Cooperative minimally invasive telesurgical system

• US 20030216715A1
• Filed: 04/24/2003
• Published: 11/20/2003
• Est. Priority Date: 11/20/1998
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Incorporated (Intuitive Surgical Holdings, LLC)
• Inventors: Rosa, David J., Guthart, Gary S., Ramans, Andris D., Niemeyer, Gunter D., Blumenkranz, Steven J., Salisbury, J. Kenneth Jr., Nowlin, William C., Tierney, Michael J., Moll, Frederic H.
• Granted Patent: US 7,865,266 B2
• Time in Patent Office: Days
• US Class Current: 606/1
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2034/305 Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 2090/506 using a parallelogram linkage, e.g. panthograph
• 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 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: G09B 23/285 for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/63 for local operation

Abstract

Improved robotic surgical systems, devices, and methods include selectably associatable master/slave pairs, often having more manipulator arms than will be moved simultaneously by the two hands of a surgeon. Four manipulator arms can support an image capture device, a left hand tissue manipulation tool, a right hand tissue manipulation tool, and a fourth surgical instrument, particularly for stabilizing, retracting, tool change, or other functions benefiting from intermittent movement. The four or more arms may sequentially be controlled by left and right master input control devices. The fourth arm may be used to support another image capture device, and control of some or all of the arms may be transferred back-and-forth between the operator and an assistant. Two or more robotic systems each having master controls and slave manipulators may be coupled to enable cooperative surgery between two or more operators.

Claims

1. A robotic surgical system comprising:

a plurality of manipulator arms;

a plurality of surgical instruments, each instrument mounted to an associated arm;

a master controller station having a master display for viewing by an operator, a first input device for manipulation by a first hand of the operator, and a second input device for manipulation by a second hand of the operator;

an assistant controller having an assistant input device for manipulation by a hand of an assistant; and

a processor selectably operatively coupling the controllers to the arms to effect movement of the surgical instruments in response to movement of the input devices.

2. The robotic surgical system of claim 1, further comprising an arm selector coupled to the processor for selecting between a plurality of modes, wherein a first arm is operatively associated with the assistant controller when the processor is in a first mode, and wherein the first arm is operatively associated with the master controller when the controller is in a second mode, the operatively associated arm moving the associated surgical instrument in response to movement of the operatively associated input device.

3. The robotic surgical system of claim 1, wherein a second arm is operatively associated with the master controller when the processor is in the first mode, and wherein the second arm is operatively associated with the assistant controller when the processor is in the second mode.

4. A robotic surgical method comprising:

robotically moving first and second surgical instruments at a surgical site with first and second robotic manipulator arms by manipulating first and second input devices with first and second hands of an operator, respectively;

positioning a third surgical instrument at the surgical site by articulating a linkage of a third manipulator;

impeding movement of the positioned third surgical instrument at the surgical site by inhibiting movement of the third manipulator.

5. A robotic surgical method comprising:

robotically positioning a surgical instruments at a surgical site with a manipulator arm by manipulating a first input device with a hand of a first operator;

selectively associating the manipulator arm with a second input device;

robotically moving the surgical instrument at the surgical site with the manipulator arm by manipulating the second input device with a hand of a second operator.

6. A robotic surgical method comprising:

showing on a display a first view of a surgical site from a first image capture device;

robotically moving a surgical instrument at the surgical site with a manipulator arm by manipulating an input device with a hand of an operator while the operator views the first view of the surgical site on the display;

selectively associating a second image capture device with the display; and

robotically moving the surgical instrument at the surgical site with the arm by manipulating the input device while the operator views a second view of the surgical site from the second image capture device on the display.

7. A robotic cardiac surgery method comprising:

introducing an image capture device into a chest cavity of a patient through an aperture disposed along a right side of the patient;

displaying an image of a surgical site adjacent the heart from the image capture device to an operator;

performing a surgical procedure on the heart by moving a surgical instrument at the surgical site with at least one robotic manipulator arm while the surgical instrument extends through another aperture disposed along the right side of the patent.

8. A robotic surgical system comprising:

a first input device manipulatable by a hand of an operator;

a first robotic arm assembly including a first manipulator arm for moving a first surgical instrument;

a second robotic arm assembly including a second manipulator arm for moving a second surgical instrument; and

a control system coupling the first input device to the first and second robotic arm assemblies, the control system permitting selective operative association of the first input device with the first robotic arm assembly and permitting selective operative association of the first input device with the second robotic arm assembly.

9. The robotic surgical system of claim 8, wherein the control system has a plurality of selectable modes, the control system in a first mode operatively associating the first robotic arm assembly with the first input device so that manipulation of the first input device effects movement of the first surgical instrument, the control system in a second mode operatively associating the second robotic arm assembly with the first input device so that manipulation of the first input device effects movement of the second surgical instrument.

