Endoscopic surgical instrument and method for use
First Claim
1. An endoscopic surgical instrument comprising a control section and an insertion section wherein:
- the insertion section is insertable into a patient through a small incision to a location adjacent a worksite in the patient;
the insertion section comprises a rigid forearm link, a wrist link and an end effector wherein;
the forearm link has a proximal end, a distal end and a forearm axis extending longitudinally from the proximal end of the forearm link to the distal end of the forearm link;
the wrist link has a proximal end and a distal end and a wrist axis extending from the proximal end of the wrist link to the distal end of the wrist link;
the proximal end of the forearm link is connected to the control section, the distal end of the forearm link is connected to a pivotal wrist joint; and
the proximal end of the wrist link is connected to the pivotal wrist joint and the distal end of the wrist link is connected to the end effector;
and the control section comprises a plurality of control motors and linkages to operate the insertion section with at least five degrees of freedom including;
insertion and retraction of the forearm link along the forearm axis and through the small incision;
rotation of the forearm link about the forearm axis;
pivotal motion of the forearm link about a first pivotal axis and a second pivotal axis which are perpendicular to each other and intersect the forearm axis at a pivot point between the proximal end of the forearm link and the distal end of the forearm link adjacent the small incision, wherein such pivotal motion of the forearm link avoids lateral movement of the forearm link at the pivot point; and
pivotal motion of the wrist link relative to the forearm link.
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Abstract
A teleoperator system with telepresence is shown which includes right and left hand controllers (72R and 72L) for control of right and left manipulators (24R and 24L) through use of a servomechanism that includes computer (42). The teleoperator system comprises a endoscope surgical instrument suited for endoscopic surgery. The surgical instrument comprises a control servomechanism which operates an insertion section. The insertion section comprises a forearm, a wrist and an end effector. The end effector is a modified surgical instrument such as retractors, electrosurgical cutters, electrosurgical coagulators, forceps, needle holders, scissors, blades and irrigators. The control section contains motors and linkages which operate the insertion section with five or more degrees of freedom. The control section inserts, retracts, pivots and rotates the forearm with four degrees of freedom about axes that all intersect adjacent a small incision through which the insertion section is introduced to the patient. The control section also pivots the wrist with at least one degree of freedom relative to the forearm and operates the end effector. The surgical manipulator provides superior flexibility in performing endoscopic procedures compared to standard rigid endoscopic instruments and is adapted for teleoperator control.
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Citations
32 Claims
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1. An endoscopic surgical instrument comprising a control section and an insertion section wherein:
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the insertion section is insertable into a patient through a small incision to a location adjacent a worksite in the patient; the insertion section comprises a rigid forearm link, a wrist link and an end effector wherein; the forearm link has a proximal end, a distal end and a forearm axis extending longitudinally from the proximal end of the forearm link to the distal end of the forearm link; the wrist link has a proximal end and a distal end and a wrist axis extending from the proximal end of the wrist link to the distal end of the wrist link; the proximal end of the forearm link is connected to the control section, the distal end of the forearm link is connected to a pivotal wrist joint; and the proximal end of the wrist link is connected to the pivotal wrist joint and the distal end of the wrist link is connected to the end effector; and the control section comprises a plurality of control motors and linkages to operate the insertion section with at least five degrees of freedom including; insertion and retraction of the forearm link along the forearm axis and through the small incision; rotation of the forearm link about the forearm axis; pivotal motion of the forearm link about a first pivotal axis and a second pivotal axis which are perpendicular to each other and intersect the forearm axis at a pivot point between the proximal end of the forearm link and the distal end of the forearm link adjacent the small incision, wherein such pivotal motion of the forearm link avoids lateral movement of the forearm link at the pivot point; and pivotal motion of the wrist link relative to the forearm link. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A surgical method for endoscopic surgery comprising the steps of:
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providing an endoscopic surgical instrument comprising a control section and an insertion section; inserting the insertion section into a patient through a small incision to a location adjacent a worksite inside the patient, wherein the insertion section comprises a rigid forearm link, a wrist link and an end effector, and wherein; the forearm link has a proximal end, a digital end and a forearm axis extending longitudinally from the proximal end of the forearm link to the distal end of the forearm link; the wrist link has a proximal end and a distal end and a wrist axis extending from the proximal end of the wrist link to the distal end of the wrist link; the proximal end of the forearm link is connected to the control section, the distal end of the forearm link is connected to a pivotal wrist joint; the proximal end of the wrist link is connected to the pivotal wrist joint and the distal end of the wrist joint is connected to the end effector; and
