U.S. patent application number 12/855434 was filed with the patent office on 2011-11-17 for surgical system architecture.
This patent application is currently assigned to Intuitive Surgical Operations, Inc.. Invention is credited to Jeffrey D. Brown, Thomas G. Cooper, Nicola Diolaiti, Eugene F. Duval, Daniel H. Gomez, Robert E. Holop, Anthony K. McGrogan, Craig R. Ramstad, Theodore W. Rogers.
Application Number | 20110282357 12/855434 |
Document ID | / |
Family ID | 44121151 |
Filed Date | 2011-11-17 |
United States Patent
Application |
20110282357 |
Kind Code |
A1 |
Rogers; Theodore W. ; et
al. |
November 17, 2011 |
SURGICAL SYSTEM ARCHITECTURE
Abstract
Robotic surgical systems are provided. In one embodiment, the
system includes a setup link for locating a remote center of motion
for the robotic surgical system; a manipulator arm assembly
including an active proximal link and an active distal link, the
proximal link operably coupled to the setup link; and a plurality
of instrument manipulators operably coupled to a distal end of the
distal link, the plurality of instrument manipulators rotatable
about an instrument manipulator assembly roll axis. A cannula mount
is movably coupled to a proximal end of the distal link, and a
cannula is coupled to the cannula mount, the cannula having a
longitudinal axis substantially coincident with the instrument
manipulator assembly roll axis. The system further includes an
entry guide tube at least partially within the cannula, the entry
guide tube rotatable about the longitudinal axis of the
cannula.
Inventors: |
Rogers; Theodore W.;
(Alameda, CA) ; Brown; Jeffrey D.; (Palo Alto,
CA) ; Cooper; Thomas G.; (Menlo Park, CA) ;
Diolaiti; Nicola; (Palo Alto, CA) ; Duval; Eugene
F.; (Menlo Park, CA) ; Gomez; Daniel H.;
(Sunnyvale, CA) ; Holop; Robert E.; (Sunnyvale,
CA) ; McGrogan; Anthony K.; (San Jose, CA) ;
Ramstad; Craig R.; (Minden, NV) |
Assignee: |
Intuitive Surgical Operations,
Inc.
Sunnyvale
CA
|
Family ID: |
44121151 |
Appl. No.: |
12/855434 |
Filed: |
August 12, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61334978 |
May 14, 2010 |
|
|
|
Current U.S.
Class: |
606/130 |
Current CPC
Class: |
A61B 2017/3447 20130101;
H04N 5/2253 20130101; A61B 34/00 20160201; A61B 17/3423 20130101;
A61B 46/10 20160201; A61B 2017/00477 20130101; H01F 2005/027
20130101; A61B 34/30 20160201; A61B 2017/3445 20130101; G03B
2205/0015 20130101; A61B 17/3421 20130101; A61B 2090/5025 20160201;
G03B 2205/0069 20130101; H04N 5/2252 20130101; A61B 17/3474
20130101; A61B 46/23 20160201; H05K 1/18 20130101; B25J 15/04
20130101; H04N 5/2254 20130101; A61B 50/00 20160201; G03B 5/02
20130101; H01F 5/04 20130101; A61M 13/003 20130101; A61B 17/0218
20130101; A61B 34/70 20160201; H04N 5/2257 20130101; A61B 34/35
20160201; A61B 90/98 20160201; F16F 1/121 20130101; Y10T 74/20305
20150115; H01F 27/2823 20130101; A61B 34/37 20160201; A61B 2034/306
20160201; B32B 3/12 20130101; H01F 5/02 20130101; H04N 5/23287
20130101; A61B 2034/302 20160201 |
Class at
Publication: |
606/130 |
International
Class: |
A61B 19/00 20060101
A61B019/00 |
Claims
1. A robotic surgical system, comprising: a setup link for locating
a remote center of motion for the robotic surgical system; a
manipulator arm assembly including an active proximal link and an
active distal link, the proximal link operably coupled to the setup
link; a plurality of instrument manipulators operably coupled to a
distal end of the distal link, the plurality of instrument
manipulators rotatable about an instrument manipulator assembly
roll axis; a cannula mount coupled to a proximal end of the distal
link; a cannula coupled to the cannula mount, the cannula having a
longitudinal axis substantially coincident with the instrument
manipulator assembly roll axis; and an entry guide tube at least
partially within the cannula, the entry guide tube rotatable about
the longitudinal axis of the cannula.
2. The system of claim 1, wherein the setup link includes a
vertical-axis setup link and two horizontal-plane setup links.
3. The system of claim 1, wherein the manipulator arm assembly has
a constantly vertical yaw axis that intersects with the instrument
manipulator assembly roll axis at the remote center of motion.
4. The system of claim 3, wherein the distal link has a constant
form factor when the distal link is rotated about the yaw axis.
5. The system of claim 1, wherein the distal link includes three
links operably coupled to one another.
6. The system of claim 1, wherein the proximal link has a constant
L-shaped form factor.
7. The system of claim 1, wherein the plurality of instrument
manipulators are operably coupled to a rotatable base plate at the
distal end of the distal link.
8. The system of claim 1, wherein each of the plurality of
instrument manipulators are operably coupled to the distal end of
the distal link by a telescoping insertion mechanism along which
the instrument manipulator moves.
9. The system of claim 1, wherein each of the plurality of
instrument manipulators includes a distal face from which a
plurality of actuator outputs distally protrude.
10. The system of claim 9, further comprising a plurality of
surgical instruments, each surgical instrument having a proximal
face of a force transmission mechanism coupled to the distal face
of a corresponding instrument manipulator.
11. The system of claim 10, wherein a surgical instrument has a
shaft with a proximal curved section and a distal straight
section.
12. The system of claim 10, wherein the surgical instrument is
selected from the group consisting of articulated tools with end
effectors, such as jaws, scissors, graspers, needle holders,
micro-dissectors, staple appliers, tackers, and clip appliers, and
non-articulated tools, such as cutting blades, cautery probes,
irrigators, catheters, and suction orifices.
13. A robotic surgical system, comprising: a setup link for
locating a remote center of motion for the robotic surgical system;
a manipulator arm assembly including an active proximal link and an
active distal link, the proximal link operably coupled to the setup
link; a plurality of instrument manipulators operably coupled to a
distal end of the distal link, the plurality of instrument
manipulators rotatable about an instrument manipulator assembly
roll axis, wherein each of the plurality of instrument manipulators
includes a distal face from which a plurality of actuator outputs
distally protrude; a cannula mount coupled to a proximal end of the
distal link; a cannula coupled to the cannula mount, the cannula
having a longitudinal axis substantially coincident with the
instrument manipulator assembly roll axis; an entry guide tube at
least partially within the cannula, the entry guide tube rotatable
about the longitudinal axis of the cannula; and a plurality of
surgical instruments, each surgical instrument having a proximal
face of a force transmission mechanism coupled to the distal face
of a corresponding instrument manipulator, wherein each surgical
instrument has a shaft passing through the entry guide tube and the
cannula.
14. The system of claim 13, wherein the manipulator arm assembly
has a constantly vertical yaw axis that intersects with the
instrument manipulator assembly roll axis at the remote center of
motion.
15. The system of claim 14, wherein the distal link has a constant
form factor when the distal link is rotated about the yaw axis.
16. The system of claim 13, wherein the distal link includes three
links operably coupled to one another.
17. The system of claim 13, wherein the proximal link has a
constant L-shaped form factor.
18. The system of claim 13, wherein the plurality of instrument
manipulators are operably coupled to a rotatable base plate at the
distal end of the distal link.
19. The system of claim 13, wherein each of the plurality of
instrument manipulators are operably coupled to the distal end of
the distal link by a telescoping insertion mechanism along which
the instrument manipulator moves.
20. The system of claim 13, wherein a surgical instrument has a
shaft with a proximal curved section and a distal straight section.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional
Application No. 61/334,978 entitled "Surgical System" filed May 14,
2010, the full disclosure of which is incorporated by reference
herein for all purposes.
[0002] This application is related to U.S. patent application Ser.
No. 11/762,165, filed Jun. 13, 2007, which is incorporated by
reference herein for all purposes. U.S. patent application Ser. No.
11/762,165 claimed the priority benefit of the following U.S.
provisional patent applications, all of which are incorporated by
reference herein: 60/813,028 entitled "Single port system 2" filed
Jun. 13, 2006 by Cooper et al.; 60/813,029 entitled "Single port
surgical system 1" filed Jun. 13, 2006 by Cooper; 60/813,030
entitled "Independently actuated optical train" filed Jun. 13, 2006
by Larkin et al.; 60/813,075 entitled "Modular cannula
architecture" filed Jun. 13, 2006 by Larkin et al.; 60/813,125
entitled "Methods for delivering instruments to a surgical site
with minimal disturbance to intermediate structures" filed Jun. 13,
2006 by Larkin et al.; 60/813,126 entitled "Rigid single port
surgical system" filed Jun. 13, 2006 by Cooper; 60/813,129 entitled
"Minimum net force actuation" filed Jun. 13, 2006 by Cooper et al.;
60/813,131 entitled "Side working tools and camera" filed Jun. 13,
2006 by Duval et al.; 60/813,172 entitled "Passing cables through
joints" filed Jun. 13, 2006 by Cooper; 60/813,173 entitled "Hollow
smoothly bending instrument joints" filed Jun. 13, 2006 by Larkin
et al.; 60/813,198 entitled "Retraction devices and methods" filed
Jun. 13, 2006 by Mohr et al.; 60/813,207 entitled "Sensory
architecture for endoluminal robots" filed Jun. 13, 2006 by
Diolaiti et al.; and 60/813,328 entitled "Concept for single port
laparoscopic surgery" filed Jun. 13, 2006 by Mohr et al.
[0003] In addition, this application is related to the following
pending U.S. patent applications, all of which are incorporated by
reference herein: Ser. No. 11/762,217 entitled "Retraction of
tissue for single port entry, robotically assisted medical
procedures" by Mohr; Ser. No. 11/762,222 entitled "Bracing of
bundled medical devices for single port entry, robotically assisted
medical procedures" by Mohr et al.; Ser. No. 11/762,231 entitled
"Extendable suction surface for bracing medical devices during
robotically assisted medical procedures" by Schena; Ser. No.
11/762,236 entitled "Control system configured to compensate for
non-ideal actuator-to-joint linkage characteristics in a medical
robotic system" by Diolaiti et al.; Ser. No. 11/762,185 entitled
"Surgical instrument actuation system" by Cooper et al.; Ser. No.
11/762,172 entitled "Surgical instrument actuator" by Cooper et
al.; Ser. No. 11/762,161 entitled "Minimally invasive surgical
instrument advancement" by Larkin et al.; Ser. No. 11/762,158
entitled "Surgical instrument control and actuation" by Cooper et
al.; Ser. No. 11/762,154 entitled "Surgical instrument with
parallel motion mechanism" by Cooper; Ser. No. 11/762,149 entitled
"Minimally invasive surgical apparatus with side exit instruments"
by Larkin; Ser. No. 11/762,170 entitled "Minimally invasive
surgical apparatus with side exit instruments" by Larkin; Ser. No.
11/762,143 entitled "Minimally invasive surgical instrument system"
by Larkin; Ser. No. 11/762,135 entitled "Side looking minimally
invasive surgery instrument assembly" by Cooper et al.; Ser. No.
11/762,132 entitled "Side looking minimally invasive surgery
instrument assembly" by Cooper et al.; Ser. No. 11/762,127 entitled
"Guide tube control of minimally invasive surgical instruments" by
Larkin et al.; Ser. No. 11/762,123 entitled "Minimally invasive
surgery guide tube" by Larkin et al.; Ser. No. 11/762,120 entitled
"Minimally invasive surgery guide tube" by Larkin et al.; Ser. No.
11/762,118 entitled "Minimally invasive surgical retractor system"
by Larkin; Ser. No. 11/762,114 entitled "Minimally invasive
surgical illumination" by Schena et al.; Ser. No. 11/762,110
entitled "Retrograde instrument" by Duval et al.; Ser. No.
11/762,204 entitled "Retrograde instrument" by Duval et al.; Ser.
No. 11/762,202 entitled "Preventing instrument/tissue collisions"
by Larkin; Ser. No. 11/762,189 entitled "Minimally invasive surgery
instrument assembly with reduced cross section" by Larkin et al.;
Ser. No. 11/762,191 entitled "Minimally invasive surgical system"
by Larkin et al.; Ser. No. 11/762,196 entitled "Minimally invasive
surgical system" by Duval et al.; and Ser. No. 11/762,200 entitled
"Minimally invasive surgical system" by Diolaiti.
[0004] This application is also related to the following U.S.
patent applications, all of which are incorporated by reference
herein: Ser. No. 12/163,051 (filed Jun. 27, 2008; entitled "Medical
Robotic System with Image Referenced Camera Control Using
Partitionable Orientation and Translational Modes"); Ser. No.
12/163,069 (filed Jun. 27, 2008; entitled "Medical Robotic System
Having Entry Guide Controller with Instrument Tip Velocity
Limiting"); Ser. No. 12/494,695 (filed Jun. 30, 2009; entitled
"Control of Medical Robotic System Manipulator About Kinematic
Singularities"); Ser. No. 12/541,913 (filed Aug. 15, 2009; entitled
"Smooth Control of an Articulated Instrument Across Areas with
Different Work Space Conditions"); Ser. No. 12/571,675 (filed Oct.
1, 2009; entitled "Laterally Fenestrated Cannula"); Ser. No.
12/613,328 (filed Nov. 5, 2009; entitled "Controller Assisted
Reconfiguration of an Articulated Instrument During Movement Into
and Out Of an Entry Guide"); Ser. No. 12/645,391 (filed Dec. 22,
2009; entitled "Instrument Wrist with Cycloidal Surfaces"); Ser.
No. 12/702,200 (filed Feb. 8, 2010; entitled "Direct Pull Surgical
Gripper"); Ser. No. 12/704,669 (filed Feb. 12, 2010; entitled
"Medical Robotic System Providing Sensory Feedback Indicating a
Difference Between a Commanded State and a Preferred Pose of an
Articulated Instrument"); Ser. No. 12/163,087 (filed Jun. 27, 2008;
entitled "Medical Robotic System Providing an Auxiliary View of
Articulatable Instruments Extending Out Of a Distal End of an Entry
Guide"); Ser. No. 12/780,071 (filed May 14, 2010; entitled "Medical
Robotic System with Coupled Control Modes"); Ser. No. 12/780,747
(filed May 14, 2010; entitled "Cable Re-ordering Device"); Ser. No.
12/780,758 (filed May 14, 2010; entitled "Force Transmission for
Robotic Surgical Instrument"); Ser. No. 12/780,773 (filed May 14,
2010; entitled "Overforce Protection Mechanism"); Ser. No.
12/832,580 (filed Jul. 8, 2010; entitled "Sheaths for Jointed
Instruments"); U.S. patent application Ser. No. ______ (filed
______; entitled "Surgical System Sterile Drape" (Attorney Docket
No. ISRG02430/US)); U.S. patent application Ser. No. ______ (filed
______; entitled "Surgical System Instrument Mounting" (Attorney
Docket No. ISRG02440/US)); U.S. patent application Ser. No. ______
(filed ______; entitled "Surgical System Entry Guide" (Attorney
Docket No. ISRG02450/US)); U.S. patent application Ser. No. ______
(filed ______; entitled "Surgical System Instrument Manipulator"
(Attorney Docket No. ISRG02460/US)); U.S. patent application Ser.
No. ______ (filed ______; entitled "Surgical System Counterbalance"
(Attorney Docket No. ISRG02560/US)); and U.S. patent application
Ser. No. ______ (filed ______; entitled "Surgical System Instrument
Sterile Adapter" (Attorney Docket No. ISRG02820/US)).
BACKGROUND
[0005] In robotically-assisted or telerobotic surgery, the surgeon
typically operates a master controller to remotely control the
motion of surgical instruments at the surgical site from a location
that may be remote from the patient (e.g., across the operating
room, in a different room or a completely different building from
the patient). The master controller usually includes one or more
hand input devices, such as joysticks, exoskeletal gloves or the
like, which are coupled to the surgical instruments with servo
motors for articulating the instruments at the surgical site. The
servo motors are typically part of an electromechanical device or
surgical manipulator ("the slave") that supports and controls the
surgical instruments that have been introduced directly into an
open surgical site or through trocar sleeves into a body cavity,
such as the patient's abdomen. During the operation, the surgical
manipulator provides mechanical articulation and control of a
variety of surgical instruments, such as tissue graspers, needle
drivers, electrosurgical cautery probes, etc., that each performs
various functions for the surgeon, e.g., holding or driving a
needle, grasping a blood vessel, or dissecting, cauterizing or
coagulating tissue.
[0006] The number of degrees of freedom (DOFs) is the number of
independent variables that uniquely identify the pose/configuration
of a telerobotic system. Since robotic manipulators are kinematic
chains that map the (input) joint space into the (output) Cartesian
space, the notion of DOF can be expressed in any of these two
spaces. In particular, the set of joint DOFs is the set of joint
variables for all the independently controlled joints. Without loss
of generality, joints are mechanisms that provide, e.g., a single
translational (prismatic joints) or rotational (revolute joints)
DOF. Any mechanism that provides more than one DOF motion is
considered, from a kinematic modeling perspective, as two or more
separate joints. The set of Cartesian DOFs is usually represented
by the three translational (position) variables (e.g., surge,
heave, sway) and by the three rotational (orientation) variables
(e.g. Euler angles or roll/pitch/yaw angles) that describe the
position and orientation of an end effector (or tip) frame with
respect to a given reference Cartesian frame.
[0007] For example, a planar mechanism with an end effector mounted
on two independent and perpendicular rails has the capability of
controlling the x/y position within the area spanned by the two
rails (prismatic DOFs). If the end effector can be rotated around
an axis perpendicular to the plane of the rails, there are then
three input DOFs (the two rail positions and the yaw angle) that
correspond to three output DOFs (the x/y position and the
orientation angle of the end effector).
[0008] Although the number of non-redundant Cartesian DOFs that
describe a body within a Cartesian reference frame, in which all
the translational and orientational variables are independently
controlled, can be six, the number of joint DOFs is generally the
result of design choices that involve considerations of the
complexity of the mechanism and the task specifications.
Accordingly, the number of joint DOFs can be more than, equal to,
or less than six. For non-redundant kinematic chains, the number of
independently controlled joints is equal to the degree of mobility
for the end effector frame. For a certain number of prismatic and
revolute joint DOFs, the end effector frame will have an equal
number of DOFs (except when in singular configurations) in
Cartesian space that will correspond to a combination of
translational (x/y/z position) and rotational (roll/pitch/yaw
orientation angle) motions.
