Surgical instrument

• US 20020128633A1
• Filed: 11/17/2001
• Published: 09/12/2002
• Est. Priority Date: 02/24/1998
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Brock, David L., Lee, Woojin
• Granted Patent: US 7,169,141 B2
• Time in Patent Office: Days
• US Class Current: 606/1
• 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 robotic surgery apparatus comprising: a surgical instrument for use at an internal operative site of a subject; a mechanically drivable mounting unit on which the surgical instrument is mounted, the mounting unit being drivably movable outside the operative site of the subject; an electrically driven drive unit for driving movement of the mounting unit; mechanical cabling drivably intercoupled to the mounting unit at one end of the cabling; the mechanical cabling having another end which is readily drivably couplable to and decouplable from the drive unit. The drive unit being readily manually portable and readily attachable to and detachable from a fixed support on or relative to which the subject is mounted.

Claims

1. A medical procedure instrument comprising:

a medical implement including a mechanically drivable mechanism intercoupled with a tool used in executing a medical procedure;

a drive unit, disposed remote from said medical implement, for mechanically driving said medical implement;

said medical implement being decouplable from said drive unit and manually insertable into a patient so as to dispose said tool at an operative site within the patient;

and said medical implement being attachable and detachable with said drive unit for coupling and decoupling said drive unit to said mechanically drivable mechanism.

2. The medical procedure instrument of claim 1 wherein said medical implement comprises a holder and an instrument insert, said holder receiving said instrument insert and said instrument insert carrying said mechanically drivable mechanism.

3. The medical procedure instrument of claim 2 wherein said instrument insert includes a stem section with said tool at its distal end.

4. The medical procedure instrument of claim 3 wherein said mechanically drivable mechanism, stem section and tool is an integral disposable unit.

5. The medical procedure instrument of claim 4 wherein said mechanically drivable mechanism comprises mechanical cabling.

6. The medical procedure instrument of claim 1 wherein said drive unit comprises an electromechanical unit.

7. The medical procedure instrument of claim 1 including mechanical cabling that intercouples the drive unit and the mechanically drivable mechanism.

8. The medical procedure instrument of claim 7 including an interface between said mechanical cabling and said drive unit to couple and decouple said mechanical cabling with said drive unit.

9. The medical procedure instrument of claim 7 wherein said medical implement has a holder receiving an instrument insert that carries at its distal end said tool.

10. The medical procedure instrument of claim 9 wherein said mechanical cabling includes first cabling coupled to said holder for controlling motion thereof, and second cabling coupled to said instrument insert for controlling motion thereof.

11. The medical procedure instrument of claim 1 wherein said medical implement has a holder for receiving an instrument insert that carries said tool at its distal end.

12. The medical procedure instrument of claim 11 wherein said drive unit is drivably interconnected to said holder.

13. The medical procedure instrument of claim 11 wherein the holder includes a first drive interface drivably interconnected to the drive unit and the mechanically drivable mechanism includes a second drive interface, the first and second drive interfaces being engageable with and disengageable from each other.

14. The medical procedure instrument of claim 11 wherein said holder has a distal end adapted, upon insertion into the patient to be positioned at the operative site.

15. The medical procedure instrument of claim 14 wherein said holder has its distal end maintained at the operative site even upon withdrawal of said instrument insert away from the operative site.

16. The medical procedure instrument of claim 1 wherein an adjacent portion of said mechanically drivable mechanism and said tool is an integral disposable unit.

17. The medical procedure instrument of claim 1 wherein said medical implement is remotely controllably drivable by a user via a manually controllable device.

18. The medical procedure instrument of claim 17 wherein said manually controllable device is electrically interconnected to the drive unit through an electrical drive control element.

20. A slave station as claimed in claim 19 including an attachable and detachable two-section housing, one housing section accommodating the ends of said mechanical cabling, and another housing section accommodating said plurality of motors.

21. A slave station as claimed in claim 20 including a plurality of coupler spindles supported by said one housing section, each coupler spindle receiving a cable of the mechanical cabling.

22. A slave station as claimed in claim 21 wherein said plurality of motors and said plurality of coupler spindles aligned arrays.

23. A slave station as claimed in claim 22 including a plurality of coupler disks, one associated with and supported by each motor of the plurality of motors.

