Apparatus for positioning a medical instrument

• US 20030208187A1
• Filed: 05/02/2003
• Published: 11/06/2003
• Est. Priority Date: 05/02/2002
• Status: Abandoned Application

• Current Assignee: Laparocision, Inc.
• Original Assignee: Gmp Surgical Solutions, Inc.
• Inventors: Layer, James H.
• Application Number:
  US10/428,078
• Publication Number:
  US 20030208187A1
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

The present device provides an apparatus for securely positioning a medical instrument through an incision within a patient. The apparatus comprises a trocar for extending through the incision in the patient and receiving the medical instrument. The apparatus also comprises a drive assembly for moving the medical instrument within the trocar in a direction that extends substantially parallel to the length of the trocar. The drive assembly can have a housing that is spaced from the trocar or that forms a portion of the trocar. The apparatus also includes a positioning system for rotating the medical instrument about a plurality of spaced points located outside the body and a plurality of perpendicularly extending axes. The positioning system includes an adapter for securing the trocar to the positioning system. A first motor system rotates the adapter and trocar about a first axis that extends substantially perpendicular to the length of the trocar and a second motor system rotates the adapter, the trocar and the drive assembly about a second axis that extends substantially perpendicular to the first axis.

Claims

1. An apparatus for positioning a medical instrument relative to a patient, said apparatus comprising:

a trocar for extending through an incision in the patient;

a drive assembly for moving the medical instrument within said trocar along a first axis that extends in a direction substantially parallel to the length of the trocar; and

a positioning system comprising;

a rotatable adapter for connecting to and supporting the drive assembly;

a first motor system for rotating said adapter and trocar about a first point positioned outside the body of the patient and a second axis that extends substantially perpendicular to said first axis; and

a second motor system for rotating said adapter, said trocar and said first motor system about a third axis that extends substantially perpendicular to said second axis.

2. An apparatus according to claim 1 wherein the drive assembly comprises a housing having an opening for receiving the medical instrument, and at least one drive motor.

3. An apparatus according to claim 2 wherein the drive assembly further comprises a plurality of rollers spaced from each other for moving the medical instrument within said trocar.

4. An apparatus according to claim 3 wherein said rollers are friction rollers for engaging and moving the medical instrument in a direction that extends parallel to a longitudinal axis of said trocar, and wherein a first of said friction rollers is powered by the at least one drive motor and a second of said friction rollers is an idler roller biased in the direction of said first friction roller.

5. An apparatus according to claim 4 wherein said rollers of said drive assembly comprise at least one roller for rotating the medical instrument about the longitudinal axis of the trocar.

6. An apparatus according to claim 1 wherein said adapter includes an opening through which said trocar is received.

7. An apparatus according to claim 6 wherein said adapter includes a clamping mechanism that removably receives the trocar, said clamping mechanism including at least two clamping members moveable relative to each other.

8. An apparatus according to claim 7 wherein the first clamping member is pivotally secured relative to the second clamping member.

9. An apparatus according to claim 7 wherein said adapter includes a moveable coupling system that secures said adapter to a shaft extending from said first motor system.

10. An apparatus according to claim 9 wherein said moveable coupling system comprises a shaft including at least one recess, at least one ball bearing for being received within said at least one recess and an outer sleeve having at least one recess for receiving said at least ball bearing, said outer sleeve being moveable relative to said shaft of said adapter.

11. An apparatus according to claim 1 wherein said first motor system includes a motor having a drive shaft carrying a drive gear;

said adapter includes a shaft having an idler gear that meshes with said drive gear; and

said adapter rotates when said drive gear rotates said idler gear.

12. An apparatus according to claim 11 wherein said first motor system is positioned within an elongated member that extends at an angle to the length of said adapter.

13. An apparatus according to claim 12 wherein said second motor system is operatively connected to said elongated member for rotating said elongated member about said third axis.

14. An apparatus according to claim 13 wherein said second motor system includes a motor and a pair of cooperating gears that rotate said elongated member about said third axis in response to the operation of the motor of the second motor system.

15. An apparatus according to claim 1 further comprising a remote control unit for selectively operating at least one of a motor of said drive assembly, said first motor system and said second motor system.

16. An apparatus according to claim 1 further comprising a substantially C-shaped arm having a first section comprised of said adapter, a second section containing said first motor system and a third section operatively connected to said second motor system.

17. An apparatus according to claim 1 wherein said trocar is free of a connection to said adapter.

18. An apparatus according to claim 17 wherein said drive assembly includes a housing containing a plurality of rollers for engaging and moving the medical instrument, and wherein said adapter is secured to said drive assembly housing for rotating said drive assembly housing in response to the operation of said first motor system and/or second motor system.

19. An apparatus according to claim 3 wherein drive assembly includes a housing containing said rollers and wherein said drive assembly housing is releasably secured to said trocar.

20. An apparatus according to claim 1 wherein said trocar includes a housing, and wherein at least a portion of said drive assembly is positioned within the trocar housing for moving the medical instrument within the trocar.