[0009] The distinction between the input and the output DOFs is
extremely important in situations with redundant or "defective"
kinematic chains (e.g., mechanical manipulators). In particular,
"defective" manipulators have fewer than six independently
controlled joints and therefore do not have the capability of fully
controlling end effector position and orientation. Instead,
defective manipulators are limited to controlling only a subset of
the position and orientation variables. On the other hand,
redundant manipulators have more than six joint DOFs. Thus, a
redundant manipulator can use more than one joint configuration to
establish a desired 6-DOF end effector pose. In other words,
additional degrees of freedom can be used to control not just the
end effector position and orientation but also the "shape" of the
manipulator itself. In addition to the kinematic degrees of
freedom, mechanisms may have other DOFs, such as the pivoting lever
movement of gripping jaws or scissors blades.
[0010] Telerobotic surgery through remote manipulation has been
able to reduce the size and number of incisions required in surgery
to enhance patient recovery while also helping to reduce patient
trauma and discomfort. However, telerobotic surgery has also
created many new challenges. Robotic manipulators adjacent the
patient have made patient access sometimes difficult for
patient-side staff, and for robots designed particularly for single
port surgery, access to the single port is of vital importance. For
example, a surgeon will typically employ a large number of
different surgical instruments/tools during a procedure and ease of
access to the manipulator and single port and ease of instrument
exchange are highly desirable.
[0011] Another challenge results from the fact that a portion of
the electromechanical surgical manipulator will be positioned
adjacent the operation site. Accordingly, the surgical manipulator
may become contaminated during surgery and is typically disposed of
or sterilized between operations. From a cost perspective, it would
be preferable to sterilize the device. However, the servo motors,
sensors, encoders, and electrical connections that are necessary to
robotically control the motors typically cannot be sterilized using
conventional methods, e.g., steam, heat and pressure, or chemicals,
because the system parts would be damaged or destroyed in the
sterilization process.
[0012] A sterile drape has been previously used to cover the
surgical manipulator and has previously included holes through
which an adaptor (for example a wrist unit adaptor or a cannula
adaptor) would enter the sterile field. However, this
disadvantageously requires detachment and sterilization of the
adaptors after each procedure and also causes a greater likelihood
of contamination through the holes in the drape.
[0013] Furthermore, with current sterile drape designs for
multi-arm surgical robotic systems, each individual arm of the
system is draped, but such designs are not applicable for a single
port system, in particular when all the instrument actuators are
moved together by a single slave manipulator.
[0014] What is needed, therefore, are improved telerobotic systems,
apparatus, and methods for remotely controlling surgical
instruments at a surgical site on a patient. In particular, these
systems, apparatus, and methods should be configured to minimize
the need for sterilization to improve cost efficiency while also
protecting the system and the surgical patient. In addition, these
systems, apparatus, and methods should be designed to minimize
instrument exchange time and difficulty during the surgical
procedure while offering an accurate interface between the
instrument and the manipulator. Furthermore, these systems and
apparatus should be configured to minimize form factor so as to
provide the most available space around the entry port for surgical
staff while also providing for improved range of motion.
Furthermore, these systems, apparatus, and methods should provide
for organizing, supporting, and efficiently operating multiple
instruments through a single port while reducing collisions between
instruments and other apparatus.
SUMMARY
[0015] The present disclosure provides improved surgical systems,
apparatus, and methods for telerobotic surgery. According to one
aspect, a system, apparatus, and method provide at least one
telemanipulated surgical instrument at a distal end of a draped
instrument manipulator and manipulator arm with an accurate and
robust interface while also providing for ease of instrument
exchange and enhanced instrument manipulation, each surgical
instrument working independently of the other and each having an
end effector with at least six actively controlled degrees of
freedom in Cartesian space (i.e., surge, heave, sway, roll, pitch,
yaw).
[0016] In one embodiment, a robotic surgical system includes a
setup link for locating a remote center of motion for the robotic
surgical system, and a manipulator arm assembly including an active
proximal link and an active distal link, the proximal link operably
coupled to the setup link. The system further includes a plurality
of instrument manipulators operably coupled to a distal end of the
distal link, the plurality of instrument manipulators rotatable
about an instrument manipulator assembly roll axis, a cannula mount
coupled to a proximal end of the distal link, and a cannula coupled
to the cannula mount, the cannula having a longitudinal axis
substantially coincident with the instrument manipulator assembly
roll axis. An entry guide tube is at least partially within the
cannula, the entry guide tube rotatable about the longitudinal axis
of the cannula.
[0017] In another embodiment, a robotic surgical system includes
the elements described above and a plurality of surgical
instruments, each surgical instrument having a proximal face of a
force transmission mechanism coupled to the distal face of a
corresponding instrument manipulator, wherein each surgical
instrument has a shaft passing through the entry guide tube and the
cannula.
[0018] A more complete understanding of embodiments of the present
disclosure will be afforded to those skilled in the art, as well as
a realization of additional advantages thereof, by a consideration
of the following detailed description of one or more embodiments.
Reference will be made to the appended sheets of drawings that will
first be described briefly.
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] FIGS. 1A and 1B illustrate schematic views of a patient side
support assembly in a telesurgical system with and without a
sterile drape, respectively, in accordance with an embodiment of
the present disclosure.
[0020] FIG. 2A is a diagrammatic perspective view that illustrates
an embodiment of a telesurgical system with a sterile drape and
mounted instruments.
[0021] FIGS. 2B and 2C illustrate side and top views, respectively,
of the telesurgical system of FIG. 2A without a sterile drape being
shown.
[0022] FIG. 3 is a perspective view that illustrates an embodiment
of a manipulator base platform, cluster of instrument manipulators,
and mounted instruments.
[0023] FIGS. 4A and 4B illustrate perspective views of an
instrument manipulator extended and retracted, respectively, along
an insertion axis.
[0024] FIGS. 5A-1 and 5B-1 illustrate operation of support hooks to
couple a proximal face of an instrument transmission mechanism to a
distal face of the instrument manipulator, and FIGS. 5A-2 and 5B-2
illustrate sectional views of FIGS. 5A1 and 5B1, respectively.
[0025] FIGS. 5C-1 through 5C-4 illustrate different views of the
instrument manipulator without an outer housing.
[0026] FIGS. 6A-6B illustrate different views of a grip module of
the instrument manipulator in accordance with an embodiment of the
present disclosure.
[0027] FIG. 7A illustrates a view of a gimbal actuator module of
the instrument manipulator in accordance with an embodiment of the
present disclosure.
[0028] FIG. 7B illustrates a view of a roll module of the
instrument manipulator in accordance with an embodiment of the
present disclosure.
[0029] FIG. 8 illustrates a view of a telescopic insertion axis of
the instrument manipulator in accordance with an embodiment of the
present disclosure.
[0030] FIGS. 9A and 9B illustrate perspective views of a proximal
portion and a distal portion, respectively, of an instrument
configured to mount to an instrument manipulator.
[0031] FIG. 10 illustrates a sectional diagram of an instrument
manipulator operably coupled to an instrument in accordance with an
embodiment of the present disclosure.
[0032] FIGS. 11A-11B illustrate perspective views of a portion of a
sterile drape in a retracted state and an extended state,
respectively, in accordance with an embodiment of the present
disclosure.
[0033] FIG. 11C illustrates a sectional view of a rotating sterile
drape portion mounted to a distal end of a manipulator arm
including a base platform in accordance with an embodiment of the
present disclosure.
[0034] FIG. 11D illustrates an extended sterile drape in accordance
with an embodiment of the present disclosure.
[0035] FIG. 12 illustrates a perspective view of a portion of an
extended sterile drape including a sterile adapter in accordance
with an embodiment of the present disclosure.
[0036] FIGS. 13A and 13B illustrate a perspective view of an
assembled sterile adapter and an exploded view of the sterile
adapter, respectively, in accordance with an embodiment of the
present disclosure.
[0037] FIG. 13C illustrates an enlarged view of a roll actuator
interface in accordance with an embodiment of the present
disclosure.
[0038] FIGS. 14A and 14B illustrate a bottom perspective view and a
bottom view of an instrument manipulator in accordance with an
embodiment of the present disclosure.
[0039] FIG. 15 illustrates a bottom perspective view of the
instrument manipulator operably coupled to the sterile adapter in
accordance with an embodiment of the present disclosure.
[0040] FIGS. 16A-16E illustrate a sequence for coupling the
instrument manipulator and the sterile adapter in accordance with
an embodiment of the present disclosure.
[0041] FIGS. 17A-17C illustrate a sequence for coupling a surgical
instrument to the sterile adapter in accordance with an embodiment
of the present disclosure.
[0042] FIGS. 18A and 18B illustrate an enlarged perspective view
and side view, respectively, of the instrument and sterile adapter
prior to engagement.
[0043] FIGS. 19A and 19B illustrate perspective views of a movable
cannula mount in a retracted position and a deployed position,
respectively.
[0044] FIGS. 20A and 20B illustrate a front and a back perspective
view of a cannula mounted on a cannula clamp in accordance with an
embodiment.
[0045] FIG. 21 illustrates a perspective view of a cannula
alone.
[0046] FIG. 22 illustrates a cross-sectional view of the cannula of
FIG. 21 and a mounted entry guide of FIGS. 23A and 23B in
combination with instruments mounted to instrument manipulators on
a manipulator platform in accordance with an embodiment of the
present disclosure.
[0047] FIGS. 23A and 23B illustrate a perspective view and a top
view of the entry guide of FIG. 22.
[0048] FIG. 24 illustrates a cross-sectional view of another
cannula and another mounted entry guide in combination with
instruments mounted to instrument manipulators on a manipulator
platform in accordance with an embodiment of the present
disclosure.
[0049] FIGS. 24A-24B illustrate perspective views of another
movable cannula mounting arm in a retracted position and a deployed
position, respectively.
[0050] FIG. 24C illustrates a proximal top section of a cannula in
accordance with another embodiment.
[0051] FIG. 24D illustrates a cannula clamp at a distal end of a
cannula mounting arm in accordance with another embodiment.
[0052] FIGS. 25A-25C, 26A-26C, and 27A-27C illustrate different
views of a surgical system with an instrument manipulator assembly
roll axis or instrument insertion axis pointed in different
directions.
[0053] FIG. 28 is a diagrammatic view of a centralized motion
control system for a minimally invasive telesurgical system in
accordance with an embodiment.
[0054] FIG. 29 is a diagrammatic view of a distributed motion
control system for a minimally invasive telesurgical system in
accordance with an embodiment.
[0055] FIGS. 30A-30B illustrate different views of a
counterbalancing link of a robotic surgical system in accordance
with an embodiment.
[0056] FIG. 31 illustrates a view of the counterbalancing link
without an exterior housing in accordance with an embodiment.
[0057] FIGS. 32A and 32B illustrate a bottom perspective view and a
sectional view, respectively, of a distal portion of the
counterbalancing link in accordance with an embodiment.
[0058] FIG. 33 illustrates a side view of the distal portion of the
counterbalancing link without an end plug, FIG. 34 illustrates an
enlarged perspective view of the end plug linear guide, and FIG. 35
illustrates a perspective view of an adjustment pin in accordance
with various aspects of the present disclosure.
[0059] FIG. 36A-36C illustrate sectional side views showing a range
of movement of the adjustment pin to move an end plug relative to
the linear guide in accordance with various aspects of the present
disclosure.
[0060] FIGS. 37A-37C illustrate detailed views from a distal end of
the counterbalancing proximal link according to various aspects of
the present disclosure.
[0061] Embodiments of the present disclosure and their advantages
are best understood by referring to the detailed description that
follows. It should be appreciated that like reference numerals are
used to identify like elements illustrated in one or more of the
figures. It should also be appreciated that the figures may not be
necessarily drawn to scale.
DETAILED DESCRIPTION
[0062] This description and the accompanying drawings that
illustrate aspects and embodiments of the present disclosure should
not be taken as limiting. Various mechanical, compositional,
structural, electrical, and operational changes may be made without
departing from the spirit and scope of this description. In some
instances, well-known circuits, structures, and techniques have not
been shown in detail in order not to obscure the disclosure. Like
numbers in two or more figures represent the same or similar
elements.
[0063] Further, this description's terminology is not intended to
limit the disclosure. For example, spatially relative terms, such
as "beneath", "below", "lower", "above", "upper" "proximal",
"distal", and the like, may be used to describe one element's or
feature's relationship to another element or feature as illustrated
in the figures. These spatially relative terms are intended to
encompass different positions and orientations of the device in use
or operation in addition to the position and orientation shown in
the figures. For example, if the device in the figures is turned
over, elements described as "below" or "beneath" other elements or
features would then be "above" or "over" the other elements or
features. Thus, the exemplary term "below" can encompass both
positions and orientations of above and below. The device may be
otherwise oriented (rotated 90 degrees or at other orientations),
and the spatially relative descriptors used herein interpreted
accordingly. Likewise, descriptions of movement along and around
various axes include various special device positions and
orientations. In addition, the singular forms "a", "an", and "the"
are intended to include the plural forms as well, unless the
context indicates otherwise. And, the terms "comprises",
"comprising", "includes", and the like specify the presence of
stated features, steps, operations, elements, and/or components but
do not preclude the presence or addition of one or more other
features, steps, operations, elements, components, and/or groups.
Components described as coupled may be electrically or mechanically
directly coupled, or they may be indirectly coupled via one or more
intermediate components.
[0064] In one example, the terms "proximal" or "proximally" are
used in a general way to describe an object or element which is
closer to a manipulator arm base along a kinematic chain of system
movement or farther away from a remote center of motion (or a
surgical site) along the kinematic chain of system movement.
Similarly, the terms "distal" or "distally" are used in a general
way to describe an object or element which is farther away from the
manipulator arm base along the kinematic chain of system movement
or closer to the remote center of motion (or a surgical site) along
the kinematic chain of system movement.
[0065] The use of an operator's inputs at a master device to
control a robotic slave device and perform work at a work site is
well known. Such systems are called various names, such as
teleoperation, telemanipulation, or telerobotic systems. One type
of telemanipulation system gives the operator a perception of being
present at the work site, and such systems are called, for example,
telepresence systems. The da Vinci.RTM. Surgical System,
commercialized by Intuitive Surgical, Inc. of Sunnyvale, Calif., is
an example of a telemanipulation system with telepresence.
Telepresence fundamentals for such a surgical system are disclosed
in U.S. Pat. No. 6,574,355 (filed Mar. 21, 2001), which is
incorporated herein by reference. A teleoperated surgical system
(with or without a telepresence feature) may be referred to as a
telesurgical system.
[0066] To avoid repetition in the figures and the descriptions
below of the various aspects and illustrative embodiments, it
should be understood that many features are common to many aspects
and embodiments. Omission of an aspect from a description or figure
does not imply that the aspect is missing from embodiments that
incorporate that aspect. Instead, the aspect may have been omitted
for clarity and to avoid prolix description. Accordingly, aspects
described with reference to one depicted and/or described
embodiment may be present with or applied to other depicted and/or
described embodiments unless it is impractical to do so.
[0067] Accordingly, several general aspects apply to various
descriptions below. Various surgical instruments, guide tubes, and
instrument assemblies are applicable in the present disclosure and
are further described in U.S. patent application Ser. No.
11/762,165 (filed Jun. 13, 2007; U.S. Patent Application Pub. No.
US 2008/0065105 A1), which is incorporated herein by reference.
Surgical instruments alone, or assemblies including guide tubes,
multiple instruments, and/or multiple guide tubes, are applicable
in the present disclosure. Therefore, various surgical instruments
may be utilized, each surgical instrument working independently of
the other, and each having an end effector. In some instances the
end effectors operate with at least six actively controlled DOFs in
Cartesian space (i.e., surge, heave, sway, roll, pitch, yaw), via a
single entry port in a patient. One or more additional end effector
DOFs may apply to, e.g., end effector jaw movement in gripping or
shearing instruments.
[0068] For example, at least one surgical end effector is shown or
described in various figures. An end effector is the part of the
minimally invasive surgical instrument or assembly that performs a
specific surgical function (e.g., forceps/graspers, needle drivers,
scissors, electrocautery hooks, staplers, clip appliers/removers,
etc.). Many end effectors themselves have a single DOF (e.g.,
graspers that open and close). The end effector may be coupled to
the surgical instrument body with a mechanism that provides one or
more additional DOFs, such as "wrist" type mechanisms. Examples of
such mechanisms are shown in U.S. Pat. No. 6,371,952 (filed Jun.
28, 1999; Madhani et al.) and in U.S. Pat. No. 6,817,974 (filed
Jun. 28, 2002; Cooper et al.), both of which are incorporated by
reference herein, and may be known as various Intuitive Surgical,
Inc. Endowrist.RTM. mechanisms as used on both 8 mm and 5 mm
instruments for da Vinci.RTM. Surgical Systems. Although the
surgical instruments described herein generally include end
effectors, it should be understood that in some aspects an end
effector may be omitted. For example, the blunt distal tip of an
instrument body shaft may be used to retract tissue. As another
example, suction or irrigation openings may exist at the distal tip
of a body shaft or the wrist mechanism. In these aspects, it should
be understood that descriptions of positioning and orienting an end
effector include positioning and orienting the tip of a surgical
instrument that does not have an end effector. For example, a
description that addresses the reference frame for a tip of an end
effector should also be read to include the reference frame of a
tip of a surgical instrument that does not have an end
effector.
[0069] Throughout this description, it should be understood that a
mono or stereoscopic imaging system/image capture component/camera
device may be placed at the distal end of an instrument wherever an
end effector is shown or described (the device may be considered a
"camera instrument"), or it may be placed near or at the distal end
of any guide tube or other instrument assembly element.
Accordingly, the terms "imaging system" and the like as used herein
should be broadly construed to include both image capture
components and combinations of image capture components with
associated circuitry and hardware, within the context of the
aspects and embodiments being described. Such endoscopic imaging
systems (e.g., optical, infrared, ultrasound, etc.) include systems
with distally positioned image sensing chips and associated
circuits that relay captured image data via a wired or wireless
connection to outside the body. Such endoscopic imaging systems
also include systems that relay images for capture outside the body
(e.g., by using rod lenses or fiber optics). In some instruments or
instrument assemblies a direct view optical system (the endoscopic
image is viewed directly at an eyepiece) may be used. An example of
a distally positioned semiconductor stereoscopic imaging system is
described in U.S. patent application Ser. No. 11/614,661 (filed
Dec. 21, 2006; disclosing "Stereoscopic Endoscope"; Shafer et al.),
which is incorporated by reference. Well-known endoscopic imaging
system components, such as electrical and fiber optic illumination
connections, are omitted or symbolically represented for clarity.
Illumination for endoscopic imaging is typically represented in the
drawings by a single illumination port. It should be understood
that these depictions are exemplary. The sizes, positions, and
numbers of illumination ports may vary. Illumination ports are
typically arranged on multiple sides of the imaging apertures, or
completely surrounding the imaging apertures, to minimize deep
shadows.
