U.S. patent application number 16/916539 was filed with the patent office on 2020-10-22 for methods, systems, and devices for surgical access and procedures.
The applicant listed for this patent is Board of Regents of the University of Nebraska. Invention is credited to Shane Farritor, Jeff Hawks, Amy Lehman, Stephen Platt, Mark Rentschler.
Application Number | 20200330170 16/916539 |
Document ID | / |
Family ID | 1000004929264 |
Filed Date | 2020-10-22 |
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United States Patent
Application |
20200330170 |
Kind Code |
A1 |
Farritor; Shane ; et
al. |
October 22, 2020 |
Methods, Systems, and Devices for Surgical Access and
Procedures
Abstract
The embodiments disclosed herein relate to various medical
device components, including components that can be incorporated
into robotic and/or in vivo medical devices. Certain embodiments
include various actuation system embodiments, including fluid
actuation systems, drive train actuation systems, and motorless
actuation systems. Additional embodiments include a reversibly
lockable tube that can provide access for a medical device to a
patient's cavity and further provides a reversible rigidity or
stability during operation of the device. Further embodiments
include various operational components for medical devices,
including medical device arm mechanisms that have both axial and
rotational movement while maintaining a relatively compact
structure. medical device winch components, medical device
biopsy/stapler/clamp mechanisms, and medical device adjustable
focus mechanisms.
Inventors: |
Farritor; Shane; (Lincoln,
NE) ; Rentschler; Mark; (Boulder, CO) ;
Lehman; Amy; (York, NE) ; Platt; Stephen;
(Urbana, IL) ; Hawks; Jeff; (Beatrice,
NE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Board of Regents of the University of Nebraska |
Lincoln |
NE |
US |
|
|
Family ID: |
1000004929264 |
Appl. No.: |
16/916539 |
Filed: |
June 30, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15966606 |
Apr 30, 2018 |
10695137 |
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16916539 |
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14454035 |
Aug 7, 2014 |
9956043 |
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15966606 |
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13329705 |
Dec 19, 2011 |
8828024 |
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14454035 |
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12171413 |
Jul 11, 2008 |
8343171 |
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13329705 |
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60949390 |
Jul 12, 2007 |
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60949391 |
Jul 12, 2007 |
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60990076 |
Nov 26, 2007 |
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61025346 |
Feb 1, 2008 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 34/30 20160201;
A61B 2034/302 20160201; A61B 34/70 20160201; A61B 34/71 20160201;
A61B 2034/306 20160201; A61B 2017/00539 20130101; A61B 34/73
20160201; A61B 34/72 20160201; A61B 2017/00544 20130101; A61B
2017/00278 20130101; A61B 17/00234 20130101 |
International
Class: |
A61B 34/30 20060101
A61B034/30; A61B 34/00 20060101 A61B034/00; A61B 17/00 20060101
A61B017/00 |
Goverment Interests
GOVERNMENT SUPPORT
[0002] This invention was made with government support under Grant
Number R21 EB056632, awarded by the National Institutes of Health.
The government has certain rights in the invention.
Claims
1. (canceled)
2. A robotic surgical system comprising a robotic device, the
device comprising; (a) a device body; (b) a first robotic arm sized
to be positioned within a patient, the first robotic arm
comprising; (i) a first arm first link operably coupled to the
device body via a first shoulder joint; (ii) a first arm second
link operably coupled to the first arm first link via a first elbow
joint; (iii) a first operational component operably coupled to the
first arm second link; and (iv) a first piston disposed within the
first robotic arm, the first piston configured to actuate movement
of the first robotic arm; and (c) a second robotic arm sized to be
positioned within the patient, the second robotic arm comprising:
(i) a second arm first link operably coupled to the device body via
a second shoulder joint; (ii) a second arm second link operably
coupled to the second arm first link via a second elbow joint;
(iii) a second operational component operably coupled to the second
arm second link; and (iv) a second piston disposed within the
second robotic arm, the second piston configured to actuate
movement of the second robotic arm.
3. The robotic surgical system of claim 2, wherein actuation of the
first piston causes movement of the first arm second link relative
to the first arm first link.
4. The robotic surgical system of claim 2, wherein the first piston
is disposed within the first arm first link and operably coupled
with the first arm second link.
5. The robotic surgical system of claim 2, further comprising a
third piston operably coupled with the first operational component
such that actuation of the third piston causes actuation of the
first operational component.
6. The robotic surgical system of claim 5, wherein the third piston
is disposed within the first arm second link.
7. The robotic surgical system of claim 2, wherein each of the
first piston and second piston is in fluid communication with a
hydraulic connection line.
8. The robotic surgical system of claim 7, wherein the hydraulic
connection line extends from an interior of a patient to an
exterior of a patient when the robotic device is positioned within
the patient.
9. A robotic surgical system comprising: (a) a tubular component
comprising a first lumen, the tubular component configured to be
positioned through an incision formed in a cavity wall of a patient
or a port disposed within the incision; (b) a device body; (c) a
first robotic arm sized to be positioned in the cavity of the
patient through the tubular component, the first robotic arm
comprising: (i) a first arm first link operably coupled to the
device body via a first shoulder joint; (ii) a first arm second
link operably coupled to a second end of the first arm first link
via a first elbow joint; (iii) a first operational component
operably coupled to the first arm second link; and (iv) a first
piston disposed within the first robotic arm, the first piston
configured to actuate movement of the first robotic arm; and (d) a
second robotic arm sized to be positioned in the cavity of the
patient through the tubular component, the second robotic arm
comprising: (i) a second arm first link operably coupled to the
device body via a second shoulder joint; (ii) a second arm second
link operably coupled to a second end of the second arm first link
via a second elbow joint; (iii) a second operational component
operably coupled to the first arm second link; and (iv) a second
piston disposed within the second robotic arm, the second piston
configured to actuate movement of the second robotic arm.
10. The robotic surgical system of claim 9, further comprising at
least one connection component disposed through the first lumen of
the tubular component, the at least one connection component
comprising a distal end operably coupled to the robotic device.
11. The robotic surgical system of claim 10, further comprising a
power source operably coupled to a proximal end of the at least one
connection component.
12. The robotic surgical system of claim 9, further comprising a
sliding component slidably positioned within the first arm, wherein
the sliding component is operably coupled with the first
operational component.
13. The robotic surgical system of claim 12, wherein the first
piston is operably coupled with the sliding component such that
actuation of the first piston causes the sliding component to slide
back and forth within the first arm.
14. The robotic surgical system of claim 12, further comprising an
actuator disposed within the sliding component, wherein the
actuator actuates a movement of the first operational
component.
15. The robotic surgical system of claim 9, wherein the first
piston is disposed within the first arm second link and the second
piston is disposed within the second arm second link.
16. A robotic surgical system comprising: (a) a tubular component
comprising a first lumen, the tubular component configured to be
positioned through an incision formed in a cavity wall of a patient
or a port disposed within the incision; (b) a device body; (c) a
first robotic arm sized to be positioned in the cavity of the
patient through the tubular component, the first robotic arm
comprising: (i) a first arm first link operably coupled to the
device body via a first shoulder joint; (ii) a first arm second
link operably coupled to a second end of the first arm first link
via a first elbow joint; (iii) a first operational component
operably coupled to the first arm second link; and (iv) a first
piston disposed within the first robotic arm, the first piston
configured to actuate movement of the first robotic arm; (d) a
second robotic arm sized to be positioned in the cavity of the
patient through the tubular component, the second robotic arm
comprising: (i) a second arm first link operably coupled to the
device body via a second shoulder joint; (ii) a second arm second
link operably coupled to a second end of the second arm first link
via a second elbow joint; (iii) a second operational component
operably coupled to the first arm second link; and (iv) a second
piston disposed within the second robotic arm, the second piston
configured to actuate movement of the second robotic arm; and (e)
at least one connection component disposed through the first lumen
of the tubular component, the at least one connection component
comprising a distal end operably coupled to the robotic device.
17. The robotic surgical system of claim 16, further comprising a
power source operably coupled to a proximal end of the at least one
connection component.
18. The robotic surgical system of claim 16, wherein the at least
one connection component comprises an electrical connection
component.
19. The robotic surgical system of claim 16, wherein the at least
one connection component comprises a hydraulic tube or a pneumatic
tube.
20. The robotic surgical system of claim 16, wherein the first
piston is disposed within the first arm first link.
21. The robotic surgical system of claim 20, wherein the first
elbow joint further comprises a pin, wherein the pin is coupled to
a distal end of the first piston and the first arm second link, and
wherein actuation of the first piston actuates the first arm second
link relative to the first arm first link.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority as a continuation of U.S.
application Ser. No. 15/966,606, filed on Apr. 30, 2018 and
entitled "Methods, Systems, and Devices for Surgical Access and
Procedures," which is a continuation of U.S. Pat. No. 9,956,043,
filed on Aug. 7, 2014, issued on May 1, 2018, and entitled
"Methods, Systems, and Devices for Surgical Access and Procedures,"
which is a continuation of U.S. Pat. No. 8,828,024, filed on Dec.
