Method and apparatus for performing minimally invasive cardiac procedures

• US 5,855,583 A
• Filed: 11/22/1996
• Issued: 01/05/1999
• Est. Priority Date: 02/20/1996
• Status: Expired due to Term

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Computer Motion Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Laby, Keith Phillip, Wang, Yulun, Jordan, Charles S., Wright, James W., Wilson, Jeff D., Uecker, Darrin R.
• Primary Examiner(s): Jackson, Gary
• Application Number:
  US08/755,063
• Time in Patent Office: 774 Days
• Field of Search: 606/130, 606/139, 414/1, 414/2, 901/1, 901/8, 901/41, 901/48, 128/898, 395/80, 395/86, 318/568.11
• US Class Current: 606/139
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/00203 with speech control or speech recognition
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2017/00973 pedal-operated
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/35 for telesurgery
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• 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 34/72 : Micromanipulators
• CPC Class Codes: A61B 34/75 : Manipulators having means for prevention or compensation of hand tremors
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 46/10 : specially adapted for instruments, e.g. microscopes
• CPC Class Codes: A61B 50/00 : Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers drapes specially adapted for instruments A61B46/10
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: B25J 9/1689 : Teleoperation
• CPC Class Codes: G05B 2219/45119 : Telesurgery with local assistent, voice communication
• CPC Class Codes: Y02A 90/10 : Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

A system for performing minimally invasive cardiac procedures. The system includes a pair of surgical instruments that are coupled to a pair of robotic arms. The instruments have end effectors that can be manipulated to hold and suture tissue. The robotic arms are coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the end effectors. The movement of the handles is scaled so that the end effectors have a corresponding movement that is different, typically smaller, than the movement performed by the hands of the surgeon. The scale factor is adjustable so that the surgeon can control the resolution of the end effector movement. The movement of the end effector can be controlled by an input button, so that the end effector only moves when the button is depressed by the surgeon. The input button allows the surgeon to adjust the position of the handles without moving the end effector, so that the handles can be moved to a more comfortable position. The system may also have a robotically controlled endoscope which allows the surgeon to remotely view the surgical site. A cardiac procedure can be performed by making small incisions in the patient'"'"'s skin and inserting the instruments and endoscope into the patient. The surgeon manipulates the handles and moves the end effectors to perform a cardiac procedure such as a coronary artery bypass graft.

Claims

1. A medical robotic system, comprising:

a robotic arm;

a coupler that pivotally attaches to the arm;

an endoscopic surgical instrument that is held by said coupler; and

a controller having a handle, the controller in electrical communication with the robotic arm; and

wherein movement at the controller produces a proportional movement of the robotic arm and surgical instrument.

2. The system of claim 1 wherein said coupler removably attaches to said robotic arm.

3. The system of claim 1 wherein said endoscopic surgical instrument is an articulable endoscopic surgical instrument.

4. The system of claim 1 wherein the articulable surgical instrument comprises a base, a pivot linkage, and a distal end.

5. The system of claim 1 wherein the coupler has an aperture formed therethrough.

6. The system of claim 4 wherein a movement at the controller results in corresponding movement of the distal end of the articulable surgical instrument relative to the base of the articulable surgical instrument.

7. The system of claim 6 wherein the tool attached at the distal end of the articulable surgical instrument is a stapler.

8. The system of claim 6 wherein the tool attached at the distal end of the articulable surgical instrument is a cauterizer.

9. A method for operating a surgical robotic system for performing a surgical procedure on a patient, the method comprising:

1) providing a first articulate arm, a controller and an input device which receives input commands, the first articulate arm in electrical communication with the controller and the controller in electrical communication with the input device;

2) cutting at least one incision into the patient;

3) attaching a surgical instrument to the first articulate arm;

4) inserting said surgical instrument into the patient through the at least one incision;

5) generating input commands to move said surgical instrument in accordance with the procedure being performed wherein said robotic arm moves said surgical instrument in accordance with the input commands; and

6) removing the surgical instrument from the patient.

10. The method of claim 9 wherein after removing the surgical instrument from the patient further comprises the steps of:

1) replacing the surgical instrument with a different surgical instrument;

2) inserting said different surgical instrument into the patient;

3) generating input commands to move the different surgical instrument in accordance with the procedure being performed wherein said robotic arm moves the different surgical instrument in accordance with the input commands; and

4) removing the different surgical instrument from the patient.

11. The method of claim 9 wherein said surgical instrument is a grasper.

12. The method of claim 9 wherein the surgical instrument is a stapler.

13. The method of claim 9 wherein the surgical instrument is a cauterizer.

14. The method of claim 9 wherein the surgical instrument is a cutting blade.

15. The method of claim 9 wherein the step of attaching a surgical instrument to the collar by passing the instrument tip through the collar.