[0070] In this description, cannulas are typically used to prevent
a surgical instrument or guide tube from rubbing on patient tissue.
Cannulas may be used for both incisions and natural orifices. For
situations in which an instrument or guide tube does not frequently
translate or rotate relative to its insertion (longitudinal) axis,
a cannula may not be used. For situations that require
insufflation, the cannula may include a seal to prevent excess
insufflation gas leakage past the instrument or guide tube.
Examples of cannula assemblies which support insufflation and
procedures requiring insufflation gas at the surgical site may be
found in U.S. patent application Ser. No. 12/705,439 (filed Feb.
12, 2010; disclosing "Entry Guide for Multiple Instruments in a
Single Port System"), the full disclosure of which is incorporated
by reference herein for all purposes. For thoracic surgery that
does not require insufflation, the cannula seal may be omitted, and
if instruments or guide tube insertion axis movement is minimal,
then the cannula itself may be omitted. A rigid guide tube may
function as a cannula in some configurations for instruments that
are inserted relative to the guide tube. Cannulas and guide tubes
may be, e.g., steel or extruded plastic. Plastic, which is less
expensive than steel, may be suitable for one-time use.
[0071] Various instances and assemblies of flexible surgical
instruments and guide tubes are shown and described in U.S. patent
application Ser. No. 11/762,165, cited above. Such flexibility, in
this description, is achieved in various ways. For example, a
segment of an instrument or guide tube may be a continuously
curving flexible structure, such as one based on a helical wound
coil or on tubes with various segments removed (e.g., kerf-type
cuts). Or, the flexible part may be made of a series of short,
pivotally connected segments ("vertebrae") that provide a
snake-like approximation of a continuously curving structure.
Instrument and guide tube structures may include those in U.S.
Patent Application Pub. No. US 2004/0138700 (filed Dec. 2, 2003;
Cooper et al.), which is incorporated by reference herein. For
clarity, the figures and associated descriptions generally show
only two segments of instruments and guide tubes, termed proximal
(closer to the transmission mechanism; farther from the surgical
site) and distal (farther from the transmission mechanism; closer
to the surgical site). It should be understood that the instruments
and guide tubes may be divided into three or more segments, each
segment being rigid, passively flexible, or actively flexible.
Flexing and bending as described for a distal segment, a proximal
segment, or an entire mechanism also apply to intermediate segments
that have been omitted for clarity. For instance, an intermediate
segment between proximal and distal segments may bend in a simple
or compound curve. Flexible segments may be various lengths.
Segments with a smaller outside diameter may have a smaller minimum
radius of curvature while bending than segments with a larger
outside diameter. For cable-controlled systems, unacceptably high
cable friction or binding limits minimum radius of curvature and
the total bend angle while bending. The guide tube's (or any
joint's) minimum bend radius is such that it does not kink or
otherwise inhibit the smooth motion of the inner surgical
instrument's mechanism. Flexible components may be, for example, up
to approximately four feet in length and approximately 0.6 inches
in diameter. Other lengths and diameters (e.g., shorter, smaller)
and the degree of flexibility for a specific mechanism may be
determined by the target anatomy for which the mechanism has been
designed.
[0072] In some instances only a distal segment of an instrument or
guide tube is flexible, and the proximal segment is rigid. In other
instances, the entire segment of the instrument or guide tube that
is inside the patient is flexible. In still other instances, an
extreme distal segment may be rigid, and one or more other proximal
segments are flexible. The flexible segments may be passive or they
may be actively controllable ("steerable"). Such active control may
be done using, for example, sets of opposing cables (e.g., one set
controlling "pitch" and an orthogonal set controlling "yaw"; three
cables can be used to perform similar action). Other control
elements such as small electric or magnetic actuators, shape memory
alloys, electroactive polymers ("artificial muscle"), pneumatic or
hydraulic bellows or pistons, and the like may be used. In
instances in which a segment of an instrument or guide tube is
fully or partially inside another guide tube, various combinations
of passive and active flexibility may exist. For instance, an
actively flexible instrument inside a passively flexible guide tube
may exert sufficient lateral force to flex the surrounding guide
tube. Similarly, an actively flexible guide tube may flex a
passively flexible instrument inside it. Actively flexible segments
of guide tubes and instruments may work in concert. For both
flexible and rigid instruments and guide tubes, control cables
placed farther from the center longitudinal axis may provide a
mechanical advantage over cables placed nearer to the center
longitudinal axis, depending on compliance considerations in the
various designs.
[0073] The flexible segment's compliance (stiffness) may vary from
being almost completely flaccid (small internal frictions exist) to
being substantially rigid. In some aspects, the compliance is
controllable. For example, a segment or all of a flexible segment
of an instrument or guide tube can be made substantially (i.e.,
effectively but not infinitely) rigid (the segment is "rigidizable"
or "lockable"). The lockable segment may be locked in a straight,
simple curve or in a compound curve shape. Locking may be
accomplished by applying tension to one or more cables that run
longitudinally along the instrument or guide tube that is
sufficient to cause friction to prevent adjacent vertebrae from
moving. The cable or cables may run through a large, central hole
in each vertebra or may run through smaller holes near the
vertebra's outer circumference. Alternatively, the drive element of
one or more motors that move one or more control cables may be
soft-locked in position (e.g., by servocontrol) to hold the cables
in position and thereby prevent instrument or guide tube movement,
thus locking the vertebrae in place. Keeping a motor drive element
in place may be done to effectively keep other movable instrument
and guide tube components in place as well. It should be understood
that the stiffness under servocontrol, although effective, is
generally less than the stiffness that may be obtained with braking
placed directly on joints, such as the braking used to keep passive
setup joints in place. Cable stiffness generally dominates because
it is generally less than servo system or braked joint
stiffness.
[0074] In some situations, the compliance of the flexible segment
may be continuously varied between flaccid and rigid states. For
example, locking cable tension can be increased to increase
stiffness but without locking the flexible segment in a rigid
state. Such intermediate compliance may allow for telesurgical
operation while reducing tissue trauma that may occur due to
movements caused by reactive forces from the surgical site.
Suitable bend sensors incorporated into the flexible segment allow
the telesurgical system to determine instrument and/or guide tube
position as it bends. U.S. Patent Application Pub. No. US
2006/0013523 (filed Jul. 13, 2005; Childers et al.), which is
incorporated by reference herein, discloses a fiber optic position
shape sensing device and method. U.S. patent application Ser. No.
11/491,384 (filed Jul. 20, 2006; Larkin et al.), which is
incorporated by reference herein, discloses fiber optic bend
sensors (e.g., fiber Bragg gratings) used in the control of such
segments and flexible devices.
[0075] A surgeon's inputs to control aspects of the minimally
invasive surgical instrument assemblies, instruments, end
effectors, and manipulator arm configuration as described herein
are generally done using an intuitive, camera-referenced control
interface. For example, the da Vinci.RTM. Surgical System includes
a surgeon's console with such a control interface, which may be
modified to control aspects described herein. The surgeon
manipulates one or more master manual input mechanisms having,
e.g., 6 DOFs to control the slave instrument assembly and
instrument. The input mechanisms include a finger-operated grasper
to control one or more end effector DOFs (e.g., closing grasping
jaws). Intuitive control is provided by orienting the relative
positions of the end effectors and the endoscopic imaging system
with the positions of the surgeon's input mechanisms and image
output display. This orientation allows the surgeon to manipulate
the input mechanisms and end effector controls as if viewing the
surgical work site in substantially true presence. This
teleoperation true presence means that the surgeon views an image
from a perspective that appears to be that of an operator directly
viewing and working at the surgical site. U.S. Pat. No. 6,671,581
(filed Jun. 5, 2002; Niemeyer et al.), which is incorporated by
reference, contains further information on camera referenced
control in a minimally invasive surgical apparatus.
Single Port Surgical System
[0076] Referring now to FIGS. 1A and 1B, schematic side and front
views are shown that illustrate aspects of a robot-assisted
(telemanipulative) minimally invasive surgical system that uses
aspects of the minimally invasive surgical instruments, instrument
assemblies, and manipulation and control systems described herein.
The three main components are an endoscopic imaging system 102, a
surgeon's console 104 (master), and a patient side support system
100 (slave), all interconnected by wired (electrical or optical) or
wireless connections 106 as shown. One or more electronic data
processors may be variously located in these main components to
provide system functionality. Examples are disclosed in U.S. patent
application Ser. No. 11/762,165, cited above. A sterile drape 1000,
shown in dotted line, advantageously drapes at least a portion of
the patient side support system 100 to maintain a sterile field
during a surgical procedure while also providing for efficient and
simple instrument exchange in conjunction with an accurate
interface between the instrument and its associated
manipulator.
[0077] Imaging system 102 performs image processing functions on,
e.g., captured endoscopic imaging data of the surgical site and/or
preoperative or real time image data from other imaging systems
external to the patient. Imaging system 102 outputs processed image
data (e.g., images of the surgical site, as well as relevant
control and patient information) to the surgeon at the surgeon's
console 104. In some aspects the processed image data is output to
an optional external monitor visible to other operating room
personnel or to one or more locations remote from the operating
room (e.g., a surgeon at another location may monitor the video;
live feed video may be used for training; etc.).
[0078] The surgeon's console 104 includes, e.g., multiple DOF
mechanical input ("master") devices that allow the surgeon to
manipulate the surgical instruments, guide tubes, and imaging
system ("slave") devices as described herein. These input devices
may in some aspects provide haptic feedback from the instruments
and instrument assembly components to the surgeon. Console 104 also
includes a stereoscopic video output display positioned such that
images on the display are generally focused at a distance that
corresponds to the surgeon's hands working behind/below the display
screen. These aspects are discussed more fully in U.S. Pat. No.
6,671,581 which is incorporated by reference herein.
[0079] Control during insertion may be accomplished, for example,
by the surgeon virtually moving the image with one or both of the
masters; she uses the masters to move the image side to side and to
pull it towards herself, consequently commanding the imaging system
and its associated instrument assembly (e.g., a flexible guide
tube) to steer towards a fixed center point on the output display
and to advance inside the patient. In one aspect the camera control
is designed to give the impression that the masters are fixed to
the image so that the image moves in the same direction that the
master handles are moved. This design causes the masters to be in
the correct location to control the instruments when the surgeon
exits from camera control, and consequently it avoids the need to
clutch (disengage), move, and declutch (engage) the masters back
into position prior to beginning or resuming instrument control. In
some aspects the master position may be made proportional to the
insertion velocity to avoid using a large master workspace.
Alternatively, the surgeon may clutch and declutch the masters to
use a ratcheting action for insertion. In some aspects, insertion
may be controlled manually (e.g., by hand operated wheels), and
automated insertion (e.g., servomotor driven rollers) is then done
when the distal end of the surgical instrument assembly is near the
surgical site. Preoperative or real time image data (e.g., MRI,
X-ray) of the patient's anatomical structures and spaces available
for insertion trajectories may be used to assist insertion.
[0080] The patient side support system 100 includes a floor-mounted
base 108, or alternately a ceiling mounted base 110 as shown by the
alternate lines. The base may be movable or fixed (e.g., to the
floor, ceiling, wall, or other equipment such as an operating
table).
[0081] Base 108 supports an arm assembly 101 that includes a
passive, uncontrolled "setup" portion and an actively controlled
"manipulator" portion. In one example, the setup portion includes
two passive rotational "setup" joints 116 and 120, which allow
manual positioning of the coupled setup links 118 and 122 when the
joint brakes are released. A passive prismatic setup joint (not
shown) between the arm assembly and the base coupled to a link 114
may be used to allow for large vertical adjustments 112.
Alternatively, some of these setup joints may be actively
controlled, and more or fewer setup joints may be used in various
configurations. The setup joints and links allow a person to place
the robotic manipulator portion of the arm at various positions and
orientations in Cartesian x, y, z space. The remote center of
motion is the location at which yaw, pitch, and roll axes intersect
(i.e., the location at which the kinematic chain remains
effectively stationary while joints move through their range of
motion). As described in more detail below, some of these actively
controlled joints are robotic manipulators that are associated with
controlling DOFs of individual surgical instruments, and others of
these actively controlled joints are associated with controlling
DOFs of a single assembly of these robotic manipulators. The active
joints and links are movable by motors or other actuators and
receive movement control signals that are associated with master
arm movements at surgeon's console 104.
[0082] As shown in FIGS. 1A and 1B, a manipulator assembly yaw
joint 124 is coupled between a distal end of setup link 122 and a
proximal end of a first manipulator link 126. Yaw joint 124 allows
link 126 to move with reference to link 122 in a motion that may be
arbitrarily defined as "yaw" around a manipulator assembly yaw axis
123. As shown, the rotational axis of yaw joint 124 is aligned with
a remote center of motion 146, which is generally the position at
which an instrument (not shown) enters the patient (e.g., at the
umbilicus for abdominal surgery). In one embodiment, setup link 122
is rotatable along a horizontal or x, y plane and yaw joint 124 is
configured to allow first manipulator link 126 to rotate about yaw
axis 123, such that the setup link 122, yaw joint 124, and first
manipulator link 126 provide a constantly vertical yaw axis 123 for
the robot arm assembly, as illustrated by the vertical dashed line
from yaw joint 124 to remote center of motion 146.
[0083] A distal end of first manipulator link 126 is coupled to a
proximal end of a second manipulator link 130, a distal end of
second manipulator link 130 is coupled to a proximal end of a third
manipulator link 134, and a distal end of third manipulator link
134 is coupled to a proximal end of a fourth manipulator link 138,
by actively controlled rotational joints 128, 132, and 136,
respectively. In one embodiment, links 130, 134, and 138 are
coupled together to act as a coupled motion mechanism. Coupled
motion mechanisms are well known (e.g., such mechanisms are known
as parallel motion linkages when input and output link motions are
kept parallel to each other). For example, if rotational joint 128
is actively rotated, then joints 132 and 136 also rotate so that
link 138 moves with a constant relationship to link 130. Therefore,
it can be seen that the rotational axes of joints 128, 132, and 136
are parallel. When these axes are perpendicular to joint 124's
rotational axis, links 130, 134, and 138 move with reference to
link 126 in a motion that may be arbitrarily defined as "pitch"
around a manipulator assembly pitch axis 139. Since links 130, 134,
and 138 move as a single assembly in one embodiment, first
manipulator link 126 may be considered an active proximal
manipulator link, and second through fourth manipulator links 130,
134, and 138 may be considered collectively an active distal
manipulator link.
[0084] A manipulator assembly platform 140 is coupled to a distal
end of fourth manipulator link 138. Manipulator platform 140
includes a rotatable base plate that supports manipulator assembly
142, which includes two or more surgical instrument manipulators
that are described in more detail below. The rotating base plate
allows manipulator assembly 142 to rotate as a single unit with
reference to platform 140 in a motion that may be arbitrarily
defined as "roll" around a manipulator assembly roll axis 141.
[0085] For minimally invasive surgery, the instruments must remain
substantially stationary with respect to the location at which they
enter the patient's body, either at an incision or at a natural
orifice, to avoid unnecessary tissue damage. Accordingly, the yaw
and pitch motions of the instrument shaft should be centered at a
single location on the manipulator assembly roll axis or instrument
insertion axis that stays relatively stationary in space. This
location is referred to as a remote center of motion. For single
port minimally invasive surgery, in which all instruments
(including a camera instrument) must enter via a single small
incision (e.g., at the umbilicus) or natural orifice, all
instruments must move with reference to such a generally stationary
remote center of motion. Therefore, a remote center of motion for
manipulator assembly 142 is defined by the intersection of
manipulator assembly yaw axis 123 and manipulator assembly pitch
axis 139. The configuration of links 130, 134, and 138, and of
joints 128, 132, and 136 is such that remote center of motion 146
is located distal of manipulator assembly 142 with sufficient
distance to allow the manipulator assembly to move freely with
respect to the patient. It can be seen that manipulator assembly
roll axis 141 also intersects remote center of motion 146.
[0086] As described in more detail below, a surgical instrument is
mounted on and actuated by each surgical instrument manipulator of
manipulator assembly 142. The instruments are removably mounted so
that various instruments may be interchangeably mounted on a
particular instrument manipulator. In one aspect, one or more
instrument manipulators may be configured to support and actuate a
particular type of instrument, such as a camera instrument. The
shafts of the instruments extend distally from the instrument
manipulators. The shafts extend through a common cannula placed at
the entry port into the patient (e.g., through the body wall or at
a natural orifice). In one aspect, an entry guide is positioned
within the cannula, and each instrument shaft extends through a
channel in the entry guide, so as to provide additional support for
the instrument shafts. The cannula is removably coupled to a
cannula mount 150, which in one embodiment is coupled to the
proximal end of fourth manipulator link 138. In one implementation,
the cannula mount 150 is coupled to link 138 by a rotational joint
that allows the mount to move between a stowed position adjacent
link 138 and an operational position that holds the cannula in the
correct position so that the remote center of motion 146 is located
along the cannula. During operation, the cannula mount is fixed in
position relative to link 138 according to one aspect. The
instrument(s) may slide through an entry guide and cannula assembly
mounted to a distal end of the cannula mount 150, examples of which
are explained in further detail below. The various passive setup
joints/links and active joints/links allow positioning of the
instrument manipulators to move the instruments and imaging system
with a large range of motion when a patient is placed in various
positions on a movable table. In some embodiments, a cannula mount
may be coupled to the proximal link or first manipulator link
126.
[0087] Certain setup and active joints and links in the manipulator
arm may be omitted to reduce the robot's size and shape, or joints
and links may be added to increase degrees of freedom. It should be
understood that the manipulator arm may include various
combinations of links, passive joints, and active joints (redundant
DOFs may be provided) to achieve a necessary range of poses for
surgery. Furthermore, various surgical instruments alone or
instrument assemblies including guide tubes, multiple instruments,
and/or multiple guide tubes, and instruments coupled to instrument
manipulators (e.g., actuator assemblies) via various configurations
(e.g., on a proximal face or a distal face of the instrument
transmission means or the instrument manipulator), are applicable
in aspects of the present disclosure.
[0088] FIGS. 2A-2C are diagrammatic perspective, side, and top
views, respectively, of a patient side support cart 200 in a
teleoperated surgical (telesurgical) system. The depicted cart 200
is an illustrative embodiment of the general configuration
described above with reference to FIGS. 1A and 1B. A surgeon's
console and a video system are not shown but are applicable as
described above with respect to FIGS. 1A and 1B and known
telerobotic surgical system architectures (e.g., the da Vinci.RTM.
