ROBOTIC SURGICAL SYSTEM WITH MECHANOMYOGRAPHY FEEDBACK

• US 20140088612A1
• Filed: 09/26/2012
• Published: 03/27/2014
• Est. Priority Date: 09/26/2012
• Status: Active Grant

• Current Assignee: Innovative Surgical Solutions, LLC (Johnson & Johnson)
• Original Assignee: Innovative Surgical Solutions, LLC (Johnson & Johnson)
• Inventors: Bartol, Stephen, Wybo, Christopher
• Granted Patent: US 8,892,259 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2090/065 for measuring contact or contact pressure
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 5/391 of genito-urinary organs
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence
• CPC Class Codes: A61B 5/6852 Catheters

Abstract

A robotic surgical system for performing a surgical procedure within the body of a subject includes an elongate surgical instrument, a robotic controller configured to control the motion of the distal end portion of the surgical instrument, and a mechanomyography feedback system in communication with the robotic controller. The mechanomyography feedback system includes an elongate sphincter contraction sensor configured to monitor a physical response of a sphincter of the subject and to provide a mechanomyography signal corresponding to the monitored response. Additionally, the feedback system includes a processor configured to receive the mechanomyography signal, to determine if the received signal is indicative of an induced sphincter response, and to provide a control signal to the robotic controller if an induced sphincter response is detected.

Claims

1. A robotic surgical system for performing a surgical procedure within the body of a subject, the robotic surgical system comprising:

an elongate surgical instrument having a proximal end portion and a distal end portion;

a robotic controller configured to control the motion of the distal end portion of the surgical instrument; and

a mechanomyography feedback system in communication with the robotic controller, the mechanomyography feedback system including;

an elongate sphincter contraction sensor including;

an elongate device body configured to be inserted within a sphincter of the subject; and

a force sensor in mechanical communication with the elongate device body and configured to provide a mechanomyography output signal in response to a contact force applied against the elongate device body by the sphincter;

a processor configured to;

receive the mechanomyography output signal;

determine if the received mechanomyography output signal is indicative of an induced sphincter response; and

provide a control signal to the robotic controller if an induced sphincter response is detected.

2. The robotic surgical system of claim 1, wherein the robotic controller is configured to limit the range of motion of the elongate surgical instrument in response to the received control signal.

3. The robotic surgical system of claim 1, wherein the robotic controller is configured to prevent motion of the distal end portion of the surgical instrument in response to the control signal.

4. The robotic surgical system of claim 1, wherein the control signal is indicative of a proximity between the distal end portion of the elongate surgical instrument and a nerve.

5. The robotic surgical system of claim 4, wherein the robotic controller is configured to vary the speed of the distal end of the elongate surgical instrument as a function of the indicated proximity.

6. The robotic surgical system of claim 1, wherein the processor of the mechanomyography feedback system is configured to determine if the received mechanomyography output signal is indicative of an induced sphincter response by:

computing a time derivative of the contact force from the mechanomyography output signal;

comparing the time derivative of the contact force to a threshold; and

determining that the received mechanomyography output signal is indicative of an induced sphincter response if the time derivative of the contact force exceeds the threshold.

7. The robotic surgical system of claim 1, wherein the distal end portion of the surgical instrument includes a stimulator configured to provide an electrical stimulus.

8. The robotic surgical system of claim 7, wherein an induced sphincter response is an involuntary contraction of the sphincter against the elongate device body that is caused by the depolarization of a sacral nerve in response to the provided electrical stimulus.

9. The robotic surgical system of claim 1, wherein the elongate surgical instrument includes an end effector disposed at the distal end portion, the end effector being actuatable in at least one degree of freedom;

wherein the robotic controller is configured to control the actuation of the end effector; and

wherein the robotic controller is configured to prevent actuation of the end effector in response to the control signal.

10. The robotic surgical system of claim 1, wherein the elongate surgical instrument includes an end effector disposed at the distal end portion, the end effector being actuatable in at least one degree of freedom;

wherein the robotic controller is configured to control the actuation of the end effector; and

wherein the robotic controller is configured to actuate the end effector in response to the control signal.

11. The robotic surgical system of claim 1, further comprising a master station in communication with the robotic controller and configured to:

receive an input from a user corresponding to an intended movement of the distal end portion of the surgical instrument; and

provide a motion command to the robotic controller corresponding to the received input; and

wherein the master station is configured to provide at least one of a visual alert and auditory alert if an induced muscle response is detected.

12. A method of nerve avoidance during robotically assisted surgery comprising:

controlling the motion of a distal end portion of an elongate surgical instrument using a robotic controller;

receiving a mechanomyography output signal from at least one elongate sphincter contraction sensor;

determining if the received mechanomyography output signal is indicative of an induced sphincter response; and

providing a control signal to the robotic controller if an induced sphincter response is detected.

13. The method of claim 12, further comprising electronically limiting the range of motion of the distal end portion of the elongate surgical instrument in response to the received control signal.

14. The method of claim 12, further comprising preventing, via the robotic controller, motion of the distal end portion of the surgical instrument in response to the control signal.

15. The method of claim 12, wherein the control signal is indicative of a proximity between the distal end portion of the elongate surgical instrument and a nerve.

16. The method of claim 15, further comprising varying the speed of the distal end portion of the elongate surgical instrument as a function of the indicated proximity.

17. The method of claim 12, wherein determining if the received mechanomyography signal is indicative of an induced sphincter response includes:

computing a time derivative of a contact force from the mechanomyography output signal;

comparing the time derivative of the contact force to a threshold; and

determining that the received mechanomyography output signal is indicative of an induced sphincter response if the time derivative of the contact force exceeds the threshold.

18. The method of claim 12, providing an electrical stimulus via a stimulator associated with the distal end portion of the elongate surgical instrument.

19. The method of claim 12, further comprising providing at least one of a visual alert and an auditory alert to a user if an induced muscle response is detected.

20. The method of claim 12, further comprising:

monitoring a contact force of at least one of an external sphincter of a bladder and an external sphincter of an anus of a subject against the elongate sphincter contraction sensor; and

generating the mechanomyography signal via the elongate sphincter contraction sensor, wherein the mechanomyography signal corresponds to the monitored contact force.