Flexible robotic surgery system and method

• US 6,999,852 B2
• Filed: 10/26/2004
• Issued: 02/14/2006
• Est. Priority Date: 01/21/1992
• Status: Expired due to Fees

• Current Assignee: SRI International, Inc.
• Original Assignee: SRI International, Inc.
• Inventors: Green, Philip S.
• Primary Examiner(s): Black, Thomas G.
• Assistant Examiner(s): Marc, McDieunel
• Application Number:
  US10/974,593
• Publication Number:
  US 20050065658A1
• Time in Patent Office: 476 Days
• Field of Search: 700245-248, 700/251, 700258-260, 700/264, 700/275, 600/407, 600/424, 600/427, 600/429, 600/595, 600/102, 600/101, 600/118, 606/1, 606/130, 606/139, 901 1- 2, 901/46, 901/34, 901/41, 318/568.11, 318/568.12, 318/568.21, 318/568.25, 318/566, 128/897, 345/184
• US Class Current: 700/245
• CPC Class Codes: A61B 1/00193 adapted for stereoscopic vision
• 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 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 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/371 with simultaneous use of two cameras
• 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 34/72 Micromanipulators
• 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 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: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: B25J 13/025 comprising haptic means
• CPC Class Codes: B25J 19/023 including video camera means
• CPC Class Codes: B25J 3/04 involving servo mechanisms servo-actuated heads B25J15/02
• CPC Class Codes: H04N 13/189 Recording image signals; Reproducing recorded image signals
• CPC Class Codes: H04N 13/194 Transmission of image signals
• CPC Class Codes: H04N 13/239 : using two 2D image sensors having a relative position equal to or related to the interocular distance H04N13/243 takes precedence
• CPC Class Codes: H04N 13/246 : Calibration of cameras
• CPC Class Codes: H04N 13/296 : Synchronisation thereof; Control thereof
• CPC Class Codes: H04N 13/337 : using polarisation multiplexing
• CPC Class Codes: H04N 13/341 : using temporal multiplexing
• CPC Class Codes: H04N 13/398 : Synchronisation thereof; Control thereof

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). Cameras (46R and 46L) view workspace (30) from different angles for production of stereoscopic signal outputs at lines (48R and 48L). In response to the camera outputs a 3-dimensional top-to-bottom inverted image (30I ) is produced which, is reflected by mirror (66) toward the eyes of operator (18). A virtual image (30V) is produced adjacent control arms (76R and 76L) which is viewed by operator (18) looking in the direction of the control arms. By locating the workspace image (30V) adjacent the control arms (76R and 76L) the operator is provided with a sense that end effectors (40R and 40L) carried by manipulator arms (34R and 34L) and control arms (76R and 76L) are substantially integral. This sense of connection between the control arms (76R and 76L) and end effectors (40R and 40L) provide the operator with the sensation of directly controlling the end effectors by hand. By locating visual display (246) adjacent control arms (244R and 244L) image (240I) of the workspace is directly viewable by the operator. (FIGS. 12 and 13.) Use of the teleoperator system for surgical procedures also is disclosed. (FIGS. 7–9 and FIG. 13.)

Claims

1. A medical robotic system, comprising:

a robotic manipulator having proximal drive system, a distal surgical instrument end effector for manipulating tissues, and a flexible body supporting the surgical instrument end effector; and

an input device having a handle;

a computer coupling the input device to the drive system of the robotic manipulator, the computer configured so that, in use, movement of the handle effects bending of the flexible body and produces a desired movement of the surgical instrument end effector so as to manipulate tissues.

2. The medical robotic system of claim 1, wherein the computer is configured so that the movement of the surgical instrument end effector is proportional to the movement of the handle at the controller.

3. The medical robotic system of claim 1, further comprising a display device for displaying an image of an object from an internal surgical site, wherein the handle is configured to receive a command to move the surgical instrument end effector in a desired direction relative to the image of the object displayed by the display device as seen by the user, and wherein the computer:

receives said command;

computes a movement of the manipulator based on said command so that the surgical instrument end effector moves in the desired direction within the internal surgical site; and

provides output signals to said drive motors to move said manipulator to effect said computed movement.

4. The medical robotic system of claim 1, wherein the manipulator comprises a shaft having a proximal end and a distal end with a lumen therebetween, the proximal end of the shaft being coupled to the drive system, the flexible body extending distally through the lumen and being movable relative to the shaft by the drive system.

5. The medical robotic system of claim 4, wherein the manipulator includes an elongate steering control element coupling the drive system to the flexible body, the control element actuatable to steer the flexible body distally of the shaft.

6. The medical robotic system of claim 5, wherein the steering control element comprises a plurality of cables, said flexible body comprising a catheter body.

7. The medical robotic system of claim 4, wherein the surgical instrument end effector, the distal end of the shaft, and a distal end of the flexible body are included within an insertion section of the manipulator, the insertion section configured to be inserted into the patient body through a minimally invasive aperture, wherein the drive system effects movement of the surgical instrument end effector using rotation of the insertion section about an axis of the insertion section passing through the aperture and translation of the insertion section along the axis of the insertion section passing through the aperture.