Surgical System architecture). In this embodiment, cart 200
includes a floor-mounted base 208. The base may be movable or fixed
(e.g., to the floor, ceiling, wall, or other sufficiently rigid
structure). Base 208 supports support column 210, and an arm
assembly 201 is coupled to support column 210. The arm assembly
includes two passive rotational setup joints 216 and 220, which
when their brakes are released allow manual positioning of the
coupled setup links 218 and 222. In the depicted embodiment, setup
links 218 and 222 move in a horizontal plane (parallel to the
floor). The arm assembly is coupled to support column 210 at a
passive sliding setup joint 215 between the column 210 and a
vertical setup link 214. Joint 215 allows the manipulator arm to be
vertically (perpendicular to the floor) adjusted. Accordingly, the
passive setup joints and links may be used to properly position a
remote center of motion 246 with reference to the patient. Once the
remote center of motion 246 is properly positioned, brakes at each
of the joints 215, 216, and 220 are set to prevent the setup
portion of the arm from moving.
[0089] In addition, the arm assembly includes active joints and
links for manipulator arm configuration and movement, instrument
manipulation, and instrument insertion. The proximal end of a first
manipulator link 226 is coupled to the distal end of setup link 222
via an actively controlled rotational manipulator assembly yaw
joint 224. As shown, the rotational manipulator assembly yaw axis
223 of yaw joint 224 is aligned with remote center of motion 246,
as illustrated by the vertical dashed line from yaw joint 224 to
remote center of motion 246.
[0090] The distal end of first manipulator link 226 is coupled to
the proximal end of a second manipulator link 230, the distal end
of second manipulator link 230 is coupled to the proximal end of a
third manipulator link 234, and the distal end of third manipulator
link 234 is coupled to the proximal end of a fourth manipulator
link 238, by actively controlled rotational joints 228, 232, and
236, respectively. As described above, links 230, 234, and 238
function as a coupled motion mechanism, so that fourth manipulator
link 238 automatically moves in concert with second manipulator
link 230 when link 230 is actuated. In the depicted embodiment, a
mechanism similar to that disclosed in U.S. Pat. No. 7,594,912
(filed Sep. 30, 2004) is modified for use (see also e.g., U.S.
patent application Ser. No. 11/611,849 (filed Dec. 15, 2006; U.S.
Patent Application Pub. No. US 2007/0089557 A1)). Thus, first
manipulator link 226 may be considered an active proximal link, and
second through fourth links 230, 234, and 238 may be considered
collectively an active distal link. In one embodiment, first link
226 may include a compression spring counterbalance mechanism, as
further described below, to counterbalance forces from movement of
the distal link about joint 228.
[0091] A manipulator assembly platform 240 is coupled to a distal
end of fourth link 238. Platform 240 includes a base plate 240a
upon which instrument manipulator assembly 242 is mounted. As shown
in FIG. 2A, platform 240 includes a "halo" ring inside which a
disk-shaped base plate 240a rotates. Configurations other than the
halo and disk may be used in other embodiments. Base plate 240a's
center of rotation is coincident with a manipulator assembly roll
axis 241, as shown by the dashed line that extends through the
center of manipulator platform 240 and remote center of motion 246.
Instruments 260 are mounted to the instrument manipulators of
manipulator assembly 242 on a distal face of the instrument
manipulators in one embodiment.
[0092] As shown in FIGS. 2A and 2B, instrument manipulator assembly
242 includes four instrument manipulators 242a. Each instrument
manipulator supports and actuates its associated instrument. In the
depicted embodiment, one instrument manipulator 242a is configured
to actuate a camera instrument, and three instrument manipulators
242a are configured to actuate various other interchangeable
surgical instruments that perform surgical and/or diagnostic work
at the surgical site. More or fewer instrument manipulators may be
used. In some operational configurations, one or more manipulators
may not have an associated surgical instrument during some or all
of a surgical procedure. The instrument manipulators are disclosed
in more detail below.
[0093] As mentioned above, a surgical instrument 260 is mounted to
and actuated by a respective instrument manipulator 242a. In
accordance with an aspect of the disclosure, each instrument is
mounted to its associated manipulator at only the instrument's
proximal end. It can be seen in FIG. 2A that this proximal end
mounting feature keeps the instrument manipulator assembly 242 and
support platform 240 as far from the patient as possible, which for
the given instrument geometries allows the actively controlled
portion of the manipulator arm to move freely within a maximum
range of motion with reference to the patient while not colliding
with the patient. The instruments 260 are mounted so that their
shafts are clustered around manipulator assembly roll axis 241.
Each shaft extends distally from the instrument's force
transmission mechanism, and all shafts extend through a single
cannula placed at the port into the patient. The cannula is
removably held in a fixed position with reference to base plate
240a by a cannula mount 250, which is coupled to fourth manipulator
link 238. A single guide tube is inserted into and freely rotates
within the cannula, and each instrument shaft extends through an
associated channel in the guide tube. The longitudinal axes of the
cannula and guide tube are generally coincident with the roll axis
241. Therefore, the guide tube rotates within the cannula as base
plate 240a rotates. In some embodiments, a cannula mount may be
operably coupled to first manipulator link 226.
[0094] Each instrument manipulator 242a is movably coupled to an
active telescoping insertion mechanism 244 (FIG. 2B) operably
coupled to the base plate 240a and may be used to insert and
withdraw the surgical instrument(s). FIG. 2A illustrates instrument
manipulators 242a extended a distance toward a distal end of
telescoping insertion mechanism 244 (see also FIGS. 3 and 4A), and
FIG. 2B illustrates instrument manipulators 242 retracted to a
proximal end of telescoping insertion mechanism 244 (see also FIG.
4B). Active joints 224, 228, 232, 236 and manipulator platform 240
move in conjunction and/or independently so that a surgical
instrument (or assembly) moves around the remote center of motion
246 at an entry port, such as a patient's umbilicus, after the
remote center of motion has been established by the passive setup
arms and joints.
[0095] As shown in FIG. 2A, cannula mount 250 is coupled to fourth
link 238 near the fourth manipulator link's proximal end. In other
aspects, cannula mount 250 may be coupled to another section of the
proximal link. As described above, cannula mount 250 is hinged, so
that it can swing into a stowed position adjacent fourth link 238
and into an extended position (as shown) to support the cannula.
During operation, cannula mount 250 is held in a fixed position
relative to fourth link 238 according to one aspect.
[0096] It can be seen that in the depicted embodiment first
manipulator link 226 is generally shaped as an inverted "L" in one
example. A proximal leg of the "L" shaped link is coupled to link
226 at yaw joint 224, and a distal leg of the link is coupled to
second manipulator link 238 at rotational joint 228. In this
illustrative embodiment, the two legs are generally perpendicular,
and the proximal leg of the first manipulator link rotates around a
plane generally perpendicular to manipulator assembly yaw axis 223
(e.g., a horizontal (x, y) plane if the yaw axis is vertical (z)).
Accordingly, the distal leg extends generally parallel to the
manipulator assembly yaw axis 223 (e.g., vertically (z) if the yaw
axis is vertical). This shape allows manipulator links 230, 234,
and 238 to move underneath yaw joint 224, so that links 230, 234,
and 238 provide a manipulator assembly pitch axis 239 that
intersects remote center of motion 246. Other configurations of
first link 226 are possible. For example, the proximal and distal
legs of the first link 226 may not be perpendicular to each other,
the proximal leg may rotate in a plane different from a horizontal
plane, or link 226 may have other than a general "L" shape, such as
an arc shape.
[0097] It can be seen that a vertical yaw axis 223 allows link 226
to rotate substantially 360 degrees, as shown by dashed lines 249
(FIG. 2C). In one instance the manipulator assembly yaw rotation
may be continuous, and in another instance the manipulator assembly
yaw rotation is approximately .+-.180 degrees. In yet another
instance, the manipulator assembly yaw rotation may be
approximately 660 degrees. The pitch axis 239 may or may not be
held constant during such yaw axis rotation. Since the instruments
are inserted into the patient in a direction generally aligned with
manipulator assembly roll axis 241, the arm can be actively
controlled to position and reposition the instrument insertion
direction in any desired direction around the manipulator assembly
yaw axis (see, e.g., FIGS. 25A-25C showing the instrument insertion
direction toward a patient's head, and FIGS. 26A-26C showing the
instrument insertion direction toward a patient's feet). This
capability may be significantly beneficial during some surgeries.
In certain abdominal surgeries in which the instruments are
inserted via a single port positioned at the umbilicus, for
example, the instruments may be positioned to access all four
quadrants of the abdomen without requiring that a new port be
opened in the patient's body wall. Multi-quadrant access may be
required for, e.g., lymph node access throughout the abdomen. In
contrast, the use of a multi-port telerobotic surgical system may
require that additional ports be made in the patient's body wall to
more fully access other abdominal quadrants.
[0098] Additionally, the manipulator may direct the instrument
vertically downwards and in a slightly pitched upwards
configuration (see, e.g., FIGS. 27A-27C showing the instrument
insertion direction pitched upwards). Thus, the angles of entry
(both yaw and pitch about the remote center) for an instrument
through a single entry port may be easily manipulated and altered
while also providing increased space around the entry port for
patient safety and patient-side personnel to maneuver.
[0099] Furthermore, links 230, 234, and 238 in conjunction with
active joints 228, 232, and 236 may be used to easily manipulate
the pitch angle of entry of an instrument through the single entry
port while creating space around the single entry port. For
example, links 230, 234, and 238 may be positioned to have a form
factor "arcing away" from the patient. Such arcing away allows
rotation of the manipulator arm about the yaw axis 223 that does
not cause a collision of the manipulator arm with the patient. Such
arcing away also allows patient side personnel to easily access the
manipulator for exchanging instruments and to easily access the
entry port for inserting and operating manual instruments (e.g.,
manual laparoscopic instruments or retraction devices). In yet
another example, fourth link 238 has a form factor that arcs away
from the remote center of motion and therefore the patient,
allowing for greater patient safety. In other terms, the work
envelope of the cluster of instrument manipulators 242a may
approximate a cone, with the tip of the cone at the remote center
of motion 246 and the circular end of the cone at the proximal end
of the instrument manipulators 242a. Such a work envelope results
in less interference between the patient and the surgical robotic
system, greater range of motion for the system allowing for
improved access to the surgical site, and improved access to the
patient by surgical staff.
[0100] Accordingly, the configuration and geometry of the
manipulator arm assembly 201 in conjunction with its large range of
motion allow for multi-quadrant surgery through a single port.
Through a single incision, the manipulator may direct the
instrument in one direction and easily change direction; e.g.,
working toward the head or pelvis of a patient (see, e.g., FIGS.
25A-25C) and then changing direction toward the pelvis or head of
the patient (see, e.g., FIGS. 26A-26C), by moving the manipulator
arm about the constantly vertical yaw axis.
[0101] This illustrative manipulator arm assembly is used, for
example, for instrument assemblies that are operated to move with
reference to the remote center of motion. Certain setup and active
joints and links in the manipulator arm may be omitted, or joints
and links may be added for increased degrees of freedom. It should
be understood that the manipulator arm may include various
combinations of links, passive, and active joints (redundant DOFs
may be provided) to achieve a necessary range of poses for surgery.
Furthermore, various surgical instruments alone or instrument
assemblies including guide tubes, multiple instruments, and/or
multiple guide tubes, and instruments coupled to instrument
manipulators (actuator assemblies) via various configurations
(e.g., on a proximal face or a distal face of the actuator assembly
or transmission mechanism), are applicable in the present
disclosure.
[0102] Referring now to FIGS. 3, 4A-4B, 5A-1 through 5B-2, 5C-1
through 5C-4, and 8, aspects and embodiments of the instrument
manipulator will be described in greater detail with no intention
of limiting the disclosure to these aspects and embodiments. FIG. 3
is a perspective view of an embodiment of a rotatable base plate
340a of a manipulator assembly platform, a cluster of four
instrument manipulators 342 mounted on the base plate 340a to form
an instrument manipulator assembly, and four instruments 360 (the
proximal portions are illustrated) each mounted to the distal face
of an associated instrument manipulator 342. Base plate 340a is
rotatable about a manipulator assembly roll axis 341, as described
above. In one embodiment, roll axis 341 runs through the
longitudinal center of a cannula and entry guide assembly, through
which the instruments 360 enter a patient's body. Roll axis 341 is
also substantially perpendicular to a substantially single plane of
the distal face of each instrument manipulator 342, and
consequently to a substantially single plane of the proximal face
of an instrument mounted to the distal face of an instrument
manipulator.
[0103] Each instrument manipulator 342 includes an insertion
mechanism 344 that is coupled to the base plate 340a. FIG. 8 is a
cutaway perspective view that illustrates an embodiment of the
instrument insertion mechanism in more detail. As shown in FIG. 8,
an instrument insertion mechanism 844 includes three links that
slide linearly with reference to one another in a telescoping
manner. Insertion mechanism 844 includes a carriage 802, a carriage
link 804, and a base link 808. As described in U.S. patent
application Ser. No. 11/613,800 (filed Dec. 20, 2006; U.S. Patent
Application Pub. No. US 2007/0137371 A1), which is incorporated
herein by reference, carriage link 804 slides along base link 808,
and carriage 802 slides along carriage link 804. Carriage 802 and
links 804,808 are interconnected by a coupling loop 806 (which in
one instance includes one or more flexible metal belts;
alternatively, one or more cables may be used). A lead screw 808a
in base link 808 drives a slider 808b that is coupled to a fixed
location on coupling loop 806. Carriage 802 is coupled to coupling
loop 806 at a fixed location as well, so that as slider 808b slides
a particular distance x with reference to base link 808, carriage
802 slides 2x with reference to base link 808. Various other linear
motion mechanisms (e.g., lead screw and carriage) may be used in
alternate implementations of the insertion mechanism.
[0104] As shown in FIGS. 3 and 8, the proximal end of base link 808
is coupled to rotatable base plate 340a, and carriage 802 is
coupled to the outer shell or inner frame of an instrument
manipulator 342 (e.g., within inner frame aperture 542i' of FIGS.
5C-1 through 5C-3). A servomotor (not shown) drives lead screw
808a, and as a result the instrument manipulator 342 moves
proximally and distally with reference to base plate 340a in a
direction generally parallel to roll axis 341. Since a surgical
instrument 360 is coupled to the manipulator 342, the insertion
mechanism 344 functions to insert and withdraw the instrument
through the cannula towards and away from the surgical site
(instrument insertion DOF). Flat electrically conductive flex
cables (not shown) running adjacent the coupling loop may provide
power, signals, and ground to the instrument manipulator.
[0105] It can be seen that an advantage of the telescoping feature
of the insertion mechanism 344 is that it provides a larger range
of motion when the instrument manipulator moves from its full
proximal to its full distal position, with a smaller protruding
insertion mechanism when the manipulator is at its full proximal
position, than if only a single stationary insertion stage piece is
used (see e.g., FIGS. 4A (full distal position) and 4B (full
proximal position)). The shortened protrusion prevents the
insertion mechanism from interfering with the patient during
surgery and with operating room personnel, e.g., during instrument
changing, when the instrument manipulator is at its proximal
position.
[0106] As further illustrated in FIG. 3, the telescopic insertion
mechanisms 344 are symmetrically mounted to the rotatable base
plate 340a in one embodiment, and therefore the instrument
manipulators 342 and mounted instruments 360 are clustered
symmetrically about the roll axis 341. In one embodiment,
instrument manipulators 342 and their associated instruments 360
are arranged around the roll axis in a generally pie-wedge layout,
with the instrument shafts positioned close to the manipulator
assembly roll axis 341. Thus, as the base plate rotates about the
roll axis 341, the cluster of instrument manipulators 342 and
mounted instruments 360 also rotates about the roll axis.
[0107] FIGS. 4A and 4B are perspective views that illustrate an
instrument manipulator 442 at an extended and retracted position,
respectively, along an insertion mechanism 444 mounted to a
rotatable base plate 440a. As noted above, instrument manipulator
442 is able to extend and retract along a longitudinal axis of the
insertion mechanism 444 between the base plate 440a and a free
distal end 444a of the insertion mechanism, as shown by the
double-sided arrows adjacent to insertion mechanism 444. In this
illustrative embodiment, instruments mount against the distal face
442a of the instrument manipulator 442.
[0108] Distal face 442a includes various actuation outputs that
transfer actuation forces to a mounted instrument. As shown in
FIGS. 4A and 4B, such actuation outputs may include a grip output
lever 442b (controlling the grip motion of an instrument end
effector), a joggle output gimbal 442c (controlling the
side-to-side motion and the up-and-down motion of a distal end
parallel linkage ("joggle" or "elbow" mechanism)), a wrist output
gimbal 442d (controlling the yaw motion and the pitch motion of an
instrument end effector), and a roll output disk 442e (controlling
the roll motion of an instrument). Details of such outputs, and the
associated parts of the instrument force transmission mechanism
that receives such outputs, may be found in U.S. patent application
Ser. No. 12/060,104 (filed Mar. 31, 2008; U.S. Patent Application
Pub. No. US 2009/0248040 A1), which is incorporated herein by
reference. Examples of the proximal ends of illustrative surgical
instruments that may receive such inputs may be found in U.S.
patent application Ser. No. 11/762,165, which is referenced above.
Briefly, the side-to-side and up-and-down DOFs are provided by a
distal end parallel linkage, the end effector yaw and end effector
pitch DOFs are provided by a distal flexible wrist mechanism, the
instrument roll DOF is provided by rolling the instrument shaft
while keeping the end effector at an essentially constant position
and pitch/yaw orientation, and the instrument grip DOF is provided
by two movable opposing end effector jaws. Such DOFs are
illustrative of more or fewer DOFs (e.g., in some implementations a
camera instrument omits instrument roll and grip DOFs).
[0109] In order to facilitate the mounting of an instrument against
the instrument manipulator's distal face, supports such as support
hooks 442f are positioned on the instrument manipulator. In the
depicted embodiment, the support hooks are stationary with
reference to the instrument manipulator's main housing, and the
instrument manipulator's distal face moves proximally and distally
to provide a secure interconnection between the instrument
manipulator and the instrument. A latch mechanism 442g is used to
move the instrument manipulator's distal face toward an
instrument's proximal face. In an alternative embodiment, a latch
mechanism may be used, to move the instrument's proximal face
toward the manipulator's distal face in order to engage or
disengage the manipulator outputs and instrument inputs.
[0110] FIGS. 5A-1 and 5B-1 are perspective views that illustrate an
exemplary architecture of an instrument manipulator 542. FIGS. 5A-2
and 5B-2 are cross-sectional views of FIGS. 5A-1 and 5B-1 along cut
lines I-I and II-II, respectively. As shown, the manipulator
includes an inner frame 542i movably coupled to an outer shell
542h, for example by sliding joints, rails, or the like. Inner
frame 542i moves distally and proximally with reference to outer
shell 542h as the result of the action of latch mechanism 542g.
[0111] Referring now to FIGS. 5A-1 through 5B-2, the operation of
support hooks 542f and latch mechanism 542g to mount an instrument
(not shown) to the instrument manipulator 542 is illustrated. As
shown, a distal face 542a of the instrument manipulator 542 is
substantially a single plane, and it is operably coupled to a
proximal face of an instrument force transmission mechanism (e.g.,
proximal face 960' of instrument 960 in FIGS. 9A-9B). Latch
mechanism 542g may include an actuation mechanism, such as a pulley
and wire, to move the inner frame and outer shell of the instrument
manipulator relative to one another, and to hold distal face 542a
against the instrument during operation.