19, 2011, issued on Sep. 9, 2014, and entitled "Methods, Systems,
and Devices for Surgical Access and Procedures," which is a
continuation of U.S. Pat. No. 8,343,171, filed on Jul. 11, 2008,
issued on Jan. 1, 2013, and entitled "Methods and Systems of
Actuation in Robotic Devices," all of which are hereby incorporated
by reference in their entireties. Further, U.S. Pat. No. 8,343,171
claims priority to Provisional Application No. 60/949,390, filed
Jul. 12, 2007; Provisional Application No. 60/949,391, filed Jul.
12, 2007; Provisional Application No. 60/990,076, filed Nov. 26,
2007; and Provisional Application No. 61/025,346, filed Feb. 1,
2008, all of which are hereby incorporated herein by reference in
their entireties.
TECHNICAL FIELD
[0003] The embodiments disclosed herein relate to various medical
device components, including components that can be incorporated
into robotic and/or in vivo medical devices. Certain embodiments
include various actuation system embodiments, including fluid
actuation systems, drive train actuation systems, and motorless
actuation systems. Further embodiments include various operational
components for medical devices, including medical device arm
mechanisms, medical device winch mechanisms, medical device
biopsy/stapler/clamp mechanisms, and medical device adjustable
focus mechanisms. Other embodiments relate to reversibly lockable
tube mechanisms.
BACKGROUND
[0004] Invasive surgical procedures are essential for addressing
various medical conditions. When possible, minimally invasive
procedures such as laparoscopy are preferred.
[0005] However, known minimally invasive technologies such as
laparoscopy are limited in scope and complexity due in part to 1)
mobility restrictions resulting from using rigid tools inserted
through access ports, and 2) limited visual feedback. Known robotic
systems such as the da Vinci.RTM. Surgical System (available from
Intuitive Surgical, Inc., located in Sunnyvale, Calif.) are also
restricted by the access ports, as well as having the additional
disadvantages of being very large, very expensive, unavailable in
most hospitals, and having limited sensory and mobility
capabilities.
[0006] There is a need in the art for improved surgical methods,
systems, and devices.
SUMMARY
[0007] One embodiment disclosed herein relates to a biopsy
component having a substantially fixed jaw component, a mobile jaw
component adjacent to the substantially fixed jaw component, and a
sliding component configured to move between a first position and a
second position. The mobile jaw component is predisposed to a
position in which a distal end of the component is not in contact
with the substantially fixed jaw component. Further, the sliding
component in the second position is in contact with the mobile jaw
component such that the sliding component urges the distal end of
the mobile jaw component toward the substantially fixed jaw
component.
[0008] Another embodiment disclosed herein relates to an arm device
having an extendable rotational arm, a first drive component, a
second drive component, a first driven component, a second driven
component, and a pin. The extendable rotational arm has an exterior
portion having a first coupling component and further has a first
aperture defined within the arm. The first drive component is
coupled with the first driven component, and the first driven
component has an inner surface having a second coupling component
that is configured to be coupled with the first coupling component.
The second drive component is coupled with the second driven
component, and the second driven component has a second aperture
defined within it. The pin is disposed within the first and second
apertures. According to one embodiment, the first and second
coupling components are threads. In a further embodiment, the first
and second drive components and first and second driven components
are gears. Alternatively, the first and second drive components and
the first and second driven components are a pulley system or a
friction drive system.
[0009] Yet another embodiment disclosed herein relates to a medical
device having a body, a first winch component and an actuation
component. The first winch component has a first drum and a first
tether operably coupled to the first drum. In one embodiment, the
actuation component is operably coupled to the first drum. In an
additional embodiment, the device further has an end effector
operably coupled to the distal end of the tether. In yet another
implementation, the device also has a second winch component having
a second drum and a second tether operably coupled to the second
drum. According to a further embodiment, the device also has a
third winch component having a third drum and third tether operably
coupled to the third drum.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1A is a schematic depicting a fluid actuation system,
according to one embodiment.
[0011] FIG. 1B is a schematic depicting a valve component,
according to one embodiment.
[0012] FIG. 2A shows a front view of a medical device having a
fluid actuation system, according to one embodiment.
[0013] FIG. 2B depicts a front view of a medical device having a
fluid actuation system, according to another embodiment.
[0014] FIG. 3 is a perspective view of a medical device, according
to another embodiment.
[0015] FIG. 4 depicts a perspective view of a medical device joint,
according to one embodiment.
[0016] FIG. 5 shows a perspective view of a medical device joint,
according to another embodiment.
[0017] FIG. 6 is a perspective view of an operational component,
according to one embodiment.
[0018] FIG. 7A depicts a front view of a medical device having a
drive train system, according to one embodiment.
[0019] FIG. 7B shows a front view of a medical device having a
drive train system, according to another embodiment.
[0020] FIG. 8 is a cutaway view of a reversibly lockable tube
positioned in a target body cavity of a patient, according to one
embodiment.
[0021] FIG. 9A depicts a perspective view of a modular tube
component, according to one embodiment.
[0022] FIG. 9B shows another perspective view of the modular tube
component of FIG. 9A.
[0023] FIG. 10 is a front view of a reversibly lockable tube,
according to one embodiment.
[0024] FIG. 11 depicts a perspective view of the reversibly
lockable tube of FIG. 10.
[0025] FIG. 12 shows a perspective view of a reversibly lockable
tube, according to another embodiment.
[0026] FIG. 13 is a perspective view of a reversibly lockable tube,
according to yet another embodiment.
[0027] FIG. 14A depicts a front view of a medical device having a
motorless actuation component, according to one embodiment.
[0028] FIG. 14B shows a side view of the medical device of FIG.
14A.
[0029] FIG. 15 is a front view of a medical device having a
motorless actuation component, according to another embodiment.
[0030] FIG. 16 depicts a perspective view of a medical device
having an arm component, according to one embodiment.
[0031] FIG. 17A shows a perspective view of an arm component,
according to one embodiment.
[0032] FIG. 17B is a perspective exploded view of the arm component
of FIG. 17A.
[0033] FIG. 18 depicts a perspective view of an arm component,
according to another embodiment.
[0034] FIG. 19A shows a perspective view of a medical device having
a winch component, according to one embodiment.
[0035] FIG. 19B is a front view of the medical device having the
winch component of FIG. 19A.
[0036] FIG. 20 depicts a cutaway view of a medical device utilizing
a winch component during a procedure in a patient, according to one
embodiment.
[0037] FIG. 21 shows a cutaway view of a medical device utilizing a
winch component during a procedure in a patient, according to
another embodiment.
[0038] FIG. 22 is a cutaway view of a medical device utilizing two
winch components during a procedure in a patient, according to yet
another embodiment.
[0039] FIG. 23A depicts a front view of a medical device having a
payload area that is a biopsy mechanism, according to one
embodiment.
[0040] FIG. 23B shows a front view of a medical device having a
payload area, according to another embodiment.
[0041] FIG. 24A is a side view of a modular biopsy mechanism,
according to one embodiment. n.
[0042] FIG. 24B depicts another side view of the modular biopsy
component of FIG. 24A.
[0043] FIG. 24C shows a front view of the modular biopsy mechanism
of FIGS. 24A and 24B.
[0044] FIG. 25A is a side view of a modular biopsy mechanism,
according to another embodiment.
[0045] FIG. 25B depicts a front view of the modular biopsy
mechanism of FIG. 25A.
[0046] FIG. 26 shows a top view of a biopsy mechanism, according to
another embodiment.
[0047] FIG. 27 is a top view of another biopsy mechanism, according
to yet another embodiment.
[0048] FIG. 28A depicts a perspective view of another biopsy
mechanism, according to a further embodiment.
[0049] FIG. 28B shows a perspective view of the biopsy mechanism of
FIG. 28A.
[0050] FIG. 29A is a side view of an adjustable focus component,
according to one embodiment.
[0051] FIG. 29B depicts a top view of the adjustable focus
component of FIG. 29A.
[0052] FIG. 29C shows an end view of the adjustable focus component
of FIGS. 29A and 29B.
[0053] FIG. 29D is a perspective view of the adjustable focus
component of FIGS. 29A, 29B, and 29C.
[0054] FIG. 29E depicts a perspective view of the adjustable focus
component of FIGS. 29A, 29B, 29C, and 29D.
[0055] FIG. 30A shows a top view of a laboratory test jig used to
measure forces applied by a biopsy mechanism, according to one
embodiment.
[0056] FIG. 30B is a perspective view of the test jig and biopsy
mechanism of FIG. 30A.
[0057] FIG. 31 depicts a line graph relating to data collected from
the operation of the test jig depicted in FIGS. 30A and 30B.
DETAILED DESCRIPTION
[0058] The various systems and devices disclosed herein relate to
devices for use in medical procedures and systems. More
specifically, the various embodiments relate to various actuation
or end effector components or systems that can be used in various
procedural devices and systems.
[0059] It is understood that the various embodiments of actuation,
end effector, and other types of device components disclosed herein
can be incorporated into or used with any known medical devices,
including, but not limited to, robotic or in vivo devices as
defined herein.
[0060] For example, the various embodiments disclosed herein can be
incorporated into or used with any of the medical devices disclosed
in copending U.S. application Ser. No. 11/932,441 (filed on Oct.
