Interchangeable fluid instrument

• US 20030055409A1
• Filed: 03/15/2002
• Published: 03/20/2003
• 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.
• Granted Patent: US 6,860,878 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 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00088 using thermistors
• CPC Class Codes: A61B 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00362 Packages or dispensers for MIS instruments A61B2017/0479 takes precedence
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00482 with a code
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• 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 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• 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 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/0086 : using infrared radiation
• CPC Class Codes: A61B 5/015 : By temperature mapping of body part
• CPC Class Codes: A61B 5/24 : Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/415 : the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/416 : the spleen
• CPC Class Codes: A61B 5/418 : lymph vessels, ducts or nodes
• CPC Class Codes: A61B 5/4893 : Nerves
• CPC Class Codes: A61B 50/30 : Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61B 6/425 : using detectors specially adapted to be used in the interior of the body
• 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

Abstract

A system and associated method for delivering to an internal body site a selected one of a plurality of instruments including fluid-dispensing instruments. An instrument storage chamber is providing having passages for separately accommodating the plurality of instruments. An outlet guide tube couples from the instrument storage chamber and receives a selected one of these instruments for delivery to an internal operative site. An indexing mechanism is provided associated with the chamber for causing relative displacement between the instruments and the outlet guide tube. An instrument driver displaces the registered instrument from the chamber into the outlet guide tube for delivery to the internal operative site.

Claims

1. An interchangeable instrument apparatus, comprising:

a plurality of separate instrument members each capable of assisting in a different phase of a medical procedure to be performed at an operative site within the anatomy;

an instrument storage chamber for releasably receiving said plurality of instrument members, accommodated in separate storage locations within the instrument storage chamber;

an instrument driver constructed and arranged for cooperative positioning relative to the instrument storage chamber, for selective alignment with one of said instrument members at a time, and for displacing the aligned instrument member from the instrument storage chamber toward the operative site;

at least one of said instrument driver and instrument storage chamber being positionally controllable so as to provide relative displacement therebetween to selectively align said instrument driver with another of said instrument members;

said plurality of separate instrument members including at least one of a mechanically actuable member and a fluid dispensing member.

2. A system as set forth in claim 1 wherein said instrument storage chamber comprises a rotating chamber having a plurality of passages therein

3. A system as set forth in claim 2 wherein said instrument member has a rest storage position when disposed in the instrument storage chamber, and a working position when coupled to the operative site, and further including an outlet guide tube having a distal end of the instrument extending from a distal end of the guide tube when the instrument is in its working position.

4. A system as set forth in claim 3 including an indexing device for causing relative displacement between the instrument members and the outlet guide tube for rotating said instrument storage chamber so that different ones of said instrument members may be aligned with said outlet guide tube.

5. A system as set forth in claim 4 wherein said instrument driver is supported by a carriage for linear translation of the instrument driver.

6. A system as set forth in claim 1 wherein said instrument driver has cabling and said instrument member has cabling.

7. A system as set forth in claim 6 further including a coupling interface for selectively connecting the cabling of the instrument driver with the cabling of the instrument member.

8. A system as set forth in claim 7 wherein said coupling interface comprises corresponding hooks associated with said instrument driver and said instrument member, and engagable when the driver selects a particular instrument member;

further including a base piece for supporting said carriage for rotation about a central axis;

each passage in the instrument storage chamber having an enlarged section to facilitate disengagement of said engagable hook;

facing ends of said instrument driver and instrument member having interlocking surfaces.

9. A system as set forth in claim 1 wherein said fluid dispensing member comprises a syringe member.

10. A system as set forth in claim 9 wherein the instrument driver supports an actuating member for selectively operating said syringe member to eject fluid at the operative site.

11. A system as set forth in claim 1 wherein said fluid dispensing member comprises a conduit member for coupling a fluid thereby from an external fluid source.

12. A system as set forth in claim 1 wherein said instrument member may be controlled from a remote drive unit.

13. A system as set forth in claim 12 wherein said instrument member is remotely operated from a user interface by way of an electrical controller.

