Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
First Claim
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1. An articulated instrument for minimally invasive surgery, comprising:
- an elongate support member having a proximal portion and a distal end with a longitudinal axis therebetween;
a pivotal wrist member coupled to the distal end of the elongate support by a wrist joint; and
a surgical end effector coupled to the wrist member by at least one joint, the end effector including at least one pair of work members pivotally coupled to the wrist member, wherein at least one work member can pivot relative to the other work member of the pair, and wherein at least one work member is removably fixed to the wrist member,said articulated instrument having a size and shape suitable for distal insertion into an internal surgical site through an aperture.
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Accused Products
Abstract
An articulated surgical instrument for enhancing the performance of minimally invasive surgical procedures. The instrument has a high degree of dexterity, low friction, low inertia and good force reflection. A unique cable and pulley drive system operates to reduce friction and enhance force reflection. A unique wrist mechanism operates to enhance surgical dexterity compared to standard laparoscopic instruments. The system is optimized to reduce the number of actuators required and thus produce a fully functional articulated surgical instrument of minimum size.
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Citations
75 Claims
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1. An articulated instrument for minimally invasive surgery, comprising:
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an elongate support member having a proximal portion and a distal end with a longitudinal axis therebetween; a pivotal wrist member coupled to the distal end of the elongate support by a wrist joint; and a surgical end effector coupled to the wrist member by at least one joint, the end effector including at least one pair of work members pivotally coupled to the wrist member, wherein at least one work member can pivot relative to the other work member of the pair, and wherein at least one work member is removably fixed to the wrist member, said articulated instrument having a size and shape suitable for distal insertion into an internal surgical site through an aperture. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 49)
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12. A minimally invasive surgical system including:
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an arm having a proximal end portion adapted to be attached to a base so as to permit a distal end portion of the arm to move relative to the base; and an articulated surgical instrument mounted on the distal end of the arm, the instrument comprising; an elongate support member having a proximal portion and a distal end with a longitudinal axis therebetween, a pivotal wrist member coupled to the distal end of the elongate support member by a wrist joint, and at least one surgical end effector work member coupled to the wrist member by at least one joint, the work member comprising an electrocautery instrument being removably fixed to the wrist members, said articulated surgical instrument having a size and shape suitable for distal insertion into an internal surgical site through an aperture. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. A method for minimally invasive surgery in a patient, comprising:
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(a) providing an articulated surgical instrument including; an elongate support member having a proximal portion and a distal end with a longitudinal axis therebetween; a pivotal wrist member coupled to the distal end of the elongate support member by a wrist joint; and a surgical end effector coupled to the wrist member by at least one joint, the end effector including at least one pair of work members pivotally coupled to the wrist member, wherein at least one work member can pivot relative to the other work member of the pair, and wherein at least one work member is removably fixed to the wrist member, said articulated surgical instrument having a size and shape suitable for distal insertion into an internal surgical site through an aperture; (b) inserting a distal portion of the surgical instrument through an aperture in a patient'"'"'s body to a location adjacent a surgical worksite, the distal portion including at least the wrist member and the end effector; (c) performing a surgical treatment using the at least one end effector work member; (d) removing the at least one end effector work member from the wrist member; (e) providing a substitute member; (f) replacing the at least one end effector work member by removably fixing the substitute member to the wrist member; and (g) performing a surgical treatment using the substitute member. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33)
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34. A minimally invasive surgical system comprising:
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a base adapted to be fixed relative to a patient'"'"'s body; an instrument positioning mechanism; an articulated surgical instrument assembly; and an instrument drive system; the instrument positioning mechanism including; a support linkage having a proximal end and a distal end, the proximal end being coupled the base and the distal end being coupled to the articulated surgical instrument assembly; a positioning drive system configured to move the distal end of the support linkage so as to move the articulated surgical instrument assembly in a plurality of degrees of freedom relative to the base; the articulated surgical instrument assembly including; a proximal portion and a distal portion, and an elongate support assembly having a proximal end and a distal end with a longitudinal axis therebetween; a pivotal wrist joint disposed adjacent the distal end of the elongate support assembly, and a surgical end effector including a first end effector element coupled to the wrist joint by a first pivotal end effector joint and a second end effector element coupled to the wrist joint by a second pivotal end effector joint so that the first and second end effector elements can manipulate tissues at the worksite therebetween; the proximal portion of the articulated surgical instrument assembly being adapted to releasably couple to the distal end of the instrument positioning mechanism; the distal portion of the articulated surgical instrument assembly having a size and shape suitable for insertion through an aperture in the patient'"'"'s body to extent to an internal surgical site; and the instrument drive system including; a plurality of actuators disposed adjacent the distal end of the positioning mechanism; a plurality of elongate drive elements extending longitudinally from the plurality of actuators to operatively couple to a corresponding plurality of pivotal joints adjacent the distal portion of the articulated surgical instrument assembly; the plurality of pivotal joints including at least the pivotal wrist joint and the first pivotal end effector joint; the instrument drive system being configured to move the first end effector element in a plurality of degrees of freedom relative to the distal end of the positioning mechanism. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48)
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50. An articulated instrument for minimally invasive surgery, comprising:
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an elongate support member having a proximal portion and a distal end with a longitudinal axis therebetween; a pivotal wrist member disposed at the distal end of the elongate support member; and a surgical end effector pivotally coupled to the wrist member, the end effector including at least one end effector work member, the work member being removably fixed to the wrist member by at least one of a clip and a screw, said articulated instrument having a size and shape suitable for distal insertion into an internal surgical site through an aperture. - View Dependent Claims (51, 52, 53, 54, 55, 56, 57, 58, 59, 60)
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61. A method for minimally invasive surgery in a patient, comprising:
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(a) providing an articulated surgical instrument including; an elongate support member having a proximal portion and a distal end with a longitudinal axis therebetween; a pivotal wrist member coupled to the distal end of the elongate support member by a wrist joint; and a surgical end effector coupled to the wrist member by at least one joint, the end effector including at least one end effector work member, the work member comprising an electrocautery instrument being removably fixed to the wrist member; said articulated instrument having a size and shape suitable for distal insertion into an internal surgical site through an aperture. (b) inserting a distal portion of the surgical instrument through an aperture in a patient'"'"'s body to a location adjacent a surgical worksite, the distal portion including at least the wrist member and the end effector; (c) performing a surgical treatment using the at least one end effector work member; (d) removing the at least one end effector work member from the wrist member; (e) providing a substitute member; (f) replacing the at least one end effector work member by removably fixing the substitute member to the wrist member; and (g) performing a surgical treatment using the substitute member. - View Dependent Claims (62, 63, 64, 65, 66, 67, 68, 69, 70)
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71. A method for performing a surgical procedure with a robotic surgical system comprising:
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providing a surgical instrument assembly comprising a shaft with a proximal end and a distal end, a pivotal wrist member coupled to the distal end of the shaft by a wrist joint and an instrument coupled to the wrist member by at least one joint; connecting the proximal end of the shaft of the surgical instrument assembly to a manipulator arm; positioning the manipulator arm by articulating a mounting joint prior to surgery; introducing the instrument of the surgical instrument assembly to a treatment site on a patient with the manipulator arm; and moving the instrument assembly with the manipulator arm so as to perform a surgical procedure with the instrument. - View Dependent Claims (72, 73, 74, 75)
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Specification