Surgery – Instruments
Reexamination Certificate
2002-06-28
2004-03-02
Gibson, Roy D. (Department: 3739)
Surgery
Instruments
C074S490030, C074S490060, C606S130000
Reexamination Certificate
active
06699235
ABSTRACT:
STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
NOT APPLICABLE
REFERENCE TO A “SEQUENCE LISTING,” A TABLE, OR A COMPUTER PROGRAM LISTING APPENDIX SUBMITTED ON A COMPACT DISK
NOT APPLICABLE
BACKGROUND OF THE INVENTION
The present invention relates generally to surgical tools and, more particularly, to various wrist mechanisms in surgical tools for performing robotic surgery.
Robotic surgery has developed to improve and expand the use of minimally invasive surgical (MIS) techniques in the treatment of patients. Minimally invasive techniques are aimed at reducing the amount of extraneous tissue that is damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and deleterious side effects. The average length of a hospital stay for a standard surgery may also be shortened significantly using MIS techniques. Thus, an increased adoption of minimally invasive techniques could save millions of hospital days and millions of dollars annually in hospital residency costs alone. Patient recovery times, patient discomfort, surgical side effects and time away from work may also be reduced with minimally invasive surgery.
The most common form of minimally invasive surgery may be endoscopy. And, probably the most common form of endoscopy is laparoscopy, which is minimally invasive inspection and surgery inside the abdominal cavity. In standard laparoscopic surgery, a patient's abdomen is insufflated with gas, and cannula sleeves are passed through small (approximately ½ inch) incisions to provide entry ports for laparoscopic surgical instruments. The laparoscopic surgical instruments generally include a laparoscope (for viewing the surgical field) and working tools. The working tools are similar to those used in conventional (open) surgery, except that the working end or end effector of each tool is separated from its handle by an extension tube. As used herein, the term “end effector” means the actual working part of the surgical instrument and can include clamps, graspers, scissors, staplers, and needle holders, for example. To perform surgical procedures, the surgeon passes these working tools or instruments through the cannula sleeves to an internal surgical site and manipulates them from outside the abdomen. The surgeon monitors the procedure by means of a monitor that displays an image of the surgical site taken from the laparoscope. Similar endoscopic techniques are employed in, e.g., arthroscopy, retroperitoneoscopy, pelviscopy, nephroscopy, cystoscopy, cisternoscopy, sinoscopy, hysteroscopy, urethroscopy and the like.
There are many disadvantages relating to current MIS technology. For example, existing MIS instruments deny the surgeon the flexibility of tool placement found in open surgery. Most current laparoscopic tools have rigid shafts, so that it can be difficult to approach the worksite through the small incision. Additionally, the length and construction of many endoscopic instruments reduces the surgeon's ability to feel forces exerted by tissues and organs on the end effector of the associated tool. The lack of dexterity and sensitivity of endoscopic tools is a major impediment to the expansion of minimally invasive surgery.
Minimally invasive telesurgical robotic systems are being developed to increase a surgeon's dexterity when working within an internal surgical site, as well as to allow a surgeon to operate on a patient from a remote location. In a telesurgery system, the surgeon is often provided with an image of the surgical site at a computer workstation. While viewing a three-dimensional image of the surgical site on a suitable viewer or display, the surgeon performs the surgical procedures on the patient by manipulating master input or control devices of the workstation. The master controls the motion of a servomechanically operated surgical instrument. During the surgical procedure, the telesurgical system can provide mechanical actuation and control of a variety of surgical instruments or tools having end effectors such as, e.g., tissue graspers, needle drivers, or the like, that perform various functions for the surgeon, e.g., holding or driving a needle, grasping a blood vessel, or dissecting tissue, or the like, in response to manipulation of the master control devices.
Manipulation and control of these end effectors is a critical aspect of robotic surgical systems. For these reasons, it is desirable to provide surgical tools which include mechanisms to provide three degrees of rotational movement of an end effector around three perpendicular axes to mimic the natural action of a surgeon's wrist. Such mechanisms should be appropriately sized for use in a minimally invasive procedure and relatively simple in design to reduce possible points of failure. In addition, such mechanisms should provide adequate degree of rotation to allow the end effector to be manipulated in a wide variety of positions. At least some of these objectives will be met by the inventions described hereinafter.
BRIEF SUMMARY OF THE INVENTION
The present invention provides a robotic surgical tool for use in a robotic surgical system to perform a surgical operation. Robotic surgical systems perform surgical operations with tools which are robotically operated by a surgeon. Such systems generally include master controllers and a robotic arm slave cart. The robotic arm slave cart is positioned adjacent to the patient's body and moves the tools to perform the surgery. The tools have shafts which extend into an internal surgical site within the patient body via minimally invasive access openings. The robotic arm slave cart is connected with master controllers which are grasped by the surgeon and manipulated in space while the surgeon views the procedure on a stereo display. The master controllers are manual input devices which preferably move with six degrees of freedom, and which often further have an actuatable handle for actuating the tools (for example, for closing grasping saws, applying an electrical potential to an electrode, or the like). Robotic surgery systems and methods are further described in co-pending U.S. patent application Ser. No. 08/975,617, filed Nov. 21, 1997, the full disclosure of which is incorporated herein by reference.
As described, robotic surgical tools comprise an elongated shaft having a surgical end effector disposed near the distal end of the shaft. As used herein, the terms “surgical instrument”, “instrument”, “surgical tool”, or “tool” refer to a member having a working end which carries one or more end effectors to be introduced into a surgical site in a cavity of a patient, and is actuatable from outside the cavity to manipulate the end effector(s) for effecting a desired treatment or medical function of a target tissue in the surgical site. The instrument or tool typically includes a shaft carrying the end effector(s) at a distal end, and is preferably servomechanically actuated by a telesurgical system for performing functions such as holding or driving a needle, grasping a blood vessel, and dissecting tissue. In addition, as used herein, “end effector” refers to the actual working part that is manipulable for effecting a predetermined treatment of a target tissue. For instance, some end effectors have a single working member such as a scalpel, a blade, or an electrode. Other end effectors have a pair or plurality of working members such as forceps, graspers, scissors, or clip appliers, for example.
In a first aspect of the present invention, the robotic surgical tool includes a wrist mechanism disposed near the distal end of the shaft which connects with the end effector. The wrist mechanism includes a distal member, configured to support the end effector, and a plurality of rods extending generally along an axial direction within the shaft and movable generally along this axial direction to adjust the orientation of the distal member with respect to the axial direction or shaft. The distal member may have any form suitable for supporting
Anderson S. Christopher
Manzo Scott
Wallace Daniel T.
Gibson Roy D.
Intuitive Surgical Inc.
Thompson Lynn M.
Townsend and Townsend / and Crew LLP
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