10. The robotic surgical system of claim 9, wherein the control system is configured so that manipulation of the first input device when the control system is in the first configuration does not effect movement of the second surgical instrument.

11. The robotic surgical system of claim 9, further comprising a second input device, the control system in the first mode operatively associating the second robotic arm assembly with the second input device so that manipulation of the second input device effects movement of the second surgical instrument, the control system in the second mode operatively associating the first robotic arm assembly with the second input device so that manipulation of the second input device effects movement of the first surgical instrument.

12. The robotic surgical system of claim 11, wherein each surgical instrument comprises a surgical end effector, and further comprising an image capture device coupled to a display adjacent to the first input device to show an image of at least one of the surgical end effectors to the operator.

13. The robotic surgical system of claim 12, wherein the control system is configured to select between the first and second configurations in response to locations of the first and second surgical instruments relative to the image capture device.

14. The robotic surgical system of claim 13, further comprising an image capture assembly comprising an image capture arm movably supporting the image capture device, the control system configured to change between the first configuration and the second configuration in response to movement of the image capture device.

15. The robotic surgical system of claim 14, wherein the image capture device comprises an endoscope, the first and second instruments comprise minimally invasive tools having elongate shafts suitable for insertion to an internal surgical site via a minimally invasive surgical aperture, the image capture arm comprising a robotic arm assembly coupled to the control system so that the control system can effect movement of the endoscope per endoscope commands from the operator.

16. The robotic surgical system of claim 12, further comprising a tool swap input device coupled to the control system, the control system changing between the first configuration and the second configuration in response to input to the tool swap input device by the operator.

17. The robotic surgical system of claim 8, wherein the control system can inhibit movement of the first instrument.

18. The robotic surgical system of claim 8, wherein the control system is configured to effect movement of the first input device in response to a change of operative association of the first input device between the first robotic arm assembly and the second robotic arm assembly.

19. The robotic surgical system of claim 18, wherein the master input device comprises a linkage having a plurality of joints and a plurality of motors drivingly engaging the joints to move a handle of the first master input device with a plurality of degrees of freedom, and wherein the control system is configured to effect movement of the handle in at least one of the plurality of degrees of freedom in response to the change of operative association.

20. The robotic surgical system of claim 19, wherein the control system is configured to effect reorientation of the handle in response to the change of operative association so that the input device appears at least substantially connected with an image of the operatively associated surgical instrument.

21. The robotic surgical system of claim 20, wherein the control system is configured to inhibit movement of the operatively associated surgical instrument while the first master controller device moves.

22. The robotic surgical system of claim 8, wherein the first surgical instrument comprises an endoscope, and wherein the second surgical instrument comprises a surgical tool having a surgical end effector adapted for treating tissue.

23. A robotic surgical system comprising:

two input devices;

an endoscope robotic arm assembly;

at least two medical instrument manipulator arm assemblies; and

a control system permitting selection of which one of the input devices is to be operatively associated with which one of the manipulator assemblies.

24. A robotic surgical system comprising:

a plurality of input devices;

a plurality of manipulator arms, each manipulator arm having an instrument holder;

a plurality of surgical instruments mountable to the instrument holders, the plurality of surgical instruments including an image capture device and a tool having a surgical end effector for treating tissue; and

a control system coupling the input devices with the manipulator arms, the control system selectably associating each input device with a manipulator arm.

25. The robotic surgical system of claim 24, the image capture device is alternatively mountable to first and second instrument holders of first and second manipulator arms, respectively, and wherein the control system can reconfigure operative association between the input devices and the manipulator arms when the tool is removed from the first instrument holder and mounted to the second instrument holder.

26. The robotic surgical system of claim 24, wherein the control system includes an input/manipulator association memory storing an association configuration identifying one or more coupling pairs, each coupling pair including at least one input device and at least one manipulator arm, the coupling pairs alterable by a signal to identify coupling between the at least one input device and at least one alternative manipulator arm.

27. The robotic surgical system of claim 26, wherein the control system comprises a pre-processor gathering positional information regarding the input devices and the manipulator arms, a controller generating comparison signals in response to a comparison between the positional information for each input device with the positional information for an associated manipulator according to the association configuration, and a post-processor transmitting commands to the manipulator arms in response to the comparison signals.

28. The robotic surgical system of claim 27, wherein the controller compares the positional information and the post-processor transmits commands to the manipulator arms more than about 900 times per second.

