Surgical instrument

• US 6,843,793 B2
• Filed: 11/16/2001
• Issued: 01/18/2005
• Est. Priority Date: 02/24/1998
• Status: Expired due to Term

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: endoVia Medical, Inc. (Johnson & Johnson)
• Inventors: Brock, David L., Lee, Woojin
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US10/008,871
• Publication Number:
  US 20020133173A1
• Time in Patent Office: 1,159 Days
• Field of Search: 606/1, 606/130, 600/424, 600/102, 600/104, 128/898, 395/99, 395/89, 395/95, 395/97
• US Class Current: 606/130
• 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 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00088 using thermistors
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• 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 2034/305 Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2034/715 Cable tensioning mechanisms for removing slack
• CPC Class Codes: A61B 2034/742 : Joysticks
• CPC Class Codes: A61B 2034/744 : Mouse
• CPC Class Codes: A61B 2090/365 : augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/506 : using a parallelogram linkage, e.g. panthograph
• 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 34/35 : 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 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/015 : By temperature mapping of body part
• CPC Class Codes: A61B 5/4893 : Nerves
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: B25J 3/04 : involving servo mechanisms servo-actuated heads B25J15/02
• CPC Class Codes: B25J 9/104 : with cables, chains or ribbons

Abstract

A program of instructions for the processor which include: receiving an insertion length of a medical instrument inserted in a patient; and determining a distal end location of the instrument at a target site in the patient from the insertion length. The instrument typically has a straight proximal portion and curved distal portion, lies in a single plane and is a rigid guide member. The instrument is typically inserted and then fixed at a pivot axis outside the patient. The pivot axis is generally aligned with an insertion point at which the instrument is inserted into the patient. The program of instructions may include determining a subsequent location of the distal end associated with pivoting about the pivot axis. The program of instructions may include determining a subsequent location of the distal end associated with axial rotation of the instrument, determining a subsequent location of the distal end associated with linear translation along a length axis of the instrument and/or determining a subsequent movement of the distal end in a single plane about the pivot axis. The pivotal axis is typically a reference point used by the program of instructions in determining subsequent movement of the distal end.

Claims

1. A method of controlling a surgical instrument that is inserted in a patient for facilitating a surgical procedure and controlled remotely from an input device manipulated by a surgeon at a user interface, said method comprising the steps of:

initializing the position of the surgical instrument without calculating its initial position, and the position of the input device under electronic control;

said initializing including establishing an initial reference position for the input device and an initial reference position for the surgical instrument calculating the current position of the input device as it is manipulated by the surgeon;

determining the desired position of the surgical instrument based upon;

the current position of the input device,

the initial reference position of the input device, and

the initial reference position of the surgical instrument, and

moving the surgical instrument to the desired position so that the position of the surgical instrument corresponds to that of the input device.

2. A method as set forth in claim 1 wherein the input device has position sensors, and the step of initializing includes these position sensors.

3. A method set forth in claim 2 wherein the initializing is to zero.

4. A method as set forth in claim 1 including computing an initial reference orientation for the input device.

5. A method as set forth in claim 4 including computing a desired orientation for the surgical instrument.

6. A method as set forth in claim 5 including computing a desired position for the surgical instrument.

7. A method as set forth in claim 1 wherein said initializing step includes performing a forward kinematic computation from the input device.

8. A method as set forth in claim 2 including reading position sensor values and current time.

9. A method as set forth in claim 8 wherein the calculating step includes calculating both the position and orientation of the input device.

10. A method as set forth in claim 1 including calculating the current orientation of the input device.

11. A method as set forth in claim 1 wherein said step of determining includes performing an inverse kinematic computation.

12. A method as set forth in claim 1 wherein said determining step includes a transformation into an earth coordinate system.

13. A method as set forth in claim 12 wherein from said transformation there are determined joint angles and drive motor angles for the surgical instrument orientation.

