Robotically controlled medical instrument with a flexible section

• US 7,608,083 B2
• Filed: 10/28/2004
• Issued: 10/27/2009
• Est. Priority Date: 02/15/2001
• Status: Expired due to Fees

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Weitzner, Barry, Lee, Woojin, Chamorro, Andres III
• Primary Examiner(s): Philogene; Pedro
• Application Number:
  US10/976,066
• Publication Number:
  US 20050216033A1
• Time in Patent Office: 1,825 Days
• Field of Search: 606/1, 606/130, 606/205, 606/206, 606/207, 600/139, 600/144, 600/141, 600/146, 604/533, 744/90, 901/29
• US Class Current: 606/130
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/062 Needle manipulators
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• 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 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00088 using thermistors
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/00371 Multiple actuation, e.g. pushing of two buttons, or two working tips becoming operational
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• 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 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• 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 2034/306 : Wrists with multiple vertebrae
• CPC Class Codes: A61B 2034/715 : Cable tensioning mechanisms for removing slack
• CPC Class Codes: A61B 2034/742 : Joysticks
• CPC Class Codes: A61B 2034/744 : Mouse
• CPC Class Codes: A61B 2090/365 : augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/506 : using a parallelogram linkage, e.g. panthograph
• CPC Class Codes: A61B 2090/571 : for clamping a support arm to a bed or other supports
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• 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 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/72 : Micromanipulators
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/015 : By temperature mapping of body part
• CPC Class Codes: A61B 5/4893 : Nerves
• 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: B25J 3/04 : involving servo mechanisms servo-actuated heads B25J15/02
• CPC Class Codes: B25J 9/104 : with cables, chains or ribbons

Abstract

A robotically controlled medical instrument includes a bending section with a unibody construction, a tool supported at a distal end of the bending section and used to perform a medical procedure on a subject such as a human patient, and an electronic controller that controls the bending section to provide at least one degree-of-freedom of movement.

Claims

1. A robotically controlled medical instrument, comprising:

a flexible bending section having a unibody construction provided with a plurality of spaced apart, disk-shaped ribs and rectangularly-shaped ridges between the respective disk-shaped ribs to form an arrangement of diametrically-disposed slots positioned along the length of the bending section;

a first pair of cables extending along the length of the bending section, wherein tension applied to at least one cable of the first pair operates the bending section with a first degree-of-freedom;

a second pair of cables extending along the length of the bending section, wherein tension applied to at least one cable of the second pair operates the bending section with a second degree-of-freedom;

a tool affixed to a distal end of the bending section for performing a medical procedure on a subject, wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close in a reciprocating relationship;

a single tool actuation cable extending along the length of the bending section and coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the tool actuation cable and being opened by pushing on the tool actuation cable; and

an electro-mechanical controller that controls a variable amount of tension applied to respective cables of the first and second cable pairs, and pushing and pulling on the tool actuation cable, in response to respective signals received from a remotely located user input device.

2. The medical instrument of claim 1, wherein the tool is movable with at least two additional degrees-of-freedom.

3. The medical instrument of claim 2, the first jaw being movable with one of the two additional degrees-of-freedom, and the second jaw being movable with the other of the two additional degrees-of-freedom.

4. The medical instrument of claim 1, wherein the tool actuation cable is positioned near the longitudinal axis of the bending section.

5. The medical instrument of claim 4, wherein the tool actuation cable is contained in a sleeve positioned along the longitudinal axis of the bending section, the tool actuation cable being able to slide back and forth along the sleeve.

6. The medical instrument of claim 5, further comprising a helical spring positioned about the sleeve along the length of the bending section to keep the sleeve and tool actuation cable near the longitudinal axis of the bending section.

7. The medical instrument of claim 1, wherein pushing and pulling on the tool actuation cable is controlled by the controller.

8. The medical instrument of claim 1, further comprising a second flexible bending section having a unibody construction, the second bending section being bendable with at least one degree-of-freedom under the control of the electro-mechanical controller.

9. The medical instrument of claim 1, wherein only the ribs and the ridges form the structure of the bending section.

10. A robotically controlled medical instrument, comprising:

a flexible bending section being bendable with two degrees-of-freedom and having a unibody construction with a series of spaced ribs, the ribs being positioned along the length of the bending section between proximal and distal ends of the bending section, the bending section including a first set of ridges extending along the length of the bending section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges;

a first pair of cables and a second pair of cables extending along the length of the bending section, wherein tension applied to at least one cable of the first pair operates the bending section with a first degree-of-freedom, and wherein tension applied to at least one cable of the second pair operates the bending section with a second degree-of-freedom;

a tool affixed to the distal end of the bending section for performing a medical procedure on a subject, wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close in a reciprocating relationship;

a single tool actuation cable extending along the length of the bending section and coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the tool actuation cable and being opened by pushing on the tool actuation cable; and

an electro-mechanical controller that controls a varying amount of tension applied to respective cables of the first and second cable pairs, and pushing and pulling on the tool actuation cable, in response to respective signals received from a remotely located user input device.