29. A minimally invasive robotic surgical system comprising:

two input devices;

at least two medical instrument robotic arm assemblies, one of the input devices being operatively associated with one of the robotic arm assemblies to cause movement of the robotic arm assembly in response to inputs on the input device, and the other input device being operatively associated with another of the robotic arm assemblies to cause movement of that other robotic arm assembly in response to inputs on that other input device; and

a control system coupling the input devices with the robotic arm assemblies, the control system enabling selective swapping so as to cause the input device to be operatively associated with the robotic arm assembly which was operatively associated with the other input device, and to cause the other input device to be operatively associated with the robotic arm assembly which was operatively associated with the input device.

30. A minimally invasive robotic surgical system comprising:

two input devices;

an image capture robotic arm assembly;

at least two medical instrument robotic arm assemblies, one of the input devices being operatively associated with one of the instrument robotic arm assemblies to cause movement of the instrument robotic arm assembly in response to inputs on the input device and the other input device being operatively associated with another of the instrument robotic arm assemblies to cause movement of that other instrument robotic arm assembly in response to inputs on that other input device; and

a control system enabling selective operative association between at least one of the input devices and robotic arm assembly to permit the position of an image capture device to be changed using the at least one input device.

31. A robotic surgical method comprising:

robotically moving a first surgical instrument using a first manipulator arm by manipulating a first input device with a hand;

reconfiguring a control system by entering a command, the control system coupling the first input device with the first manipulator arm and with a second manipulator arm; and

robotically moving a second surgical instrument using the second manipulator arm by manipulating the input device with the hand after the reconfiguring step.

32. A robotic surgical method comprising:

robotically moving a surgical instrument using a manipulator arm by manipulating a first input device with a first hand;

reconfiguring a control system by entering a command, the control system coupling the first input device and a second input device with the manipulator arm; and

robotically moving the surgical instrument using the manipulator arm by manipulating the second input device with a second hand after the reconfiguring step.

33. A robotic telesurgical network comprising:

a robotic surgical system configured for performing a surgical procedure on a patient, including

a plurality of manipulator arms,

a plurality of surgical instruments, each instrument mounted to an associated arm, and

a controller station having a display for viewing by an operator, a first input device for manipulation by a hand of the operator, and a second input device for manipulation by another hand of the operator;

another controller station including

a display for viewing by another operator, and

a third input device for manipulation by a hand of the another operator;

a control processor coupled to the manipulator arms, the controller station and the another controller station, the control processor providing for selectably coupling at least one of the manipulator arms and its associated instruments in a plurality of switchable modes including

a first mode in which the selectably coupled arm is operatively associated with the controller station for operation by one of the first or second input devices by the operator; and

a second mode in which the selectably coupled arm is operatively disassociated from the controller station and operatively associated with the another controller station for operation by the third input device by the another operator.

34. The robotic telesurgical network of claim 33, wherein the control processor can selectively couple any input device with any of the plurality of manipulator arms so that the selected arm moves in response to manual movement of the selected input device.

35. The robotic telesurgical network of claim 34, wherein the plurality of manipulator arms comprise a first arm and a second arm, and wherein the control processor can selectably couple the first input device to the first arm according to a first transformation or the first input device to the second arm according to a second transformation.

36. The robotic telesurgical network of claim 33, further comprising an imaging system transmitting an image from a first image capture device to the display of the controller station and/or the display of the another controller station.

37. The robotic telesurgical network of claim 36,wherein the control processor moves the surgical instrument associated with one arm relative to the image capture device so that an image of the associated surgical instrument as shown in the either of the displays appears substantially connected with the selected input device.

38. The robotic telesurgical network of claim 37, wherein the processor moves the selected input device into alignment with the instrument associated with the selected arm when the arm is selected.

39. The robotic telesurgical network of claim 33, wherein the plurality of manipulator arms include a first arm, a second arm and a third arm.

40. The robotic telesurgical network of claim 39, wherein the third arm has a stationary configuration, the third arm inhibiting movement of the associated surgical instrument at a surgical site when the input devices move and the arm is in the stationary configuration.

41. The robotic telesurgical network of claim 40, wherein the surgical instrument associated with the third arm comprises a surgical tool selected from the group consisting of a stabilizer and a retractor.

42. The robotic telesurgical network of claim 39, wherein the third arm has a driven configuration, the first arm comprising a linkage with a plurality of joints and a plurality of actuators drivingly engaging the linkage to effect articulation of the joints so that the third arm moves the associated surgical instrument at the surgical site when the third arm is in the driven configuration.

43. The robotic telesurgical network of claim 33, wherein the controller station is located in a local location and the operator is a local operator, and wherein the another controller station is located in a remote location and the another operator is a remote operator.