a left icon image
2010L is overlaid onto the left image 400L of the surgical site
provided by the liquid crystal display 2002L. In this manner, a
stereo image of the icons may be used to provide user feedback of
the control of the IAB robotic surgical tool maybe provided in the
viewer 312B.
Exemplary Operation of the IAB Robotic Surgical Instruments
[0270] In order to use the IAB robotic surgical tools, it is first
undergoes an initial setup prior to surgery. The IAB robotic
surgical instrument is mounted to a robotic arm 153 of the robotic
surgical manipulator 152. One or more hoses 160A-160C are coupled
from the IAB robotic surgical instrument to one or more pumps
102A-102C. The robotic surgical manipulator 152 is oriented with
the patient P so that the tip of the hollow tube of the
irrigation-aspiration robotic surgical instrument may be inserted
into the patient near the desired surgical site. During the
surgery, the operator O may control the flow of fluids between the
surgical site and the IAB robotic surgical instrument from the
master control console 150 using the flow control system 417 of the
IAB robotic surgical tool. Alternatively or conjunctively, the
operator may also control the flow of fluids between the IAB
robotic surgical instrument and the one or more pumps. To control
the flow of fluids, the operator O at the master control console
150 may generate one or more control signals to control the IAB
robotic surgical instrument. The one or more control signals may be
directly or indirectly coupled into the IAB robotic surgical
instrument. For example, the one or more control signals may be
electrical signals that are directly coupled into the IAB robotic
surgical instrument to electrically control one or more valves.
Alternatively, the one or more control signals may be electrical
signals that are translated into a mechanical motion. In this case,
the mechanical motion may be directly coupled into IAB robotic
surgical instrument while the electrical control signals are
indirectly coupled into the IAB robotic surgical instrument. In any
case, one or more valves in the IAB robotic surgical instrument may
be opened to flow one or more fluids over a surgical site in
response to the control signals. Similarly, one or more valves in
the IAB robotic surgical instrument may be closed to reduce the
flow of the one or more fluids over the surgical site in response
to the control signals.
[0271] In alternative embodiments of the invention, the control of
the flow of fluids between the surgical site and the IAB robotic
surgical instrument is provided by controlling the one or more
pumps. In which case, the control signals are coupled to the pumps
and/or flow control valves located external to the IAB robotic
surgical instrument. The IAB robotic surgical instrument may
include a coupler to couple between the hoses from the one or more
pumps and the hollow tube that is inserted into a patient.
[0272] The one or more control signals may be generated in various
ways including in response to movement of a touch sensitive handle
of a master control console, squeezing of a grip of the touch
sensitive handle, rotation of the touch sensitive handle, movement
of a foot pedal, or a spoken command at the master control
console.
[0273] The level of flow of the fluids and the control thereof may
be monitored between the surgical site and the IAB robotic surgical
instrument through the user-feedback means previously described.
One user-feedback means is one or more light emitting diodes
coupled near the tip of the hollow tube of the IAB robotic surgical
instrument. The one or more light emitting diodes generate a
visible light in response to the control of a flow of a fluid
through the IAB robotic surgical instrument. Another user-feedback
means is a light pipe coupled along the length of the hollow tube
of the irrigation-aspiration robotic surgical instrument with a
light emitting diode. The light emitting diode couples photons into
the light pipe and generates a visible side light in response to
the control of a flow of a fluid through the irrigation-aspiration
robotic surgical instrument. Still another user-feedback means is a
sliding sleeve coaxial with the hollow tube and a scale coupled to
the irrigation-aspiration robotic surgical instrument. The sliding
sleeve slides along the hollow tube and reveals the scale in
response to the control of a flow of a fluid through the
irrigation-aspiration robotic surgical instrument.
[0274] After the using the IAB robotic surgical instrument, it is
removed from the patient and can then be dismounted from the
robotic arm of the robotic surgical manipulator 152. If the IAB
robotic surgical instrument is to be reused, a modular valve
assembly and one or more hoses of the irrigation-aspiration robotic
surgical instrument may be discarded and the remaining components
of the IAB robotic surgical instrument sterilized for reuse. In the
case that the IAB robotic surgical instrument includes a flow
control system with an inexpensive valve subassembly, the
irrigation-aspiration robotic surgical instrument can be removed
from the patient; dismounted from the robotic arm; and then
discarded.
[0275] While certain exemplary embodiments of the invention have
been described and shown in the accompanying drawings, it is to be
understood that such embodiments are merely illustrative of and not
restrictive on the broad invention, and that the embodiments of the
invention not be limited to the specific constructions and
arrangements shown and described, since various other modifications
may occur to those ordinarily skilled in the art. For example,
while an irrigation/aspiration/blowing robotic surgical instrument
has been shown and described in a number of embodiments of the
invention, it may be modified into an irrigation robotic surgical
instrument with a single valve to provide irrigation only or it may
be modified into an aspiration robotic surgical instrument with a
single valve to provide aspiration only. Furthermore, while
aspiration or suction has been described as being provided by a
vacuum pump, one would recognize that a pressurized gas maybe
provided instead, such as air by an air pump. The pressurized gas
may be used to blow debris or cut tissue, if sufficient pressure is
provided. Rather, the embodiments of the invention should be
construed according to the claims that follow below.
* * * * *