11. The medical instrument of claim 10, wherein the tool actuation cable is contained in a sleeve positioned along the longitudinal axis of the bending section, the tool actuation cable being able to slide back and forth along the sleeve.

12. The medical instrument of claim 10, wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section.

13. The medical instrument of claim 10, wherein only the ribs and the ridges form the structure of the bending section.

14. A method of remotely controlling a medical instrument, comprising:

controlling the bending movements of a flexible bending section of the medical instrument in at least two degrees-of-freedom using an electro-mechanical controller, the bending section having a unibody construction including a plurality of spaced apart, disk-shaped ribs, with respective rectangular-shaped ridges located between the respective disk-shaped ribs to form an arrangement of diametrically-disposed slots positioned along a length of the bending section; and

performing a medical procedure on a subject with a tool affixed to a distal end of the bending section, wherein performing the procedure includes using an automated system operated via respective signals received from a user input device located remotely from the instrument for

(i) pushing and pulling an actuation element extending along the length of the bending section, the actuation element being coupled to a first jaw and a second jaw connected to the first jaw at a pivot joint, the pushing and pulling causing the jaws to open and close, respectively,

(ii) applying a variable tension to at least one cable of a first pair of cables extending along the length of the bending section to operate the bending section with one degree-of-freedom, and

(iii) applying a variable tension to at least one cable of a second pair cables extend along the length of the bending section to operate the bending section with a second degree-of-freedom.

15. The method of claim 14, wherein performing further includes using the automated system for applying a tension to at least one additional cable extending along the length of bending section and coupled to a first jaw of the tool, and applying a tension to at least one additional cable extending along the length of bending section and coupled to a second jaw of the tool.

16. The method of claim 14, further comprising using the automated system operated for controlling a second bending section of the medical instrument, the second bending section having a unibody construction having at least one degree-of-freedom.

17. The method of claim 14, wherein only the ribs and the ridges form the structure of the bending section.

18. A robotically controlled medical instrument, comprising:

an elongated shaft having proximal and distal ends;

an articulating tool supported at the distal end of said elongated shaft and useable for performing a medical procedure on a subject, wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close in a reciprocating relationship, the shaft having at least one flexible, controllably bendable section disposed proximally of said tool;

a single tool actuation cable extending within said instrument shaft along the length of the bendable section and coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the tool actuation cable and being opened by pushing on the tool actuation cable, said single cable positioned at at least one of a substantially center axis and substantially center plane of said controllably bendable section so as to de-couple motion at said controllably bendable section from tool actuation;

a first pair of cables extending along a length of the bendable section, wherein tension applied to at least one cable of the first pair operates the bendable section in one degree-of-freedom; and

a second pair of cables extending along the length of the bendable section, wherein tension applied to at least one cable of the second pair operates the bendable section in a second degree-of-freedom,

wherein a varying amount of tension applied to respective cables of the first and second cable pairs, and a respective amount of pushing and pulling on the tool actuation cable, are controlled by an electro-mechanical controller in response to respective signals received from a remotely located user input device.

19. The medical instrument of claim 18, wherein the tool actuation cable is positioned near the longitudinal axis of the bendable section.

20. The medical instrument of claim 19, wherein the tool actuation cable is contained in a sleeve positioned along the longitudinal axis of the bendable section, the tool actuation cable being able to slide back and forth along the sleeve.

21. The medical instrument of claim 20, further comprising a helical spring positioned about the sleeve along the length of the bendable section to keep the sleeve and tool actuation cable near the longitudinal axis of the bendable section.

22. The medical instrument of claim 18, wherein the amount of pushing and pulling on the tool actuation cable is controlled by the electro-mechanical controller.

23. The medical instrument of claim 18, wherein the bendable section comprises a uni-body, bellows construction with alternating peaks and valleys positioned between proximal and distal ends of the bendable section.

24. The medical instrument of claim 18, wherein the bendable section comprises a series of spaced ribs positioned along the length of the bendable section between respective proximal and distal ends of the bendable section.

25. The medial instrument of claim 24, wherein the bendable section includes a set of opposed ridges extending along the length of the bendable section, individual ridges of the set of ridges being positioned in a respective slot defined by adjacent ribs.

26. The medical instrument of claim 24, wherein the bendable section includes

a first set of ridges extending along the length of the bendable section, individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and

a second set of ridges, individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges.

27. The medical instrument of claim 26, wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bendable section.

28. The medical instrument of claim 18, further comprising a second flexible bendable section having a unibody construction, and being bendable by the controller with at least one degree-of-freedom.