24. A slave station as claimed in claim 23 wherein the housing sections support the coupler spindles and the coupler disks in aligned engagement.

25. A slave station as claimed in claim 24 including a securing member holding the housing sections together and the coupler spindles and disks in engagement.

26. A slave station as claimed in claim 25 wherein the coupler spindles are of different diameters.

27. A slave station as claimed in claim 26 wherein the diameters of the coupler spindles progressively increase from one end of the array to the other.

28. A slave station as claimed in claim 25 wherein said securing member comprises a pair of screws holding the housing sections together.

29. A slave station as claimed in claim 23 wherein the coupler spindles and coupler disks each have an engagement element to lock the coupler spindles and disks against relative rotation.

30. A slave station as claimed in claim 29 including a conduit stop at one end of the coupler spindles array for receiving in slots thereof cables of said mechanical cabling.

31. A slave station as claimed in claim 30 wherein one of said cables wraps about and is fixed onto each coupler spindle.

32. A slave station as claimed in claim 31 wherein the engagement element includes a spring-biased pin and hole.

19. A slave station of a robotic surgery system in which manipulations by a surgeon control motion of a surgical instrument at the slave station, said slave station comprising:

a manually portable support for holding the surgical instrument at a position over an operating table so that the instrument may be disposed at an operative site;

mechanical cabling coupled to said instrument for controlling movement of said surgical instrument;

a plurality of motors controlled, by way of a computer interface, and by surgeon manipulations for driving said mechanical cabling; and

said mechanical cabling being driven by said plurality of motors in a manner to be attachable to and detachable therefrom.

33. A robotic surgery system comprising:

a mechanically driven surgical instrument;

a manually portable support for holding the instrument at a position over an operating table so that the instrument may be disposed at an operative site in a patient for remote control thereof via a computer interface;

mechanical cabling drivably coupled to said instrument for controlling movement or operation of said instrument;

an array of electrically driven actuators controlled by way of the computer interface for driving said mechanical cabling; and

an engagement member coupling the mechanical cabling to the array of actuators so that the mechanical cabling is attachable and detachable from the array of actuators.

35. The apparatus of claim 34 wherein the drive unit is manually portable and readily attachable to and detachable from a fixed support on or relative to which the subject is mounted.

36. The apparatus of claim 34 wherein the drive unit is disposed at a location remote from the operative site of the subject.

37. The apparatus of claim 36 wherein the drive unit is remotely controlled by a computer.

38. The apparatus of claim 34 wherein the surgical instrument includes one or more mechanically drivable components which are driven by the mechanical cabling.

40. The apparatus of claim 39 wherein the drive unit is manually portable and readily attachable to and detachable from a fixed support on or relative to which the subject is mounted.

41. The apparatus of claim 39 wherein the drive unit is disposed at a location remote from the operative site of the subject.

42. The apparatus of claim 41 wherein the drive unit is remotely controlled by a computer.

34. A robotic surgery apparatus comprising:

a mechanically drivable surgical instrument for use at an internal operative site of a subject;

an electrically driven drive unit for driving the surgical instrument;

mechanical cabling drivably intercoupled to the surgical instrument at one end of the cabling;

the mechanical cabling having another end which is readily drivably couplable to and decouplable from the drive unit.

39. A robotic surgery apparatus comprising:

a surgical instrument for use at an internal operative site of a subject;

a mechanically drivable mounting unit on which the surgical instrument is mounted, the mounting unit being drivably movable outside the operative site of the subject;

an electrically driven drive unit for driving movement of the mounting unit;

mechanical cabling drivably intercoupled to the mounting unit at one end of the cabling;

the mechanical cabling having another end which is readily drivably couplable to and decouplable from the drive unit.

43. A robotic surgery apparatus comprising:

a mechanically drivable surgical instrument for use at an internal operative site of a subject;

an electrically driven drive unit for driving the surgical instrument;

mechanical cabling drivably intercoupled to the surgical instrument at one end of the cabling;

the drive unit being readily manually portable and readily attachable to and detachable from a fixed support on or relative to which the subject is mounted.

44. The apparatus of claim 43 wherein the drive unit is disposed at a location remote from the operative site of the subject.

45. The apparatus of claim 43 wherein the drive unit is remotely controlled by a computer.