14. A system as set forth in claim 13 including an indexing mechanism for controlling the position of said instrument storage chamber.

15. A system as set forth in claim 14 including an actuation member at said user interface for remotely controlling said indexing mechanism.

16. A system as set forth in claim 15 wherein the actuation member includes at least one of a switch, touch screen, pointer, or voice activation device.

17. A method of delivering to an internal operative site a selected one of a plurality of instruments, said method comprising the steps of:

storing a plurality of separate instruments in a storage chamber with each instrument capable of assisting in a different phase of a medical procedure to be performed at the operative site, and with the instrument members including at least one of a mechanically actuable member and a fluid dispensing member;

providing an instrument driver constructed and arranged for;

cooperative positioning relative to the instrument storage chamber,

selective alignment with one of said instruments at a time, and

displacing the aligned instrument from the instrument storage chamber;

and positionally controlling at least one of said instrument driver and instrument storage chamber so as to provide relative displacement therebetween and so as to selectively align said instrument driver with another of said instrument members.

18. A method as set forth in claim 17 including guiding the instrument, when it is displaced, by means of a guide tube.

19. A method as set forth in claim 17 wherein the step of positionally controlling to provide relative displacement includes causing relative rotation.

20. A method as set forth in claim 17 wherein the step of positionally controlling to provide relative displacement includes causing linear movement.

21. A surgical instrument apparatus, comprising:

an instrument member including;

a work section that supports at its distal end a selectively actuable member used in performing a medical procedure at an operative site within the anatomy,

a driver section that is releasably engageable with the work section, and

a guide member for receiving said work section and said drive section, and

for directing, upon engagement of said driver section with said work section, the delivery of the selectively actuable member to the operative site;

the driver section, in an inoperative position thereof, disengaged from the work section, and in an operative position thereof, engageable with the work section to direct the work section, via the guide member, to the operative site, and further engageable with the work section to enable operative coupling to the selectively actuable member for actuation thereof from a remote drive unit.

22. An apparatus as set forth in claim 21 further including an interface section for selectively and releasably intercoupling the driver and work sections.

23. An apparatus as set forth in claim 22 further including interconnecting hooks, one set associated with said driver section and one set associated with said work section and interengageable when the work section and the driver section are interengaged so as to provide cable continuity from the driver section, through the work section to the selectively actuable member;

further including a carriage for supporting said driver section and for moving said driver section toward and away from a storage chamber for the work section;

said storage chamber having passages for receiving a plurality of work sections, and each passage in said storage chamber having an enlarged portion to facilitate release between said driver section and said work section; and

further including an indexing drive for selectively rotating the instrument storage chamber.

24. An apparatus as set forth in claim 21 wherein said selectively actuable member comprises at least one of a mechanically actuable member and a fluid dispensing member.

25. An apparatus as set forth in claim 24 wherein the fluid dispensing member includes a syringe member and the driver section supports an actuating piece for selectively operating said syringe member to eject fluid at the operative site.

26. An apparatus as set forth in claim 24 wherein said fluid dispensing member comprises a conduit member for coupling a fluid thereby from an external fluid source.

27. An apparatus as set forth in claim 21 including a storage chamber for holding a plurality of work sections, and an indexing device for providing relative displacement between the storage chamber and the driver section so that different ones of the work sections may be aligned with the driver section.

28. An apparatus as set forth in claim 27 wherein said indexing device rotates the storage chamber.

29. An apparatus as set forth in claim 27 wherein said indexing device causes linear translation of said storage chamber.

30. An apparatus as set forth in claim 21 wherein facing ends of the driver section and the work section have interlocking surfaces that enable the driver section to properly position the work section while effecting inter-coupling between inter-coupling cables.

31. An apparatus as set forth in claim 21 wherein said work section is remotely operated from a user interface by way of an electrical controller.

32. An apparatus as set forth in claim 31 including an actuation member at said user interface for remotely controlling said indexing mechanism.

