MEDICAL INSTRUMENT ELECTRONICALLY ENERGIZED USING DRIVE CABLES

• US 20100016852A1
• Filed: 07/16/2008
• Published: 01/21/2010
• Est. Priority Date: 07/16/2008
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Incorporated (Intuitive Surgical Holdings, LLC)
• Inventors: HEATON, LISA W., MANZO, SCOTT E., GRESHAM, RICHARD D., BURBANK, WILLIAM A.
• Granted Patent: US 9,204,923 B2
• Time in Patent Office: Days
• US Class Current: 606/46
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2945 Curved jaws
• CPC Class Codes: A61B 2018/00345 Vascular system
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00619 Welding
• CPC Class Codes: A61B 2018/1432 curved
• CPC Class Codes: A61B 2018/146 Scissors
• 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 34/71 Manipulators operated by drive cable mechanisms

Abstract

An electrically energized medical instrument uses one or more drive cables to both actuate mechanical components of a wrist mechanism or an effector and to electrically energize the effector. Electrical isolation can be achieved using an insulating main tube through which drive cables extend from a backend mechanism to the effector, an insulating end cover that leaves only the desired portions of the effector exposed, and one or more seals to prevent electrically conductive liquid from entering the main tube. Component count and cost may be further reduced using a pair of pulleys that are shared by four drive cables.

Claims

1. A medical instrument comprising:

a main tube;

an effector coupled to a distal end of the main tube and containing an electrically conductive component;

a cable coupled to the effector and extending through the main tube, wherein an actuation of the effector involves movement of the cable, and the cable is electrically conductive; and

a backend mechanism coupled to a proximal end of the main tube, wherein the backend mechanism comprises a mechanical system coupled to the cable and operable to move the cable for the actuation of the effector and an electrical system connected to the cable for application of an electrical signal that energizes the electrically conductive component of the effector.

2. The instrument of claim 1, wherein the main tube is made of an insulating material.

3. The instrument of claim 1, wherein the effector comprises a wrist mechanism operable to change a pitch, a yaw, and a grip of the effector.

4. The instrument of claim 1, wherein the effector comprises scissors.

5. The instrument of claim 1, wherein the cable is one of a plurality of cables that move for actuation of the effector.

6. The instrument of claim 1, wherein the electrical signal energizes the electrically conductive component for a clinical function selected from the group consisting of desiccation, hemostasis, cutting, dissection, fulguration, incisions, tissue destruction, cauterizing, and vessel sealing.

7. The medical instrument of claim 1, wherein the medical instrument comprises monopolar scissors.

8. The instrument of claim 1, further comprising a seal in the main tube through which the cable passes, the seal preventing liquid flow into the main tube.

9. The instrument of claim 1, wherein the cable couples to the effector through a crimp placed medially on the cable.

10. The instrument of claim 1, wherein the instrument is a single-use instrument.

11. The instrument of claim 1, wherein the backend mechanism fits into a docking port of a control system, and the mechanical system of the backend mechanism provides a mechanical coupling of the cable to a motorized axis provided by drive motors in the control system.

12. The instrument of claim 1, wherein the electrical system of the backend mechanism is connected to a generator of monopolar cauterizing instrument.

13. The instrument of claim 1, wherein the electrical system of the backend mechanism is connected to a generator capable of providing the electrical signal suitable for a cauterizing procedure.

14. The instrument of claim 1, wherein the electrical system of the backend mechanism is connected to a generator capable of providing the electrical signal with a frequency above 100 kHz.

15. A method for operating a medical instrument comprising:

actuating an effector on a distal end of a main tube through movement of one or more cables that are attached to the effector and extend through the main tube; and

electrically energizing the effector by applying a first electrical signal that one or more of the cables conducts through the main tube to the effector.

16. The method of claim 15, wherein actuating the effector comprises using the one or more cables to change a pitch, a yaw, and a grip of the effector.

17. The method of claim 15, her comprising:

positioning the effector at a work site in a patient; and

applying a contact on the patient, wherein the first electrical signal cause a current to flow between the effector and the contact.

18. The method of claim 15, further comprising using the effector when energized to perform a clinical function selected from the group consisting of desiccation, hemostasis, cutting, dissection, filguration, incisions, tissue destruction, cauterizing, and vessel sealing.

19. The method of claim 15, wherein actuating the effector comprises operating a control system that operates motors to move the one or more cables.

20. The method of claim 19, further comprising:

checking by the control system of a number of uses of an instrument including the effector; and

disabling use of the instrument if the number of uses indicates the instrument has been used.

21. A medical instrument comprising:

a clevis rotatably mounted on a first pin, the clevis including a second pin;

first and second pulleys rotatably mounted on the first pin;

first and second jaws rotatably mounted on the second pin;

first and second cables attached to the first jaw, wherein the first and second cables respectively ride on the first and second pulleys when the clevis is in a first position; and

third and fourth cables attached to the second jaw, wherein the third and fourth cables respectively ride on the first and second pulleys when the clevis is in the first position.

22. The instrument of claim 21, further comprising:

a tube having the first pin at a distal end, wherein the first, second, third, and fourth cables extend through the tube; and

a backend mechanism attached to a proximal end of the tube, wherein the backend mechanism mechanically couples the first, second, third, and fourth cables to rotational axes.

23. The instrument of claim 22, wherein the backend mechanism rotates the clevis about the first pin by pulling in the first and second cables while releasing the third and fourth cables.

24. The instrument of claim 22, wherein the backend mechanism rotates the first jaw about the second pin by moving the first and second cables in opposite directions.

25. The instrument of claim 24, wherein during rotation of the first jaws when the clevis is in the first position, one of the first and third cables slides on the first pulley.

26. The instrument of claim 21, wherein rotation of the clevis in a first direction increases a first wrap angle of the first cable around the first pulley, increases a second wrap angle of the second cable about the second pulley, decreases a third wrap angle of the third cable about the first pulley, and decreases a fourth wrap angle of the fourth cable about the second pulley.

27. The instrument of claim 21, wherein at a second position of the clevis, the first cable rides on the first pulley, and the third cable is lifted off the first pulley.

28. The instrument of claim 21, wherein during rotation of at least one of the first and second blades, the first pulley rotates in a direction corresponding to movement whichever of the first and third cables has a greater wrap angle about the first pulley.

29. The instrument of claim 21, wherein during rotation of at least one of the first and second blades, the first pulley rotates in a direction corresponding to movement whichever of the first and third cables has a greater tension.

30. The instrument of claim 21, wherein the first and second cables are opposite ends of a first loop of cable, and the third and fourth cables are opposite ends of a second loop of cable.