Surgical system entry guide

• US 8,784,435 B2
• Filed: 08/12/2010
• Issued: 07/22/2014
• Est. Priority Date: 06/13/2006
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Cooper, Thomas G., Brown, Jeffrey D., Diolaiti, Nicola, Duval, Eugene F., Gomez, Daniel H., Lilagan, Paul E., McGrogan, Anthony K., Ramstad, Craig R., Holop, Robert Elliot
• Primary Examiner(s): Erezo, Darwin
• Assistant Examiner(s): LOUIS, RICHARD G
• Application Number:
  US12/855,488
• Publication Number:
  US 20110282351A1
• Time in Patent Office: 1,440 Days
• Field of Search: 606/1, 606/130, 606/108, 600/106, 600/139, 600/153, 600/183, 600/104, 600/123, 600/156, 604/95.04
• US Class Current: 606/130
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/00142 with means for preventing contamination, e.g. by using a sanitary sheath
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3474 Insufflating needles, e.g. Veress needles
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas
• CPC Class Codes: A61B 2034/302 specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
• CPC Class Codes: A61B 2034/306 Wrists with multiple vertebrae
• CPC Class Codes: A61B 2050/3008 having multiple compartments
• CPC Class Codes: A61B 2090/5025 with a counter-balancing mechanism
• CPC Class Codes: A61B 34/00 Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
• 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 46/10 specially adapted for instruments, e.g. microscopes
• CPC Class Codes: A61B 46/23 : with means to retain or hold surgical implements
• CPC Class Codes: A61B 50/00 : Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers drapes specially adapted for instruments A61B46/10
• CPC Class Codes: A61B 50/20 : Holders specially adapted for surgical or diagnostic appliances or instruments drapes with means to hold surgical instruments A61B46/23; for catheters A61M25/02
• CPC Class Codes: A61B 50/30 : Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61B 90/98 : using electromagnetic means, e.g. transponders
• CPC Class Codes: A61M 13/003 : Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
• CPC Class Codes: B25J 15/0066 : with different types of end effectors, e.g. gripper and welding gun B25J15/0057 and B25J15/0061 take precedence
• CPC Class Codes: B25J 15/02 : servo-actuated
• CPC Class Codes: B25J 15/04 : with provision for the remote detachment or exchange of the head or parts thereof
• CPC Class Codes: B32B 3/12 : characterised by a layer of regularly- arranged cells, e.g. a honeycomb structure
• CPC Class Codes: F16F 1/121 : adjustable, e.g. to modify spring characteristics
• CPC Class Codes: G03B 2205/0015 : by displacing one or more optical elements normal to the optical axis
• CPC Class Codes: G03B 2205/0069 : using electromagnetic actuators, e.g. voice coils
• CPC Class Codes: G03B 3/00 : Focusing arrangements of general interest for cameras, projectors or printers
• CPC Class Codes: G03B 35/00 : Stereoscopic photography
• CPC Class Codes: G03B 5/02 : Lateral adjustment of lens
• CPC Class Codes: H01F 2005/027 : wound on formers for receiving several coils with perpendicular winding axes, e.g. for antennae or inductive power transfer
• CPC Class Codes: H01F 27/2823 : Wires H01F27/2866 takes precedence
• CPC Class Codes: H01F 5/02 : wound on non-magnetic supports, e.g. formers
• CPC Class Codes: H01F 5/04 : Arrangements of electric connections to coils, e.g. leads
• CPC Class Codes: H04N 23/51 : Housings
• CPC Class Codes: H04N 23/54 : Mounting of pick-up tubes, electronic image sensors, deviation or focusing coils
• CPC Class Codes: H04N 23/55 : Optical parts specially adapted for electronic image sensors; Mounting thereof
• CPC Class Codes: H04N 23/555 : for picking-up images in sites, inaccessible due to their dimensions or hazardous conditions, e.g. endoscopes or borescopes
• CPC Class Codes: H04N 23/57 : Mechanical or electrical details of cameras or camera modules specially adapted for being embedded in other devices
• CPC Class Codes: H04N 23/60 : Control of cameras or camera modules
• CPC Class Codes: H04N 23/687 : by shifting the lens or sensor position
• CPC Class Codes: H05K 1/18 : Printed circuits structurally associated with non-printed electric components H05K1/0201, H05K1/023, H05K1/0243, and H05K1/16 take precedence
• CPC Class Codes: Y10T 74/20305 : Robotic arm

Abstract

An entry guide tube and cannula assembly, a surgical system including the assembly, and a method of surgical instrument insertion are provided. In one embodiment, the assembly includes a cannula having a proximal portion that operably couples to an accessory clamp of a manipulator arm, and a distal tubular member coupled to the proximal portion, the tubular member having an opening for passage of at least one instrument shaft. The assembly also includes an entry guide tube rotatably coupled to the proximal portion of the cannula, the entry guide tube including a plurality of channels for passage of a plurality of instrument shafts, wherein the entry guide tube is rotatably driven relative to the proximal portion of the cannula by rotation of at least one instrument shaft about a longitudinal axis of the entry guide tube.

