Surgery – Instruments – Suture – ligature – elastic band or clip applier
Reexamination Certificate
1998-12-08
2001-12-04
Jackson, Gary (Department: 3731)
Surgery
Instruments
Suture, ligature, elastic band or clip applier
C606S170000, C318S568110, C700S245000, C700S264000, C901S001000
Reexamination Certificate
active
06325808
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates generally to minimally invasive surgery, and more particularly, to a system for minimally invasive surgery having a docking station and one or more surgical tools which are releasably and interchangeably attachable to the docking system, and in which the docking station and the surgical tools are collaboratively controllable both manually by a surgeon and actively by a computer.
BACKGROUND INFORMATION
Open surgery traditionally involves operative procedures in which one or more large incisions are made in a patient. The incision and the dissection required for access and visualization by the surgeon during the operative procedure contributes to increased pain to and delayed recovery of the patient.
Minimally invasive surgery is a cost-effective alternate to open surgery whereby the operative procedures are performed using specialized surgical instruments designed to fit into the body through one or more small incisions. The surgeon monitors the operative procedure on a display via an endoscopic camera inserted through one of the small incisions. By eliminating large incisions and extensive dissections, the pain to the patient and the time for recovery is reduced.
Surgical instruments for assisting a surgeon in minimally invasive surgery typically have an elongated body with a handle at one end and an end effector such as a grasper or scissors at the other end. The surgeon inserts the end effector through a small incision in the patient and manipulates the instrument by pivoting it about the incision, rotating it about the incision, sliding it through the incision, and actuating the end effector.
Teleoperated systems have been employed in which a pair of surgical instruments are coupled to a pair of robotic arms. The robotic arms are coupled via a controller to a pair of master handles. The master handles can be moved and actuated by the surgeon to produce a corresponding movement of the surgical instrument and actuation of the end effector.
Compared to open surgery, minimally invasive surgery is affected by physical, visual, motor, spatial, and haptic constraints. As a result of these constraints, there is an extended learning curve that surgeons must go through to gain the required skill and dexterity. Furthermore, there is a great deal of variability even among trained surgeons. Time motion studies of minimally invasive surgeries indicate that for operations such as tissue dissection, suturing, knot tying, and suture cutting, the operation time variation between surgeons can be as large as fifty percent. In suturing, it is noted that the major difference between surgeons lies in the proficiency of the surgeon at grasping a needle and moving the needle to a desired position and orientation without slipping or dropping the needle.
A drawback with use of the above-noted surgical instruments and teleoperated systems for minimally invasive surgery is that a high level of dexterity is required to accurately control the position of the surgical instrument and actuate the end effector. Another drawback is that the handles and end effector have a master-slave relationship so that movement of the handles causes a corresponding movement of the end effector. Still another drawback is that minimally invasive surgery requires usage of a variety of different surgical instruments during an operative procedure which requires the surgeon to switch between different surgical instruments and position each surgical instrument in the patient before continuing the operative procedure.
Therefore, there exists a need for a compact system for minimally invasive surgery in which the system includes one or more docking stations for controlling the position of one or more releasably attachable surgical tools and in which the docking station and an end effector of the surgical tool are manually controllable solely by a surgeon, collaboratively controllable by both the surgeon and computer, or autonomously controllable by a computer, e.g., in tying a knot in suturing.
SUMMARY OF THE INVENTION
The above-mentioned needs are met by the present invention which relates in one aspect to a docking system for use with a surgical tool in minimally invasive surgery in which the surgical tool has a handle, an end effector and is operable by a surgeon for actuating the end effector. The docking station includes a first support attachable to a stand and positionable adjacent to an incision in a patient. Means attachable to the first support are provided for restraining movement of the surgical tool through the incision to four degrees of freedom, and means are provided for releasably attaching the surgical tool to the restraining means.
Desirably, the restraining means comprises means for pivoting the surgical tool about an incision in a patient, means for rotating the surgical tool about an axis through the incision, and means for translating the surgical tool into and out of the incision. The restraining means may further comprises a plurality of actuators for pivotal, rotational, translational movement of the surgical tool, and a controller for controlling the actuators. Advantageously, the restraining means is collaboratively controllable actively by a controller and manually by a surgeon.
Another aspect of the present invention relates to a surgical tool for minimally invasive surgery in which the surgical tool includes an elongated body having a first end and a second end, an end effector attached to the first end of the elongated body, a handle attached to the second end, and means for releasably attaching the handle to a docking station operable to restrain movement of the surgical tool to four degrees of freedom.
Desirably, the second end of the elongated body is releasably attachable to the handle and the elongated body and the end effector are disposable. The handle may include a plurality of actuators operably connected to the end effector for actuating the end effector. Advantageously, the handle includes means for translating at least one rod, and preferably three rods, through the elongated body for actuating the end effector.
Another aspect of the present invention relates to a system for minimally invasive surgery in which the system includes a surgical tool and a docking station for restraining movement of the surgical tool to four degrees of freedom about an incision in a patient. The docking station includes a plurality of actuators for moving the surgical tool relative to the incision in the patient, a controller operably connected to the actuators, and wherein movement of the surgical tool is collaboratively controllable by the controller and a surgeon.
Still another aspect of the present invention relates to a method for forming a knot in a suture thread inserted through an entry point on a first portion to be sutured and exited through an exit point on a second portion to be sutured in which one end of the suture thread is attached to a needle and the needle is attached to a first jaw of a suturing end effector of a suturing surgical tool and the tail of the suture thread is attached to the gripping end effector of a gripping surgical tool. The method includes the steps of contacting a second jaw of the suturing end effector to an elongated body of the gripping surgical tool, rotating the suturing surgical tool until the suture thread drapes over the second jaw, moving the suturing end effector so that the elongated body of the gripping tool is disposed between the jaws of the suturing end effector, passing the needle from the first jaw to the second jaw, and moving the suturing end effector away from the gripping end effector to form a knot in the suture thread.
The method may also include the step of repeating the steps to form a square knot. Desirably, the method further includes the step of computer implementing control of the suturing surgical tool and the gripping surgical gripping tool to autonomously perform the steps of contacting, rotating, passing, and retracting.
REFERENCES:
patent: 3821498 (1974-06-01), Schaefer, Jr. et al.
pa
Bernard Christopher J.
Kang Hyosig
Sachs Barton L.
Singh Sunil K.
Wen John T.
Advanced Realtime Control Systems, Inc.
Heslin Rothenberg Farley & & Mesiti P.C.
Jackson Gary
LandOfFree
Robotic system, docking station, and surgical tool for... does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Robotic system, docking station, and surgical tool for..., we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Robotic system, docking station, and surgical tool for... will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-2591918