31, 2007 and entitled "Robot for Surgical Applications"), Ser. No.
11/695,944 (filed on Apr. 3, 2007 and entitled "Robot for Surgical
Applications"), Ser. No. 11/947,097 (filed on Nov. 27, 2007 and
entitled "Robotic Devices with Agent Delivery Components and
Related Methods), Ser. No. 11/932,516 (filed on Oct. 31, 2007 and
entitled "Robot for Surgical Applications"), Ser. No. 11/766,683
(filed on Jun. 21, 2007 and entitled "Magnetically Coupleable
Robotic Devices and Related Methods"), Ser. No. 11/766,720 (filed
on Jun. 21, 2007 and entitled "Magnetically Coupleable Surgical
Robotic Devices and Related Methods"), Ser. No. 11/966,741 (filed
on Dec. 28, 2007 and entitled "Methods, Systems, and Devices for
Surgical Visualization and Device Manipulation"), Ser. No.
60/949,391 (filed on Jul. 12, 2007), Ser. No. 60/949,390 (filed on
Jul. 12, 2007), Ser. No. 60/990,062 (filed on Nov. 26, 2007), Ser.
No. 60/990,076 (filed on Nov. 26, 2007), Ser. No. 60/990,086 (filed
on Nov. 26, 2007), Ser. No. 60/990,106 (filed on Nov. 26, 2007),
Ser. No. 60/990,470 (filed on Nov. 27, 2007), Ser. No. 61/025,346
(filed on Feb. 1, 2008), Ser. No. 61/030,588 (filed on Feb. 22,
2008), and Ser. No. 61/030,617 (filed on Feb. 22, 2008), all of
which are hereby incorporated herein by reference in their
entireties.
[0061] In an exemplary embodiment, any of the various embodiments
disclosed herein can be incorporated into or used with a natural
orifice translumenal endoscopic surgical device, such as a NOTES
device. Those skilled in the art will appreciate and understand
that various combinations of features are available including the
features disclosed herein together with features known in the
art.
[0062] Certain device implementations disclosed in the applications
listed above can be positioned within a body cavity of a patient,
including certain devices that can be positioned against or
substantially adjacent to an interior cavity wall, and related
systems. An "in vivo device" as used herein means any device that
can be positioned, operated, or controlled at least in part by a
user while being positioned within a body cavity of a patient,
including any device that is positioned substantially against or
adjacent to a wall of a body cavity of a patient, further including
any such device that is internally actuated (having no external
source of motive force), and additionally including any device that
may be used laparoscopically or endoscopically during a surgical
procedure. As used herein, the terms "robot," and "robotic device"
shall refer to any device that can perform a task either
automatically or in response to a command.
[0063] Certain embodiments disclosed herein relate to actuation
components or systems that are configured to provide motive force
to any of the various procedural device embodiments described
above. One such embodiment is a fluid actuation system. FIG. 1A
schematically depicts one embodiment of a fluid actuation system 10
for a procedural device. According to one implementation, the fluid
actuation system 10 is a hydraulic system. Alternatively, the fluid
actuation system 10 is a pneumatic system. In a further
alternative, the fluid actuation system can be any known such
system. Hydraulic systems are generally preferred for higher power
transmission, while pneumatic systems can be a good actuation
system for binary actuation, such as actuation required for a
grasper. In the hydraulic embodiment depicted in FIG. 1A, the
system 10 includes a medical device 12 that is connected via a
hydraulic connection line 20 to external hydraulic components 22.
The device 12 as shown has a hydraulic piston assembly 14 having a
piston 16 positioned within a cylinder 18. The piston assembly 14
can be used for any actuation associated with the device 12, such
as powering movement of the device 12 in relation to the patient's
body, actuating a component of the device to perform an action, or
any other desired actuation.
[0064] As further shown in FIG. 1A, the piston assembly 14 is
connected via a hydraulic connection line 20 to the external
hydraulic components 22, which include a reservoir 24, a pump 26,
and an accumulator 28. The external hydraulic components 22 are
positioned at a location external to the patient's body. Thus, the
hydraulic connection line 20 is connected to the piston assembly 14
in the device 12 through the valve component 30 and to the external
hydraulic components 22 such that the line 20 extends from the
interior of the patient's body to the exterior when the device 12
is positioned in the patient's body. According to one embodiment,
the line 20a that couples the accumulator 28 to the valve component
30 is a high pressure supply line 20a that provides fluid to the
valve component 30 under high pressure. In accordance with a
further implementation, the line 20b that couples the valve
component 30 to the reservoir 24 is a low pressure supply line 20b
that allows fluid to move from the valve component 30 to the
reservoir 24 under low pressure.
[0065] In one embodiment, the hydraulic fluid used in the hydraulic
system 10 is saline solution. Alternatively, the fluid is
water-based. In a further alternative, the hydraulic fluid can be
any fluid that is non-toxic, biocompatible, and less compressible
as required to provide sufficient precise control.
[0066] In one implementation, the external hydraulic components 22
are the reservoir 24, pump 26, and accumulator 28 as discussed
above, which operate in known fashion to hydraulically power the
piston assembly 14. In one example, the pump 26 used in this system
is a commercially-available surgical irrigation pump, while the
accumulator 28 and reservoir 24 are commercially available from
Parker Hannifin, which is located in Cleveland, Ohio.
Alternatively, the external hydraulic components 22 can be any
known configuration of any hydraulic components capable of
hydraulically powering the piston 16.
[0067] According to one implementation of a fluid actuation system,
the piston 16 is a standard syringe handle and the cylinder 18 is
the syringe body. Alternatively, the piston assembly 14 can be a
small commercially available system used for model airplane landing
gear. In a further embodiment, the piston 16 is custom machined
with an o-ring around the piston head, while the cylinder 18 is a
machined or molded cavity within the robot's base or arms.
[0068] The valve component 30 has a valve for each piston assembly
14. Thus, the valve component 30 may have anywhere from one valve
to any number equal to the maximum number of valves provided in the
system.
[0069] Another example of a valve component 32 is provided in FIG.
1B. In this embodiment, the component 32 has six valves 34. The
fluid is provided at high pressure through the high pressure supply
line 36a and exits the valve component 32 at a low pressure through
the low pressure line 36b. In addition, the valves 34 are each
coupled to a respective piston assembly 38 as shown. According to
one embodiment, such a valve component 30 (also referred to as a
"valve system") is sold by Parker Hannifin.
[0070] As mentioned above, the fluid actuation systems depicted in
FIGS. 1A and 1B can alternatively be a pneumatic system. Returning
to FIG. 1A, in this embodiment of a pneumatic system 10, the
external pneumatic components 22 are disposed externally to the
patient's body. Thus, the pneumatic connection line 20 is connected
to the valve component 30 in the medical device 12 and to the
external pneumatic components 22 such that the line 20 extends from
the interior of the patient's body to the exterior when the device
12 is positioned in the patient's body.
[0071] According to one embodiment of a pneumatic system, in place
of the pump 26, accumulator 28, and reservoir 24. the external
pneumatic component 22 is a pressurized cylinder (not shown). In
this embodiment, the return air is emitted into the external
environment of the system. One example of a pressurized cylinder is
a canister of readily-available carbon dioxide, which is commonly
used to insufflate the abdominal cavity during laparoscopic
surgery. Alternatively, the external pneumatic components 22 can be
any known configuration of any pneumatic components capable of
pneumatically powering the piston 16.
[0072] FIGS. 2A and 3 depict a robotic device 40 with a hydraulic
system, according to one embodiment. The device 40 has six piston
assemblies 42a, 42b, 42c, 42d, 42e, 42f. Piston assemblies 42a and
42b are disposed within the body 44 of the device 40 and actuate
the first links 48a, 48b of the robotic arms 46a, 46b. Piston
assemblies 42c, 42d are disposed within the first links 48a, 48b
and actuate the second links 50a, 50b. In addition, piston
assemblies 42e, 42f are disposed within the second links 50a, 50b
and actuate the operational components 52, 54.
[0073] Alternatively, the device 40 can have from one to any number
of piston assemblies that can be integrated into the robotic device
as actuation components. According to one embodiment, a piston is
provided for each degree of freedom.
[0074] According to one embodiment as shown in FIG. 2B, the
external components of the hydraulic system 56 provide a high
pressure supply line 57a to the robotic device and receive a low
pressure return line 57b from the device. In a further embodiment,
the robotic device has a system of valves or a master valve system
58 that controls the hydraulic fluid flow and directs the fluid as
needed to the piston assemblies, such as the assemblies depicted in
FIGS. 2A and 3.
[0075] FIG. 4 depicts a robotic device joint 60 connecting a link
62 to the robotic body 64, according to one embodiment. The body 64
has a piston assembly 66 in which the piston 68 is coupled to a pin
70 that is coupled in turn to the link 62 at the connection point
72. In one implementation, the link 62 is a first link 62 such that
the joint 60 is a joint 60 between a robotic body 64 and a first
link 62 (also referred to as a "shoulder joint").
[0076] FIG. 5 depicts a robotic device joint 80 connecting a first
link 82 to a second link 84, according to one embodiment. The first
link 82 has a piston assembly 86 in which the piston 88 is coupled
to a pin 90 that is coupled in turn to the second link 84 at the
connection point 92. In one implementation, the joint 80 between
the two links 82, 84 is referred to as an "elbow joint."