8. The medical robotic system of claim 1, wherein the handle of the input device has an actuation sensor, wherein the surgical instrument end effector is movingly actuatable, and wherein the computer and drive system operatively couple the sensor to the surgical instrument end effector so that actuation of the sensor with the hand of the user effects moving actuation of the surgical instrument end effector so as to manipulate tissue at the surgical site.

9. The medical robotic system of claim 8, wherein the surgical instrument end effector comprises a pair of jaws coupled to the sensor to allow the user to control opening and closing of the jaws via the sensor.

10. The medical robotic system of claim 1, wherein the surgical instrument end effector comprises a retractor, an electro surgical cutter, an electrosurgical coagulator, microforceps, a microneedle holder, scissors, a blade, an irrigator, or suture.

11. A minimally invasive surgery system comprising:

a surgical manipulator positioning an end effector so that the end effector can move in a three dimensional internal surgical site, the manipulator including an elongate member having a proximal end and a distal end, the proximal end of the member movable in a plurality of degrees of freedom, wherein a plurality of distal degrees of freedom are provided between the distal end of the member and the end effector;

an operator'"'"'s station including a handle supported by a movable controller linkage, the handle movable in a three dimensional controller workspace; and

a computer coupling the operator'"'"'s station to the manipulator so that movement of the handle in the three dimensional controller workspace effects movement of the end effector in the internal surgical site by driving the proximal end of the member in the proximal degrees of freedom from outside the patient body, by movement of the member through a minimally invasive aperture, and by articulating the manipulator about the distal degrees of freedom within the body so as to manipulate tissue with the end effector at the internal surgical site.

12. The minimally invasive surgery system of claim 11, wherein the manipulator comprises an insertion section and a control section, the insertion section including the end effector and a distal end of the elongate member, the elongate member comprising a flexible and steerable body, wherein the control section includes control motors and linkages coupled to the flexible body to insert and steer the end effector when an operator manually moves the handle and controller.

13. The minimally invasive surgery system of claim 12, wherein the flexible body comprises a steerable catheter body passing through a channel of the member.

14. The minimally invasive surgery system of claim 13, wherein the member comprises an endoscope, wherein the motors of the control section effect bending of the steerable catheter body using steering wires of the catheter body, and wherein the endoscope is coupled to a display device for presenting visual display of the internal surgical site.

15. The minimally invasive surgery system of claim 11, wherein the handle comprises an actuatable handle, wherein the actuatable handle is operationally associated with the end effector so that actuation of the handle effects actuation of the end effector.

16. The minimally invasive surgery system of claim 11 wherein the end effector comprises a surgical instrument head selected from the group of retractors, electrosurgical cutters, electrosurgical coagulators, forceps, needle holders, scissors, blades and irrigators.

17. A medical robotic method comprising:

introducing an insertion section of a robotic manipulator into a minimally invasive aperture so that a surgical instrument end effector is at an internal surgical site, the end effector supported by an elongate flexible body;

inputting a command to move the end effector by moving a handle of an input device;

computing signals in response to the input command; and

bending the flexible body and manipulating the tissues at the internal surgical site in response to the computed signals.

18. The medical robotic method of claim 17, further comprising displaying an image of an object at the internal surgical site, wherein the input command comprises a command to move the end effector in a desired direction relative to the image of the object displayed by the display device as seen by the user, and wherein the computer:

receives said command;

computes a movement of the manipulator based on said command so that the surgical instrument end effector moves in the desired direction within the internal surgical site; and

provides output signals to drive motors of the manipulator to move said manipulator and bend the elongate flexible body so as to effect said computed movement.

19. A surgical manipulator system comprising:

a control section and an insertion section, wherein the insertion section is insertable into a patient through an aperture in a body of a patient to a location adjacent a surgical worksite in the patient;

the insertion section comprising an elongate portion having proximal and distal ends with a longitudinal centerline extending between the proximal and distal ends, and an end effector, the end effector coupled to the elongate portion distal end in such a manner as to provide the end effector with at least two degrees of freedom of movement within the patient, wherein the end effector is coupled to a medical device having a flexible and steerable distal end; and

the control section comprising an operators control stations having a manual controller, and a drive system having a plurality of control motors and linkages, the drive system operatively couple to both the insertion section and the control station so that an operator is able to manually move the controller to operate the insertion section to insert and steer the medical device inside the aperture using a steering control element coupled to the drive system and the medical device.

20. The surgical manipulator system of claim 19, wherein the medical device comprises a steerable catheter supporting the end effector and slidingly received in a working channel of the elongate portion, the steering control element of the control section effecting bending of the steerable catheter in response to movement of the manual controller.

21. The surgical manipulator system of claim 20, wherein the control section comprises a computer configured to remap a movement of the manual controller to a coordinate system of the end effector.