the forearm link is inserted distally along the forearm axis through the small incision;operating a servomechanism to rotate the forearm link about the forearm axis; operating the servomechanism to pivot the forearm link about a first pivotal axis and a second pivotal axis which are perpendicular to each other and intersect the forearm axis at a pivot point, the pivot point disposed between the proximal end of the forearm link and the distal end of the forearm link and adjacent the small incision, wherein such pivotal operation of the forearm link avoids lateral movement of the forearm link at the pivot point; operating the servomechanism to pivot the wrist link relative to the forearm; and manipulating human tissue with the end effector at the worksite inside the patient. - View Dependent Claims (9, 10, 11, 12, 13, 14)
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15. An endoscopic surgical instrument comprising an insertion section and a control section wherein:
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the insertion section is insertable into a patient through a small incision to a location adjacent a worksite in the patient; the insertion section comprises a rigid forearm link, a wrist link and an end effector wherein; the forearm link has a proximal end, a distal end and a forearm axis extending longitudinally from the proximal end of the forearm to the distal end of the forearm; the wrist link has a proximal end and a distal end and a wrist axis extending from the proximal end of the forearm to the distal end of the forearm; the proximal end of the forearm link is connected to the control section, the distal end of the forearm link is connected to a pivotal wrist joint; and the proximal end of the wrist link is connected to the pivotal wrist joint and the distal end of the wrist joint is connected to the end effector; and the control section comprises; means for inserting and retracting the forearm link along the forearm axis and through the small incision; means for rotating the forearm link about the forearm axis; means for pivoting the forearm link about a first pivotal axis and a second pivotal axis which are perpendicular to each other and intersect the forearm axis at a pivot point between the proximal end of the forearm link and the distal end of the forearm link adjacent the small incision, wherein such pivotal means avoids lateral movement of the forearm link at the pivot point; and means for pivoting the wrist link relative to the forearm link so as to control the angle between the forearm axis and the wrist axis. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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22. A minimally invasive surgery system comprising:
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a surgical station including a manipulating linkage supporting an actuatable end effector, the manipulator including an elongate rigid member having a proximal end and a distal end, wherein a joint is disposed between the distal end of the member and the end effector; a control station including an actuatable handle and a movable controller; and a servomechanism coupling the handle to the end effector so that actuation of the handle effects actuation of the end effector to manipulate tissue at an internal surgical site within a patient body, wherein the servomechanism moves the end effector within the internal surgical site in response to movement of the controller by pivoting the member about a first pivotal axis and a second pivotal axis which are perpendicular to each other and intersect at an insertion point between the proximal and distal ends of the member, wherein such pivotal movement of the member avoids lateral movement of the member at the insertion point, and by articulating the joint distally of the insertion point and within the patient body. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29)
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30. A minimally invasive surgery system comprising:
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a surgical station including a manipulator linkage supporting an end effector so that the end effector can move in three dimensions, the manipulator including an elongate rigid member having a proximal end and a distal end, the proximal end of the member movable in a plurality of proximal degrees of freedom, wherein a joint is disposed between the distal end of the member and the end effector, the joint providing a plurality of distal degrees of freedom; a control station including an actuatable handle and a movable controller, the actuatable handle movable in a three dimensional station workspace; and a servomechanism coupling the handle to the end effector so that actuation of the handle effects actuation of the end effector, the servomechanism coupled to the manipulator so that movement of the controller in the three dimensional space effects movement of the end effector in the surgical site by driving the proximal end in the proximal degrees of freedom, by pivoting the member about a first pivotal axis and a second pivotal axis which are perpendicular to each other and intersect at an insertion point between the proximal end and the distal end, wherein such pivotal movement of the member avoids lateral movement of the member at the insertion point, and by articulating the joint about the distal degrees of freedom.
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31. A minimally invasive surgery method comprising:
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inserting a surgical end effector into an internal surgical site of a patient body through a percutaneous penetration, the end effector attached to a rigid member by a joint; actuating the end effector to manipulate tissue in response to actuation of a handle of a control station; moving the end effector at the surgical site with a servomechanism in response to movement of the handle by driving a proximal end of the member outside the patient body with the servomechanisms and by articulating the joint inside the patient body with the servomechanism, wherein the member pivots about a first pivotal axis and a second pivotal axis which are perpendicular to each other and intersect at the percutaneous penetration between the proximal end of the member and a distal end of the member when the end effector is moved by the servomechanism so as to avoid lateral movement of the member relative to the percutaneous penetration. - View Dependent Claims (32)
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Specification