[0077] FIG. 6 depicts an operational component 100 coupled to a
robotic arm 102, according to one embodiment. The robotic arm 102
has a piston assembly 104 in which the piston 106 is coupled to a
portion of the operational component 100. More specifically, the
piston 106 is coupled to a sliding component 108 at a connection
point 110, wherein the sliding component is slidably positioned in
the arm 102 such that the force created by the piston assembly 104
is translated to the sliding component 110, causing the sliding
component 110 to slide back and forth in the arm 102.
[0078] The operational component 100 is coupled to the sliding
component 110 at joint 112 such that the sliding back and forth of
the sliding component 110 causes the operational component 100 to
extend and retract relative to the arm 102. This allows for the
lengthening and shortening of the reach of the operational
component 100 with respect to the arm 102 and the procedural space
in which the operational component 100 is operating. Stated in
another way, according to one embodiment, this slidable coupling of
the sliding component 110 and the arm 102 is considered to be the
"wrist" of the arm 102, wherein the sliding of the sliding
component 110 back and forth operates to lengthen and shorten the
"wrist" in relation to the rest of the arm 102.
[0079] In one embodiment, an actuator (not shown) disposed in the
sliding component 108 actuates the operational component 100. For
example, in the embodiment depicted in FIG. 6 in which the
operational component 100 is a set of graspers 100, the actuator
actuates the graspers to move between the open and closed
positions.
[0080] It is understood that a pneumatic system could be
incorporated into any of the embodiments and components depicted in
FIGS. 2A, 2B, and 3-6 and could operate in generally the same
fashion as discussed above. It is further understood that any other
type of fluid actuation system could also be implemented in any of
these embodiments in generally the same fashion.
[0081] In accordance with one implementation, a device having a
fluid actuation system such as the various systems disclosed herein
could reduce costs associated with the device. That is, the
components of the system associated with the device can be
integrated into the device at a low cost (in comparison to devices
having costly onboard motors, etc.), while the more expensive
components can be incorporated into the external components of the
system and thus can be re-used for extended periods of time. In
another embodiment, the use of a fluid actuation system in a device
can provide increased force and/or speed in comparison to internal
motors.
[0082] In a further alternative embodiment, the device is a
"hybrid" that has at least one piston and at least one motor,
thereby providing for further flexibility in the configuration of
the device and the capability of accomplishing very precise
motions. For example, the precise motions could include motions of
the wrist such as rotation or extension that might require very
precise control for delicate tissue dissection. In such an
embodiment, the fluid actuation piston assemblies could be used for
purposes of gross and/or quick actuations that require greater
power, such as actuation of the shoulder and/or elbow joints, while
the motor assemblies could be used for purposes of precise, slower
actuations, such as actuation of the wrist or operational component
for precise tasks such as dissection. In this context, the fluid
actuation assemblies of the shoulder and elbow joints could then
subsequently be used for the pulling or cutting motions that
require greater power.
[0083] In addition to the fluid actuation systems described above,
yet another actuation system that can be implemented with the
various medical devices disclosed or incorporated herein is a drive
train system. One exemplary implementation of a drive train system
is shown in FIG. 7A, which depicts a robotic device 202
mechanically powered or actuated with a drive train system 200. The
system 200 has a drive component 204 that is coupled to the robotic
device 202 and thereby provides mechanical force to the device
202.
[0084] In one embodiment as shown in FIG. 7B, the drive component
204 includes a series of axles and couplers that are connected to
each other and to an actuation component 212 (which, according to
one implementation, can be a drive motor 212) and ultimately are
connected to the device 202. More specifically, the drive component
204 includes the drive shaft 214, the first coupling component 215,
the second coupling component 216, the connecting shaft 217, and
the third coupling component 218. According to one embodiment, the
first, second, and third coupling components 215, 216, 218 are
coupleable gears. In operation, the actuation component 212
depicted in FIG. 7B powers the drive component 204 by actuating the
drive shaft 214. The rotation of drive shaft 214 powers the
rotation of the connecting shaft 217 via the first and second
coupleable gears 215, 216. The power is then transferred to the
medical device 202 via the third gear 218.
[0085] Alternatively, the drive component 204 is a flexible rod
that is capable of transferring rotational power to the device 202.
In a further embodiment, the drive component 204 is any known drive
component capable of transferring power to a robotic device
202.
[0086] As shown in FIGS. 7A and 7B, this particular embodiment
relates to a drive component 204 that is positioned inside a
needle, port, or other kind of insertion component 206 that is
connected to a device 202 positioned inside the patient's body.
Alternatively, the insertion component 206 is an opening or channel
that provides for access or connection to the device 202 inside the
patient's body. More specifically, in the embodiment depicted in
FIG. 7, the insertion component 206 is a trocar-like port 206 that
is inserted through an incision 208 in the patient, such as an
incision 208 through the abdominal wall 210. The drive component
204 is then positioned within the port 206 and coupled to the
device 202 positioned in the patient's body cavity.
[0087] As described above, the drive component 204 can be a rotary
shaft 204 that supplies rotational actuation to the device 202. In
one exemplary implementation, the shaft 204 has a series of
clutches (not shown) that transfer the actuation to the piston
assemblies or other translation assemblies for actuation of the
joints and other actuable components. The miniature clutches are
common components that are available commercially from Small Parts,
Inc., located in Miami Lakes, Fla. In one embodiment, the clutches
are operated hydraulically. Alternatively, the clutches are
operated electrically or by any other known method.
[0088] In a further alternative implementation, the drive component
204 winds one or more onboard tensionable springs that can then be
used to provide power to the end effectors or other drivable/driven
components in the device through a clutch system.
[0089] Alternatively, the rotary shaft 204 is a flexible rod 204.
In this embodiment, the insertion component 206 does not
necessarily need to be straight. In one example, the insertion
component 206 is inserted through the esophagus of the patient and
into the abdominal cavity through an incision in the stomach wall.
The inner flexible rod 204 is positioned within the insertion
component 206 and coupled to the robotic device 202. In this
example, the flexible rod 204 is rotated to provide rotational
actuation to the robotic device 202.
[0090] One component that can be used in conjunction with any fluid
actuation or drive train actuation system such as those systems
described above is a reversibly lockable tube. As used herein,
"reversibly lockable tube" is intended to mean any tubular
component that can be switched, adjusted, or otherwise changed
between a flexible configuration and a locked configuration (in
which "locked" is intended to encompass any level of substantial
rigidity). This adjustability between flexible and rigid
configurations shall also be referred to herein as the "reversibly
lockable" feature. Please note that the term "tube" as used herein
is intended to encompass any tubular or hose-like component that
provides access to various cavities of a patient's body for medical
procedure devices and/or connection to such devices positioned in
the patient's body.
[0091] FIG. 8 provides one exemplary depiction of an embodiment of
a reversibly lockable tube 220 coupled to a robotic device 222 that
is positioned in the target body cavity of the patient. As
discussed above, one embodiment of the tube 220 can be adjusted
between a flexible configuration and a rigid or "locked"
configuration. In use, such components as a hydraulic or pneumatic
actuation system as described above can be disposed within the tube
220, along with any other components that connect a robotic device
disposed within the patient's body with components positioned
externally to the patient's body. More specifically, the tube 220
is maintained in its flexible configuration while the tube 220 is
being positioned through an orifice into a patient's body such as
through the mouth and esophagus of the patient as depicted in FIG.
8. Once the tube 220 has been positioned, the tube 220 can be
adjusted into the locked configuration during operation of the
device 222. The operation of the various lockable tube embodiments
disclosed herein will be described in further detail below.
[0092] FIGS. 10 and 11 depict a reversibly lockable tube 240
according to one embodiment that is made up of multiple modular
tube components (also referred to herein as "links").
[0093] One example of modular tube components 260 (such as those
used in the tube 240 shown in FIGS. 10 and 11) is depicted in FIGS.
9A and 9B. FIG. 9A depicts the male end 262 (or "protrusion"),
while FIG. 9B depicts the female end 264. As shown in FIG. 9A, the
male end 262 is a convex protrusion. Alternatively, the male end
262 can be any form of protrusion that mates with the female end
264. As shown in FIG. 9B, the female end 264 is a concave
formation. Alternatively, the female end 264 can take any form or
configuration that mates with the male end 262.
[0094] As shown in FIGS. 9A and 9B, each modular component 260 has
at least one hole 268 (also referred to herein as a "channel")
defined through the component 260. As depicted, the component 260
has three channels 268, 270, 272. According to one embodiment, the
channels 268, 270, 272 are configured to receive and/or allow the
passage of any cables or tubes that are to be inserted through or
positioned within the reversibly lockable tube 240, such as those
shown in FIGS. 10 and 11. In accordance with one implementation,
the center channel 268 is configured to receive a rigidity cable
242, best shown in FIGS. 10 and 11. The rigidity cable 242 is used
to convert or adjust the tube 240 into the rigid configuration or
phase. Any additional channels, such as channels 270, 272, are
configured to receive electrical connection components, hydraulic
or pneumatic tubes, or any other elongate members that require
insertion into the target cavity or connection to a robotic device
positioned in the target cavity.
