Methods and Systems for Indicating a Clamping Prediction

• US 20120209314A1
• Filed: 01/13/2012
• Published: 08/16/2012
• Est. Priority Date: 02/15/2011
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Weir, David, Duque, Grant, Durant, Kevin, Flanagan, Patrick, Robinson, David, Zabinski, John, Nixon, Maggie
• Granted Patent: US 8,989,903 B2
• Time in Patent Office: Days
• US Class Current: 606/205
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/28 Surgical forceps for holding suture needles or materials A61B17/0483; for removing or smashing calculi A61B17/221; surgical scissors A61B17/3201 ; obstetrical forceps A61B17/44; for inserting intraocular lenses A61F2/1662; hand-held gripping tools in general B25B7/00 ]
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00115 with audible or visual output with imaging means A61B90/37, A61B34/20
• CPC Class Codes: A61B 2017/00132 Setting operation time of a device A61B2017/00123 takes precedence
• CPC Class Codes: A61B 2017/2808 Clamp, e.g. towel clamp
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• 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 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• 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 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61B 90/08 Accessories or related features not otherwise provided for
• CPC Class Codes: B25J 9/1694 characterised by use of sensors other than normal servo-feedback from position, speed or acceleration sensors, perception control, multi-sensor controlled systems, sensor fusion
• CPC Class Codes: G06F 3/016 Input arrangements with force or tactile feedback as computer generated output to the user
• CPC Class Codes: G06F 3/14 Digital output to display device ; Cooperation and interconnection of the display device with other functional units
• CPC Class Codes: G06F 3/16 Sound input; Sound output speech processing G10L

Abstract

End effectors with closing mechanisms, and related tools and methods are disclosed. The disclosed end effectors may be particularly beneficial when used for minimally invasive surgery. An example surgical tool comprises a first and second jaw movable between a closed grasped or clamped configuration and an open configuration. The tool further comprises a soft grip mode for grasping the tissue at a first force during which a separation parameter between the jaws is measured, and a therapeutic clamping mode in which the jaws clamp on the body tissue at a force greater than the grasping force. The methods comprise grasping the body tissue between jaw members, measuring the separation parameter between jaws, indicating on a user interface the separation parameter for comparison to a desired separation parameter, and then releasing the body tissue for repositioning or therapeutically clamping the body tissue in response to the separation parameter indication.

Claims

1. A method comprising:

measuring a grasping separation parameter between two jaws grasping a material with a grasping force; and

outputting an indication on a user interface in response to the measured separation parameter, wherein the indication indicates a predicted success or failure of clamping the grasped material between the two jaws at a desired clamping force, wherein the clamping force is a range of clamping forces greater than the grasping force.

2. The method of claim 1, wherein the method further comprises:

determining successful clamping of the tissue; and

outputting an indicator of elapsed time on the user interface after a determination of successful clamping.

3. The method of claim 2, wherein the method further comprises:

outputting an indicator that it is safe to proceed with stapling of the successfully clamped tissue after a pre-determined period of time after successful clamping.

4. The method of claim 1, wherein the method is non-surgical in nature and wherein the material comprises a compliant material.

5. The method of claim 1, further comprising applying the grasping force in response to a measurement grasping force command.

6. The method of claim 1, wherein the material comprises a tissue.

7. The method of claim 6, wherein the tissue comprises a skin on the outside of a body of a patient.

8. The method of claim 6, wherein the indication of success is output in response to a determination that a clamped jaw separation will be within a desired range of clamped jaw separations when clamping the grasped tissue between the two jaws at the desired clamping force.

9. The method of claim 8, wherein the desired range of clamped jaw separations is determined in response to a dimension of a staple or fastener to be used in stapling or fastening the clamped tissue.

10. The method of claim 8, wherein the desired range of clamped jaw separations comprises a distance between the jaws that is suitable for applying a staple to the tissue between the jaws.

11. The method of claim 6, wherein the grasping of tissue between the two jaws at the grasping force is performed in response to a user command to grasp and before measuring the grasping separation parameter;

and

further comprising;

therapeutically clamping the grasped body tissue between the jaws at the clamping force in response to a user command to clamp and after providing the indication of predicted success, or;

releasing the grasped body tissue body tissue from between the jaws after providing the indication of predicted failure.

12. The method of claim 11, wherein grasping occurs in a soft grip tissue manipulation mode and clamping occurs in a therapeutic clamping mode, the method further comprising:

switching from the soft grip mode to the clamping mode.

13. The method of claim 12, wherein switching from the soft grip mode to the clamping mode occurs in response to a user input command to clamp the tissue.

14. The method of claim 11, wherein grasping the body tissue comprises driving the jaws with a grasping torque applied by an actuator system, and wherein the grasping separation parameter is measured during application of the grasping torque.

15. The method of claim 1, wherein the separation parameter comprises an angle between the jaws or a distance between the jaws.