Claims

1. A surgical system, comprising:

a plurality of instrument manipulators operably coupled to a distal link of the surgical system, the plurality of instrument manipulators being rotatable as a group about a roll axis;

a cannula having a longitudinal axis;

an entry guide positioned in and rotatable within the cannula, the entry guide comprising a plurality of channels extending longitudinally through the entry guide, and the entry guide having a longitudinal axis aligned with the longitudinal axis of the cannula; and

a plurality of surgical instruments, wherein each of the plurality of surgical instruments is coupled to a corresponding instrument manipulator of the plurality of instrument manipulators, wherein each of the plurality of surgical instruments comprises a shaft that passes through a corresponding channel in the plurality of channels of the entry guide, the shaft of at least one individual surgical instrument being configured to impinge against an interior surface of the corresponding channel when the or each individual surgical instrument is moved around the roll axis by rotation of the or each corresponding instrument manipulator about the roll axis as the plurality of instruments manipulators rotate as a group about the roll axis, and wherein rotation of the plurality of instrument manipulators about the roll axis causes the shaft of the or each surgical instrument to impinge against the interior surface of the corresponding channel of the entry guide and rotate the entry guide within the cannula.

2. The system of claim 1, wherein a distal end of the distal link includes a rotatable base configured to rotate about the roll axis.

3. The system of claim 1, wherein the roll axis of the plurality of instrument manipulators is aligned with the longitudinal axis of the cannula.

4. The system of claim 1, wherein at least one of the plurality of surgical instruments includes a camera.

5. The system of claim 1, wherein the cannula is coupled to a cannula mount movably joined to the distal link.

6. The system of claim 1, wherein the cannula is coupled to a cannula mount detachably joined to the distal link.

7. The system of claim 1, further comprising:

a setup link configured to position a remote center of motion of the plurality of surgical instruments; and

a proximal link operably coupled to the setup link;

wherein the distal link is operably coupled to the proximal link.

8. The system of claim 1, wherein the entry guide further includes a lip portion that movably couples to a proximal portion of the cannula.

9. The system of claim 1, wherein a first channel in the plurality of channels in the entry guide has a first cross-sectional shape different from a second cross-sectional shape of a second channel in the plurality of channels, and wherein the first cross-sectional shape of the first channel is an oblong-shaped cross section.

10. The system of claim 1, wherein the shaft of a first one of the plurality of surgical instruments has a first cross-sectional shape, the shaft of a second one of the plurality of surgical instruments has a second cross-sectional shape different from the first cross-sectional shape, the channel corresponding to the shaft of the first one of the plurality of surgical instruments is shaped to receive the first-cross sectional shape, and the channel corresponding to the shaft of the second one of the plurality of surgical instruments is shaped to receive the second cross-sectional shape.

11. A surgical system comprising:

a cannula having a longitudinal axis;

an entry guide positioned in and rotatable within the cannula, the entry guide comprising a plurality of channels extending longitudinally through the entry guide, and the entry guide having a longitudinal axis aligned with the longitudinal axis of the cannula; and

a plurality of surgical instruments rotatable as a group around a roll axis, each of the plurality of surgical instruments comprising a shaft that passes through a corresponding channel in the plurality of channels of the entry guide, the shaft of one surgical instrument of the plurality of surgical instruments being configured to impinge against an interior surface of the corresponding channel when the one surgical instrument is moved around the roll axis, wherein rotation of the plurality of surgical instruments as a group around the roll axis causes the shaft of the one surgical instrument to impinge against the interior surface of the corresponding channel of the entry guide and rotate the entry guide within the cannula.

12. The surgical system of claim 11, wherein the one surgical instrument comprises a camera instrument.

13. A surgical system comprising:

a cannula having a longitudinal axis defined between proximal and distal ends of the cannula;

an entry guide having a roll axis defined between proximal and distal ends of the entry guide and having a longitudinal channel parallel to and offset from the roll axis of the entry guide, the entry guide being positioned in the cannula so that the roll axis of the entry guide is aligned with the longitudinal axis of the cannula;

a manipulator having a roll axis aligned with the roll axis of the entry guide; and

a surgical instrument having a proximal end coupled to the manipulator and having a shaft positioned in the channel of the entry guide, wherein roll of the manipulator around the roll axis of the manipulator moves the surgical instrument and the shaft around the roll axis of the manipulator, and the movement of the shaft rolls the entry guide around the roll axis of the entry guide.

14. The surgical system of claim 13 further comprising:

a second manipulator coupled to the manipulator, the second manipulator supporting the proximal end of the surgical instrument.

15. The surgical system of claim 14 further comprising:

an adaptor between the second manipulator and the proximal end of the surgical instrument; and

a sterile barrier coupled to the adaptor and covering the manipulator and the second manipulator.

16. The surgical system of claim 13 further comprising:

an arm including a plurality of links, the manipulator and the cannula each being coupler single one of the plurality of links.