Robotic medical instrument system

• US 8,671,950 B2
• Filed: 06/13/2007
• Issued: 03/18/2014
• Est. Priority Date: 08/14/2002
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Weitzner, Barry D., Rogers, Gary S., Solbjor, Albert, Meglan, Dwight, Ailinger, Robert, Brock, David L., Lee, Woojin, Driscoll, David
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US11/762,730
• Publication Number:
  US 20070239186A1
• Time in Patent Office: 2,470 Days
• Field of Search: 128/898, 600/102, 600/117, 600/118, 700/245, 700/257, 700/264, 901/2, 901/8, 901/31
• US Class Current: 128/898
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0491 Sewing machines for surgery
• 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 17/1114 of the digestive tract, e.g. bowels or oesophagus
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• 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 2017/22054 with two balloons
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• 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 34/32 operating autonomously
• 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 90/361 Image-producing devices, e.g. surgical cameras

Abstract

A method of performing a medical procedure (e.g., a cardiac bypass procedure) on a patient comprises introducing at least one medical instrument into a patient (e.g., percutaneously), conveying control signals from a remote controller to a drive unit, and operating the drive unit in accordance with the control signals to actuate at least one tool respectively located on the medical instrument(s) to transversely secure a first anatomical vessel (e.g., a blood vessel) to a sidewall of a second anatomical vessel (e.g., another blood vessel). In one method, the control signals are conveyed from the remote controller to the drive unit in response to user commands. The user commands may be movements made at a user interface that correspond to movements of the medical instrument(s).

Claims

1. A method of performing a medical procedure on a patient involving a first anatomical vessel and a second anatomical vessel that is to be transversely secured to the first anatomical vessel, the method comprising:

positioning a first remotely computer-controlled medical instrument within the second anatomical vessel, wherein the first medical instrument is sufficiently flexible so as to be capable of being remotely controlled and maneuvered through a curvature of an elongated portion of the second anatomical vessel within the patient;

manipulating a user input device to robotically control movement of the first medical instrument in order to position the second anatomical vessel adjacent to a sidewall of the first anatomical vessel within the patient and to which the second anatomical vessel is to be attached;

introducing a second remotely computer-controlled medical instrument into the patient, the second medical instrument being located outside of both of the first and second anatomical vessels and comprising a first active tool configured to pierce the first anatomical vessel and the second anatomical vessel;

introducing a third remotely computer-controlled medical instrument into the first anatomical vessel, the third medical instrument comprising a second active tool configured to receive a stitch delivered by the first active tool and extending through the first anatomical vessel and the second anatomical vessel;

conveying control signals from the user input device to a drive unit; and

operating the drive unit in accordance with the control signals to actuate the first and second tools in unison to transversely secure the second anatomical vessel to the sidewall of the first anatomical vessel by piercing the first anatomical vessel and the second anatomical vessel and stitching the second anatomical vessel to first anatomical vessel using the second medical instrument and the third medical instrument.

2. The method of claim 1, wherein the control signals are conveyed from the user input device to the drive unit in response to user commands.

3. The method of claim 2, wherein the user commands are movements made at the user input device that correspond to respective movements of the second medical instrument and the third medical instrument.

4. The method of claim 1, wherein the second medical instrument is percutaneously introduced within the patient.

5. The method of claim 1, wherein the second medical instrument and the third medical instrument are introduced into the patient by operating the drive unit in accordance with the respective control signals.

6. The method of claim 1, wherein the first anatomical vessel is a blood vessel.

7. The method of claim 1, wherein the medical procedure is a cardiac bypass procedure.

8. The method of claim 1, wherein each of the first and second active tools comprises respective first and second suturing or sewing tools, and the drive unit is operated in accordance with the control signals to actuate the first and second suturing or sewing tools in unison to transversely secure the second anatomical vessel to the sidewall of the first anatomical vessel.

9. The method of claim 1, further comprising:

operating the drive unit in accordance with the control signals to actuate a third tool located on the first medical instrument to hold a lumen of the second anatomical vessel open while transversely securing the second anatomical vessel to the side wall of the first anatomical vessel.

10. The method of claim 9, wherein the third tool is a balloon that is inflated within the second anatomical vessel to hold the lumen open.

11. The method of claim 1, further comprising:

introducing a fourth medical instrument within the second anatomical vessel; and

operating the drive unit in accordance with the control signals to actuate a third tool located on the fourth medical instrument to create an opening within the side wall of the first anatomical vessel.

12. The method of claim 11, wherein the third tool is a cutting blade that is operated to cut an opening through the side wall of the first anatomical vessel.

13. The method of claim 11, further comprising:

introducing a fifth medical instrument within the first anatomical vessel; and

operating the drive unit in accordance with the control signals to actuate a fourth tool located on the fifth medical instrument to hold the side wall of the first anatomical vessel in place while creating the opening within the side wall of the first anatomical vessel.

14. The method of claim 13, wherein the fourth tool is a balloon that is inflated within the first anatomical vessel where the opening is to be formed within the sidewall to hold the side wall in place.

15. The method of claim 14, the balloon of the fourth tool being inflated across the opening to be formed within the sidewall.

16. The method of claim 14, the balloon of the fourth tool being positioned adjacent to the opening to be formed before the opening is formed.