16. The method of claim 1, wherein the desired clamping force is at least twice the grasping force.

17. The method of claim 1, wherein the desired clamping force is between 5 to 10 times the grasping force.

18. The method of claim 1, wherein the indication comprises predicted clamping failure when the measured separation parameter is greater than a desired grasping separation, and wherein indication is of predicted clamping success when the separation parameter is equal to or less than the desired grasping separation parameter.

19. The method of claim 18, wherein each of the jaws has a distal tip, and wherein the separation parameter comprises a separation distance between the distal tips of the jaws.

20. The method of claim 19, wherein the desired grasping separation is a distance within a range of about 0.7 mm to 8 mm.

21. The method of claim 19, wherein the desired grasping separation is a distance of about 4 mm.

22. The method of claim 19, wherein the grasping force corresponds to a tip force between the distal tips of the jaws within a range from about 3 lb-f to 10 lb-f.

23. The method of claim 19, wherein the clamping force corresponds to a tip force between the distal tips of the jaws within a range from about 30 to 70 lb-f.

24. The method of claim 18, further comprising determining the desired grasping separation parameter in response to one or more clamping parameters, the clamping parameters including any or all of a dimension of the jaws, a texture of a clamping surface on the jaws, a dimension of a staple, and a characteristic of the body tissue being clamped.

25. The method of claim 24, wherein the characteristic of the body tissue includes a type of tissue, a thickness of tissue, and a stiffness of tissue.

26. The method of claim 18, wherein the desired grasping separation parameter comprises an angle between the jaws.

27. The method of claim 26, wherein the angle is within a range a ranges from 1 degree to about 10 degrees.

28. The method of claim 1, further comprising:

repositioning the jaws relative to the tissue after the indication of predicted failure;

after repositioning the jaws, grasping with the jaws at the grasping force while measuring the grasping separation between the jaws;

outputting a second indication of predicted failure or success of clamping the grasped tissue between the repositioned jaws at the desired clamping force in response to the measured grasping separation between the repositioned jaws.

29. An apparatus comprising:

a first and a second jaw;

a drive system coupled to the jaws; and

an electronic data processor coupled to the drive system and the user interface,

wherein the drive system is configured to close the jaws on a body tissue at a grasping force, and wherein the electronic data processor is configured to measure a grasping separation parameter between the jaws; and

wherein based on the measured grasping separation parameter, the electronic data processor outputs an indicator that is predictive of success or failure in clamping the tissue between the two jaws at a desired clamping force, wherein the clamping force is within a predetermined range of forces greater than the grasping force.

30. The apparatus of claim 29, wherein the processor determines the grasping separation parameter between the jaws from positional data transmitted from the drive system.

31. The apparatus of claim 29, further comprising:

a sensor for measuring the grasping separation parameter between the first and second jaw.

32. The method of claim 29, wherein the grasping separation parameter comprises an angle between the jaws or a distance between the jaws.

33. The apparatus of claim 29, wherein the processor outputs to a user interface the indicator, wherein the indicator comprises a graphical indicator predictive of success or failure in clamping the tissue grasped between the jaws at the desired clamping force to a desired clamped jaw separation, the clamped jaw separation within a predetermined range of separations.

34. The apparatus of claim 33, wherein the desired clamped jaw separation comprises a suitable separation for applying a staple to the tissue between the jaws.

35. The apparatus of claim 29, wherein the data processor has a tissue soft grip mode wherein the jaws can be positioned so as to receive a body tissue between the jaws and wherein the jaws can be closed so as to grasp the body tissue at the grasping force;

wherein the processor also has a therapeutic clamping mode wherein the jaws close so as to clamp the body tissue at the clamping force;

wherein a user interface displays the indication of predicted clamping success or failure while in the soft grip mode.

36. The apparatus of claim 29, wherein the indicator includes any or all of an audio sound, a visual indicator, and a sensory indicator.

37. The apparatus of claim 35, further comprising:

a controller for switching between the soft grip and therapeutic clamping modes.

38. The apparatus of claim 35, wherein the drive system further comprises an actuator system that can apply a first and second torque, the actuator system coupled to the jaws such that, in the soft grip mode, applying the first torque effects grasping with the jaws at the grasping force, and in the clamping mode, the second torque effects clamping with the jaws at the clamping force.

39. The apparatus of claim 38, wherein the actuator system comprises one or more actuators, the actuators comprising any or all of an electric motor, a hydraulic actuator, a pneumatic actuator, and a variable torque output actuator.

40. The apparatus of claim 38, wherein the actuator system is coupled to the jaws through one or more mechanisms of the drive system.

41. The apparatus of claim 40, wherein the mechanism comprises any or all of a cable, hypotube, and a leadscrew

42. The apparatus of claim 35, wherein the indicator is indicative of a relationship between the separation parameter and the reference separation parameter from which the prediction of failure or success can be determined by a user.

43. The apparatus of claim 35, wherein the indicator is further indicative of a time elapsed after a determination of successful clamping of the tissue.