[0095] According to one embodiment as best shown in FIGS. 10, 11,
and 12, the rigidity cable 242 operates in the following manner to
adjust or convert the tube 240 from the flexible configuration to
the rigid configuration. In the flexible state as shown in FIG. 11,
the cable 242 is allowed to be loose and thus the modular
components 246 are not being urged against each other into a tight
configuration. According to one embodiment, each modular component
246 can move about 20 degrees relative to the adjacent components
246 in the flexible state. When it is desirable to adjust or
transform the tube 240 from the flexible state to the rigid state,
the cable 242 is pulled or otherwise urged at its proximal end 248
in a direction away from the tube 240. This causes the cable end
244 to contact the distal modular component 250 and begin urging
that component 250 toward the other components of the tube 240.
Ultimately, this urges the modular components 246 into a tight
configuration of the components 246 in which each of the components
246 is stacked tightly, or is otherwise in close contact, with the
other components 246, thereby resulting in a substantially rigid
configuration of the tube 240.
[0096] In use, the tube (such as tubes 220 or 240, for example) is
placed in its flexible configuration or state for insertion of the
robotic device into the patient's body. Once the device has been
positioned as desired by the user (such as the positioning of the
device 222 and tube 220 depicted in FIG. 8 or alternatively as
shown in FIG. 13), the tube is then adjusted or converted or
otherwise placed into its rigid configuration or phase. This
rigidity can assist in maintaining the geometric or physical shape
and/or positioning of the tube in relation to the patient and
resist against the straightening force of the hydraulic, pneumatic,
or physical force being applied through the connections between the
device and the external components of the hydraulic, pneumatic, or
drive train systems, respectively, as known in the art or as
described above. Thus, the tube can assist in maintaining the
stability of the robotic device during use. Alternatively, the
rigidity can assist with maintaining the geometric or physical
shape and/or positioning of the tube for any reason that may
benefit the operation of the medical device or the medical
procedure generally.
[0097] In addition to the fluid actuation system and drive train
embodiments discussed above, yet another actuation component that
can be incorporated into or used with any of the medical devices
disclosed or otherwise described herein is a motorless actuation
system or component.
[0098] FIGS. 14A and 14B depict one embodiment of a motorless
actuation component. More specifically, FIGS. 14A and 14B depict a
robotic camera device 310, according to one embodiment, in which
the robotic device 310 is disposed within the abdominal cavity of a
patient, and a magnetic handle 312 is disposed at a location
external to the patient. The handle 312 operates to hold the device
310 inside the abdominal cavity against the peritoneum (abdominal
wall) via magnetic forces.
[0099] It is understood that this embodiment is similar to the
embodiments disclosed in U.S. patent application Ser. No.
11/766,720, filed on Jun. 21, 2007, and U.S. patent application
Ser. No. 11/766,683, filed on Jun. 21, 2007, both of which were
incorporated herein above. It is further understood that any of the
instant motorless actuation component embodiments can be
incorporated into any of the embodiments disclosed in those
co-pending applications.
[0100] In the implementation shown in FIGS. 14A and 14B, the device
310 is cylindrical and includes an imaging component 314, a
lighting component 316, magnets 318 at each end of the device, and
a wired connection component 320 (also referred to herein as a
"wire tether"). The magnets 318 are magnetically coupleable with
magnets 322 on the handle 312 such that the device 310 is urged
toward and held against the body cavity wall. In one embodiment,
the magnets 318 are configured to ensure that the imaging component
314 is positioned to capture a view of the body cavity or the
target area of interest.
[0101] It is understood that the magnets 318 in the device 310 and
those magnets 322 in the handle 312 can be positioned in any
configuration and include any number of magnets as disclosed in the
U.S. patent application Ser. Nos. 11/766,720 and 11/766,683,
incorporated herein.
[0102] It is further understood that, in one embodiment, the
magnetic handle 312, also referred to herein as an "external
magnet," is in the shape of a handle. Alternatively, the handle 312
is intended to encompass any magnetic component that is
magnetically coupleable with any robotic device as described herein
such that the magnetic component can be used to position, operate,
or control the device.
[0103] In one embodiment as described in the incorporated
references above, the handle 312 can be rotated as shown by arrow
342 to allow a tilting functionality for the imaging component.
Further, the device can also provide for a panning functionality
via rotation of the imaging component as shown by arrow 344, as
described in further detail below.
[0104] In use, the device 310 can be moved within the patient's
body to any desired position by moving the handle 312 outside the
body. Alternatively, the device 310 can be positioned, operated, or
controlled anywhere in a patient's body at least in part by the
magnetic handle 312 positioned outside the body in any fashion
described in the references incorporated above.
[0105] According to one implementation, the robotic device 310
shown in FIGS. 14A and 14B has two portions: an inner portion 330
and an outer portion 332, as best shown in FIG. 14B. The inner
portion 330, according to one embodiment, is a cylindrically shaped
inner body 330, and the outer portion 332 is an outer sleeve 332
configured to be rotatably disposed over the inner body 330. In
such an embodiment, the imaging component 314 and lens 315 can be
panned by rotating the inner body 330 with respect to the sleeve
332, causing the lens 315 to rotate in a fashion similar to that
depicted by the arrow 344. In accordance with one implementation,
the inner body 330 is coupled to the outer sleeve 332 with a set of
bearings (not shown).
[0106] In one implementation, the actuation component 334 that
rotates the inner portion 330 relative to the outer portion 332 is
a motorless actuation component. That is, the actuation component
is not a motor or a motorized component of any kind. For example,
the actuation component 334 as shown in FIGS. 14A and 14B includes
a race 336 and ball 338. In this embodiment, a magnet 340 external
to the patient is used to urge the ball 338 along the race 336. In
such an embodiment, the magnet 340 can be coupled with the magnetic
handle 312 described here as shown in FIG. 14A. In one embodiment,
the race 336 is helical and the ball 338 is steel. In a race and
ball implementation, as the ball 338 moves along the race channel
336, the inner body 330 rotates relative to the outer sleeve 332.
In another embodiment, the ball 338 is magnetic and moves along a
race 336.
[0107] FIG. 15 depicts an alternative embodiment of a motorless
actuation component in which the actuation component 352 has
multiple magnets 354 that are disposed in or on the robotic device
350. In this embodiment, the magnets 354 are placed in a helical
pattern in the inner cylinder (not shown) so that as the external
magnet 356 is translated, the inner body rotates relative to the
outer sleeve 358 as the inner body magnet 354 in closest proximity
to the external magnet 356 is urged toward the external magnet 356.
In another embodiment, a series of electromagnets in the handle 360
can be actuated in order to move the effective magnetic field along
the handle 360.
[0108] In yet another alternative embodiment, the ball can be urged
along the race by other means. For example, the device can have a
cable or wire connected to it and also connected to an external
handle. Actuation of this cable urges the ball along the race,
thereby resulting in a panning motion of the inner body relative to
the outer sleeve. In one embodiment, the cable is attached or
operably coupled in some fashion to the ball so that actuation of
the cable urges the ball along the race.
[0109] In a further alternative, the motorless actuation component
does not include a ball and race, but instead has a drum. In this
embodiment, a cable such as that described above is attached to the
drum so that actuation of the cable urges the drum to rotate. This
rotation of the drum causes rotational actuation in the medical
device. Alternatively, any known method of transitioning
translation motion into rotary motion could be used. Further, it is
understood that any known motorless actuation component can be
incorporated into any of the medical devices described herein or
incorporated by reference herein.
[0110] Various mechanical arm embodiments are provided herein that
can be incorporated into any number of different kinds of medical
devices. The medical device arm configurations disclosed herein
provide for various arm embodiments having two degrees of
freedom--both (1) axial movement (extension and retraction of a
portion of the arm along the longitudinal axis of the arm), and (2)
rotational movement around the axis of the arm. These
configurations provide for the two degrees of freedom while
maintaining a relatively small or compact structure in comparison
to prior art configurations.
[0111] It is understood that the arm embodiments disclosed herein
can be utilized in any type of medical device, including those
devices in which a compact or smaller size is desirable, such as
devices for procedures to be performed within a patient. For
example, the arm embodiments could be incorporated into various
robotic medical devices, including in vivo robotic devices such as
robotic devices positionable on or near an interior cavity wall of
a patient, mobile robotic devices, or robotic visualization and
control systems. An "in vivo device" as used herein is any device
that can be positioned, operated, or controlled at least in part by
a user while being positioned within a body cavity of a patient,
including any device that is positioned substantially against or
adjacent to a wall of a body cavity of a patient, and further
including any such device that is internally actuated (having no
external source of motive force). As used herein, the terms
"robot," and "robotic device" shall refer to any device that can
perform a task either in response to a command or automatically.
Further, the arm embodiments could be incorporated into various
robotic medical device systems that are actuated externally, such
as those available from Apollo Endosurgery, Inc., Hansen Medical,
Inc., Intuitive Surgical, Inc., and other similar systems.
[0112] According to one embodiment as depicted in FIG. 16, one arm
embodiment is incorporated into an in vivo medical device 402 as
shown. The device 402 has two robotic arms 404, 406 that can be
configured according to any embodiment described herein.
