In vivo accessories for minimally invasive robotic surgery

• US 8,182,476 B2
• Filed: 03/18/2010
• Issued: 05/22/2012
• Est. Priority Date: 12/08/1998
• Status: Expired due to Term

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Julian, Christopher A., Wallace, Daniel T., Moll, Frederick H., Hoornaert, Dean F., Rosa, David J., Freund, John G., Hill, John W.
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US12/727,060
• Publication Number:
  US 20100198215A1
• Time in Patent Office: 796 Days
• Field of Search: 606/130, 606/33, 606/1, 606/41, 606/49, 606/174, 600/102, 600/114, 600/227, 600/228, 600/229, 128/898
• US Class Current: 606/33
• CPC Class Codes: A61B 1/00149 using articulated arms
• 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 17/0218 for minimally invasive surgery A61B17/0281, 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 17/06061 Holders for needles or sutures, e.g. racks, stands hand-held holding instruments A61B17/0483; holders for articles A61B50/20; racks for syringes or for hypodermic or infusion needles A61M5/008
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/54 Chiropodists' instruments , e.g. pedicure chiropractic devices A61H1/008
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• 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 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/00362 Packages or dispensers for MIS instruments A61B2017/0479 takes precedence
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/0243 : for immobilizing local areas of the heart, e.g. while it beats trocars attached to inner organs or inner body tissue A61B2017/3488
• 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 2017/2825 : Inserts of different material in jaws
• CPC Class Codes: A61B 2017/2829 : with a removable cover
• CPC Class Codes: A61B 2017/2902 : characterized by features of the actuating rod
• 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 2017/2931 : with releasable head
• CPC Class Codes: A61B 2017/2937 : with flexible part
• CPC Class Codes: A61B 2017/294 : Connection of actuating rod to jaw, e.g. releasable
• CPC Class Codes: A61B 2017/2946 : Locking means
• CPC Class Codes: A61B 2034/305 : Details of wrist mechanisms at distal ends of robotic arms
• 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 34/72 : Micromanipulators
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• 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: B66C 23/48 : Manually-movable jib cranes for use in workshops

Abstract

Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Examples of in vivo accessories include fastening accessories such as surgical clips for use with a clip applier, single working member accessories such as a blade which can be grasped and manipulated by a grasping tool for cutting, sheath accessories that fit over working members of a tool, flow tubes for providing suction or introducing a fluid into the surgical site, and a retraction member resiliently biased to retract a tissue to expose an area in the surgical site for treatment. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site. The accessory introducer can be resiliently biased to bias the accessories toward a predetermined position in the surgical site.

Claims

1. A method of performing minimally invasive robotic surgery in an internal cavity of a patient body, the method comprising:

contacting a portion of a target tissue with a first robotic surgical tool, the first robotic surgical tool being electrically conductive;

grasping an electrically conductive cautery member with a second robotic surgical tool;

manipulating the second robotic surgical tool so that the electrically conductive cautery member contacts another portion of the target tissue; and

energizing the first robotic surgical tool and the cautery member for coagulating the target tissue.

2. The method of claim 1 wherein the first robotic surgical tool and the cautery member are energized by connection to opposite leads of a radiofrequency power source to form a bipolar system.

3. The method of claim 1 wherein the second robotic surgical tool is a forceps.

4. The method of claim 3 wherein the second robotic surgical tool is electrically insulated from the cautery member.