33. A system as set forth in claim 32 wherein the actuation member includes at least one of a switch, touch screen, pointer, or voice activation device.

34. An interchangeable instrument system, comprising:

a storage retainer that supports a plurality of separately arranged instruments, and further includes inlet and outlet ports, the outlet port arranged in alignment with a target or operative site where the instrument is to be delivered for performing a medical procedure;

a work implement supported at the distal end of each instrument;

at least one of said work implements comprising a fluid releasing device;

an instrument transporter in alignment with the inlet port, and adapted to engage a registered instrument disposed in the storage retainer, so as to deliver the selected instrument, via the outlet port to the target or operative site;

said instrument transporter, in addition to engagement with the instrument, also operatively coupling with and enabling operation of the work implement of the instrument;

said storage retainer being selectively operable, upon command, to permit different instruments to align between the inlet and outlet ports.

35. A system as set forth in claim 34 wherein said work implement is remotely operated from a user interface by way of an electrical controller.

36. A system as set forth in claim 35 wherein said retainer comprises an instrument storage chamber and further including an indexing mechanism for controlling the position of said instrument storage chamber, further including an actuation member at said user interface for remotely controlling said indexing mechanism, the actuation member including at least one of a switch, touch screen, pointer, or voice activation device.

37. A system as set forth in claim 34 wherein said fluid releasing device contains a medicinal liquid and is further comprised of a syringe type member, said instrument transporter supporting an actuating member for selectively operating said syringe type member to eject liquid at the target or operative site.

38. A system as set forth in claim 34 wherein said fluid releasing device couples a medicinal liquid and is further comprised of a conduit type member for coupling the liquid thereby and from an external liquid source.

39. An interchangeable instrument system, comprising:

an instrument retainer having multiple storage location for receiving a plurality of instruments disposed separately in the respective storage locations;

said plurality of instruments including at least one of a mechanically actuable member and a fluid dispensing member;

an instrument driver constructed and arranged for cooperative positioning relative to the instrument retainer, for selective alignment with one of said instruments at a time, and for displacing the aligned instrument from the instrument retainer toward the operative site;

an indexing mechanism controlling the position of the instrument retainer so as to selectively align different instruments with the instrument driver; and

an actuation member disposed at a user interface for controlling said indexing mechanism.

40. A system as set forth in claim 39 wherein said indexing mechanism is remotely operated from a user interface by way of an electrical controller.

41. A system as set forth in claim 39 wherein the actuation member includes at least one of a switch, touch screen, pointer, or voice activation device.

42. A system as set forth in claim 39 wherein said user interface is a remote user interface.

43. An interchangeable instrument system, comprising:

a plurality of medical instruments;

an instrument retainer for releasably holding said plurality of instruments;

said instruments retained in said instrument retainer including both at least one articulating mechanically actuable instrument and at least one fluid dispensing instrument;

an instrument transporter associated with the instrument retainer, for selective alignment with one of said instruments at a time, and for displacing the aligned instrument from the instrument retainer toward an operative site in a subject.

44. An interchangeable instrument system as set forth in claim 43 including at least one of said instrument retainer and instrument transporter being positionally controllable so as to provide relative displacement therebetween to selectively align said instrument transporter with another of said instruments.

45. An interchangeable instrument system as set forth in claim 43 wherein said instrument retainer comprises a rotating chamber having a plurality of passages therein.

46. An interchangeable instrument system as set forth in claim 43 wherein said instrument retainer comprises a linear chamber for receiving the instruments.

47. An interchangeable instrument system as set forth in claim 46 wherein said transporter is positioned in parallel to said linear chamber, and a selected instrument is moved transversely out of said chamber for alignment with said instrument transporter.

48. An interchangeable instrument system as set forth in claim 43 including an indexing mechanism controlling the position of the instrument retainer so as to selectively align different instruments with the instrument transporter, and an actuation member disposed at a remote user interface for controlling said indexing mechanism.