[0113] FIGS. 17a and 17b depict a device arm 410, according to one
embodiment. The arm 410 has two gears: (1) a distal gear 412 that
provides for extension and retraction of the arm 410, and (2) a
proximal gear 414 that provides for rotation of the arm 410.
[0114] The distal gear 412 has gear teeth 416 on its outer surface
and further is threaded on its inner surface (not shown). The gear
teeth 416 mate or couple with gear teeth 418 on a drive gear 420,
which is coupled to an actuator (not shown). In one embodiment, the
actuator is a Permanent Magnet Direct Current ("PMDC") motor. Thus,
the distal gear 412 is driven by the actuator.
[0115] The threading on the inner surface of the distal gear 412
mates or couples with the threading 413 on the outer surface of the
arm 410 such that when the distal gear 412 is driven by the
actuator, the gear 412 rotates and the coupling of the threads on
the inner surface of the gear 412 with the threads 413 on the arm
410 causes the arm 410 to extend or retract depending on which
direction the gear 412 turns.
[0116] The proximal gear 414 has gear teeth 422 on its outer
surface that mate or couple with gear teeth 424 on a drive gear
426, which is coupled to an actuator (not shown). The gear 414 also
has a pin 428 disposed within the gear 414 that extends through the
gear 414 and further through a slot 430 in the arm 410. Thus, when
the proximal gear 414 turns, the pin 428 causes the arm 410 to turn
as well.
[0117] The distal 412 and proximal 414 gears interface or interact
at the bearing surfaces. More specifically, the distal gear 412 has
a bearing surface 432 (best shown in FIG. 17b) having two bushings
434, 436 disposed or positioned on the outer surface of the bearing
surface 432. Similarly, the proximal gear 414 has a bearing surface
438 having two bushings 440, 442. The bearing surface 432 has a
smaller diameter than, and is disposed within, the bearing surface
438 such that the inner surface of bearing surface 438 is in
contact with the two bushings 434, 436. As such, the bearing
surfaces 432, 438 contact each other and rotate in relation to one
another at the two bushings 434, 436. Further, the two bushings
440, 442 disposed on the outer surface of the bearing surface 438
typically contact the external gear housing or other type of
housing (not shown).
[0118] In an alternative embodiment, gear pairs 418, 412 and 424,
422 as depicted in FIGS. 17A and 17B are replaced with round wheel
pairs in which each wheel is configured to be in contact with the
other wheel in the pair. In such an embodiment, each wheel has a
coating or other surface component that provides for sufficient
friction when the wheels are in contact to transmit rotational
energy between the two wheels. According to one embodiment, the
coating is a thin rubber coating. Alternatively, the coating or
surface can be any known coating or surface that provide sufficient
friction to allow transmission of rotational energy. This friction
drive system allows the gearing components to be reduced in size
because of the elimination of the gear teeth.
[0119] In a further embodiment, the gears can also be replaced with
a series of cables and drums that are used to actuate the arm. In
this pulley system embodiment, the actuator that drives the cables
can be located in another portion of the robot, while a series of
drums are disposed on the arms. The cabling connects the drums with
the actuator (such as a motor). This embodiment allows the
actuators, drums, and arm components to be configured in a variety
of different orientations while still providing sufficient
actuation forces and speed to the arm end effectors.
[0120] FIG. 18 depicts another device arm 450, according to an
alternative embodiment. The arm 450 has a distal gear 452 and a
proximal gear 454.
[0121] The distal gear 452 has gear teeth 456 and is threaded on
its inner surface (not shown). The gear teeth 456 mate or couple
with gear teeth 458 on a drive gear 460, which is coupled to an
actuator (not shown). As with the previous embodiment, the
threading on the inner surface of the distal gear 452 mates or
couples with the threading (453) on the outer surface of the arm
450 such that when the distal gear 452 is driven by the actuator,
the gear 452 rotates and the coupling of the threads on the inner
surface of the gear 452 with the threads 453 on the arm 450 causes
the arm 450 to extend or retract depending on which direction the
gear 452 turns.
[0122] Similarly, the proximal gear 454 has gear teeth 462 on its
outer surface that mate or couple with gear teeth 464 on a drive
gear 466, which is coupled to an actuator (not shown). The gear 454
also has a pin 468 disposed within the gear 454 that extends
through the gear 454 and further through a slot 470 in the arm 450.
Thus, when the proximal gear 454 turns, the pin 468 causes the arm
450 to turn as well.
[0123] The bearing surfaces in this embodiment depicted in FIG. 18
differ from those in the prior embodiment. That is, the distal gear
452 has a bearing surface 472 that is adjacent to and in contact
with a bearing surface 474 of the proximal gear 454. Thus, the
gears 452, 454 rotate in relation to each other at the bearing
surfaces 472, 474. In addition, the two bearing surfaces 472, 474
typically contact or are disposed within an external gear housing
476.
[0124] Although the present invention has been described with
reference to preferred embodiments, persons skilled in the art will
recognize that changes may be made in form and detail without
departing from the spirit and scope of the invention.
[0125] One end effector or operational component that can be used
with any of the procedural devices disclosed herein is a winch
system. Generally, the devices or systems discussed herein are
configured to be inserted into or positioned in a patient's body,
such as a body cavity, for example. Alternatively, the winch
systems and devices disclosed herein can be used with any medical
or procedural device.
[0126] One embodiment of a medical device having a winch component
is set forth in FIGS. 19A and 19B. The medical device 510 is an in
vivo robotic device 510 that can be positioned within a cavity of a
patient, and further has a magnetic handle 512 that can be disposed
at a location external to the patient. In this embodiment, the
handle 512 operates to hold the device 510 inside the abdominal
cavity against the peritoneum (abdominal wall) via magnetic forces.
Alternatively, any known method or component for holding the device
510 against the wall could be used. For example, in one embodiment,
the robot 510 could be held against the wall using hooks or clamps.
In a further alternative, the winch systems disclosed herein can be
used with any known medical devices, including--but not limited
to--in vivo devices with arms or wheels.
[0127] In the implementation depicted in FIGS. 19A and 19B, the
device 510 has a winch component 524 and a motor 530 to actuate the
winch 524. In this embodiment, the winch component 524 includes a
drum 526 and a winch tether 528. The drum 526 operates to wind and
unwind the winch tether 528.
[0128] In accordance with the depicted embodiment, the device 510
has magnets 520 that are magnetically coupleable with magnets 532
on the handle 512 such that the device 510 is urged toward and held
against the body cavity wall. The device 510, the handle 512, and
the magnets 520, 532 can be configured and/or operated in the same
fashion as described in U.S. application Ser. No. 11/766,720, filed
on Jun. 21, 2007 and entitled "Magnetically Coupleable Robotic
Devices and Related Methods," which is incorporated by reference
above. In one embodiment, it is understood that the magnets 520 are
configured not only to ensure that the imaging component 516 is
positioned to capture a view of the body cavity or the target area
of interest for securing the winch 524, but are also configured to
provide a magnetic coupling that is strong enough to maintain the
device 510 in a stable and substantially fixed position such that
the winch component 524 can be operated as desired and as described
herein.
[0129] According to the exemplary embodiment in FIGS. 19A and 19B,
the actuation component 530 is a motor 530 that provides force for
rotating the drum 526. In this embodiment, the motor 530 is a 6 mm
brushed motor that turns a planetary gear, which revolves around a
stationary sun gear, thereby causing the drum 526 to rotate inside
the body 514. Alternatively, a clutch (not shown) can be used to
provide both (1) panning motion of a camera 516 along the axis of
the body 514, and (2) winch actuation using a single motor. In a
further alternative, an exterior drive train can be used to actuate
the winch 524. It is understood that any known actuation component
that can be used with medical devices can be used with the winch
components or systems disclosed herein.
[0130] In one embodiment, the winch tether 528 is made from suture
material. In another embodiment, it is metallic cabling.
Alternatively, any known material for use in a medical winch tether
can be used.
[0131] In one embodiment, various operational components or end
effectors can be attached to the end of the winch tether. In one
embodiment, the end of the winch tether 528 is attached to a hook
536, as depicted in the embodiment of FIGS. 19A and 19B. Such a
hook is depicted in use in FIG. 20. Alternatively, the end effector
(also referred to as an "operational component") of the tether can
be a clamp or loop. In a further alternative, any known operational
component, including any known component for attaching to tissue,
can be used.
[0132] In another embodiment, the operational component can be a
magnet 540 that can be held against the wall with a second handle
542 as depicted in FIG. 21. In a further embodiment, the device
could have two winch components 550 with magnet operational
components 552 that attach to two points in vivo as depicted in
FIG. 22. Such a device could have two separate drums and motors, or
alternatively, a single motor and drum.
[0133] The winch components and systems can be used to accomplish a
variety of procedural tasks. In one embodiment, a device having a
winch component could be used to retract an organ, such as the
gallbladder, as depicted for example in FIG. 20. In another
embodiment, a device having a winch component and a magnet
operational component could be used as a sling to retract or move a
very large organ such as the liver as depicted in FIG. 21. In yet
another embodiment, the device is used as a "gantry crane" with two
winch tethers attached to the abdominal wall, as depicted in FIG.