[0112] In the depicted embodiment, instrument support hooks 542f
are rigidly mounted to instrument manipulator outer shell 542h, and
when latch mechanism 542g is actuated, the distal face 542a of the
inner frame 542i of the instrument manipulator moves distally
toward a distal end of support hooks 542f and away from a proximal
face 542j of the outer shell of the instrument manipulator. Thus,
when an instrument force transmission mechanism is mounted on the
support hooks 542f, distal face 542a of the instrument manipulator
moves toward the proximal face of the instrument transmission
mechanism, which is restrained by support hooks 542f, in order to
engage or otherwise operably interface the instrument manipulator
outputs with the instrument force transmission inputs, as
illustrated by arrow A1 in FIGS. 5A-1 and 5A-2. As illustrated by
this embodiment, actuator outputs of the manipulator compress
against and interface with the proximal instrument face to transmit
instrument actuator signals to the instrument. When the latch 542g
is actuated in a reverse direction, distal face 542a of the
instrument manipulator moves toward proximal face 542j of the
instrument manipulator (i.e., away from distal ends of stationary
support hooks 542f) in order to disengage the instrument
manipulator outputs from the instrument inputs, as illustrated by
arrow A2 in FIGS. 5B-1 and 5B-2. An advantage of the depicted
embodiment is that when the latch mechanism is activated, the
actuator portions of the instrument manipulator move relative to a
stationary instrument fixed in space on the support hooks. The
movement of the instrument manipulator's actuators toward or away
from the instrument minimizes unnecessary or unintended instrument
motion during the latching or unlatching process. Accordingly,
since the instrument does not move relative to the patient during
the instrument mounting process, potential damage to tissue is
avoided, since the distal end of the instrument may still be inside
the patient.
[0113] In alternate embodiments, the support hooks 542f may be
retracted toward proximal face 542j to move a proximal face of an
instrument toward the distal face 542a of a stationary instrument
manipulator in order to engage the instrument manipulator outputs
with the instrument inputs, as shown by arrows B1 in FIGS. 5A-1 and
5A-2. When the latch is opened or reversely actuated, the process
is reversed and the support hooks 542f move away from the distal
face 542a of the stationary instrument manipulator in order to
disengage the instrument manipulator outputs with the instrument
inputs, as illustrated by arrows B2 in FIGS. 5B-1 and 5B-2.
[0114] FIGS. 5C-1 through 5C-4 illustrate different views of the
instrument manipulator 542 without outer shell 542h in order to
reveal independent drive modules for actuating the instrument
manipulator outputs. The drive modules are mounted in modular form
to inner frame 542i of the instrument manipulator, which moves
along with the drive modules, relative to outer shell 542h and
support hooks 542f of the instrument manipulator. When the latch is
closed, the inner frame of the instrument manipulator moves toward
the instrument a set distance, and spring-loaded module outputs
engage instrument inputs through a sterile drape, as further
described below. When the latch is opened, the process is reversed.
Spring-loaded actuator drive module outputs provide a robust
interface with the instrument force transmission mechanism inputs
through the drape, as described in more detail below.
[0115] As illustrated in the depicted embodiment, instrument
manipulator 542 includes a grip actuator drive module 542b' for
actuating a grip output lever 542b, a joggle actuator drive module
542c' for actuating a joggle output gimbal 542c, a wrist actuator
drive module 542d' for actuating wrist output gimbal 542d, and a
roll actuator drive module 542e' for actuating a roll output disc
542e. Outputs 542b, 542c, 542d, and 542e distally protrude from the
distal face 542a of instrument manipulator 542, as shown for
example in FIG. 5C-4, and they are adapted to engage with
instrument force transmission mechanism inputs to actuate X-Y
translation of the mounted instrument and grip, pitch, yaw, and
roll end effector movements.
[0116] FIGS. 6A-6B are upper and lower perspective views of a grip
actuator drive module 642b' of an instrument manipulator. Grip
actuator drive module 642b' includes a linear slide 602, a drive
spring mechanism 604 that includes a spring 606, and a grip drive
output lever 642b. Drive spring mechanism 604 is coupled to the
inner frame 542i of the instrument manipulator. As the latch 542g
is actuated to engage an instrument, the inner frame moves, and the
grip drive module 642b' moves along linear slide 602 until output
lever 642b contacts its mating input on the instrument. This
contact preloads the spring 606, thereby spring-loading the grip
output 642b against an instrument input as the instrument is
latched in place. The preloaded spring 606 then ensures that proper
actuator drive output/input contact is maintained during operation,
so that a clearance does not develop in the output/input contact,
which would render precise kinematic control difficult.
[0117] FIG. 7A is a bottom perspective view of a gimbal drive
module 742c/d' of the instrument manipulator that can be used to
provide either the joggle output gimbal controlling X-Y translation
for the joggle mechanism of the instrument or the wrist output
gimbal controlling pitch and yaw for the instrument end effector.
In this embodiment, gimbal drive module 742c/d' includes a linear
slide 702, a drive spring mechanism 704 including a spring 706, and
an actuator output gimbal 742c/d on a gimbal pin 710. Drive spring
mechanism 704 is coupled to the inner frame 542i of the instrument
manipulator. As latch 542f is actuated to engage an instrument, the
inner frame moves distally, and actuator drive module 742c/d' moves
along linear slide 702 until output gimbal 742c/d contacts its
mating input on the instrument. This contact preloads the spring
706, thereby spring-loading the output gimbal 742c/d against an
instrument input as the instrument is latched in place. As with the
grip actuator drive module, the preloaded spring then ensures that
proper actuator drive output/input contact is maintained during
operation, so that a clearance does not develop in the output/input
contact, which would render precise kinematic control difficult.
Gimbal drive module 742c/d' further includes two "dog bone" links
712, two ball screws 714, two motors 716, two Hall effect sensors
718, and two rotary or linear motion encoders 720. Motors 716 drive
associated ball screws 714, which actuate dogbone links 712. The
proximal end of dogbone links 712 are coupled to linear slides 721,
which move along axes parallel to ball screws 714. The distal end
of dogbone lines 712 are coupled to output gimbals 742c/d, which
each rotate about two orthogonal axes perpendicular to the
longitudinal axis through gimbal pin 710. In one aspect, the
gimbals of the drive modules have two degrees of freedom but do not
have orthogonal axes.
[0118] FIG. 7B is a bottom perspective view of a roll actuator
drive module 742e' of the instrument manipulator that can be used
to provide roll output disc controlling roll movement of a mounted
instrument. In this embodiment, roll actuator drive module 742e'
includes a motor 734 which drives a harmonic drive 736, which in
turn drives spur gears 740. The spur gears 740 rotate the roll
output disc 742e and thus drive the roll input disc on the
instrument. An encoder 732 is used to sense position and commutate
the motor 734. An absolute encoder 738 is coupled to the roll
output disc 742e and senses the absolute position of instrument
roll.
[0119] In one aspect, the system drive modules are operably
independent and sufficiently isolated from one another, such that
large forces applied through one interface output are not
transferred to the other interface outputs. In other words, large
forces through one interface output do not transfer to other
interface outputs, and so do not affect the instrument components
actuated by the other interface outputs. In one aspect, a drive
module and its corresponding actuator outputs have substantially no
unintended force input from another drive module and/or its
corresponding actuator outputs. This feature improves instrument
operation and consequently patient safety.
[0120] FIGS. 9A and 9B are perspective views of a proximal portion
960a and a distal portion 960b, respectively, of an instrument 960
configured to mount to the instrument manipulators of FIGS. 4A-4B
and 5A-1 through 5C-4. A proximal face 960' of a transmission
mechanism of instrument 960 includes an instrument grip input lever
962b that interfaces with grip output lever 542b, an instrument
joggle input gimbal 962c that interfaces with joggle output gimbal
542c, an instrument wrist input gimbal 962d that interfaces with
wrist output gimbal 542d, and an instrument roll input disc 962e
that interfaces with roll output disc 542e. FIG. 9B illustrates an
example of a distal end 960b of a flexible surgical instrument 960
including a wrist 964, a joggle mechanism 966, and an end effector
968. In one embodiment, proximal face 960' of the transmission
mechanism of instrument 960 has a substantially single plane that
operably interfaces with the distal face of the instrument
manipulator when the manipulator outputs and instrument inputs are
operably engaged. U.S. patent application Ser. No. 11/762,165
entitled "Minimally Invasive Surgical System" by Larkin et al.,
which is incorporated herein by reference, and U.S. patent
application Ser. No. 11/762,154 entitled "Surgical Instrument With
Parallel Motion Mechanism" by Cooper et al., which is incorporated
herein by reference, disclose further details on applicable distal
portions and proximal portions of surgical instruments, such as
instrument 960.
[0121] In the illustrative aspect shown in FIGS. 9A and 9B,
instrument 960 includes a transmission portion at its proximal end,
an elongated instrument body, one of various surgical end effectors
968, and a snake-like, two degree of freedom wrist mechanism 964
that couples end effector 968 to the joggle mechanism 966 and the
instrument body. As in the da Vinci.RTM. Surgical Systems, in some
aspects the transmission portion includes disks that interface with
electrical actuators (e.g., servomotors) permanently mounted on a
support arm so that instruments may easily be changed. Other
linkages such as matching gimbal plates and levers may be used to
transfer actuating forces at the mechanical interface. Mechanical
mechanisms (e.g., gears, levers, gimbals) in the transmission
portion transfer the actuating forces from the disks to cables,
wires, and/or cable, wire, and hypotube combinations that run
through one or more channels in the instrument body (which may
include one or more articulated segments) to control wrist 964 and
end effector 970 movement. In some aspects, one or more disks and
associated mechanisms transfer actuating forces that roll the
instrument body around its longitudinal axis. The main segment of
the instrument body is a substantially rigid single tube, although
in some aspects it may be slightly resiliently flexible. This small
flexibility allows a proximal body segment proximal of a guide tube
(i.e., outside the patient) to be slightly flexed so that several
instrument bodies can be spaced more closely within a guide tube
than their individual transmission segment housings would otherwise
allow, like several cut flowers of equal length being placed in a
small-necked vase. This flexing is minimal (e.g., less than or
equal to about a 5-degree bend angle in one embodiment) and does
not induce significant friction because the bend angle for the
control cables and hypotubes inside the instrument body is small.
In other words, in one embodiment, an instrument shaft may distally
exit a force transmission mechanism at a slight angle instead of
orthogonal to a distal or proximal face of the force transmission
mechanism. The instrument shaft may then bend slightly and continue
straight to form a slight arc at a proximal section of the
instrument shaft distally exiting the force transmission mechanism.
Thus, the instrument may have an instrument shaft with a proximal
curved section proximal to the guide tube and a distal straight
section. In one example, the instrument shaft may be pitched
between about zero degrees and about five degrees when distally
exiting the force transmission mechanism.
[0122] As shown in FIGS. 9A and 9B, instrument 960 includes a
proximal body segment 968 (that extends through a guide tube in one
example) and at least one distal body segment or joggle mechanism
966 (that is positioned beyond the guide tube's distal end in one
example). For example, instrument 960 includes proximal body
segment 968, joggle mechanism 966 that is coupled to proximal body
segment 968 at a joint 967, wrist mechanism 964 that is coupled to
joggle mechanism 966 at another joint 965 (the coupling may include
another, short distal body segment), and an end effector 970. In
some aspects the joggle mechanism 966 and joints 965 and 967
function as a parallel motion mechanism in which the position of a
reference frame at the distal end of the mechanism may be changed
with respect to a reference frame at the proximal end of the
mechanism without changing the orientation of the distal reference
frame. Details of an applicable parallel motion or joggle mechanism
including related joints of an applicable instrument is further
disclosed in U.S. patent application Ser. No. 11/762,165, which has
been incorporated by reference.
[0123] FIG. 10 is a cross-sectional side view of an instrument
manipulator 542 operably coupled to an instrument 960 in accordance
with aspects of the present disclosure. As shown in FIG. 10,
actuator outputs 542b-542e on a distal face of the instrument
manipulator 542 interface with actuator inputs 962b-962e on a
proximal face of the surgical instrument 960.
[0124] Since the instrument end effector is provided with seven
degrees of freedom (instrument insertion, grip, 2-DOF wrist
articulation, 2-DOF joggle (wrist translation), and instrument
roll) to facilitate surgery, the requirement for instrument
actuation precision is high and a high-fidelity, low backlash
interface between the instrument and the instrument manipulator is
desirable. The independently operated drive system modules of the
instrument manipulator (e.g., modules 542b', 542c', 542d', and
542e') allow the various drive trains to be coupled to a surgical
instrument through an imprecisely manufactured drape substantially
without performance comprise. As the drive system modules are not
coupled to one another and sufficiently isolated from one another,
large forces applied through one interface output are not
transferred to the other interface outputs. In other words, large
forces through one interface output do not transfer to other
interface outputs, and so do not affect the instrument components
actuated by the other interface outputs. In one aspect, a drive
module and its corresponding actuator outputs have substantially no
unintended force input from another drive module and/or its
corresponding actuator outputs. This feature improves instrument
operation and consequently patient safety.
[0125] In one aspect, mating disks may be used for force
transmission features and actuating feature as in the da Vinci.RTM.
Surgical System instrument interface. In another aspect, mating
gimbal plates and levers are used. Various mechanical components
(e.g., gears, levers, cables, pulleys, cable guides, gimbals, etc.)
in the transmission mechanisms are used to transfer the mechanical
force from the interface to the controlled element. Each actuator
mechanism includes at least one actuator (e.g., servomotor (brushed
or brushless)) that controls movement at the distal end of the
associated instrument. For example, an actuator can be an electric
servomotor that controls a surgical instrument's end effector grip
DOF. An instrument (including a guide probe as described herein) or
guide tube (or, collectively, the instrument assembly) may be
decoupled from the associated actuator mechanisms) and slid out. It
may then be replaced by another instrument or guide tube. In
addition to the mechanical interface there is an electronic
interface between each transmission mechanism and actuator
mechanism. This electronic interface allows data (e.g.,
instrument/guide tube type) to be transferred. Examples of the
mechanical and electrical interfaces for the various instruments,
guide tubes, and imaging systems, and also about sterile draping to
preserve the sterile field, are discussed in U.S. Pat. Nos.
6,866,671 (filed Aug. 13, 2001; Tierney et al.) and 6,132,368
(filed Nov. 21, 1997; Cooper), both of which are incorporated by
reference herein.
[0126] Surgical instruments alone or assemblies including guide
tubes, multiple instruments, and/or multiple guide tubes, and
instruments coupled to actuator assemblies via various
configurations (e.g., on a proximal face or a distal face of the
instrument/actuator assembly), are applicable in the present
disclosure. Therefore, various surgical instruments may be
utilized, each surgical instrument working independently of the
other and each having an end effector with at least six actively
controlled DOFs in Cartesian space (i.e., surge, heave, sway, roll,
pitch, yaw), via a single entry port in a patient.
[0127] The instrument shafts forming the end of these kinematic
chains described above may be guided through cannulas and/or entry
guides for insertion into a patient, as further described below.
Examples of applicable accessory clamps and accessories, such as
cannulas, are disclosed in pending U.S. application Ser. No.
11/240,087, filed Sep. 30, 2005, the full disclosure of which is
incorporated by reference herein for all purposes.
Sterile Drape
[0128] Embodiments of the sterile drape will now be described in
greater detail. Referring back to FIGS. 1A-1B and 2A-2C, sterile
drape 1000 and 2000 are shown covering a portion of the arm
assembly 101 and 201, respectively, to shield non-sterile parts of
the manipulator arm from the sterile field, and also to shield the
arm and its various parts from materials from the surgical
procedure (e.g., body fluids, etc.). In one embodiment, the sterile
drape includes a drape pocket configured to receive an instrument
manipulator of an instrument manipulator assembly. The drape pocket
includes an exterior surface adjacent the sterile field, and an
interior surface adjacent the non-sterile instrument manipulator.
The drape further includes a flexible membrane at a distal end of
the drape pocket for interfacing between an output of the
instrument manipulator (e.g., the interface that transmits an
actuating force to the associated instrument) and an input of the
surgical instrument (e.g., the interface that receives the
actuating force from the associated instrument manipulator), and a
rotatable seal operably coupled to a proximal opening of the drape
pocket.
[0129] In another embodiment, the sterile drape includes a
plurality of drape pockets, with each drape pocket including a
plurality of flexible membranes at a distal end for interfacing
between outputs of a respective instrument manipulator and inputs
of a respective surgical instrument that control wrist, roll, grip,
and translational motions of the surgical instrument. A rotatable
seal, such as a labyrinth seal, may be operably coupled to a
proximal opening of the drape pockets to allow all drape pockets to
rotate together as a group with reference to a more proximal
portion of the drape. In one example, a first portion of the
rotatable seal that includes the multiple drape pockets is coupled
to the rotatable base plate of the manipulator assembly platform
and a second portion of the rotatable seal is coupled to a frame of
the manipulator assembly platform.
[0130] In yet another embodiment, a method of draping the
manipulator arm of a robotic surgical system includes first
positioning a distal end of a sterile drape at the distal ends of
the instrument manipulators, and then draping each instrument
manipulator with a drape pocket from the distal end of the
instrument manipulator to a proximal end of the instrument
manipulator. The rotatable seal of the sterile drape is then
coupled to a frame and a rotatable base plate of the manipulator
assembly platform. The remaining parts of the manipulator arm may
then be draped as desired from a distal end of the manipulator arm
to a proximal end of the manipulator arm. In this example, the
manipulator arm is draped from instrument manipulators to the yaw
joint.
[0131] Advantageously, the configuration and geometry of the
manipulator arm and instrument manipulators with a sterile drape
provide for a large range of motion allowing for multi-quadrant
surgery through a single port (i.e., surgical access in all patient
quadrants from the single entry port), increased space around the
patient and the entry port, and increased patient safety, while
also providing for a robust instrument/manipulator interface, ease
of instrument exchange, and maintenance of a sterile environment,
as described above.
[0132] Referring back to FIG. 10, the actuator outputs of the
instrument manipulator 542 engage with the actuator inputs of the
instrument 960 through sterile drape 1000 or 2000. As noted above,
in one embodiment, when latch 542g is actuated, the inner frame of
the instrument manipulator 542 moves toward the instrument 960 a
set distance and spring-loaded module outputs 542b-542e engage
instrument inputs 962b-962e through drape 1000 or 2000. The
independent actuator drive modules 542b', 542c', 542d', and 542e'
in the instrument manipulator 542 provide actuator outputs 542b,
542c, 542d, and 542e, respectively, that engage instrument inputs
962b, 962c, 962d, and 962e, respectively, through the sterile drape
upon actuating latch mechanism 542g, as described above.
