Robotic medical instrument system

• US 7,959,557 B2
• Filed: 06/13/2007
• Issued: 06/14/2011
• Est. Priority Date: 08/14/2002
• Status: Expired due to Fees

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Meglan, Dwight, Driscoll, David, Ailinger, Robert, Weitzner, Barry D., Brock, David L., Lee, Woojin, Solbjor, Albert, Rogers, Gary S.
• Primary Examiner(s): Johnson, III; Henry M
• Assistant Examiner(s): ROANE, AARON F
• Application Number:
  US11/762,726
• Publication Number:
  US 20070238924A1
• Time in Patent Office: 1,462 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: 600/102
• 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 on a patient comprises introducing a 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 the tool located on the medical instrument to secure a stent to an anatomical vessel (e.g., a blood vessel, such as an abdominal aorta). The tool may be a sewing tool that is controlled to stitch the stent to the anatomical 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.

Claims

1. A method of performing a medical procedure on a patient, comprising:

introducing a stent into an anatomical vessel of the patient;

introducing a first medical instrument and a second medical instrument into the patient, the first medical instrument being located outside of the anatomical vessel, the second medical instrument being located within the anatomical vessel and within an inner space defined by the stent, a distal end of the first medical instrument comprising a first active tool configured to pierce the anatomical vessel and the stent, the second medical instrument comprising a second active tool configured to receive a stitch delivered by the first active tool and extending through the anatomical vessel and the stent;

conveying control signals from a remote controller to a drive unit; and

operating the drive unit in accordance with the control signals to actuate the first and second active tools in unison to pierce a wall of the anatomical vessel, pierce the stent, and secure the stent to an inner wall of the anatomical vessel using the stitch.

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

3. The method of claim 2, wherein the user commands are movements made at a user interface that correspond to movements of the medical instrument.

4. The method of claim 1, wherein the second medical instrument is introduced within the patient through a natural body orifice of the patient or percutaneously.

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

6. The method of claim 1, the stent being introduced by operating the drive unit in accordance with the control signals to introduce the stent adjacent the anatomical vessel.

7. The method of claim 1, further comprising operating the drive unit in accordance with the control signals to advance the second medical instrument within the anatomical vessel.

8. The method of claim 1, wherein the first and second tools are sewing tools that are controlled to stitch the stent to the inner wall of the anatomical vessel.

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

10. The method of claim 9, wherein the blood vessel is an abdominal aorta.

11. The method of claim 1, wherein first and second ends of the stent are stitched to respective first and second portions of the inner wall of the anatomical vessel by piercing the first and second portions of the inner wall and the first and second ends of the stent.

12. The method of claim 1, the first active tool comprising a needle end effector that pierces the anatomical vessel and the stent and advances a suture through the anatomical vessel and the stent, and the second active tool comprising a hook end effector that receives the suture to stitch together the stent and the anatomical vessel from within the anatomical vessel.

13. The method of claim 1, wherein a stent defining a plurality of slots is introduced into the anatomical vessel.

14. The method of claim 1, wherein introducing the first medical instrument and the second medical instrument comprises introducing a first medical instrument and a second medical instrument each instrument comprising

a shaft;

a flexing section extending from a distal end of the shaft and being controllably bendable, the flexing section defining a plurality of diametrically disposed slots on opposite sides of the flexing section thereby defining respective spaced ribs, the plurality of slots and spaced ribs being structurally configured for controllable bending of the flexing section in a first plane with a first degree of freedom; and

a wrist extending from a distal end of the flexing section and being controllably rotatable about a first axis in a second plane with a second degree of freedom, the first and second planes being substantially perpendicular to each other, the method further comprising;

controllably bending the flexing section within the first plane; and

controllably bending the wrist within the second plane.

15. The method of claim 14, wherein introducing the first medical instrument and the second medical instrument comprises introducing a first medical instrument and a second medical instrument each instrument further comprising

a link extending from a distal end of the wrist and being controllably rotatable about a second axis in a third plane with a third degree of freedom;

an active tool extending from a distal end of the link, the active tool being movable within the link.

16. The method of claim 14, the wrist comprising a fixed wrist pivot, wherein rotation of the fixed wrist pivot is limited to rotation about the first axis in the second plane substantially perpendicular to the first plane, the method further comprising:

controllably bending the fixed wrist pivot within the second plane.

17. The method of claim 14, the wrist comprising flexible wrist comprising alternating ridges configured for universal controllable wrist bending, the method further comprising:

controllably bending the flexible wrist pivot within multiple planes.

18. The method of claim 14, the flexible wrist comprising a series of spaced arcuate ribs disposed in parallel and extending circumferentially at least partially around an outer portion of the flexible wrist, wherein a plane of each arcuate rib extends substantially orthogonally to a longitudinal axis of the flexible wrist.

19. The method of claim 18, the plurality of arcuate ribs being spaced apart from each other by respective alternating ridges.

20. The method of claim 19, the ridges alternating every 90 degrees such that each ridge extends across only two arcuate ribs.

21. The method of claim 19, the alternating ridges being substantially parallel to a central axis defined by the flexible wrist, respective outer surfaces of the plurality of arcuate ribs and the alternating ridges defining an outer surface of the flexible wrist.