Flexible instrument

• US 20020095175A1
• Filed: 11/16/2001
• Published: 07/18/2002
• Est. Priority Date: 02/24/1998
• Status: Abandoned Application

• Current Assignee: endoVia Medical, Inc. (Johnson & Johnson)
• Original Assignee: endoVia Medical, Inc. (Johnson & Johnson)
• Inventors: Rogers, Gary, Brock, David L., Weitzner, Barry, Lee, Woojin
• Application Number:
  US10/023,024
• Publication Number:
  US 20020095175A1
• Time in Patent Office: Days
• US Class Current: 606/205
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00088 using thermistors
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/00986 Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0645 : being elastically deformed for insertion
• CPC Class Codes: A61B 2017/0648 : threaded, e.g. tacks with a screw thread
• CPC Class Codes: A61B 2017/22069 : Immobilising; Stabilising
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2939 : Details of linkages or pivot points
• CPC Class Codes: A61B 2034/2051 : Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2059 : Mechanical position encoders
• CPC Class Codes: A61B 2034/301 : for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2034/305 : Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2034/715 : Cable tensioning mechanisms for removing slack
• CPC Class Codes: A61B 2034/742 : Joysticks
• CPC Class Codes: A61B 2034/744 : Mouse
• CPC Class Codes: A61B 2090/365 : augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/506 : using a parallelogram linkage, e.g. panthograph
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/35 : for telesurgery
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/72 : Micromanipulators
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/015 : By temperature mapping of body part
• CPC Class Codes: A61B 5/4893 : Nerves
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 2/2445 : Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2466 : Delivery devices therefor
• CPC Class Codes: B25J 3/04 : involving servo mechanisms servo-actuated heads B25J15/02
• CPC Class Codes: B25J 9/104 : with cables, chains or ribbons

Abstract

A remote control flexible instrument system, employing a shaft which supports a tool, is described in which the has proximal and distal ends with at least a portion thereof extending through a lumen of the human body so as to locate the shaft at an internal target site. A master station including an input device provides control of the instrument situated at a slave station. The master station can control at least one degree-of-freedom of the flexible instrument. A controller intercouples the master and slave stations and is operated in accordance with a computer algorithm that receives a command from the input device for controlling at least one degree-of-freedom of the catheter so as to respond in accordance with action at the input device. The flexible instrument further comprises a controlled flexible segment along the shaft, for controlled bending at the flexible segment to guide the shaft and to dispose the tool at an operative site.

Claims

1. A surgical instrument comprising:

a shaft having at least one controllably flexible segment and a tool mounted at a distal end of the shaft, the tool being insertable into a subject;

a shaft mount drivably coupled to the shaft at a proximal end of the shaft, the shaft mount being drivably coupled to the tool through the shaft; and

a drive unit drivably coupled to the shaft mount, the drive unit being operable from a location remote from the subject to control flexure of the flexible segment so as to control disposition of the tool at an operative site.

2. The instrument of claim 1, wherein the shaft, the shaft mount, and the tool are constructed and arranged as a single piece disposable unit.

3. The instrument of claim 1, further comprising a receiver intercoupled with the drive unit, the shaft mount being readily mountable on the receiver for drivable intercoupling of the shaft mount with the drive unit.

4. The instrument of claim 3, wherein the drive unit is engageable with and disengageable from the receiver, the drive unit being portable.

5. The instrument of claim 1, wherein the shaft mount and the receiver are engagable with and disengagable from each other.

6. The instrument of claim 1, wherein the shaft, the shaft mount, and the tool are constructed and arranged as a single piece portable unit.

7. The instrument of claim 1, including a cabling pathway extending from the drive unit to the flexible segment, for actuation of controlled bending at the flexible segment by the drive unit.

8. The instrument of claim 1, including a cabling pathway extending from the drive unit to the tool, for actuation of the tool by the drive unit.

9. The instrument of claim 8, wherein the shaft supports the tool via a wrist, the wrist being pivotable.

10. The instrument of claim 1, wherein the flexible segment comprises a series of slots defining spaced ribs.

11. The instrument of claim 1, further comprising a receiver for engaging the shaft mount, the receiver supported by a carriage slideably engaging rails controlled to translate the shaft toward and away from the operative site.

12. The instrument of claim 1, wherein the shaft is an inner shaft, the instrument further comprising a guide shaft for coaxially receiving the inner shaft, the guide shaft capable of disposing the tool at the operative site.

13. The instrument of claim 12, wherein the guide shaft also has at least one flexible segment, the bending of which is remotely controllable.

14. The instrument of claim 1, wherein the shaft is remote controllably drivable by a user via a manually controllable input device remote from the subject.

