Robotic surgical tool with ultrasound cauterizing and cutting instrument

• US 20020177843A1
• Filed: 04/18/2002
• Published: 11/28/2002
• Est. Priority Date: 04/19/2001
• Status: Active Grant

• Current Assignee: Kranos IP II Corporation (Kranos Intermediate Holding Corporation)
• Original Assignee: Intuitive Surgical Incorporated (Intuitive Surgical Holdings, LLC)
• Inventors: Julian, Christopher A., Anderson, Stephen C.
• Granted Patent: US 6,783,524 B2
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 17/320092 with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/320071 with articulating means for working tip
• CPC Class Codes: A61B 2017/320093 additional movable means performing cutting operation
• CPC Class Codes: A61B 2017/320094 additional movable means performing clamping operation
• CPC Class Codes: A61B 2017/320095 with sealing or cauterizing means
• CPC Class Codes: A61B 2034/305 Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 34/30 Surgical robots
• 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 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 8/4405 Device being mounted on a trolley
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras

Abstract

A surgical instrument for enhancing robotic surgery generally includes an elongate shaft with an ultrasound probe, an end effector at the distal end of the shaft, and a base at the proximal end of the shaft. The end effector includes an ultrasound probe tip and the surgical instrument is generally configured for convenient positioning of the probe tip within a surgical site by a robotic surgical system. Ultrasound energy delivered by the probe tip may be used to cut, cauterize, or achieve various other desired effects on tissue at a surgical site. In various embodiments, the end effector also includes a gripper, for gripping tissue in cooperation with the ultrasound probe tip. The base is generally configured to removably couple the surgical instrument to a robotic surgical system and to transmit forces from the surgical system to the end effector, through the elongate shaft. A method for enhancing robotic surgery generally includes coupling the surgical instrument to a robotic surgical system, positioning the probe tip in contact with tissue at a surgical site, and delivering ultrasound energy to the tissue.

Claims

1. A method of performing a robotic surgical procedure on a patient, the method comprising:

coupling a surgical instrument with a robotic surgical system, the surgical instrument having a distal end having an ultrasound probe tip;

positioning, with the robotic surgical system, the ultrasound probe tip in contact with tissue at a surgical site in the patient; and

delivering ultrasound energy to the tissue with the ultrasound probe tip.

2. A method as in claim 1, wherein the distal end of the surgical instrument further includes a gripping member, the method further comprising:

transmitting at least one force from the robotic surgical system to the gripping member; and

moving the gripping member with the at least one force to hold a portion of the tissue between the gripping member and the ultrasound probe tip.

3. A method as in claim 2, wherein the transmitting and moving steps further comprise transmitting the at least one force from an interface member on the robotic surgical system to a first rotatable shaft on the surgical instrument, the first rotatable shaft being coupled to a second rotatable shaft by a cable, the cable being coupled to an actuator rod, and the actuator rod being coupled to the gripping member, wherein the at least one force causes the first shaft, the second shaft and the cable to rotate, causing the actuator rod to move the gripping member.

4. A method as in claim 2, further comprising releasing the portion of tissue after delivering a desired amount of ultrasound energy to the portion of tissue.

5. A method as in claim 1, further comprising using the ultrasound probe tip to cut the tissue, cauterize the tissue, or both.

6. A surgical instrument for use with a robotic surgical system, the surgical instrument comprising

an elongate shaft having a proximal end and a distal end, the elongate shaft including an ultrasound probe;

an end effector disposed at the distal end, the end effector including an ultrasound probe tip of the ultrasound probe; and

a base disposed at the proximal end for removably connecting the surgical instrument to the robotic surgical system.

7. A surgical instrument as in claim 6, wherein the elongate shaft is configured to rotate in relation to the base about an axis drawn from the proximal end to the distal end.

8. A surgical instrument as in claim 7, wherein the base includes:

at least two shafts rotatably mounted to the base, each of the shafts having two ends, at least one of the ends of one of the shafts disposed to engage a corresponding interface member on the robotic surgical system;

at least two spools, each spool being mounted on one of the shafts;

at least one cable for connecting two of the spools; and

a rotating member coupled to the cable and to the elongate shaft, the rotating member being configured to rotate the elongate shaft in response to movements of the interface member, the at least two shafts, the at least two spools and the at least one cable.

9. A surgical instrument as in claim 6, wherein the end effector further includes a gripping member hingedly attached to the end effector for gripping tissue in cooperation with the ultrasound probe tip.

10. A surgical instrument as in claim 9, further comprising at least one force transmitting member for transmitting one or more forces between the robotic surgical system and the gripping member to move the gripping member.

11. A surgical instrument as in claim 10, wherein the at least one transmitting member comprises:

at least two shafts rotatably mounted to the base, each of the shafts having two ends, at least one of the ends of one of the shafts disposed to engage a corresponding interface member on the robotic surgical system;

at least two spools, each spool being mounted on one of the shafts;

at least one cable for connecting two of the spools; and

an actuator rod coupled to the cable and to the gripping member and extending through the elongate shaft, the actuator rod being configured to move the gripping member in response to movements of the interface member, the at least two shafts, the at least two spools and the at least one cable.

