System and method for augmentation of surgery

• US 6,024,695 A
• Filed: 05/06/1999
• Issued: 02/15/2000
• Est. Priority Date: 06/13/1991
• Status: Expired due to Fees

• Current Assignee: International Business Machines Corporation
• Original Assignee: International Business Machines Corporation
• Inventors: Taylor, Russell Highsmith, Kim, Yong-yil
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US09/306,558
• Time in Patent Office: 285 Days
• Field of Search: 128/897, 600/102, 600/160
• US Class Current: 600/102
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00203 with speech control or speech recognition
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/3916 Bone tissue
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/5025 with a counter-balancing mechanism
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: B25J 17/0275 Universal joints, e.g. Hooke, Cardan, ball joints
• CPC Class Codes: B25J 9/04 by rotating at least one arm, excluding the head movement itself, e.g. cylindrical coordinate type or polar coordinate type
• CPC Class Codes: G05B 2219/37074 : Projection device, monitor, track tool, workpiece form, process on display
• CPC Class Codes: G05B 2219/40418 : Presurgical planning, on screen indicate regions to be operated on
• CPC Class Codes: G05B 2219/40609 : Camera to monitor end effector as well as object to be handled
• CPC Class Codes: G05B 2219/45123 : Electrogoniometer, neuronavigator, medical robot used by surgeon to operate
• CPC Class Codes: G05B 2219/45166 : Tomography

Abstract

The system and method includes a manipulator for manipulating a surgical instrument relative to a patient'"'"'s body and, a position sensor for sensing the position of the surgical instrument relative to the patient'"'"'s body. The manipulator can be manually or computer actuated and can have brakes to limit movement. In a preferred embodiment, orthogonal only motion between members of the manipulator is provided. The position sensor includes beacons connected to the patient and manipulator or surgical instrument and, a three dimensional beacon sensor adapted to sense the location and position of the beacons. Redundant joint sensors on the manipulator may also be provided. The system and method uses a computer to actively interact with the surgeon and can use various different input and output devices and modes.

Claims

1. A medical laparoscopic system comprising:

a first laparoscopic instrument having an optical system adapted to transmit an image therethrough;

a second laparascopic instrument; and

a first manipulator apparatus connected to at least one of the laparoscopic instruments for holding and moving the at least one laparoscopic instrument, wherein the manipulator apparatus is adapted to hold the at least one laparoscopic instrument at an incision into a patient'"'"'s body with a center of rotation of the at least one laparoscopic instrument being provided and maintained by the manipulator apparatus at the incision.

2. A system as in claim 1 wherein the first and second laparoscopic instruments are both connected to the first manipulator apparatus.

3. A system as in claim 1 wherein the first laparoscopic instrument is connected to first manipulator apparatus.

4. A system as in claim 1 wherein the first manipulator apparatus comprises a four degree-of-freedom remote center-of-motion wrist, and wherein the at least one laparoscopic instrument is connected to the wrist.

5. A system as in claim 4 wherein the four degrees-of-freedom of the wrist can be selectively locked and moved independently of each other.

6. A system as in claim 1 further comprising a computer connected to the first manipulator apparatus by a drive motor interface, wherein the computer controls, at least partially, movement of the first manipulator apparatus.

7. A system as in claim 6 wherein the optical system of the first laparoscopic instrument is connected to the computer, and wherein the computer is adapted to control movement of the first manipulator apparatus based, at least partially, upon an image transmittal through the optical system.

8. A system as in claim 7 further comprising a user input device connected to the computer, wherein the computer is adapted to control movement of the first manipulator apparatus based, at least partially, upon a combination of input from the user input device and the image transmittal through the optical system.

9. A method for moving a laparoscopic medical instrument during laparoscopy comprising steps of:

providing a manipulator apparatus with a remote center-of-motion wrist having at least four degrees-of-freedom;

connecting the laparoscopic medical instrument to the wrist;

inserting the laparoscopic medical instrument through an incision into a patient'"'"'s body;

controlling movement of the manipulator apparatus to maintain a center of rotation of the laparoscopic medical instrument at the incision.

10. A method as in claim 9 wherein the step of controlling movement of the manipulator apparatus comprises a computer being connected to the manipulator apparatus and limiting movement of the manipulator apparatus.

11. A method as in claim 10 wherein the laparoscopic medical instrument includes an optical system which is connected to the computer, and wherein the step of controlling movement of the manipulator apparatus comprises the computer controlling the movement based, at least partially, upon an image transmitted through the optical system.

12. A method as in claim 11 wherein a user input device is connected to the computer and the step of controlling movement of the manipulator apparatus comprises the computer controlling the movement based, at least partially, upon a combination of real time input from the user input device while the laparoscopic medical instrument is in the incision and the image transmittal through the optical system.

13. A medical laparoscopy system comprising:

a first laparoscopic instrument having an optical system adapted to transmit an image therethrough;

a second laparoscopic instrument;

a manipulator apparatus connected to at least one of the laparoscopic instruments for holding and moving the at least one laparoscopic instrument;

a computer;

a drive motor interface connecting the manipulator apparatus to the computer; and

a display connected to the computer for displaying an image from the first laparscopic instrument on the display;

wherein the computer, drive motor interface and manipulator apparatus are adapted to maintain a center of rotation of the at least one laparoscopic instrument at an incision into a patient'"'"'s body with a center of rotation of the at least one laparoscopic instrument being maintained at the incision when the instrument is moved.

14. A system as in claim 13 wherein the optical system of the first laparoscopic instrument is connected to the computer and wherein the computer is adapted to control movement of the manipulator apparatus based, at least partially, upon an image transmitted through the optical system.

15. A system as in claim 14 further comprising a user input device connected to the computer, wherein the computer is adapted to control movement of the manipulator apparatus based, at least partially, upon a combination of input into the user input device and the image transmitted through the optical system.

16. A system as in claim 13 wherein the manipulator apparatus comprises a four degree-of-freedom remote center-of-motion wrist, and wherein the first laparoscopic instrument is connected to the wrist.