Articulating mechanism for remote manipulation of a surgical or diagnostic tool

• US 20050251112A1
• Filed: 07/13/2005
• Published: 11/10/2005
• Est. Priority Date: 05/23/2003
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Novare Surgical Systems, Inc. (Groupe Peters Surgical SAS)
• Inventors: Danitz, David J., Gold, Adam
• Granted Patent: US 7,615,066 B2
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 1/0055 Constructional details of insertion parts, e.g. vertebral elements
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2034/306 Wrists with multiple vertebrae
• CPC Class Codes: A61B 2090/508 with releasable brake mechanisms
• 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 34/77 Manipulators with motion or force scaling
• CPC Class Codes: A61M 2025/015 Details of the distal fixation of the movable mechanical means
• CPC Class Codes: A61M 2025/0161 wherein the distal tips have two or more deflection regions
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61M 25/0138 having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

The invention provides an articulating mechanism useful, for example, for remote manipulation of various surgical instruments and diagnostic tools within, or to, regions of the body. Movement of segments at the proximal end of the mechanism results in a corresponding, relative movement of segments at the distal end of the mechanism. The proximal and distal segments are connected by a set of cables in such a fashion that each proximal segment forms a discrete pair with a distal segment. This configuration allows each segment pair to move independently of one another and also permits the articulating mechanism to undergo complex movements and adopt complex configurations.

Claims

1-32. -32. (canceled)

33. An articulating mechanism comprising:

a proximal end and a distal end;

at least one proximal linking member positioned at or near the proximal end;

at least one distal linking member positioned at or near the distal end; and

at least one cable set connected to each proximal linking member and to a corresponding distal linking member such that movement of each proximal linking member causes movement in the corresponding distal linking member.

34. The articulating mechanism of claim 33, comprising a user interface coupled to the at least one proximal linking member.

35. The articulating mechanism of claim 33, wherein the at least one distal linking member is coupled to a tool.

36. The articulating mechanism of claim 33, wherein:

the at least one proximal linking member comprises a first set of links;

the at least one distal linking member comprises a second set of links; and

each link of the first set is connected to a corresponding link in the second set of links by a distinct cable set.

37. The articulating mechanism of claim 33, wherein the proximal or distal linking member is flexible.

38. The articulating mechanism of claim 34, wherein operation of the user interface causes movement of the distal linking member.

39. The articulating mechanism of claim 38, wherein operation of the user interface causes operation of a tool coupled to the distal linking member.

40. The articulating mechanism of claim 33, wherein rotational movement of the proximal linking member results in rotational movement of the distal linking member.

41. The articulating mechanism of claim 33, wherein movement of the proximal linking member results in inverted movement of the distal linking member.

42. The articulating mechanism of claim 33, wherein movement of the proximal linking member results in movement of the distal linking member in the same direction as the movement of the proximal linking member.

43. The articulating mechanism of claim 33, comprising a middle portion disposed between the at least one proximal linking member and the at least one distal linking member.

44. The articulating mechanism of claim 33, wherein the at least one cable set comprises two or more cables.

45. The articulating mechanism of claim 36, comprising a spacer link disposed between links of the first set or between links of the second set, wherein the spacer link is not connected to any cable set.

46. The articulating mechanism of claim 43, wherein the middle portion is flexible.

47. The articulating mechanism of claim 34, wherein the user interface comprises a handle.

48. The articulating mechanism of claim 35, wherein the tool is selected from the group consisting of catheters, endoscopes, retractors, ablative devices, Doppler flow meters, microphones, probes, dissectors, staplers, clamps, graspers, cutters and scissors.

49. The articulating mechanism of claim 33, comprising a locking mechanism to lock a portion of the articulating mechanism.

50. The articulating mechanism of claim 49, wherein the locking mechanism comprises a sheath positioned over a portion of the at least one proximal linking member or the at least one distal linking member.

51. The articulating mechanism of claim 49, wherein the locking mechanism comprises a rod.

52. The articulating mechanism of claim 46, comprising ball-and-socket joints disposed between links of the first set or between links of the second set and a tensioning cable operating to exert friction between the balls and sockets such that a portion of the articulating mechanism can be locked into a configuration.

53. The articulating mechanism of claim 33, wherein the at least one proximal linking member is configured to be attached to at least a portion of a hand.

54. The articulating mechanism of claim 33, wherein the at least one distal linking member operates as a tool.

55. The articulating mechanism of claim 33, wherein the at least one proximal linking member operates as a user interface.

56. The articulating mechanism of claim 33, wherein multiple distal linking members operate as a tool.

57. A surgical instrument comprising:

a proximal end and a distal end;

a first linking member coupled to a user interface positioned near the proximal end;

a second linking member coupled to a tool positioned near the distal end; and

at least one cable set connected to the first linking member and to the second linking member such that movement of the first linking member causes corresponding movement in the second linking member.

58. The surgical instrument of claim 57, wherein:

the first linking member comprises a first set of links;

the second linking member comprises a second set of links; and

each link in the first set is connected to a corresponding link in the second set of links by a distinct cable set.

59. The surgical instrument of claim 57, wherein the tool is selected from the group consisting of catheters, endoscopes, retractors, ablative devices, Doppler flow meters, microphones, probes, dissectors, staplers, clamps, graspers, cutters and scissors.

60. An articulating mechanism comprising:

a proximal end and a distal end;

at least one proximal linking member positioned at or near the proximal end;

at least one distal member positioned at or near the distal end; and

at least one pliant member capable of supporting a tension load connected to each proximal linking member and to a corresponding distal linking member such that movement of each proximal linking member results in movement of the corresponding distal linking member.

61. The articulating mechanism of claim 60, wherein:

the at least one proximal linking member comprises a first set of links;

the at least one distal linking member comprises a second set of links; and

each link of the first set is connected to a corresponding link in the second set of links by a distinct pliant member.

62. The articulating mechanism of claim 60, comprising a tool coupled to the at least one distal linking member.

63. The articulating mechanism of claim 62, wherein the tool is selected from the group consisting of catheters, endoscopes, retractors, ablative devices, Doppler flow meters, microphones, probes, dissectors, staplers, clamps, graspers, cutters and scissors.

64. A surgical clamp comprising:

a proximal end and a distal end;

a first linking member positioned near the proximal end and coupled to a user handle;

a second linking member positioned near the distal end and coupled to a clamping mechanism; and

at least one pliant member capable of supporting a tension load connected to the first linking member and to the second linking member such that operation of the user handle causes manipulation of the clamping mechanism.