[0133] Referring now to FIGS. 11A-11D in conjunction with FIG. 10,
FIGS. 11A-11B illustrate perspective views of a first drape portion
1100a of a sterile drape 1100 (FIG. 11D) in a retracted state and
an extended state, respectively, and FIG. 11C illustrates a
sectional view of drape portion 1100a mounted to a distal end of a
rotatable base plate 1140a of a manipulator platform in accordance
with an embodiment of the present disclosure. Descriptions of
sterile drapes 1000 and 2000 above are applicable with respect to
sterile drape 1100. For example, sterile drape 1100 covers a
portion of the manipulator arm assembly, and in particular the
instrument manipulators, to shield non-sterile parts of the
manipulator arm from the sterile field. Furthermore, drape portion
1100a includes a plurality of drape pockets 1105 (e.g., four
wedge-shaped drape pockets 1105a-1105d are shown), each including
an exterior surface configured to be adjacent the sterile field,
and an interior surface configured to be adjacent the non-sterile
instrument manipulators. Each of the drape pockets 1105 further
includes a plurality of flexible membranes 1102 at a distal end
1101 of the drape pockets 1105 for interfacing between outputs of
the instrument manipulators and inputs of the surgical instruments.
In one example, flexible membranes 1102b, 1102c, 1102d, and 1102e
interface between the instrument manipulator outputs 542b, 542c,
542d, and 542e and the instrument inputs 962b, 962c, 962d, 962e to
control instrument grip, translation, wrist, and roll motions,
respectively, of the surgical instrument. A flexible membrane
provides a pocket extension 1106 for the telescoping insertion
mechanism of each instrument manipulator (e.g., insertion mechanism
444) along which the instrument manipulator may translate.
[0134] In one aspect, a distal end of pocket extension 1106 is
attached to the insertion mechanism such that the drape pocket
extension 1106 moves with the insertion mechanism and remains in a
compact form away from the patient to provide space and access to a
surgical port. In one example, the distal end of pocket extension
1106 can be attached to the carriage link 804 of an insertion
mechanism 844 (FIG. 8) by any appropriate attachment means, such as
clips, tabs, Velcro strips, and the like.
[0135] A rotatable seal 1108 operably couples proximal openings
1103 of the drape pockets 1105 to the manipulator platform of the
manipulator arm assembly. In one example, the rotatable seal 1108
includes a rotatable labyrinth seal having a roll cover portion
1108a and a base comb portion 1108b rotatable within and relative
to the roll cover portion 1108a. In one embodiment, base comb
portion 1108b includes a disc with ribs 1104 that form a plurality
of wedge-shaped "frames" with apertures, each of the frames sized
to circumscribe an instrument manipulator. In one embodiment, base
comb portion 1108b includes ribs 1104 formed ninety degrees apart
within the disc. Proximal ends of the drape pockets 1105 are
coupled to each of the frames of the base comb portion 1108b.
Accordingly, the ribbed base comb portion 1108b aids in draping
individual instrument manipulators which are closely clustered on
the rotatable base plate of the instrument manipulator and further
aids in maintaining the orientation and arrangement of the drape
pockets 1105 as the draped instrument manipulators move during a
surgical procedure.
[0136] Roll cover portion 1108a fixedly mounts to the frame of the
manipulator platform and base comb portion 1108b fixedly mounts to
the rotatable base plate 1140a, such that when base plate 1140a is
rotated, the base comb portion 1108b also rotates in combination
with the draped instrument manipulators while roll cover portion
1108a is stationary being fixedly mounted to the manipulator
platform frame.
[0137] FIGS. 11A and 11B illustrate the drape pockets 1105 in
retracted and extended states, respectively, as the instrument
manipulators retract and extend along their respective insertion
axes. Although the four drape pockets 1105 are shown equally
retracted and extended, the drape pockets may independently retract
and extend as the instrument manipulators are independently and/or
dependently controlled with respect to one another.
[0138] It is also noted that base comb portion 1108b may include
various number of ribs oriented at angles other than ninety degrees
as long as space is provided to fit an instrument manipulator
through each of the frames of the base comb portion. In one
example, the base comb portion 1108b may be comprised of ribs that
divide a circular area into a multitude of segments that are each
sized to enclose an instrument manipulator.
[0139] Sterile drape 1100 also allows for transitioning from the
draping of the individual instrument manipulators to the remaining
parts of the manipulator arm assembly, as shown in FIG. 11D. The
drape 1100 may continue from the rotatable seal 1108 (e.g., the
roll cover portion 1108a) to blend into a larger second drape
portion 1100b designed to cover remaining portions (e.g., joints
and links) of the manipulator arm as desired, in one example
continuously covering the manipulator arm to the manipulator
assembly yaw joint (e.g., yaw joint 124, 224). Accordingly, the
rotatable seal 1108 allows for the instrument manipulator cluster
to freely rotate relative to the rest of the manipulator arm
assembly while substantially the entire arm assembly remains
draped, thereby preserving the sterile environment of the surgical
site.
[0140] In accordance with another embodiment, the sterile drape
portion 1100b includes a cannula mounting arm pocket 1110 designed
to drape a retractable cannula mounting arm as described in further
detail below. In one embodiment, a movable cannula mount includes a
base portion coupled to the manipulator arm and a retractable
portion movably coupled to the base portion. The retractable
portion may be moved between a retracted position and a deployed
position via a rotating joint so that the rectractable portion may
be rotated upwards or folded toward the base portion to create more
space around the patient and/or to more easily don a drape over the
cannula mount when draping the manipulator arm. Other joints may be
used to couple the retractable portion and the base portion,
including but not limited to a ball and socket joint or a universal
joint, a sliding joint to create a telescoping effect, and the
like, so that the retractable portion may be moved closer to the
base portion in order to reduce the overall form factor of the
cannula mount. In another embodiment, the entire cannula mount may
be internally telescoping relative to the manipulator arm.
Accordingly, the movable cannula mounting arm allows for the
draping of a larger robot arm with a relatively smaller opening in
the drape. The drape may be positioned over the retracted cannula
mounting arm and then after being draped within pocket 1110, the
cannula mounting arm may be extended into an operating position.
According to one aspect, the cannula mounting arm is fixed in the
operating position during operation of an instrument.
[0141] In one instance, drape pocket 1110 may include a reinforced
drape section 1111 that fits over a clamp (see, e.g., clamps 1754
in FIGS. 19A-19B and 20A-20B, and clamp 2454 and receptacle 2456 in
FIGS. 24A-24D) on a distal end of the cannula mounting arm.
[0142] The drape 1100a may further include a latch cover 1107 on
the side of individual drape pockets 1105 to cover the individual
latches 1342g (FIG. 14A, 15, 16A, and 17A-17C) that may extend
outside the circumference of the instrument manipulator during
use.
[0143] Advantageously, because of the distal face of the instrument
manipulator that interfaces with an instrument, the spring-loaded
and independent outputs of the instrument manipulator, and
advantageous sterile drape, instruments may be easily and robustly
exchanged onto the instrument manipulator while maintaining a
robust sterile environment during a surgical procedure.
Furthermore, the sterile drape allows for the surgical robotic
system to be quickly and easily prepared while also providing for
improved range of motion (e.g., rotational motion) with a small
form factor, thereby reducing operating room preparation time and
costs.
Sterile Adapter
[0144] Another embodiment of a drape including a sterile adapter
will now be described in greater detail. FIG. 12 illustrates a
perspective view of a drape portion 1200a of an extended sterile
drape including a sterile adapter 1250 in accordance with another
embodiment of the present disclosure. Drape portion 1200a may
replace drape portion 1100a in FIG. 11D, and is operably coupled to
drape portion 1100b by way of a rotatable seal 1208 which is
substantially similar to rotatable seal 1108. Drape portion 1200a
includes a plurality of drape sleeves 1205 coupled between
rotatable seal 1208 and sterile adapter 1250. Drape portion 1200a
further includes pocket extensions 1206 coupled to the sterile
adapter 1250 for draping over insertion mechanisms of the
instrument manipulators.
[0145] Rotatable seal 1208 operably couples proximal openings 1203
of the drape sleeves 1205 to the manipulator platform of the
manipulator arm assembly. In one example, the rotatable seal 1208
includes a rotatable labyrinth seal having a roll cover portion
1208a and a base comb portion 1208b rotatable relative to the roll
cover portion 1208a. In one embodiment, base comb portion 1208b
includes a disc with ribs 1204 that form a plurality of
wedge-shaped "frames" with apertures, each of the frames sized to
circumscribe an instrument manipulator. In one embodiment, base
comb portion 1208b includes ribs 1204 formed ninety degrees apart
within the disc. Proximal ends of the drape sleeves 1205 are
coupled to each of the frames of the base comb portion 1208b.
Accordingly, the ribbed base comb portion 1208b aids in draping
individual instrument manipulators which are closely clustered on
the rotatable base plate of the instrument manipulator and further
aids in maintaining the orientation and arrangement of the drape
sleeves 1205 as the draped instrument manipulators move during a
surgical procedure.
[0146] Although FIG. 12 illustrates all the drape sleeves 1205 in
extended states, for example as the instrument manipulators extend
along their respective insertion mechanisms, it is noted that the
drape sleeves may independently retract and extend as the
instrument manipulators are independently and/or dependently
controlled with respect to one another.
[0147] It is also noted that base comb portion 1208b may include
various number of ribs oriented at angles other than ninety degrees
as long as space is provided to fit an instrument manipulator
through each of the frames of the base comb portion. In one
example, the base comb portion 1208b may be comprised of ribs that
divide a circular area into a multitude of segments that are sized
to each enclose an instrument manipulator.
[0148] Roll cover portion 1208a fixedly mounts to the frame of the
manipulator platform (e.g., the manipulator halo) and base comb
portion 1208b fixedly mounts to the rotatable base plate 1140a,
such that when base plate 1140a is rotated, the base comb portion
1208b also rotates in combination with the draped instrument
manipulators. In one example, since the proximal end of drape
sleeves 1205 are coupled to base comb portion 1208b, all the drape
sleeves 1205 rotate together as a group with reference to a more
proximal drape portion 1100b.
[0149] FIGS. 13A and 13B illustrate a perspective view of an
assembled sterile adapter 1250 and an exploded view of the sterile
adapter 1250, respectively, in accordance with an embodiment of the
present disclosure. Sterile adapter 1250 includes a boot 1252
having a boot wall 1252a and cylindrical apertures 1252b that serve
as passageways for posts on the instrument manipulator as will be
further described below. A distal end of drape sleeves 1205 may be
coupled to an exterior surface of boot wall 1252a. Adapter 1250
further includes a pair of supports 1258 that serve to properly
align, position, and retain a surgical instrument on an underside
of the sterile adapter for engagement with the instrument
manipulator on a top surface of the sterile adapter. Adapter 1250
further includes a flexible membrane interface 1254 that interfaces
between outputs of a respective instrument manipulator and inputs
of a respective surgical instrument for controlling wrist, roll,
grip, and translational motions of the surgical instrument. In one
embodiment, membrane interface 1254 includes a grip actuator
interface 1254b, a joggle actuator interface 1254c, a wrist
actuator interface 1254d, and a roll actuator interface 1254e for
interfacing with associated instrument manipulator outputs.
[0150] In one embodiment, roll actuator interface 1254e is designed
to rotate and maintain a sterile barrier within the sterile adapter
1250. As illustrated in FIG. 13C, in one aspect, the roll actuator
interface 1254e includes a roll disc 1257a having a slot or groove
1257b around the circumference of the disc that accepts a flat
retaining plate 1254f (FIG. 13B). The retaining plate 1254f is
attached to the flexible membrane interface 1254 and allows the
roll disc to rotate while maintaining a sterile barrier for the
sterile adapter and drape.
[0151] Membrane interface 1254 is positioned between boot 1252 and
supports 1258, and tubes 1256 couple boot 1252, membrane interface
1254, and supports 1258 together. Tubes 1256 are aligned with boot
apertures 1252b and membrane apertures 1254b and a shaft portion of
tubes 1256 are positioned within the apertures. A tube lip 1256a is
retained within boot aperture 1252b and a tube end 1256 is fixedly
coupled to support 1258 such that tubes 1256 and therefore supports
1258 are movable a certain lengthwise distance of the tube shaft,
as shown by the double sided arrows in FIG. 13A.
[0152] Optionally, a grip actuator interface plate 1254b', a joggle
actuator interface plate 1254c', and a wrist actuator interface
plate 1254d' may be coupled to an underside of the grip actuator
interface 1254b, the joggle actuator interface 1254c, and the wrist
actuator interface 1254d, respectively, for increased engagement
and coupling with associated instrument inputs.
[0153] FIGS. 14A and 14B illustrate a bottom perspective view and a
bottom view of an instrument manipulator 1300 in accordance with an
embodiment of the present disclosure. In this illustrative
embodiment, instruments mount against the distal face 1342a of the
instrument manipulator 1300. Distal face 1342a includes various
actuation outputs that transfer actuation forces to a mounted
instrument, similar to the instrument manipulators described above
with respect to FIGS. 3-8. As shown in FIGS. 14A and 14B, such
actuation outputs may include a grip output lever 1342b
(controlling the grip motion of an instrument end effector), a
joggle output gimbal 1342c (controlling the side-to-side motion and
the up-and-down motion of a distal end parallel linkage ("joggle"
or "elbow" mechanism)), a wrist output gimbal 1342d (controlling
the yaw motion and the pitch motion of an instrument end effector),
and a roll output disk 1342e (controlling the roll motion of an
instrument). Independent actuator drive modules (similar to those
described above with respect to modules 542b', 542c', 542d', and
542e') in the instrument manipulator 1300 provide the actuator
outputs 1342b, 1342c, 1342d, and 1342e. In a similar manner, the
actuator outputs 1342b-1342e may be spring-loaded. Details of
applicable outputs, and the associated parts of the instrument
force transmission mechanism that receives such outputs, may be
found in U.S. patent application Ser. No. 12/060,104 (filed Mar.
31, 2008; U.S. Patent Application Pub. No. US 2009/0248040 A1),
which is incorporated herein by reference. Examples of the proximal
ends of illustrative surgical instruments that may receive such
inputs may be found in U.S. patent application Ser. No. 11/762,165,
which is referenced above. Briefly, the side-to-side and
up-and-down DOFs are provided by a distal end parallel linkage, the
end effector yaw and end effector pitch DOFs are provided by a
distal flexible wrist mechanism, the instrument roll DOF is
provided by rolling the instrument shaft while keeping the end
effector at an essentially constant position and pitch/yaw
orientation, and the instrument grip DOF is provided by two movable
opposing end effector jaws. Such DOFs are illustrative of more or
fewer DOFs (e.g., in some implementations a camera instrument omits
instrument roll and grip DOFs).
[0154] Instrument manipulator 1300 further includes a latch
mechanism 1342g for engaging the actuator outputs of the instrument
manipulator 1300 with the actuator inputs of a mounted instrument
through sterile adapter 1250. In one embodiment, similar to the
latch mechanism described above, when latch 1342g is actuated, the
inner frame 1342i of the instrument manipulator 1300 moves a set
distance relative to outer shell 1342h and towards a mounted
instrument. Spring-loaded module outputs 1342b-1342e engage
appropriate instrument inputs through the sterile adapter 1250, and
in one example through the membrane interface 1254. A mounted
instrument is thus clamped between the upper surface of supports
1258 and the spring loaded outputs through the membrane interface
of the sterile adapter.
[0155] As noted above, the drape 1100a may include a latch cover
1107 (FIG. 11D) on the individual drape pockets 1105 to cover the
individual latches 1342g that may extend outside the circumference
of the instrument manipulator during use. The latch handles are
each able to fold inside the circumference of a corresponding
instrument manipulator to enable the rotatable seal of a drape to
pass over the instrument manipulators.
[0156] Instrument manipulator 1300 further includes posts 1350 for
operably coupling the instrument manipulator 1300 to the sterile
adapter 1250 as will be further described below.
[0157] Referring now to FIGS. 15 and 16A-16E, the coupling of the
instrument manipulator 1300 to the sterile adapter 1250 is
illustrated and described. FIG. 15 illustrates a bottom perspective
view of the instrument manipulator 1300 operably coupled to the
sterile adapter 1250 in accordance with an embodiment of the
present disclosure. FIGS. 16A-16E illustrate a sequence for
coupling the instrument manipulator 1300 and the sterile adapter
1250 in accordance with an embodiment of the present disclosure. As
shown in FIG. 16A, posts 1350 are aligned with tubes 1256 within
boot apertures 1252b. Then, as shown in FIG. 16B, the free end of
posts 1350 are positioned through tube 1256 until tabs at the end
of posts 1350 engage with associated support apertures, as shown in
FIG. 16E. Thus, one end of posts 1350 are fixedly mounted to the
supports 1258. In one embodiment, supports 1258 include a slide
1258a having a keyhole aperture 1258b, as illustrated in FIGS.
16C-1 and 16C-2. Support 1258 is slid in a direction of arrow I to
allow the post 1350 to pass to the end of the keyhole aperture
1258b, as the sterile adapter is lifted into a final position as
shown by arrow II. Then support 1258 is returned in a direction of
arrow III by a biasing means such that the narrow section of the
keyhole aperture 1258b locks into a groove 1350a in the post 1350
(FIG. 16E).
[0158] After the supports 1258 of the sterile adapter have been
attached to the posts on the instrument manipulator housing, the
boot 1252 of the sterile adapter 1250 is attached to the distal
face 1342a of the instrument manipulator 1300. In one embodiment,
this attachment is accomplished by protrusions on the inside walls
of the boot that register in depressions on the sides of the inner
frame 1342i of the instrument manipulator. Such an attachment
allows the boot to stay attached to the inner frame as the inner
frame is raised or lowered by the latch 1342g.
[0159] Referring now to FIGS. 17A-17C and 18A-18B, the coupling of
a surgical instrument 1460 to the sterile adapter 1250 is
illustrated and described. FIGS. 17A-17C illustrate a sequence for
coupling the surgical instrument 1460 to the sterile adapter 1250
in accordance with an embodiment of the present disclosure. As
shown in FIG. 17A, the instrument 1460 includes a force
transmission mechanism 1460a and a shaft 1460b. A tip of shaft
1460b is placed within an entry guide 1500, which is freely
rotatable within a cannula 1600. FIG. 17B shows tabs (e.g., tabs
1462 of FIG. 18A) on the force transmission mechanism 1460a of
instrument 1460 engaged with and aligned by a pair of supports
1258, and FIG. 17C shows force transmission mechanism 1460a being
further translated along a top surface of supports 1258.