12. A surgical instrument as in claim 6, wherein the base further comprises an ultrasound source connector for connecting the ultrasound probe to an external ultrasound source.

13. A surgical instrument as in claim 6, wherein the base further comprises an internal ultrasound source for providing ultrasound energy to the ultrasound probe.

14. A surgical instrument as in claim 6, wherein the ultrasound probe further comprises:

an ultrasound transducer for generating ultrasonic vibrations; and

at least one amplifying horn for amplifying the ultrasonic vibrations.

16. The surgical robotic system of claim 15, wherein the ultrasound driver remains mounted to the connector when detaching the instrument from the robotic arm.

17. The surgical robotic system of claim 16, further comprising a vibration transmitting member extending distally within the shaft so as to couple the connector to the ultrasound probe, the transmitting member being at least in part vibrationally isolated from the shaft and the proximal portion.

18. The surgical robotic system of claim 15, wherein at least one actuatable end effector member is disposed adjacent the ultrasound probe of the ultrasonic instrument, and further comprising an articulating instrument mountable to the instrument holder of the robotic arm in place of the ultrasonic instrument, the articulating instrument comprising a proximal portion and a shaft extending distally from the proximal portion to a distal wrist joint, at least one actuatable end effector member mounted to the distal wrist joint, the at least one actuatable end effector orientable within an internal surgical site by articulation of the wrist joint, and wherein the ultrasonic instrument does not have a wrist joint disposed between the proximal housing and the ultrasound probe.

20. The surgical instrument of claim 19, further comprising an end effector coupled to the instrument probe assembly adjacent the distal end, the end effector having at least one end effector member configured to engage tissue employing a medical energy modality.

21. The surgical instrument of claim 20, wherein:

the surgical instrument further comprises at least one energy connector device engageable to operatively communicate with a medical energy system; and

the instrument probe assembly further comprises at least one energy conduction element operatively coupled to the energy connector device and extending between the proximal end and the distal end, the conduction element coupled to the end effector member to communicate the medical energy modality to the engaged tissue.

22. The surgical instrument of claim 21, wherein the medical energy modality is ultrasound treatment energy.

23. The surgical instrument of claim 21, wherein the medical energy modality is ultrasound diagnostic energy.

24. The surgical instrument of claim 21, wherein the medical energy modality is electrosurgical treatment energy.

25. The surgical instrument of claim 21, wherein the medical energy modality is electrosurgical treatment energy.

26. The surgical instrument of claim 21, wherein the instrument probe assembly includes an ultrasonic treatment probe assembly, and medical energy modality is ultrasound treatment energy.

27. The surgical instrument of claim 21, wherein:

the instrument probe assembly further comprises an ultrasonic transducer coupled to the energy connection device, the energy connection device operatively connectable to a surgical ultrasound generator;

the conduction element further comprises an ultrasonic conduction core coupled to the transducer; and

the end effector member further comprises an ultrasonic treatment probe tip coupled to the ultrasonic conduction core and configured to engage tissue to transmit ultrasonic energy to the engaged tissue.

28. The surgical instrument of claim 27, wherein the instrument probe assembly further comprises at least one grip drive element extending between the distal end and the proximal end and coupled to the interface assembly, the interface assembly being configured to move the drive element in response to the at least one actuation input;

and

the end effector further comprises a grip member pivotally coupled adjacent the ultrasonic treatment probe tip, the grip member coupled to the drive element so as to pivot in response to movement of the drive member to be closeable against the probe tip so as to engage tissue therebetween.

29. The surgical instrument of claim 27, wherein:

at least a distal portion of the instrument probe assembly including the end effector defines an elongate instrument shaft portion extending distally from the instrument base, at least the instrument shaft portion of the instrument probe assembly being coupled to the instrument base so as to be rotatable about a instrument axis;

the instrument includes at least one shaft drive element coupled to the interface assembly, the interface assembly being configured to move the shaft drive element in response to the at least one actuation input; and

the shaft drive element being coupled to at least the instrument shaft portion of the instrument probe assembly so as to cause at least the instrument shaft portion to rotate about the instrument axis in response to movement of the shaft drive element.

15. A surgical robotic system comprising:

a robotic arm having an instrument holder;

an ultrasonic robotic instrument detachably mountable on the instrument holder, the ultrasonic instrument having a proximal portion for engaging the instrument holder, an elongate shaft extending from the proximal portion to a distal end, and an ultrasound probe adjacent the distal end, the ultrasound probe drivingly coupled to a connector of the proximal portion; and

an ultrasound driver detachably mounted to the connector of the proximal portion so as to transmit ultrasound energy distally to the ultrasound probe.

19. A surgical instrument for use with a robotic surgical system, the surgical instrument comprising:

an elongate instrument probe assembly having a proximal end and a distal end, the distal end insertable through a minimally invasive surgical incision into the body of a patient; and

an instrument base coupled to the instrument probe assembly adjacent the proximal end, the instrument base comprising an instrument interface assembly removably connectable to the robotic surgical system and engagable with at least one interface actuator of the robotic surgical system so as to receive at least one input actuation, the interface assembly being coupled to the instrument probe assembly so as to move at least a portion of the instrument probe assembly in at least one degree of freedom.