16. The instrument of claim 15, further comprising a plurality of motors coupled to the controller and drivably coupled to the shaft, for controlling at least one degree of freedom of the flexible segment.

17. The instrument of claim 15, further comprising cables extending between the proximal and distal ends of the shaft.

18. The instrument of claim 17, wherein the electronic signal link activates the cables to effect flexure of the shaft at the flexible segment.

19. The instrument of claim 15, wherein the shaft is an inner shaft, the instrument further comprising an outer shaft.

20. The instrument of claim 15, wherein said master station includes a user interface manipulated by a user, and the electronic signal link is provided by a computer system responsive to the user interface manipulations, and the slave station further comprises a drive unit coupled from the computer system to the shaft for controlling actuation of the shaft.

15. A remotely controllable surgical instrument, comprising:

a user input device, for inputting a command;

a slave station for receiving the command from the input device, the user input device being remotely disposed from the slave station, the slave station further comprising a mechanically drivable mechanism comprising a shaft having a proximal end, a distal end supporting a tool and a flexible portion between the proximal and distal ends; and

an electronic signal link between the user input device and the slave station, the command from the input device being communicated via the link for controlling bending of the flexible portion so as to controllably position the tool at an operative site of a subject.

21. A remotely controllable catheter comprising:

a tube having a proximal end and a distal end, at least a segment of the tube being controllably flexible;

a drivable bending mechanism mechanically coupled to and interactive with the controllably flexible segment of the tube; and

a computer remote from and interconnected to the bending mechanism, the computer having a program receiving input from a user, and the program directing the bending mechanism to controllably flex the flexible segment of the tube according to the user input.

22. The catheter of claim 21, wherein:

the bending mechanism comprises a cable extending from the flexible segment and a motor mechanism;

the motor mechanism is interconnected to the computer; and

the cable being driven by the motor mechanism to direct bending of the flexible portion according to the user input.

23. The catheter of claim 21, further comprising a user input device interconnected to the computer, the user input device being remotely mounted relative to the tube and adapted to receive the user input, the program processing the commands capable of directing movement of the bending mechanism according to the user input.

25. The catheter of claim 24, wherein the flexible segment comprises a deformable material, at least one of the cables exerting a pulling or pushing force on the flexible portion of the shaft to effect controlled deformational bending of the flexible portion of the shaft.

26. The catheter of claim 24, wherein the shaft is an inner shaft and the catheter further comprises an outer shaft, the inner shaft being coaxially insertable into the outer shaft.

27. The catheter of claim 24, wherein the flexible segment comprises a coiled section.

28. The catheter of claim 26, wherein the at least one cable associated with the flexible segment is operable to bend the shaft at the flexible segment.

29. The catheter of claim 28, wherein the at least one cable is secured to an outer surface of the shaft between the flexible segment and the distal-most point of the shaft.

30. The catheter of claim 29, wherein the at least one cable extends along the shaft from the secured point to the proximal end.

31. The catheter of claim 28, wherein the at least one cable extends between the inner and outer shafts along the proximal shaft section.

32. The catheter of claim 28, wherein the proximal end of the shaft extends to a mechanically drivable mechanism comprising a first control element for controlling the at least one cable to bend the distal end of the shaft at the flexible segment.

33. The catheter of claim 32, further comprising a second control element that controls rotation of the outer shaft about the co-axis.

34. The catheter of claim 33, further comprising a third control element that controls rotation of the inner shaft about the co-axis.

35. The catheter of claim 34, further comprising a fourth control element associated with an actuating link to control rotation of the tool.

36. The catheter of claim 32, wherein the mechanically drivable mechanism, the shaft and the tool are constructed as a single piece unit that is disposable.

37. The catheter of claim 32, wherein the mechanically drivable mechanism engages a receiver which is supported by a carriage, the carriage slideably engaging rails to translate the catheter to and from the subject.

38. The catheter of claim 24, further comprising a user interface, wherein the electronic control mechanism couples the user interface to a drive unit remote from the body cavity or vessel, the drive unit capable of mechanically driving the at least two cables.

39. The catheter of claim 38, wherein manipulations at the user interface control operation of the tool.

40. The catheter of claim 39, wherein the tool comprises a pair of jaws and the user interface manipulations control the opening and closing of the jaws.

24. A catheter, comprising:

a shaft having proximal and distal ends and at least one flexible segment along a length of the shaft, the distal end being insertable within a body cavity or vessel;

a tool supported at the distal end of the shaft for performing a medical procedure;

at least two cables extending along the shaft between the proximal and distal ends, at least one of the cables associated with the flexible segment of the shaft and at least another of the cables associated with the tool;

an electronic control mechanism drivably coupled to the cables, the electronic control mechanism capable of communicating drive signals from a user input device to the cables to effect bending of the flexible segment and operation of the tool.