22, or to other organs. In this embodiment, the device is guided
along the winch tethers to change the camera or illumination
location. In another embodiment, the device could be guided along
the winch tether, with a third winch hook (or grasper) below the
device as shown in FIG. 22. This would allow the robot to
reposition itself along the line of the first two tethers while the
third winch could be used to grasp a tissue of interest for
retraction or other manipulation. In yet another embodiment, the
guide tethers are not suspended but lying on the organs.
[0134] In yet another alternative embodiment, the winch component
can be any known configuration or be made up of any known
components for use in a winch. Further, while certain device
embodiments are described for exemplary purposes herein, it is
understood that a winch component can be incorporated into any
known robotic device for use inside a patient. For example, such a
component can be incorporated into any of the devices disclosed in
the applications that are incorporated herein elsewhere in this
application.
[0135] Various additional embodiments disclosed herein relate to
procedural devices with modular mechanical and electrical packages
that can be used together in various combinations to provide
capabilities such as obtaining multiple tissue samples, monitoring
physiological parameters, and wireless command, control and data
telemetry. This modular technology provides a flexible device into
which one or more of various different components or systems can be
integrated.
[0136] Current known minimally-invasive surgical technologies
require two to three ports to accommodate the laparoscopic tools to
explore the abdominal cavity and biopsy tissue of interest. The
various embodiments of the devices and modular components disclosed
herein require only one port for any medical procedure, thereby
reducing patient trauma (1 incision rather than 2 or 3).
[0137] FIG. 23A depicts one exemplary implementation of a modular
device having a payload area 566. The payload area 566 is
configured to receive any one of several modular components,
including such components as the sensor, controller, and biopsy
components discussed herein. It is understood that in addition to
the specific modular components disclosed herein, the payload areas
of the various embodiments could receive any known component to be
added to a medical procedural device.
[0138] The modular technology disclosed herein can be incorporated
into any type of medical procedural device and is not limited to
the robotic devices described in detail herein. Certain device
embodiments can be in vivo or robotic devices as defined herein,
including devices configured to be positioned within a body cavity
of a patient, including certain devices that can be positioned
against or substantially adjacent to an interior cavity wall, and
related systems. For example, FIG. 23B depicts a different device
embodiment having a payload area 566. Thus, while the robotic
device embodiments depicted in FIG. 23A is a mobile device having
wheels, the various modular components described herein could just
as readily be positioned or associated with a payload area in any
other kind of robotic device or in vivo device such as the device
depicted in FIG. 23B or can further be used in other medical
devices and applications that don't relate to robotic devices.
[0139] FIGS. 24A, 24B, and 24C depict a biopsy component 600
according to one embodiment that can be used with any robotic
device disclosed herein, including as shown for exemplary purposes
in FIG. 23A or FIG. 23B. The mechanism 600 has a biopsy grasper 632
that in this implementation has a piercing or lower jaw component
602 and an upper jaw component 630. The piercing component 602 and
jaw component 630 are structured like a pair of jaws, with the
piercing component 602 being configured to remain stationary during
the sampling process, providing a substantially rigid and stable
base against which the upper jaw component 630 can move in a
jaw-like fashion in relation to the piercing component 602 such
that the jaw component 630 can ultimately make contact with the
piercing component 602 and thereby cut the target tissue. Unlike
standard laparoscopic biopsy tools that are generally designed to
grasp tissue so that the surgeon can then tear the sample free,
this grasper is designed to completely sever the sample from the
tissue of interest without manual manipulation required by the
surgeon or user.
[0140] In this embodiment, the upper jaw component 630 is moved in
relation to the piercing component 602 via the collar 604. More
specifically, the collar 604 is movably disposed over the piercing
component 602 such that it can move back and forth in the direction
indicated by arrow A. A proximal portion of the upper jaw component
630 is disposed between the piercing component 602 and the collar
604 and is configured to be positioned such that the distal end of
the upper jaw 630 is not in contact with the piercing component 602
and remains in that position when no force is applied to the jaw
630. Thus, when the collar 604 is urged toward the distal end of
the piercing component 602, the distal end of the upper jaw
component 630 is urged toward the piercing component 602 such that
the component 630 is capable of incising or cutting any tissue
disposed between the upper jaw 630 and the piercing component 602
as the upper jaw 630 makes contact with the component 602. And when
the collar 604 is urged away from the distal end of the piercing
component 602, the distal end of the upper jaw 630 moves away from
the piercing component 602 and toward its unrestrained position.
Alternatively, it is understood that any known component that can
operate in the same fashion as the collar to urge the upper jaw 630
into contact with the piercing component 602 can be incorporated
herein.
[0141] The collar 604 is urged back and forth by the motor 624. It
is understood that this embodiment is intended to encompass any
actuation structure that urges the collar 634 to move back and
forth such that the upper jaw component 630 is urged to move in
relation to the piercing component 602 and thereby cut target
tissue.
[0142] In this particular embodiment as shown in FIG. 24A, the
grasper 632 is powered by the motor 624. Motor 624 is coupled to a
nut 618 that is driven by the motor 624 along the axis of a lead
screw 616 parallel to arrow B. The nut 618 is coupled to a slider
608 via a linkage 610 that is pivotally coupled to the nut at pin
620 and to the slider 618 at pin 628. The nut 618, linkage 610, and
slider 608 convert the actuation direction from the direction of
arrow B to the direction of arrow A and, according to one
embodiment, increase the amount of force applied by the motor 624
to the slider 608.
[0143] The slider 608 is coupled to the collar 604 at two flexible
components 606A, 606B, which can be shape-memory components 606A,
606B according to one embodiment. In one example, the flexible
components 606A, 606B are comprised of nitinol. Further, the
piercing component 602 is coupled to the housing 622 via a flexible
component 626. According to one embodiment, the flexible component
626 is a shape-memory component 626 such as nitinol. These flexible
components 606A, 606B, and 626 allow for the grasper 632 to be
repositioned in relation to the rest of the robotic device to which
it is coupled, as will be discussed in further detail below.
[0144] Alternatively, the actuation component and the connection of
the actuation component to the collar 634 can be any known
structure or component or combination thereof that provides motive
force to actuate the grasper 632.
[0145] In one alternative implementation, the piercing component
602 has an internal reservoir (not shown) for storing one or more
acquired samples. Unlike most standard laparoscopic biopsy tools
that include space for only a single sample, this reservoir can be
generally large enough or long enough (or otherwise has sufficient
volume) to house multiple samples during a biopsy procedure.
[0146] In use, the biopsy component 600 is positioned next to the
target tissue using a method such as the mobile robot wheel, or
articulating robot arm. Next, the biopsy component 600 operates in
the following manner to obtain a tissue sample. The motor 624
actuates the collar 604 to move toward the distal end of the
piercing component 602 and thus actuates the upper jaw 630 to close
and contact the piercing component 602. The tissue is cut as the
upper jaw 630 is actuated towards the piercing component 602 in a
slicing motion. In one embodiment the tissue sample is then stored
in the piercing component 602 while additional samples are
taken.
[0147] It is understood that the device containing the biopsy
component 600 may also have other actuable components such as
wheels, arms, etc. FIG. 24A further depicts a motor 614 disposed
within a second housing 612 that is configured to actuate one or
more additional actuable components of the device. In one example,
the motor 614 can actuate a wheel (not shown) operably coupled with
the device. In another example, this motor 614 actuates an arm (not
shown) connected to the device.
[0148] In one aspect, the biopsy component 600 can also be
configured to make it easier for the medical device to be inserted
through incisions, transported, and stored. FIG. 24B depicts the
grasper 632 of the biopsy component 600 positioned at a ninety
degree angle in relation to its position in FIG. 24A. This
re-positioning of the grasper 632 is accomplished due to the
flexibility of the flexible components 606A, 606B, 626 as discussed
above. According to one embodiment, this second position of the
grasper 632 allows for easier insertion and retraction of the
device to which the grasper is coupled. That is, the second
position of the grasper 632 allows for the entire device to fit
more easily through an incision, a port, or any other opening or
device for use in medical procedures. In its operating position as
depicted in FIG. 24A, the grasper 632 is positioned perpendicularly
to the body of the robotic device to which it is coupled. The
overall length of the robot body and grasper 632 is greater than
the diameter of most laparoscopic trocars. Thus, to allow the
robot/grasper 632 to be inserted through a trocar, the grasper 632
can be moved into a position that is parallel to the length of the
robotic device using the support mechanism provided by the three
flexible components 606A, 606B, 626 that provide both rigidity and
the ability to flex the arm 640 degrees during insertion and
retraction through a trocar or through any type of orifice,
incision, or tool as necessary. This support mechanism provides the
rigidity and forces required during biopsy sampling, with the
flexibility required for insertion and retraction before and after
the biopsy occurs.
[0149] Alternatively, a variety of alternative support mechanisms
using this concept can be envisioned.