21. An apparatus according to claim 20 wherein said trocar is removably secured to said adapter such that said trocar pivots in response to the rotation of the adapter.

22. An apparatus according to claim 1 wherein said second motor system rotates said adapter, said trocar and said first motor system about a second point outside the body of the patient that is spaced from said first point.

23. A system for positioning a medical instrument relative to a patient, said system comprising:

a drive assembly for moving the medical instrument relative to the patient in a direction that extends substantially parallel to a first axis, said first axis being substantially parallel to the length of the medical instrument when said medical instrument is positioned within said drive assembly; and

a positioning system supported for movement relative to the patient and operatively connected to the drive assembly for rotating the medical instrument, said positioning system comprising;

(a) a first motor system located at a first section of the positioning system for rotating said drive assembly and the medical instrument about a second axis that extends substantially perpendicular to said first axis and a first point located outside the body of the patient when a portion of the medical instrument is positioned within the body of the patient; and

(b) a second motor system located at a second section of said positioning system for rotating said drive assembly about a third axis that extends substantially perpendicular to said second axis and a second point located outside the body of the patient when a portion of the medical instrument is positioned within the body of the patient.

24. A system according to claim 23 further comprising:

a trocar for extending through an incision in the patient and for receiving the medical instrument, and wherein said drive assembly is free of a connection to said trocar; and

wherein said drive assembly further includes a housing having an opening for receiving the medical instrument, a plurality of instrument engaging members and at least one drive motor for driving at least one of said instrument engaging members and said medical instrument.

25. A system according to claim 23 wherein the drive assembly forms a portion of an elongated trocar and said instrument engaging members include cooperating rollers.

26. A system according to claim 23 wherein the drive assembly further comprises a plurality of rollers positioned within said housing for moving the medical instrument relative to the patient, said rollers being spaced from each other within said housing.

27. A system according to claim 26 wherein said rollers are friction rollers for engaging and moving the medical instrument in a direction that extends parallel to a longitudinal axis of said trocar, and wherein a first of said friction rollers is powered by the at least one drive motor and a second of said friction rollers is an idler roller biased in the direction of said first friction roller.

28. A system according to claim 27 wherein said rollers of said drive assembly further comprise at least one roller for rotating the medical instrument about the longitudinal axis of the medical instrument and relative to the body of the patient.

29. A system according to claim 24 further comprising an adapter including a moveable coupling system that secures said adapter to a shaft extending from said first motor system.

30. A system according to claim 29 wherein said coupling system comprises a shaft including at least one recess, at least one ball bearing for being received within said at least one recess and an outer sleeve having at least one recess for receiving said at least one ball bearing, said outer sleeve being moveable relative to said shaft of said first motor system.

31. A system according to claim 23 further comprising an adapter including an elongated member extending from said positioning system, said elongated member including at least one clamping member.

32. A system according to claim 23 further comprising an adapter including a shaft and an idler gear, and wherein said first motor system includes a motor having a drive shaft carrying a drive gear that meshes with said drive gear;

and said adapter rotates when said drive gear rotates said idler gear.

33. A system according to claim 32 wherein said first motor system is positioned within an elongated portion of said positioning system that extends at an angle to a length of said adapter.

34. A system according to claim 33 wherein said second motor system is operatively connected to said elongated portion of said positioning system for rotating said elongated portion of said positioning system about said third axis.

35. A system according to claim 34 wherein said second motor system includes a motor and a pair of cooperating gears that rotate said elongated portion of said positioning system about said second axis in response to the operation of the motor of the second motor system.

36. A system according to claim 23 further comprising a remote control unit for selectively operating at least one of a motor of said drive assembly, said first motor system and said second motor system.

37. A system according to claim 23 wherein said positioning system comprises a substantially C-shaped arm having a first section including an adapter, a second section including said first motor system and a third section operatively connected to said second motor system.

38. A system according to claim 25 further comprising an adapter including a support member, and wherein said drive assembly housing is moveable along the length of said support member so that said drive assembly housing can be adjustably spaced from the body of the patient.

39. A system according to claim 38 wherein said drive assembly housing includes an opening for receiving said support member.

40. An apparatus for positioning a medical instrument relative to a patient, said apparatus comprising:

a drive assembly for moving the medical instrument relative to the patient, said drive assembly comprising a motor for moving the medical instrument in a direction that extends along a first axis and substantially parallel to the length of the medical instrument; and

a medical instrument positioning system comprising;

a plurality of elongated members operatively connected to and supporting said drive assembly;

a first motor system including a motor for rotating the medical instrument in opposite directions about a point positioned outside the body of the patient when a portion of the medical instrument is positioned within the body of the patient and a second axis that extends substantially perpendicular to the first axis; and

a second motor system including a motor for rotating the medical instrument and said plurality of positioning system members about a second axis that extends substantially perpendicular to the length of said first axis.

41. The apparatus according to claim 40 wherein said drive assembly further comprises a motor housing including a first housing portion that is moveable relative to a second housing portion from a first position to a second position.