14. A method of controlling a tool of a surgical instrument that is inserted in a patient for carrying out a surgical procedure and is controlled remotely by way of an electronic controller from an input device at a user interface, said method comprising the steps of:

setting the input device at an initial reference configuration and under electronic controller control;

setting the surgical instrument in the patient at an initial predefined reference configuration without electronic controller control;

calculating the current absolute position of the input device;

determining the desired location of the tool by a kinematic computation that accounts for at least the initial reference configuration of the input device and the current absolute position of the input device; and

moving the surgical instrument to the desired position so that the location of the tool corresponds to that of the input device.

15. A method as set forth in claim 14 wherein said step of determining is also based upon the initial reference configuration of the tool.

16. A method as set forth in claim 14 wherein the input device has position sensors, and the step of setting includes initializing these position sensors.

17. A method as set forth in claim 14 including computing an initial reference orientation for the input device.

18. A method as set forth in claim 14 including computing a desired orientation for the surgical instrument.

19. A method as set forth in claim 14 wherein said calculating step includes performing a forward kinematic computation from the input device.

20. A method as set forth in claim 14 including calculating the current orientation of the input device.

21. A method as set forth in claim 14 wherein said step of determining includes performing an inverse kinematic computation.

22. A method as set forth in claim 14 wherein said determining step includes a transformation into an earth coordinate system.

23. A method as set forth in claim 22 wherein from said transformation there are determined joint angles and drive motor angles for the surgical instrument orientation.

24. A method of controlling a medical implement remotely from an input device that is controlled by an operator, said method comprising the steps of:

positioning the medical implement at an initial start position at an operative site for the purpose of facilitating a medical procedure;

establishing a fixed position reference coordinate representative of the initial start position of said medical implement based upon a base point of the implement and an active point of the implement being in an initial known relative dimensional configuration,

positioning the input device at an initial start position;

establishing a fixed position reference coordinate;

calculating the current position of the input device as it is controlled;

determining the desired position of the medical implement based upon;

the current position of the input device,

the fixed position reference coordinate of the input device, and

the fixed position reference coordinate of the medical implement, and

moving the medical implement to the desired position so that the position of the medical implement corresponds to that of the input device.

25. A method as set forth in claim 24 wherein, in said step of positioning the medical implement, the medical implement comprises a surgical instrument.

26. A method as set forth in claim 25 wherein, in said step of positioning the medical implement, the medical implement comprises a catheter.

27. A method as set forth in claim 24 wherein said step of positioning the medical implement includes physically placing the distal end of the medical implement at the operative site.

28. A method as set forth in claim 27 wherein said medical implement is placed without pre-computation of a coordinate position at which it is placed.

29. A method as set forth in claim 28 wherein said step of positioning the medical implement is only controlled by manual placement without any electric pre-computation of a predetermined coordinate position to control the actual placement of the medical implement.

30. A method as set forth in claim 24, wherein, in said step of positioning the medical implement, the medical implement comprises a surgical instrument having a tool and a wrist, said established reference coordinate corresponding to an initial position of a location on said wrist.

31. A method as set forth in claim 24 further including providing an electronic controller for controlling said medical implement and wherein the step of positioning the medical implement includes manually placing the medical implement without computation by said controller of an initial coordinate position.

32. A method as set forth in claim 24 further including providing an electronic controller for controlling said medical implement and wherein the step of positioning the input device includes initially moving the input device under controller control so as to establish the reference coordinate position of the input device.

33. A method as set forth in claim 25 including storing in the controller the reference coordinate position of the input device.

34. A method as set forth in claim 24 wherein said step of establishing includes performing a forward kinematic computation.

35. A method as set forth in claim 34 wherein said calculating step includes calculating both the position and the orientation of the input device.

36. A method as set forth in claim 35 wherein said step of determining includes performing an inverse kinematic computation.

37. The method as set forth in claim 24 wherein said step of establishing a fixed position reference coordinate representative of the initial start position of said medical implement includes establishing said reference coordinate in relation to the patients body.

38. The method as set forth in claim 37 wherein the reference coordinate of the implement is at a predetermined location of the patient.

39. The method as set forth in claim 38 wherein the predetermined location is at an incision.

40. The method as set forth in claim 38 wherein the reference coordinate of the implement corresponds to an internal site of the patient.

41. The method as set forth in claim 40 wherein the reference coordinate of the implement corresponds to a site external of the patient.