[0160] FIGS. 18A and 18B illustrate an enlarged perspective view
and side view, respectively, of the instrument 1460 and sterile
adapter 1250 prior to full translation of the force transmission
mechanism 1460a along supports 1258. Instrument 1460 is translated
along supports 1258 until a retention mechanism is reached along
the supports, which in one example can be a protrusion on an
underside of tab 1462 that aligns and couples with an aperture on a
top surface of support 1258. Latch 1342g may then be actuated to
engage the instrument manipulator outputs with the instrument
inputs through sterile adapter 1250. In one embodiment, supports
1258 are prevented from being removed from posts 1350 after an
instrument has been mounted. In one aspect, a protrusion on the
support may engage with a depression on the side of the instrument
force transmission mechanism housing to prevent the support from
moving while the instrument has been mounted.
Entry Guide
[0161] Embodiments of an entry guide, cannula, and cannula mounting
arm will now be described in greater detail. As previously
described, a surgical instrument is mounted on and actuated by each
surgical instrument manipulator. The instruments are removably
mounted so that various instruments may be interchangeably mounted
on a particular manipulator. In one aspect, one or more
manipulators may be configured to support and actuate a particular
type of instrument, such as a camera instrument. The shafts of the
instruments extend distally from the instrument manipulators. The
shafts extend through a common cannula placed at the entry port
into the patient (e.g., through the body wall, at a natural
orifice). The cannula is coupled to a cannula mounting arm which is
movably coupled to a manipulator arm. In one aspect, an entry guide
is positioned at least partially within the cannula, and each
instrument shaft extends through a channel in the entry guide, so
as to provide additional support for the instrument shafts.
[0162] FIGS. 19A and 19B illustrate perspective views of an
embodiment of a movable and/or detachable cannula mount 1750 in a
retracted position and a deployed position, respectively. Cannula
mount 1750 includes an extension 1752 that is movably coupled to a
link 1738 of the manipulator arm, such as adjacent a proximal end
of fourth manipulator link 138 (FIGS. 1A and 1B). Cannula mount
1750 further includes a clamp 1754 on a distal end of extension
1752. In one implementation, extension 1752 is coupled to link 1738
by a rotational joint 1753 that allows extension 1752 to move
between a stowed position adjacent link 1738 and an operational
position that holds the cannula in the correct position so that the
remote center of motion is located along the cannula. In one
implementation, extension 1752 may be rotated upwards or folded
toward link 1738, as shown by arrow C, to create more space around
the patient and/or to more easily don a drape over the cannula
mount when draping the manipulator arm. Other joints may be used to
couple the extension 1752, including but not limited to a ball and
socket joint or a universal joint, a sliding joint to create a
telescoping effect, and the like, so that the extension may be
moved closer to the link in order to reduce the overall form factor
of the cannula mount and manipulator arm. In another embodiment,
the extension 1752 may be internally telescoping relative to the
manipulator arm, or the extension 1752 may be detachable from and
operably couplable to the link. During operation of the surgical
system, extension 1752 is maintained in an operating position.
[0163] FIGS. 20A and 20B illustrate perspective views of a cannula
1800 mounted to clamp 1754 of cannula mount 1750 as illustrated in
FIGS. 19A-19B, and FIG. 21 illustrates a perspective view of
free-standing cannula 1800. In one embodiment, cannula 1800
includes a proximal portion 1804, which is removably coupled to the
clamp 1754, and a tube 1802 for passage of instrument shafts (as
shown in FIG. 22). Once the cannula 1800 is mounted in clamp 1754,
the clamp may keep cannula 1800 from rotating. In one example, tube
1802 is comprised of stainless steel, and an interior surface of
tube 1802 may be coated or lined with a lubricating or
anti-friction material, although the cannula may be comprised of
other materials, liners or no liners. Proximal portion 1804 may
include exterior ridges 1806, 1808 and an interior space for
receipt of an entry guide with channels, as shown in FIGS. 22 and
23A-23B and as described in more detail below. Examples of
applicable accessory clamps and accessories, such as cannulas, are
disclosed in pending U.S. application Ser. No. 11/240,087, filed
Sep. 30, 2005, the full disclosure of which is incorporated by
reference herein for all purposes.
[0164] Referring now to FIGS. 22 and 23A-23B in accordance with
embodiments of the present disclosure, FIG. 22 illustrates a
cross-sectional view of the cannula 1800 of FIG. 21, and a
cross-sectional view of a mounted entry guide tube 2200. Instrument
manipulators 1942 are coupled to a rotatable base plate 1940 of a
manipulator platform, in one example by telescoping insertion
mechanisms 1942a, and instruments 2160 are mounted to the
instrument manipulators 1942 (e.g., on a distal or proximal face of
the instrument manipulator). In one embodiment, the telescoping
insertion mechanisms 1942a are symmetrically mounted to the
rotatable base plate 1940, and in one example are set apart 90
degrees from one another to provide for four instrument
manipulators. Other configurations and number of insertion
mechanisms (and therefore instrument manipulators and instruments)
are possible.
[0165] Thus, the instruments 2160 are mounted to the instrument
manipulators 1942 such that the instrument shafts 2160b are
clustered around manipulator assembly roll axis 1941. Each shaft
2160b extends distally from the instrument's force transmission
mechanism 2160a, and all shafts extend through cannula 1800 placed
at the port into the patient. The cannula 1800 is removably held in
a fixed position with reference to base plate 1940 by cannula mount
1750, which is coupled to fourth manipulator link 138 in one
embodiment. Entry guide tube 2200 is inserted into and freely
rotates within cannula 1800, and each instrument shaft 2160b
extends through an associated channel 2204 in the guide tube 2200.
The central longitudinal axes of the cannula and guide tube are
generally coincident with the roll axis 1941. Therefore, as the
base plate 1940 rotates to rotate the instrument manipulators and
respective instrument shafts, the guide tube 2200 rotates within
the cannula as base plate 1940 rotates. In one example, entry guide
tube 2200 is freely rotatable within the cannula about a central
longitudinal axis of the guide tube, which is aligned to a central
longitudinal axis of the cannula, which in turn is aligned or runs
parallel to the roll axis 1941 of the manipulator platform. In
other embodiments, the entry guide tube 2200 may be fixedly mounted
to the cannula if such fixed support for the instrument shafts is
desirable.
[0166] The cross-sectional view of entry guide tube 2200 is taken
along a line III-III in FIGS. 23A and 23B, which illustrate a side
view and a top view, respectively, of an entry guide tube 2200
having a coupling lip 2202, a tube 2206, and channels 2204a, 2204b.
Entry guide tube 2200 includes lip 2202 on a proximal end of the
tube 2206 to rotatably couple the entry guide to the proximal
portion 1804 of cannula 1800. In one example, lip 2202 couples
between ridges (e.g., ridges 1806 and 1808 in FIG. 22) of the
cannula. In other embodiments, the entry guide does not need a
coupling lip, as will be further described below.
[0167] Entry guide tube 2200 further includes channels 2204a, 2204b
through the entry guide for passage of instrument shafts (e.g.,
instrument shafts 2160b in FIG. 22). In one aspect, one channel or
passageway is provided per instrument shaft and the channels may
have different geometric shapes and sizes. As illustrated in FIGS.
23A and 23B, channel 2204a is of a different shape and size from
channels 2204b, and in one example, channel 2204a is used to guide
a camera instrument which has a larger and more rigid shaft, and
channels 2204b are used to guide instrument shafts of typical
instruments. Other shapes and sizes of the channels are applicable,
including but not limited to openings which are shaped as a circle,
an oval, an ellipse, a triangle, a square, a rectangle, and a
polygon.
[0168] As the base plate rotates about the roll axis 1941, the
cluster of instrument manipulators 1942 and instruments 2160 also
rotate about the roll axis. As instrument shafts 2160b rotate about
roll axis 1941 while in channels 2204 of the entry guide, an
instrument shaft impinges against an interior surface of an entry
guide channel, and at least one rotating instrument shaft drives
entry guide tube 2200 to rotate relative to and within cannula
1800, which is clamped and kept stationary by the clamp of a
cannula mount; e.g., clamp 1754 of cannula mount 1750.
[0169] The instrument shafts may be inserted and retracted through
the entry guide channels independently or in coordination with one
another by movement of respective insertion mechanisms 1942a. The
instruments 2160 may rotate in a clockwise or counterclockwise
direction about roll axis 1941, and accordingly, entry guide tube
2200 may correspondingly rotate in a clockwise or counterclockwise
direction about the roll axis. It is further noted that although
four channels are illustrated in the entry guide and a plurality of
instrument shafts are illustrated as passing through the entry
guide and cannula, the entry guide and cannula assembly may
function within the surgical system with other numbers of channels
and instrument/instrument assembly shafts running through the entry
guide and cannula. For example, an entry guide tube with one or
more channels for running one or more instrument/instrument
assembly shafts through the entry guide and cannula is within the
scope of the present disclosure. Furthermore, torque provided by
the instrument shafts to rotate the entry guide need not be
symmetrically provided by a plurality of instrument shafts but may
be provided asymmetrically and independently, including the
majority of the torque being provided by a single instrument
shaft.
[0170] In one embodiment, entry guide tube 2200 and cannula 1800
may each include an electronic interface or a wireless interface,
such as a radio frequency identification (RFID) chip or tag, which
includes identifying information about the cannula and/or entry
guide tube and allows for the surgical system (e.g., read by the
manipulator arm) to recognize the identification of a particular
entry guide and/or cannula. Metal rings, mechanical pins, and
inductive sensing mechanisms may also be used to read
identification data. This electronic or wireless interface allows
data (e.g., entry guide tube/cannula type) to be transferred to the
surgical system. Details about mechanical and electrical interfaces
for various instruments, guide tubes, and imaging systems, and also
about sterile draping to preserve the sterile field, are discussed
in U.S. Pat. Nos. 6,866,671 (Tierney et al.) and 6,132,368
(Cooper), both of which are incorporated by reference, and which
may be similarly used with the entry guide and cannula.
[0171] It is further noted that in other embodiments, the entry
guide tube may not include a coupling lip. FIG. 24 illustrates a
cross-sectional view of an entry guide tube 2300 mounted to a
cannula 2400. Entry guide tube 2300 includes channels 2304 and is
similar to entry guide tube 2200 described above but does not
include a coupling lip. Instead, entry guide tube 2300 is rotatably
coupled to the proximal portion of the cannula by impingement force
of the instrument shafts 2160b against the interior walls of the
entry guide tube channels 2304. It is further noted that the
cannula need not include exterior ridges at a proximal portion. It
is further noted that in one aspect, the entry guide tube may move
rotatably and longitudinally along the cannula's longitudinal axis
or the roll axis, driven by the instrument shafts running through
the entry guide tube.
[0172] Referring now to FIGS. 24A-24D, a different embodiment of a
cannula mounting arm, clamp, and cannula are illustrated which may
be used with an entry guide as described above. FIGS. 24A and 24B
illustrate perspective views of an embodiment of a movable and/or
detachable cannula mount 2450 in a retracted position and a
deployed operating position, respectively. Cannula mount 2450
includes an extension 2452 that is movably coupled to a link 2438
of the manipulator arm having an instrument manipulator assembly
platform 2440, such as adjacent a proximal end of fourth
manipulator link 138 (FIGS. 1A and 1B). In one implementation,
extension 2452 is coupled to link 2438 by a rotational joint 2453
that allows extension 2452 to move between a stowed position
adjacent link 2438 and an operational position that holds the
cannula in the correct position so that the remote center of motion
is located along the cannula. In one implementation, extension 2452
may be rotated upwards or folded toward link 2438, as shown by
arrow D, to create more space around the patient and/or to more
easily don a drape over the cannula mount when draping the
manipulator arm. Other joints may be used to couple the extension
2452, including but not limited to a ball and socket joint or a
universal joint, a sliding joint to create a telescoping effect,
and the like, so that the extension may be moved closer to the link
in order to reduce the overall form factor of the cannula mount and
manipulator arm. In another embodiment, the extension 2452 may be
internally telescoping relative to the manipulator arm, or the
extension 2452 may be detachable from and operably couplable to the
link.
[0173] Cannula mount 2450 further includes a clamp 2454 over a
receptacle 2456 on a distal end of extension 2452. FIG. 24C
illustrates a perspective view of a cannula 2470 mountable to clamp
2454 and receptacle 2456 of cannula mount 2450 as illustrated in
FIG. 24D. In one embodiment, cannula 2470 includes a proximal
portion 2474 having a boss 2476. Boss 2476 includes a bottom
hemispherical surface 2478 that is positioned within the mating
receptacle 2456 (as shown by the arrow from hemispherical surface
2478 to receptacle 2456). Boss 2476 further includes a top surface
2479 which is engaged by clamp 2454 to lock the boss in position
and therefore the cannula 2470 in a fixed position relative to
cannula mount extension 2452. Clamp 2454 is actuated by a lever
2480. Cannula 2470 further includes a tube 2472 for passage of
instrument shafts (as shown in FIGS. 22 and 24). Once the cannula
2470 is mounted by clamp 2454 and receptacle 2456, the clamp may
keep cannula 2470 from rotating. In one example, tube 2472 is
comprised of stainless steel, and an interior surface of tube 2472
may be coated or lined with a lubricating or anti-friction
material, although the cannula may be comprised of other materials,
liners or no liners. Proximal portion 2474 includes an interior
space for receipt of an entry guide with channels, as shown in
FIGS. 22, 23A-23B, and 24. Examples of applicable accessory clamps
and accessories, such as cannulas, are disclosed in pending U.S.
application Ser. No. 11/240,087, filed Sep. 30, 2005, the full
disclosure of which is incorporated by reference herein for all
purposes.
[0174] In one aspect, the entry guide and cannula assemblies
described above support insufflation and procedures requiring
insufflation gas at the surgical site. Further disclosure of
insufflation through the entry guide and cannula assembly may be
found in U.S. application Ser. No. 12/705,439, filed Feb. 12, 2010
and entitled "Entry Guide for Multiple Instruments in a Single Port
System", the full disclosure of which is incorporated by reference
herein for all purposes.
[0175] Advantageously, because the entry guide is dependently
driven by the instrument shaft(s), the need for a motor or other
actuating mechanism to rotate the entry guide is eliminated.
Furthermore, the entry guide allows for the removal of a bulky
actuator mechanism near the patient or surgical site. Thus, the
entry guide and cannula assembly provide for an efficient and
robust means to advantageously organize and support multiple
instruments through a single port and reduce collisions between
instruments and other apparatus during a surgical procedure.
Single Port Surgical System Architecture
[0176] FIGS. 25A-25C, 26A-26C, and 27A-27C illustrate different
views of a surgical system 2500 with an instrument manipulator
assembly roll axis or instrument insertion axis pointed at
different directions relative to a patient P. FIGS. 25A-25C
illustrate a manipulator assembly roll axis 2541 directed downward
and toward patient P's head H. FIGS. 26A-26C illustrate manipulator
assembly roll axis 2541 directed downward and toward patient P's
feet F. FIGS. 27A-27C illustrate manipulator assembly roll axis
2541 directed upward and toward patient P's head H.
[0177] Surgical system 2500 includes a setup link 2518 for locating
a remote center of motion for the robotic surgical system, and a
manipulator arm assembly 2501 including an active proximal link
2526 and an active distal link 2528, in which the proximal link
2526 is operably coupled to the setup link 2518 by an active yaw
joint 2524. A plurality of instrument manipulators 2542 form an
instrument manipulator assembly which is rotatably coupled to a
distal end of the distal link 2528. In one embodiment, the
plurality of instrument manipulators are coupled to a manipulator
assembly platform 2540 by telescoping insertion mechanisms 2544.
The plurality of instrument manipulators 2542 are rotatable about
the roll axis 2541. In one embodiment, each of the plurality of
instrument manipulators includes a distal face from which a
plurality of actuator outputs distally protrude, and a plurality of
surgical instruments 2560 are coupled to the distal face of a
corresponding instrument manipulator. A cannula mount 2550 is
movably coupled to the distal link 2528, and a cannula and entry
guide tube assembly 2552 is coupled to the cannula mount 2550. In
one embodiment, the cannula has a central longitudinal axis
substantially coincident with the roll axis 2541. Each surgical
instrument has a shaft passing through the entry guide tube and the
cannula, such that rotation of at least one instrument shaft
rotates the entry guide tube about the longitudinal axis of the
cannula.
[0178] A vertical manipulator assembly yaw axis 2523 at yaw joint
2524 allows the proximal link 2526 to rotate substantially 360
degrees or more about the remote center of motion for the surgical
system (see, e.g., FIG. 2C). In one instance the manipulator
assembly yaw rotation may be continuous, and in another instance
the manipulator assembly yaw rotation is approximately .+-.180
degrees. In yet another instance, the manipulator assembly yaw
rotation may be approximately 660 degrees. Since the instruments
are inserted into the patient in a direction generally aligned with
manipulator assembly roll axis 2541, the manipulator arm assembly
2501 can be actively controlled to position and reposition the
instrument insertion direction in any desired direction around the
manipulator assembly yaw axis (see, e.g., FIGS. 25A-25C showing the
instrument insertion direction toward a patient's head, and FIGS.
26A-26C showing the instrument insertion direction toward a
patient's feet). This capability may be significantly beneficial
during some surgeries. In certain abdominal surgeries in which the
instruments are inserted via a single port positioned at the
umbilicus (see, e.g., FIGS. 25A-25C), for example, the instruments
may be positioned to access all four quadrants of the abdomen
without requiring that a new port be opened in the patient's body
wall. Multi-quadrant access may be required for, e.g., lymph node
access throughout the abdomen. In contrast, the use of a multi-port
telerobotic surgical system may require additional ports be made in
the patient's body wall to more fully access other abdominal
quadrants.
[0179] Additionally, the manipulator may direct the instrument
vertically downwards and in a slightly pitched upwards
configuration (see, e.g., FIGS. 27A-27C showing the instrument
insertion direction pitched upwards near a body orifice O). Thus,
the angles of entry (both yaw and pitch about the remote center)
for an instrument through a single entry port may be easily
manipulated and altered while also providing increased space around
the entry port for patient safety and patient-side personnel to
maneuver.
[0180] Furthermore, the links and active joints of the manipulator
arm assembly 2501 may be used to easily manipulate the pitch angle
of entry of an instrument through the single entry port while
creating space around the single entry port. For example, the links
of the arm assembly 2501 may be positioned to have a form factor
"arcing away" from the patient. Such arcing away allows rotation of
the manipulator arm about the yaw axis 2523 that does not cause a
collision of the manipulator arm with the patient. Such arcing away
also allows patient side personnel to easily access the manipulator
for exchanging instruments and to easily access the entry port for
inserting and operating manual instruments (e.g., manual
laparoscopic instruments or retraction devices). In other terms,
the work envelope of the cluster of instrument manipulators 2542
may approximate a cone, with the tip of the cone at the remote
center of motion and the circular end of the cone at the proximal
end of the instrument manipulators 2542. Such a work envelope
results in less interference between the patient and the surgical
robotic system, greater range of motion for the system allowing for
improved access to the surgical site, and improved access to the
patient by surgical staff.