42. The apparatus according to claim 41 wherein the first housing portion is connected to the second housing portion by a spring, and wherein said spring returns the first housing portion to said first position after the medical instrument has been inserted into the motor housing.

43. The apparatus according to claim 42 wherein the first housing portion is at least partially received within said second housing portion.

44. The apparatus according to claim 43 wherein the motor housing includes a spring for biasing a pinch roller toward a driven roller.

45. An apparatus according to claim 40 wherein the drive assembly comprises a plurality of rollers spaced from each other for moving the medical instrument.

46. An apparatus according to claim 45 wherein said rollers are friction rollers for engaging and moving the medical instrument in a direction that extends parallel to a longitudinal axis of said trocar, and wherein a first of said friction rollers is powered by the at least one drive motor and a second of said friction rollers is an idler roller biased in the direction of said first friction roller.

47. An apparatus according to claim 46 further comprising a trocar extending substantially parallel to said first axis and wherein said plurality of elongated members form a substantially C-shaped arm, said first of said elongated members includes an adapter that supports said trocar, said second of said elongated members includes said first motor system and a third of said elongated members is operatively connected to said second motor system.

48. An apparatus according to claim 47 wherein said adapter includes a support member, and wherein said trocar is moveable along the length of said support member so that said drive assembly of said trocar can be adjustably spaced from the body of the patient.

49. An apparatus according to claim 47 wherein said second motor system further includes a pair of cooperating gears that rotate said trocar about said second axis in response to the operation of the motor of the second motor system.

50. An apparatus according to claim 40 further comprising a remote control unit for selectively operating at least one of said drive assembly motor, said first motor system and said second motor system.

51. An apparatus according to claim 40 wherein the medical instrument includes an endoscope.

52. An apparatus for positioning a medical instrument relative to a patient, said apparatus comprising:

a first elongated medical instrument moveable relative to the body of the patient;

a drive assembly for engaging said first elongated medical instrument and moving said first elongated medical instrument toward and away from the body of the patient; and

a positioning system operatively connected to the drive assembly and said first elongated medical instrument for moving said first elongated medical instrument about a plurality of axes and a plurality of spaced points located outside the body of the patient.

53. An apparatus for positioning a medical instrument according to claim 52 further comprising a second elongated medical instrument, said second elongated medical instrument including a trocar having an internal passageway for receiving said first elongated medical instrument.

56. An apparatus for positioning a medical instrument according to claim 53 wherein said trocar is free of a connection to said positioning system.

57. An apparatus for positioning a medical instrument according to claim 53 further comprising an adapter, and wherein said trocar is secured to said positioning system by said adapter.

58. An apparatus for positioning a medical instrument according to claim 57 wherein said adapter supports said trocar relative to the body of the patient.

59. An apparatus for positioning a medical instrument according to claim 58 wherein said adapter includes a trocar receiving portion having an opening through which said trocar extends.

60. An apparatus for positioning a medical instrument according to claim 58 wherein said adapter includes a first member secured to a housing of said motor system and a second member that extends substantially parallel to the longitudinal axis of said trocar, said first member being moveable along the length of said second member.

61. An apparatus for positioning a medical instrument according to claim 60 wherein said first member has an internal opening through which said second member extends, and wherein said first member includes a locking member for securing said first member to said second member.

62. An apparatus for positioning a medical instrument according to claim 61 wherein said first member includes a moveable elongated member and said second member includes a plurality of holes spaced at intervals for receiving said moveable elongated member, and wherein said first motor system includes a drive motor, a first roller driven by said drive motor and a biased follower roller.

63. An apparatus for positioning a medical instrument according to claim 62 wherein the motor system housing includes a moveable portion, and wherein said biased follower roller is positioned within said moveable portion such that said follower roller moves relative to said driven roller when said moveable portion travels relative to said first member of said adapter.

54. An apparatus for positioning a medical instrument 53 wherein said trocar includes said motor system, and wherein said motor system includes a motor and a plurality of rollers for engaging said first elongated medical instrument and moving said first elongated medical instrument within said trocar.

55. An apparatus for positioning a medical instrument according to claim 54 wherein said trocar is securely connected to said positioning system such that said trocar moves in response to the movement of said positioning system.

64. An apparatus for positioning a medical instrument relative to a patient, said apparatus comprising:

a vertical support member;

a first motor system supported by said vertical support member, said first motor system including a motor and a drive system;

a first link having a first end pivotally secured to said vertical support member, wherein said drive assembly is operatively coupled to said first end of said first link for driving said first link about a pivot point;

an arm having a first portion secured at a fixed angle to a portion of said first link, said portion of said first link being spaced from said first end of said first link, said arm including a second motor system;

an adapter having a first end secured at a fixed angle to a second portion of said arm, said adapter being operatively connected to said second motor system for rotating said adapter relative to said arm, and wherein said adapter is capable of supporting the medical instrument.

65. The apparatus of claim 64 wherein said adapter includes a drive assembly for moving the medical instrument relative to the body'"'"' of a patient.

66. The apparatus of claim 65 wherein said arm is longitudinally moveable relative to said first link.