42. The method as set forth in claim 24 wherein the step of establishing a fixed position reference coordinate representative of the initial start position of said medical implement includes aligning an axis of the base point of the medical implement with an incision in the patient.

43. The method as set forth in claim 24 wherein the step of determining includes performing a coordinate transformation from the base point to the active point of the implement.

44. The method as set forth in claim 43 wherein the coordinate transform is a fixed transform less than 90 degrees.

45. The method as set forth in claim 44 wherein the fixed transform is on the order of 45 degrees.

46. The method as set forth in claim 45 wherein the fixed transform on the order of 45 degrees corresponds to the curvature of the guide tube.

47. A method of controlling a surgical instrument remotely from an input device and by way of an electronic controller, said method comprising the steps of:

inserting the surgical instrument through an incision in the patient so as to dispose the distal end of the instrument at an initial start position;

establishing a fixed position reference coordinate system corresponding to a fixed predefined configuration of the surgical instrument at the initial start position of said surgical instrument;

positioning the input device at an initial start position;

establishing a fixed position reference coordinate system representative of the initial start position of said input device;

calculating the current absolute position of the input device as it is controlled;

determining the desired position of the surgical instrument based upon the current absolute position of the input device, and the fixed position reference coordinate system for the respective surgical instrument and input device; and

moving the surgical instrument to the desired position so that the position of the surgical instrument corresponds to that of the input device.

48. A method as set forth in claim 47 wherein said step of positioning the input device includes initializing the location of the input device wider control of the controller.

49. A method as set forth in claim 48 wherein said surgical instrument is initially positioned without control from said controller.

50. A method as set forth in claim 47 wherein the initial start position is determined only by manual insertion.

51. A method as set forth in claim 50 wherein the step of positioning the input device comprises initially moving the input device under controller control so as to establish the reference coordinate position of the input device.

52. A method as set forth in claim 51 including storing in the controller the reference coordinate position of the input device.

53. A method as set forth in claim 47 wherein said step of calculating includes performing a forward kinematic computation.

54. A method as set forth in claim 53 wherein said calculating step includes calculating both the position and the orientation of the input device.

55. A method as set forth in claim 54 wherein said step determining includes performing an inverse kinematic computation.

56. A method of controlling a medical implement remotely from an input device and by way of an electronic controller, said method comprising the steps of:

inserting the medical implement through an incision in a patient so as to dispose the medical implement in a pre-select initial configuration;

assigning a fixed initial reference coordinate to a work element of the medical implement based upon a known dimension between said work element and a base of the medical implement and said preselected initial configuration;

positioning the input device at an initial start position;

establishing a fixed initial reference coordinate representative of the initial start position of die input device;

calculating the current position of the input device as it is controlled;

determining the desired position of the medical implement based upon at least the current position of the input device; and

moving the medical implement so that the position thereof corresponds to that of the input device.

57. A method as set forth in claim 56 wherein said step of inserting the medical implement includes inserting a surgical instrument.

58. A method as set forth in claim 56 wherein said step of inserting the medical implement includes inserting a catheter.

59. A method as set forth in claim 56 wherein said step of inserting the medical implement includes inserting a distal end of the medical implement through the incision so as to be disposed at a target site.

60. A method as set forth in claim 56 wherein said step of inserting the medical implement includes placing the medical implement without pre-computation of a coordinate position at which it is placed.

61. A method as set forth in claim 56 wherein said step of assigning includes placing the medical implement without pre-computation to determine a coordinate position.

62. A method as set forth in claim 56 wherein said step of establishing a fixed initial reference coordinate for the input device includes executing a forward kinematic computation to determine the reference coordinate.

63. A method as set forth in claim 62 wherein said step of executing a forward kinematic computation includes determining both the position and orientation of the input device.

64. A method as set forth in claim 62 wherein said step of executing a forward kinematic computation includes determining a position by a geometric calculation.

65. A method as set forth in claim 64 including determining an orientation by a transformation matrix.

66. A method as set forth in claim 56 wherein said step of determining includes performing an inverse kinematic computation.

67. A method as set forth in claim 66 including determining joint angles and insertion length of the instrument.

68. A method as set forth in claim 67 including determining the instrument orientation.