49. An interchangeable instrument system as set forth in claim 43 wherein said fluid dispensing instrument comprises one of a syringe type member, and a conduit type member for coupling the liquid thereby and from an external fluid source.

50. A remotely controllable medical apparatus comprising:

a remote user interface manually manipulable by a user for sending operation command signals to a signal processor, the signal processor processing the command signals and sending processed signals to a drive mechanism;

an instrument exchange mechanism mechanically intercoupled to the drive mechanism;

the instrument exchange mechanism comprising an instrument delivery mechanism containing two or more selectable instruments;

the instrument delivery mechanism being drivably movable to align a selected instrument with an operable site for insertion and withdrawal to and from the site, the instrument delivery mechanism being remotely drivable via the user interface to insert and withdraw selected instruments.

51. A remotely controllable medical apparatus as set forth in claim 50 wherein the selectable instruments comprise at least one of a mechanically actuable member and a fluid dispensing member.

52. A remotely controllable medical apparatus as set forth in claim 51 wherein said fluid dispensing member comprises a syringe member.

53. A remotely controllable medical apparatus as set forth in claim 52 including an instrument driver.

54. A remotely controllable medical apparatus as set forth in claim 53 wherein the instrument driver supports an actuating member for selectively operating said syringe member to eject fluid at the operative site.

55. A remotely controllable medical apparatus as set forth in claim 51 wherein said fluid dispensing member comprises a conduit member for coupling a fluid thereby from an external fluid source.

56. A remotely controllable medical apparatus comprising:

a remote user interface manually manipulable by a user for sending operation command signals to a signal processor, the signal processor processing the command signals and sending processed signals to a drive mechanism;

an instrument exchange mechanism mechanically intercoupled to the drive mechanism;

the instrument exchange mechanism comprising a shaft and an instrument delivery mechanism containing two or more selected instruments;

the shaft having a lumen which readily receives the selected instruments for insertion and withdrawal from the instrument delivery mechanism;

an instrument drive mechanism mechanically intercoupled to the drive mechanism and readily mechanically couplable to and decouplable from an instrument;

the instrument drive mechanism being remotely drivable via the user interface to operably couple to and drive an instrument;

the instrument being of one of the type of, an articulating instrument and a fluid dispensing instrument.

57. A remotely controllable medical apparatus as set forth in claim 56 wherein said fluid dispensing instrument comprises a syringe member.

58. A remotely controllable medical apparatus as set forth in claim 56 including an instrument driver.

59. A remotely controllable medical apparatus as set forth in claim 58 wherein the instrument driver supports an actuating member for selectively operating said syringe member to eject fluid at the operative site.

60. A remotely controllable medical apparatus as set forth in claim 56 wherein said fluid dispensing instrument comprises a conduit member for coupling a fluid thereby from an external fluid source.

61. A remotely controllable surgical apparatus for performing a medical procedure on a subject, the apparatus comprising:

a remotely disposed user interface comprising left hand and right hand manual command input devices, the manual command input devices sending command signals to a processor that is interconnected to a drive system that is mechanically interconnected to first and second surgical operative devices;

the first surgical operative device being separately controllable by command signals from the left hand manual command input device;

the second surgical operative device being separately controllable by command signals from the rigt hand manual command input device.

62. The remotely controllable surgical apparatus of claim 61 wherein the first and second surgical operative devices respectively comprise first and second instruments, mounted on first and second adaptors each drivably interconnected to the drive system, each adaptor being mounted on a stationary mount relative to the subject and drivably pivotable for movement in only a planar motion.

63. The remotely controllable surgical apparatus of claim 62 wherein at least one of the first and second instruments comprises an elongated shaft having an axis and a distal end, the elongated shaft being mounted on an associated adaptor for rotatable movement of the elongated shaft around the axis.

64. The remotely controllable surgical apparatus of claim 63 wherein the distal end of the instrument has a curved or curvilinear contour such that the distal end of the instrument is displaced a selected distance away from the axis of the elongated shaft, the distal end of the instrument being rotatable around the axis of the shaft.