[0181] Accordingly, the configuration and geometry of the
manipulator arm assembly 2501 in conjunction with its large range
of motion allow for multi-quadrant surgery through a single port.
Through a single incision, the manipulator may direct the
instrument in one direction and easily change direction; e.g.,
working toward the head a patient (see, e.g., FIGS. 25A-25C) and
then changing direction toward the pelvis of the patient (see,
e.g., FIGS. 26A-26C), by moving the manipulator arm about the
constantly vertical yaw axis 2523.
[0182] Referring now to FIG. 28, a diagrammatic view illustrates
aspects of a centralized motion control and coordination system
architecture for minimally invasive telesurgical systems that
incorporate surgical instrument assemblies and components described
herein. A motion coordinator system 2802 receives master inputs
2804, sensor inputs 2806, and optimization inputs 2808.
[0183] Master inputs 2804 may include the surgeon's arm, wrist,
hand, and finger movements on the master control mechanisms. Inputs
may also be from other movements (e.g., finger, foot, knee, etc.
pressing or moving buttons, levers, switches, etc.) and commands
(e.g., voice) that control the position and orientation of a
particular component or that control a task-specific operation
(e.g., energizing an electrocautery end effector or laser, imaging
system operation, and the like).
[0184] Sensor inputs 2806 may include position information from,
e.g., measured servomotor position or sensed bend information. U.S.
patent application Ser. No. 11/491,384 (Larkin, et al.) entitled
"Robotic surgery system including position sensors using fiber
Bragg gratings", incorporated by reference, describes the use of
fiber Bragg gratings for position sensing. Such bend sensors may be
incorporated into the various instruments and imaging systems
described herein to be used when determining position and
orientation information for a component (e.g., an end effector
tip). Position and orientation information may also be generated by
one or more sensors (e.g., fluoroscopy, MRI, ultrasound, and the
like) positioned outside of the patient, and which in real time
sense changes in position and orientation of components inside the
patient.
[0185] As described below, the user interface has three coupled
control modes: a mode for the instrument(s), a mode for the imaging
system, and a mode for the manipulator arm configuration and/or
roll axis control. A mode for the guide tube(s) may also be
available. These coupled modes enable the user to address the
system as a whole rather than directly controlling a single
portion. Therefore, the motion coordinator must determine how to
take advantage of the overall system kinematics (i.e., the total
DOFs of the system) in order to achieve certain goals. For example,
one goal may be to optimize space around the patient or to minimize
the form factor of the manipulator arm. Another goal may be
optimize instrument workspace for a particular configuration.
Another goal may be to keep the imaging system's field of view
centered between two instruments. Therefore, optimization inputs
2808 may be high-level commands, or the inputs may include more
detailed commands or sensory information. An example of a high
level command would be a command to an intelligent controller to
optimize a workspace. An example of a more detailed command would
be for an imaging system to start or stop optimizing its camera. An
example of a sensor input would be a signal that a workspace limit
had been reached.
[0186] Motion coordinator 2802 outputs command signals to various
actuator controllers and actuators (e.g., servomotors) associated
with manipulators for the various telesurgical system arms. FIG. 28
depicts an example of output signals being sent to four instrument
controllers 2810, to an imaging system controller 2812, to a roll
axis controller 2814, and to a manipulator arm controller 2816,
which then can send control signals to instrument actuators, active
arm joints, rotation mechanisms of the manipulator platform, and
active telescoping insertion mechanisms. Other numbers and
combinations of controllers may be used. Control and feedback
mechanisms and signals, such as position information (e.g., from
one or more wireless transmitters, RFID chips, etc.) and other data
from a sensing system, are disclosed in U.S. patent application
Ser. No. 11/762,196, which is incorporated by reference, and are
applicable in the present disclosure.
[0187] Accordingly, in some aspects the surgeon who operates the
telesurgical system will simultaneously and automatically access at
least the three control modes identified above: an instrument
control mode for moving the instruments, an imaging system control
mode for moving the imaging system, and a manipulator arm roll axis
control mode for configuring the links of the manipulator arm into
a certain form factor or relative to one another or the rotation of
the manipulator platform, and also for active movement about the
outer yaw axis to enable multi-quadrant surgery. A similar
centralized architecture may be adapted to work with the various
other mechanism aspects described herein.
[0188] FIG. 29 is a diagrammatic view that illustrates aspects of a
distributed motion control and coordination system architecture for
minimally invasive telesurgical systems that incorporate surgical
instrument assemblies and components described herein. In the
illustrative aspects shown in FIG. 29, control and transform
processor 2902 exchanges information with two master arm
optimizer/controllers 2904a, 2904b, with three surgical instrument
optimizer/controllers 2906a, 2906b, 2906c, with an imaging system
optimizer/controller 2908, and with a roll axis
optimizer/controller 2910. Each optimizer/controller is associated
with a master or slave arm (which includes, e.g., the camera
(imaging system) arm, the instrument arms, and the manipulator arm)
in the telesurgical system. Each of the optimizer/controllers
receives arm-specific optimization goals 2912a-2912g.
[0189] The double-headed arrows between control and transform
processor 2902 and the various optimizer/controllers represent the
exchange of Following Data associated with the
optimizer/controller's arm. Following Data includes the full
Cartesian configuration of the entire arm, including base frame and
distal tip frame. Control and transform processor 2902 routes the
Following Data received from each optimizer/controller to all the
optimizer/controllers so that each optimizer/controller has data
about the current Cartesian configuration of all arms in the
system. In addition, the optimizer/controller for each arm receives
optimization goals that are unique for the arm. Each arm's
optimizer/controller then uses the other arm positions as inputs
and constraints as it pursues its optimization goals. In one
aspect, each optimization controller uses an embedded local
optimizer to pursue its optimization goals. The optimization module
for each arm's optimizer/controller can be independently turned on
or off. For example, the optimization module for only the imaging
system and the instrument arm may be turned on.
[0190] The distributed control architecture provides more
flexibility than the centralized architecture, although with the
potential for decreased performance. In this distributed
architecture, however, the optimization is local versus the global
optimization that can be performed with the centralized
architecture, in which a single module is aware of the full
system's state.
Link Counterbalance
[0191] An embodiment of a counterbalancing mechanism in a proximal
link will now be described in greater detail with reference to
FIGS. 30A-37C. FIG. 30A illustrates a manipulator arm assembly 3001
which is substantially similar to the arm assemblies described
above, the features of which are applicable with respect to
assembly 3001 as well, and FIG. 30B illustrates a closer view of
the counterbalancing proximal link of the arm assembly 3001. FIGS.
31-37C illustrate different views and aspects of the
counterbalancing system without the walls of a proximal link
housing. In particular, FIG. 31 illustrates a perspective view of
the counterbalancing system, FIGS. 32A-36C illustrate views of an
adjustment pin, a linear guide, and a range of movement of the
adjustment pin to move an end plug relative to the linear guide,
and FIGS. 37A-37C illustrate detailed views from a distal end of
the counterbalancing proximal link showing a rocker arm and set
screws according to various aspects of the present disclosure.
[0192] Referring now to FIGS. 30A-30B, manipulator arm assembly
3001 includes a proximal link 3026 which is operably couplable to a
setup link by a yaw joint to form a manipulator assembly yaw axis
3023. Proximal link 3026 is rotatably coupled to a distal link 3028
about a pivot axis 3070. In one example, a motor 3073 may be
controlled to pivot the distal link 3028 about the pivot axis 3070.
In one embodiment, distal link 3028 includes an instrument
manipulator assembly platform 3040 at a distal end of the distal
link. A cannula mount 3050 is movably coupled to the distal link
3028. In one embodiment, platform 3040 provides a rotatable base
plate on which instrument manipulators may be mounted and rotated
about an instrument manipulator assembly roll axis 3041. The
intersection of yaw axis 3023, roll axis 3041, and an instrument
manipulator assembly pitch axis 3039 form a remote center of motion
3046 as has been previously described above.
[0193] Referring now in particular to FIGS. 30B and 31,
counterbalancing link 3026 includes a housing 3084 having a central
longitudinal axis 3084c that runs between a housing proximal end or
first end 3084a and a housing distal end or second end 3084b. A
compression spring 3080 is disposed along the longitudinal axis
3084c and has a spring proximal end or first end 3080a and a spring
distal end or second end 3080b. In one embodiment, the compression
spring is comprised of silicon chrome alloy, but may be comprised
of other materials. A base 3092 is disposed at the first end of the
housing and is coupled to the first end 3080a of the compression
spring 3080 by an alignment ring 3090 therebetween. A plug 3074 is
disposed at the second end of the housing and is coupled to the
second end 3080b of the compression spring 3080. In one embodiment,
alignment ring 3090 is fixedly coupled to first end 3080a of the
compression spring 3080, and plug 3074 includes an external screw
thread (e.g., screw thread 3074a) onto which is screwed the spring
second end 3080b.
[0194] A cable 3088 having a coupler 3071 at a first end of the
cable is coupled to a load from the distal link 3028, and a second
end of the cable 3088 is operably coupled to the plug 3074. From
the load bearing end of cable 3088 at coupler 3071, cable 3088
passes through a plurality of pulleys 3076 and 3078 outside of
housing 3084, and then through a pulley 3094 at base 3092 prior to
coupling to plug 3074. The load from the distal link 3028 pulls
cable 3088 in directions E1 and E2 about pulley 3094 (FIG. 31),
causing plug 3074 to compress spring 3080 in the E2 direction,
which is set to counterbalance at least a portion of the load from
the distal link about the pivot axis 3070.
[0195] In order to increase safety, cable 3088 may include
redundant cables which are coupled to a cable tension equalizer
3082 that equalizes tension across the redundant cables. A cable
twister 3095 is optionally used to operably couple the redundant
cables to one another between pulley 3094 and coupler 3071. A
plurality of cap screws 3075 may be disposed between the cable
tension equalizer 3082 and the plug 3074, and may be used to adjust
the force offset of the counterbalancing link. In one embodiment,
three cap screws 3075 couple the cable tension equalizer 3082 and
the plug 3074 with one cap screw bearing substantially all of the
tension and the other two cap screws provided for redundancy and
safety purposes.
[0196] In one aspect, the portion of cable 3088 between pulley 3094
and plug 3074 runs substantially along the central longitudinal
axis 3084c of the proximal link housing. In a further aspect,
spring 3080 compresses substantially along the central longitudinal
axis 3084c of the proximal link housing. Spring compression can
however cause "bowing" or non-linear compression of the spring
along the longitudinal axis of the housing, which can lead to
scraping and contact of the spring against the inner surface of the
proximal link housing. In order to reduce or substantially
eliminate bowing, the orientation of spring 3080 at both the first
and second ends 3080a and 3080b may be adjusted in accordance with
various aspects of the present disclosure. Furthermore, in one
embodiment, the housing includes a linear guide track 3096 disposed
parallel to the longitudinal axis of the housing 3084c. A linear
guide 3086 that is movably or slidably joined to the linear guide
track 3096 is fixedly coupled to a coil of the compression spring
3080. A linear guide 3072 that is also movably or slidably joined
to the linear guide track 3096 is operably coupled to the plug
3074. The linear guide track 3096 and linear guides 3086 and 3072
further reduce or substantially eliminate bowing of the compression
spring 3080. It should be noted that in some embodiments, the
counterbalancing system may be operated without linear guides and a
linear guide track.
[0197] Referring now to adjustable alignment of the first end or
proximal end of the compression spring, in one aspect, alignment
ring 3090 is movably coupled to base 3092 by a plurality of
adjustment screws 3091, such that movement of the adjustment screws
3091 adjusts an orientation of the alignment ring 3090 and
therefore an orientation of the first end of spring 3080a fixedly
coupled to the alignment ring 3090. In one example, base 3092 is
coupled to alignment ring 3090 by four adjustment screws 3091 set
apart from one another in a square or rectangular configuration.
Other geometric configurations of the screws are possible. The
adjustment screws 3091 are each movable in a direction
substantially perpendicular to a planar top surface of the
alignment ring 3090 (e.g., via a screwing action through base
apertures having interior screw threads) such that the orientation
of the alignment ring may be adjusted at each point of contact with
the adjustment screws. Accordingly, the orientation of the
alignment ring 3090 and the fixedly coupled first end 3080a of
spring 3080 may be adjusted at various points along the alignment
ring 3090. More or less adjustment screws 3091 are within the scope
of the present disclosure.
[0198] Referring now to FIGS. 32A-37C, detailed views from a distal
end of the counterbalancing proximal link without the walls of the
link housing are illustrated. In particular, the figures illustrate
views of an adjustment pin 3106, a rocker arm 3108, and a range of
movement of the adjustment pin and the rocker arm to adjust an
orientation of the end plug 3074 and the fixedly coupled second end
3080b of spring 3080, according to various aspects of the present
disclosure.
[0199] FIG. 32A illustrates a bottom perspective view of the
counterbalancing system, and FIG. 32B illustrates a perspective
view of a cross-section along line IV-IV of FIGS. 31, 32A, and 37A.
As noted above, a plurality of cap screws 3075a and 3075b are
disposed between and couple the cable tension equalizer 3082 and
the plug 3074. Cap screw 3075a bears all the tension in this
embodiment and the other two cap screws 3075b are provided for
redundancy and safety purposes. As further noted above, a distal
end of spring 3080 is coupled to plug 3074 by screwing onto
external screw threads 3074a of the plug 3074. Plug 3074 may
optionally include a plurality of grooves 3200 formed to lighten
the weight of the plug. It is also noted that linear guide 3072 may
be slidably coupled to linear guide track 3096 by linear guide
flanges 3072a.
[0200] As can be seen in FIGS. 32A-32B, plug 3074 is coupled to
linear guide 3072 by adjustment pin 3106, a socket screw 3104 that
runs through an interior channel of the adjustment pin 3106, and a
nut 3102 that screws onto a free end 3104a of socket screw 3104 to
lock in place the position of the adjustment pin 3106 and linear
guide 3072 relative to one another. In one embodiment, the socket
screw 3104 is a hex socket screw. A head 3104b of the socket screw
3104 opposite the free end 3104a is placed within an engaging
trench 3105 of the adjustment pin 3106 to lock the head portion of
the socket screw within the adjustment pin when the nut 3102 is
fully engaged at the free end 3104a of the socket screw, thus
locking the position of adjustment pin 3106 and linear guide 3072
relative to one another.
[0201] Referring now to FIGS. 33-36C, adjusting movement of the
adjustment pin 3106 relative to linear guide 3072 is described in
greater detail. FIG. 33 illustrates a side view of the adjustment
pin 3106 coupled to linear guide 3072, a circle 3114, and a circle
center 3114a about which adjustment pin 3106 may pivot when the
adjustment pin is not fully locked in place relative to linear
guide 3072. FIG. 34 illustrates linear guide markings 3072b and
adjustment pin markings 3106c when a central longitudinal axis 3107
of adjustment pin 3106 is perpendicular to a central longitudinal
axis 3097 of the linear guide 3072 or guide track 3096. The linear
guide markings 3072b and adjustment pin markings 3106c may be used
by an adjuster of the counterbalancing system (and in particular
the plug orientation) to determine relative positions of the
adjustment pin and linear guide. FIG. 35 illustrates a perspective
view of the adjustment pin 3106 including a pin shaft 3106a and a
pin head 3106b. As can be seen in FIGS. 33-35, pin head 3106b has a
curved top surface that operably mates with a curved surface of the
linear guide 3072.
[0202] FIGS. 36A-36C illustrate side views of the adjustment pin
3106 and linear guide 3072 and their respective central
longitudinal axis 3107 and 3097, respectively. FIG. 36A illustrates
a perpendicular position of central longitudinal axis 3107 of
adjustment pin 3106 relative to central longitudinal axis 3097 of
linear guide 3072, FIG. 36B illustrates a position in which the
central longitudinal axis 3107 of adjustment pin 3106 forms an
obtuse angle with central longitudinal axis 3097 of linear guide
3072, and FIG. 36C illustrates a position in which the central
longitudinal axis 3107 of adjustment pin 3106 forms an acute angle
with central longitudinal axis 3097 of linear guide 3072.
Accordingly, FIGS. 36A-36C illustrate the pivot movement of
adjustment pin 3106 relative to linear guide 3072, and thus the
orientation adjustment that may be made to plug 3074 and the
fixedly coupled second end 3080b of spring 3080.
[0203] FIG. 37A illustrates another bottom perspective view of the
counterbalancing system showing a rocker arm 3108 and set screws
3110, FIG. 37B illustrates FIG. 37A with the plug 3074 removed, and
FIG. 37C illustrates FIG. 37B with the rocker arm 3108 removed.
Rocker arm 3108 is coupled to adjustment pin 3106 at a free end of
pin shaft 3106a and set screws 3110 couple the rocker arm 3108 to
plug 3074. A cross disc pin 3112 clamps the rocker arm 3108 to
adjustment pin 3106. Rocker arm 3108 and coupled plug 3074 may
pivot about the central longitudinal axis 3107 of adjustment pin
3106 and may be adjusted by the movement of set screws 3110 in a
direction substantially perpendicular to longitudinal axis 3107,
for example by screwing action through rocker arm apertures having
interior screw threads. Thus, the orientation of the plug 3074 and
fixedly coupled second end 3080b of spring 3080 may be adjusted at
each point of contact with the set screws 3110. More or less
adjustment screws 3110 are within the scope of the present
disclosure. Accordingly, the orientation of the plug and therefore
the second or distal end of spring 3080 may be adjusted at various
points by pivoting adjustment pin 3106 and pivoting rocker arm
3108. In one aspect, adjustment pin 3106 and rocker arm 3108 pivot
about axes which are perpendicular to one another.
[0204] Furthermore, the counterbalancing link of the present
disclosure allows for adjustment between the plug and the second
end of the compression spring to change the number of active coils
that are compressible in the compression spring. In one aspect, the
second end of the compression spring may be screwed further or less
onto the exterior screw threads of the plug to change the number of
active coils that are compressible.
[0205] Advantageously, as a motor pivots the distal link 3028 about
the pivot axis 3070 for increased and advantageous robot arm
configuration and instrument manipulation, the counterbalancing
proximal link 3026 allows for easier movements of the distal link,
and less torque required from the motor pivoting the distal link,
while also providing for increased safety from any motor failure.
In some embodiments, although the counterbalancing mechanism of the
proximal link was to totally fail, the motor pivoting the distal
link may brake to hold the distal link in place.
[0206] Embodiments described above illustrate but do not limit the
disclosure. It should also be understood that numerous
modifications and variations are possible in accordance with the
principles of the present disclosure. For example, in many aspects
the devices described herein are used as single-port devices; i.e.,
all components necessary to complete a surgical procedure enter the
body via a single entry port. In some aspects, however, multiple
devices and ports may be used.
* * * * *