Cannula mounting fixture

• US 8,465,476 B2
• Filed: 11/13/2009
• Issued: 06/18/2013
• Est. Priority Date: 09/23/2009
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Rogers, Theodore W., Steger, John Ryan, Swinehart, Charles E.
• Primary Examiner(s): Johnson, III, Henry M
• Application Number:
  US12/618,631
• Publication Number:
  US 20110071347A1
• Time in Patent Office: 1,313 Days
• Field of Search: 606/1, 606/130
• US Class Current: 606/1
• CPC Class Codes: A61B 1/00149 using articulated arms
• CPC Class Codes: A61B 1/00193 adapted for stereoscopic vision
• CPC Class Codes: A61B 1/313 for introducing through surgical openings, e.g. laparoscopes
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3431 being collapsible, e.g. made of thin flexible material A61B17/3423 takes precedence
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• 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 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/00845 of moving parts with respect to each other
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/2904 curved, but rigid
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/2948 Sealing means, e.g. for sealing the interior from fluid entry
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3429 : having a unitary compressible body, e.g. made of silicone or foam
• CPC Class Codes: A61B 2017/3445 : used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3447 : Linked multiple cannulas
• CPC Class Codes: A61B 2017/3454 : Details of tips
• CPC Class Codes: A61B 2017/3466 : for simultaneous sealing of multiple instruments
• CPC Class Codes: A61B 2034/2061 : using shape-sensors, e.g. fiber shape sensors with Bragg gratings
• 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 34/30 : Surgical robots
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/73 : Manipulators for magnetic surgery
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61B 90/90 : Identification means for patients or instruments, e.g. tags
• CPC Class Codes: A61B 90/92 : coded with colour
• CPC Class Codes: A61M 25/0041 : pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0105 : Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B

Abstract

A robotic surgical system is configured with rigid, curved cannulas that extend through the same opening into a patient'"'"'s body. Surgical instruments with passively flexible shafts extend through the curved cannulas. The cannulas are oriented to direct the instruments towards a surgical site. Various port features that support the curved cannulas within the single opening are disclosed. Cannula support fixtures that support the cannulas during insertion into the single opening and mounting to robotic manipulators are disclosed. The support fixtures include arms that swing in an arc to insert a curved cannula, repositionable arms coupled to a stable cannula base, and an insertion cap that holds a cannula. A teleoperation control system that moves the curved cannulas and their associated instruments in a manner that allows a surgeon to experience intuitive control is disclosed.

Claims

1. An insertion fixture comprising:

a pointed cap comprising an interior;

wherein the interior of the cap is configured to removably hold a distal end of a first surgical implement and a distal end of a second surgical implement;

wherein the cap is made of a material sufficiently rigid to function as an obturator to penetrate a body wall; and

wherein the cap is configured to hold the distal ends of the first and second surgical implements and move with the distal ends of the first and second surgical implements during advancement into a patient'"'"'s body.

2. The insertion fixture of claim 1:

wherein the cap comprises a transparent portion through which an endoscope captures an image.

3. The insertion fixture of claim 1:

wherein the first surgical implement comprises a straight cannula; and

wherein the second surgical implement comprises a curved cannula.

4. The insertion fixture of claim 1:

wherein the interior of the cap is further configured to removably hold a distal end of a third surgical implement.

5. The insertion fixture of claim 4:

wherein the first surgical implement comprises an endoscope cannula; and

wherein the second and third surgical implements each comprises a curved cannula.

6. The insertion fixture of claim 1 further comprising:

a tether coupled to the cap.

7. The insertion fixture of claim 1:

wherein the cap is configured to removably hold the distal ends of the first and second surgical implements during advancement of the surgical implements along an insertion path to a remote site.

8. The insertion fixture of claim 1:

wherein the cap configured to removably hold the distal ends of the surgical implements during insertion.

9. An insertion fixture comprising:

a pointed cap comprising an interior;

wherein the interior of the cap is configured to removably hold a distal end of a first surgical implement and a distal end of a second surgical implement; and

a specimen bag removably coupled to the interior of the cap.

10. The insertion fixture of claim 9 further comprising:

a specimen bag draw string that is coupled to a tether for the cap.

11. A method of inserting a plurality of surgical implements into a patient'"'"'s body through an incision, the method comprising:

positioning in an interior of a pointed cap a distal end of a first surgical implement and a distal end of a second surgical implement; and

advancing the cap within the patient'"'"'s body away from the incision, the distal ends of the first surgical implement and the second surgical implement being held in the interior of the cap during the advancing.

12. The method of claim 11, further comprising:

capturing an image via an endoscope through a transparent portion of the cap.

13. The method of claim 11, further comprising:

capturing a specimen in a specimen bag removably coupled to the interior of the cap.

14. The method of claim 13, further comprising:

closing the specimen bag via a draw string that is coupled to a tether for the cap.

15. The method of claim 11:

further comprising inserting the cap into the patient'"'"'s body prior to the advancing, wherein the inserting the cap comprises penetrating a body wall of the patient with the pointed cap.

16. A method of inserting a plurality of surgical implements into a patient'"'"'s body, the method comprising:

positioning a distal end of each of a plurality of surgical implements within an interior of a pointed cap, the pointed cap removably holding the distal ends of each of the plurality of surgical implements;

inserting the pointed cap through a port feature in a body wall of a patient, wherein the pointed cap holds the distal ends of the plurality of surgical instruments during the inserting; and

advancing the cap into the patient'"'"'s body by advancing the distal ends of the surgical instruments away from the port feature.

17. The method of claim 16 further comprising:

coupling a proximal end of each of the plurality of surgical implements to a robotic manipulator after the inserting.

18. The method of claim 16:

wherein the plurality of surgical implements comprise a plurality of cannulas; and

wherein the method further comprises inserting a surgical instrument through at least one of the cannulas.

19. The method of claim 18 further comprising:

removing the cap from the distal ends of the cannulas with the surgical instrument.

20. The method of claim 16, further comprising:

after the inserting, removing the cap from holding the distal ends of the surgical implements.

21. The method of claim 16:

wherein the advancing the cap into the patient'"'"'s body includes advancing the cap past the port feature to a position spaced from the port feature.