17. A method of performing a medical procedure on a patient involving a first anatomical vessel and a second anatomical vessel that is to be transversely secured to the first anatomical vessel, the method comprising:

positioning a first remotely computer-controlled medical instrument within the second anatomical vessel, wherein the first medical instrument is sufficiently flexible so as to be capable of being remotely controlled and maneuvered through a curvature of an elongated portion of the second anatomical vessel, and wherein the first medical instrument comprises a first expandable member;

inflating the first expandable member within the second anatomical vessel that is to be attached to a sidewall of the first anatomical vessel such that the first expandable member applies pressure to an inner surface of the second anatomical vessel;

manipulating a user input device to robotically control movement of the first medical instrument in order to position the second anatomical vessel adjacent to the sidewall of the first anatomical vessel;

attaching the second anatomical vessel to the sidewall of the first anatomical vessel;

positioning a second remotely computer-controlled medical instrument within the first anatomical vessel, wherein the second medical instrument is sufficiently flexible so as to be capable of being remotely controlled and maneuvered through a curvature of an elongated portion of the first anatomical vessel, and wherein the second medical instrument comprises a second expandable member;

inflating the second expandable member within the first anatomical vessel such that the second expandable member applies pressure to an inner surface of the first anatomical vessel; and

forming an opening within the sidewall of the first anatomical vessel while the second expandable member applies pressure to the inner surface of the first anatomical vessel.

18. The method of claim 17, the second expandable member being inflated adjacent to the location of the opening to be formed.

19. The method of claim 18, wherein the first expandable member is inflated at a position within the second anatomical vessel that is proximal and not adjacent to the location of the opening to be formed at a distal end of the second anatomical vessel such that the inflated first expandable member does not contact the sidewall of the first anatomical vessel.

20. The method of claim 17, the second anatomical vessel being attached by sewing or suturing the second anatomical vessel to the sidewall of the first anatomical vessel.

21. The method of claim 17, further comprising

inflating a third expandable member within the first anatomical vessel such that the second and third expandable members apply pressure to an inner surface of the first anatomical vessel, wherein the second and third expandable members are positioned adjacent to the location of the opening to be formed on opposite sides of the location of the opening to be formed,

wherein the opening is formed within the sidewall of the first anatomical vessel and between the second and third expandable members while the second and third expandable members apply pressure to the inner surface of the first anatomical vessel.

22. A method of performing a medical procedure on a patient involving a first anatomical vessel and a second anatomical vessel that is to be transversely secured to the first anatomical vessel, the method comprising:

introducing a first remotely computer-controlled medical instrument comprising a first expandable member within the second anatomical vessel that is to be attached to a sidewall of the first anatomical vessel, wherein the first medical instrument is sufficiently flexible so as to be capable of being remotely controlled and maneuvered through a curvature of an elongated portion of the second anatomical vessel;

inflating the first expandable member such that the first expandable member applies pressure to an inner surface of the second anatomical vessel;

manipulating a user input device to robotically control movement of the first medical instrument in order to position the second anatomical vessel adjacent to the sidewall of the first anatomical vessel;

introducing a second remotely computer-controlled medical instrument into the patient, the second medical instrument being located outside of both of the first and second anatomical vessels and comprising a tool configured to pierce the first anatomical vessel and the second anatomical vessel;

introducing a third remotely computer-controlled medical instrument comprising a second expandable member within the first anatomical vessel to which the second anatomical vessel is to be attached, wherein the third medical instrument is sufficiently flexible so as to be capable of being remotely controlled and maneuvered through a curvature of an elongated portion of the first anatomical vessel;

positioning the third medical instrument within the first anatomical vessel such that the second expandable member is adjacent to a location where an opening is to be formed;

inflating the second expandable member such that the second expandable member applies pressure to an inner surface of the first anatomical vessel adjacent to the location where the opening is to be formed;

operating the first medical instrument, second medical instrument and third medical instrument in unison to transversely secure the second anatomical vessel to the sidewall of the first anatomical vessel; and

forming the opening in the sidewall of the first anatomical vessel.

23. The method of claim 22, the third medical instrument comprising a third expandable member, the method further comprising:

inflating the third expandable member within the first anatomical vessel such that the second and third expandable members apply pressure to an inner surface of the first anatomical vessel, wherein the second and third expandable members are positioned on opposite sides of the location of the opening to be formed, and wherein the opening is formed within the sidewall of the first anatomical vessel and between the second and third expandable members while the second and third expandable members apply pressure to the inner surface of the first anatomical vessel.

24. The method of claim 22, wherein the second anatomical vessel is transversely secured to the first anatomical vessel by the second medical instrument piercing the first anatomical vessel and the second anatomical vessel and stitching the second anatomical vessel to first anatomical vessel using the second medical instrument.

25. The method of claim 22, wherein the first and third instruments are intraluminally introduced into the patient, and the second medical instrument is percutaneously introduced into the patient.

26. The method of claim 22, wherein the first expandable member is inflated at a position within the second anatomical vessel that is proximal and not adjacent to the location of the opening to be formed at a distal end of the second anatomical vessel such that the inflated first expandable member does not contact the sidewall of the first anatomical vessel.