[0150] FIG. 25A depicts an alternative embodiment of a biopsy
component 640 that can be used with any robotic device disclosed
herein. The component 640 has actuation components similar to those
in the embodiment depicted in FIGS. 24A, 24B, and 24C, including a
nut 646 driven along the axis of a lead screw 648 in the direction
indicated by arrow B by a motor 644. The nut 646 is attached to a
slider 656 via a linkage 650 that is coupled to the nut 646 at pin
652 and to the slider 656 at pin 650.
[0151] In this embodiment, the slider 656 performs generally the
same function as the collar described in FIG. 24. That is, the
slider 656 can move in the direction indicated by arrow A in
relation to the piercing component 658. Thus, similarly to the
collar as described above, as the slider 656 moves over the upper
jaw 664, the upper jaw 664 is closed relative to the lower piercing
jaw 658.
[0152] FIG. 26 depicts an alternative embodiment of the biopsy
component 660 that can be used with any robotic device disclosed
herein. The component 660 has actuation components similar to those
in the embodiment depicted in FIGS. 24A, 24B, and 24C. In this
embodiment the collar 662 is urged in the direction A. As the
collar 662 moves forward it pushes the top jaw 664 downwards toward
the bottom jaw 666 in direction B. The collar is held in place by
the housing 672 in the same manner as described for FIGS. 24.
[0153] Unlike other laparoscopic biopsy forceps in which both jaws
are hinged about a pivot point, only one jaw, the top jaw 664, of
the robotic grasper moves during sampling. The lower half of the
grasper, bottom jaw 666, remains stationary and provides a rigid
and stable base against which the top jaw 664 can cut. The fixed
bottom jaw 666 is constructed from a hypodermic medical stainless
steel tube and it forms a reservoir for storing multiple
samples.
[0154] In one embodiment the profile of the top jaw 664 is
constructed out of a super-elastic shape-memory nickel titanium
alloy (Nitinol) ribbon (Memry Corporation) 0.25 mm thick and 3 mm
wide. It is profiled such that the grasper is normally open. A wide
variety of profiles can be achieved by heat-treating the ribbon for
approximately 10 min at 500.degree. C., followed by quenching in
water. The Nitinol ribbon is glued to a fixed nylon rod insert that
fits inside the bottom jaw 666.
[0155] The blades of the grasper are titanium nitrate coated
stainless steel approximately 1.5 mm long. Small plastic inserts
are fixed to the top and bottom jaws, and the blades 668 and 670
are glued to these inserts. The round blade 670 fixed to the bottom
jaw has a diameter of 3 mm. The top blade 668 has a semi-circular
profile with a diameter of 3.8 mm and overlaps the bottom blade
when the jaw is closed. The sample is held within the bottom blade
as the trailing edges of the top blade help sever the sample from
the tissue.
[0156] FIG. 27 depicts an alternative embodiment of the biopsy
component 680 that can be used with any robotic device disclosed
herein to staple or clamp tissue. The component 680 has actuation
components similar to those in the embodiment depicted in FIGS.
24A, 24B, and 24C. In this embodiment the collar 682 is urged in
the direction A. As the collar 682 moves forward it pushes the top
jaw 684 downwards toward the bottom jaw 686 in direction B. As the
top jaw 684 is pressed downwards against the bottom jaw 686, a
small surgical staple 688 can be compressed to staple tissue of
interest or to clamp an artery or other vessel.
[0157] This stapling arm 680 was designed to hold and close a
common laparoscopic surgical staple. In addition to stapling, this
end effector can also be used for applications requiring clamping
and holding, such as applying pressure to a bleeding blood vessel
or manipulating other tissues of interest.
[0158] FIGS. 28A and 28B depict a further embodiment of a biopsy
mechanism 690, according to one implementation. These two figures
provide a detailed depiction of the opening and closing of grasper
jaws 694, 696 according to one embodiment. More specifically, FIG.
28A depicts the mechanism 690 with the grasper jaws 694, 696 in
their open configuration. In this configuration, the upper jaw 694
is in a position in which the distal end is not in contact with the
distal end of the lower jaw 696.
[0159] FIG. 28B depicts the mechanism 690 with the grasper jaws
694, 696 in their closed configuration. That is, the collar 698 has
moved from its retracted position in FIG. 28A to its extended
position in FIG. 28B such that it has urged the upper jaw 694 down
toward the lower jaw 696 such that the jaws 694, 696 ultimately
reach the closed configuration.
[0160] According to one embodiment, an imaging component in any
medical device disclosed or incorporated herein having an imaging
component can have an adjustable focus mechanism incorporated into
or used with the imaging component. One exemplary implementation of
such an adjustable focus mechanism 702 is depicted in FIGS. 29A,
29B, 29C, 29D, and 29E. As best shown in FIG. 29E, the mechanism
702 includes a lens subassembly 704 and two magnetic subassemblies
706. The lens subassembly 704 comprises a lens 710, two coils of
wire 712 (as best shown in FIGS. 29B, 29D, and 29E), and a lens
holding component 714 (as best shown in FIGS. 29A, 29D, and 29E) to
hold the lenses 710 and coils 712 together in one subassembly. As
best shown in FIGS. 29D and 29E, each magnetic subassembly 706
includes a small magnet 716 attached to one side of a U-channel 722
made from ferrous metal. The lens subassembly 704 is positioned
between the two magnetic subassemblies 706. The coils 712 pass over
the U-channels 722 and are positioned in the magnetic field that is
generated between the small magnet 716 and the open side of the
U-channel 722 where the coil 712 sits. As current is passed through
the coiled wire 712 that is positioned in the magnetic field, an
electromagnetic force is created that is parallel to the axis of
the lens 710 and imager 718. This electromagnetic force is created
by the magnetic field being perpendicular to the direction of the
current.
[0161] In one embodiment, the small magnets 716 are Neodymium
Magnets manufactured by K and J Magnetics of Jamison, Pa., the
coils 712 are manufactured by Precision Econowind of North Fort
Myers, Fla., and the lens 710 is manufactured by Sunex of Carlsbad,
Calif. In this embodiment the magnets have a pull force of 2.17 lbs
and a surface field of 2505 Gauss, while the coils are made of 120
turns of 36 AWG coated copper wire with a DSL758 lens.
Alternatively, the above components can be any commercially
available components.
[0162] According to one implementation, the lens holding component
714 is manufactured of polycarbonate plastic to minimize weight. In
the embodiment shown in FIGS. 29D and 29E, the magnets 716 are
1/16''.times.1/8''.times.1/4'' and the lens subassembly has a
vertical stroke of 1 mm.
[0163] In one embodiment, a restoring force is provided that urges
the lens 710 back to it resting position when the current from the
coiled wire 712 is removed. This allows for consistent lens
subassembly travel and can be used to maintain the lens in an
optimum middle range of focus. According to one implementation, the
restoring force component 720 as best shown in FIGS. 29A and 29B is
a foam component 720. Alternatively, any known component for
providing a restoring force can be used.
[0164] In accordance with one embodiment, the adjustable focus
mechanism 702 is coupled with an auto focus algorithm to
automatically command the mechanism 702 to focus the lens to a
commanded depth. In a further embodiment, additional lens
subassemblies 704 and magnetic subassemblies 706 can be combined to
provide additional points of depth adjustment around the lens.
These additional adjustment points allow a higher range of
orientation angles of the lens to correct for any imperfections in
manufacturing assembly. In this embodiment, the coils can be
commanded separately to tilt the lens to correct for manufacturing
error.
EXAMPLE
[0165] In this example, different biopsy grasper profiles and
lengths were examined, including the effects of those profiles and
lengths on the forces required to actuate the biopsy mechanism and
further the maximum forces that could actually be applied by the
mechanism.
[0166] FIGS. 30A and 30B depict a test jig 730 having a biopsy
mechanism according to one embodiment. The test jig 730 as shown
included a load cell 748 that was used to measure the tensile force
in the nylon supporting rod when the collar 738 was actuated.
Further, the biopsy mechanism of the jig 730 had a motor 732,
linkage 736, lead nut 734, collar 738, lower jaw 746 and upper jaw
744.
[0167] Various grasper embodiments with a wide range of jaw
lengths, opening angles, and jaw profiles were tested for actuation
forces. Required actuation forces were determined by using the
motor 732 and lead screw linkage 736 to slide the grasper collar
738 over the upper jaw 744 until closed. For each actuation, the
required force was recorded starting with the upper jaw 744
completely open and continuing until the upper jaw 744 was closed.
Maximum actuation forces were determined by recording the forces
applied with the collar 738 held fixed at various positions
corresponding to different times during actuation process. Each
complete test consisted of 50 actuations of the biopsy grasper.
Load cell data were recorded during each actuation at a rate of 20
Hz.
[0168] FIG. 31 depicts the mean results from a required force test
for a grasper that is approximately 12 mm long, has an opening
angle of 25.degree. and has a cutting tip with a length of 4 mm
profiled with a closing angle of approximately 40.degree.. The
error bars indicate the standard deviation in the measured forces
at intervals of approximately 1.8 seconds. The maximum required
actuation force of 2.83 N is at the very start of the motion of the
collar due to the need to overcome static friction and to begin
flexing the top jaw of the grasper. The force decreases with time
as the contact point between the collar and the top jaw moves
farther away from the anchor point. The test results indicate that
approximately a maximum of 3 N of force is required to close the
biopsy grasper.
* * * * *