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WO2024118547A1 - Système robotique chirurgical avec système d'accès à orifice unique - Google Patents

Système robotique chirurgical avec système d'accès à orifice unique Download PDF

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Publication number
WO2024118547A1
WO2024118547A1 PCT/US2023/081251 US2023081251W WO2024118547A1 WO 2024118547 A1 WO2024118547 A1 WO 2024118547A1 US 2023081251 W US2023081251 W US 2023081251W WO 2024118547 A1 WO2024118547 A1 WO 2024118547A1
Authority
WO
WIPO (PCT)
Prior art keywords
joint
drive unit
surgical
coupled
robotic system
Prior art date
Application number
PCT/US2023/081251
Other languages
English (en)
Inventor
Alexander D. NORMAN
Michael J. BLOM
Andrew G. FORBES
Charles F. Kilby
Gary Stacey
Original Assignee
Covidien Lp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covidien Lp filed Critical Covidien Lp
Publication of WO2024118547A1 publication Critical patent/WO2024118547A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/37—Master-slave robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/302—Surgical robots specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B2090/5025—Supports for surgical instruments, e.g. articulated arms with a counter-balancing mechanism
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B2090/506—Supports for surgical instruments, e.g. articulated arms using a parallelogram linkage, e.g. panthograph
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B2090/508—Supports for surgical instruments, e.g. articulated arms with releasable brake mechanisms

Definitions

  • Surgical robotic systems are currently being used in a variety of surgical procedures, including minimally invasive medical procedures.
  • Some surgical robotic systems include a surgeon console controlling a surgical robotic arm and a surgical instrument having an end effector (e.g., forceps or grasping instrument) coupled to and actuated by the robotic arm.
  • the robotic arm In operation, the robotic arm is moved to a position over a patient and then guides the surgical instrument into a small incision via a surgical port or a natural orifice of a patient to position the end effector at a work site within the patient’s body.
  • a surgical robotic system includes a control drive unit having a plurality of instrument drive units and a camera drive unit.
  • the system also includes a plurality of instruments each of which is coupled to one instrument drive unit and a camera coupled to the camera drive unit.
  • the system further includes a surgical port assembly configured to receive the plurality of instruments and the camera, and a setup arm having a plurality of links.
  • the setup arm is coupled to the control drive unit and has a constrained remote center of motion.
  • the setup arm may further include a parallelogram joint configured to mechanically constrain the remote center of motion.
  • the setup arm may also include a rotatable joint coupled to the parallelogram joint.
  • the rotatable joint may be disposed along a vertical axis passing through the remote center of motion.
  • the parallelogram joint may be configured to constrain pitch motion of the control drive unit from about +10 degrees to about -50 degrees.
  • the surgical port assembly may be disposed at least partially at the remote center of motion.
  • the setup arm may include an L-shaped link having a first joint coupled to the setup arm and a second joint coupled to the control drive unit.
  • the first joint may be configured to control yaw motion of the control drive unit and the second joint may be configured to control pitch motion of the control drive unit.
  • Each of the first joint and the second may include an actuator.
  • the controller may be configured to control the actuators to constrain the pitch motion and the yaw motion of the control drive unit.
  • FIG. 1 is a schematic illustration of a surgical robotic system including a control tower, a console, and one or more surgical robotic arms each disposed on a movable cart according to an embodiment of the present disclosure
  • FIG. 2 is a perspective view of a surgical robotic arm of the surgical robotic system of FIG.
  • FIG. 3 is a perspective view of a movable cart having a setup arm with the surgical robotic arm of the surgical robotic system of FIG. 1 according to an embodiment of the present disclosure
  • FIG. 4 is a schematic diagram of a computer architecture of the surgical robotic system of FIG. 1 according to an embodiment of the present disclosure
  • FIG. 5A is a perspective view of a movable cart having a setup arm with a multiple instrument drive units according to one embodiment of the present disclosure
  • FIG. 5B is a perspective view of the movable cart of FIG. 5B with covers removed from the setup arm according to one embodiment of the present disclosure
  • FIG. 6 is a perspective view of a movable cart having a setup arm with a multiple instrument drive units according to another embodiment of the present disclosure.
  • FIG. 7 is a perspective view of a control drive assembly for controlling a plurality of surgical robotic instruments and a camera according to another embodiment of the present disclosure.
  • a surgical robotic system which includes a surgeon console, a control tower, and one or more movable carts having a surgical robotic arm coupled to a setup arm.
  • the surgeon console receives user input through one or more interface devices, which are processed by the control tower as movement commands for moving the surgical robotic arm and an instrument and/or camera coupled thereto.
  • the surgeon console enables teleoperation of the surgical arms and attached instrum ents/cam era.
  • the surgical robotic arm includes a controller, which is configured to process the movement command and to generate a torque command for activating one or more actuators of the robotic arm, which would, in turn, move the robotic arm in response to the movement command.
  • a surgical robotic system 10 includes a control tower 20, which is connected to all of the components of the surgical robotic system 10 including a surgeon console 30 and one or more movable carts 60.
  • Each of the movable carts 60 includes a robotic arm 40 having a surgical instrument 50 removably coupled thereto.
  • the robotic arms 40 also couple to the movable carts 60.
  • the robotic system 10 may include any number of movable carts 60 and/or robotic arms 40.
  • the surgical instrument 50 is configured for use during minimally invasive surgical procedures.
  • the surgical instrument 50 may be configured for open surgical procedures.
  • the surgical instrument 50 may be an electrosurgical forceps configured to seal tissue by compressing tissue between jaw members and applying electrosurgical current thereto.
  • the surgical instrument 50 may be a surgical stapler including a pair of jaws configured to grasp and clamp tissue while deploying a plurality of tissue fasteners, e.g., staples, and cutting stapled tissue.
  • the surgical instrument 50 may be a surgical clip applier including a pair of jaws configured apply a surgical clip onto tissue.
  • One of the robotic arms 40 may include an endoscopic camera 51 configured to capture video of the surgical site.
  • the endoscopic camera 51 may be a stereoscopic endoscope configured to capture two side-by-side (i.e., left and right) images of the surgical site to produce a video stream of the surgical scene.
  • the endoscopic camera 51 is coupled to a video processing device 56, which may be disposed within the control tower 20.
  • the video processing device 56 may be any computing device as described below configured to receive the video feed from the endoscopic camera 51 and output the processed video stream.
  • the surgeon console 30 includes a first display 32, which displays a video feed of the surgical site provided by camera 51 of the surgical instrument 50 disposed on the robotic arm 40, and a second display 34, which displays a user interface for controlling the surgical robotic system 10.
  • the first display 32 and second display 34 may be touchscreens allowing for displaying various graphical user inputs.
  • the surgeon console 30 also includes a plurality of user interface devices, such as foot pedals 36 and a pair of handle controllers 38a and 38b which are used by a user to remotely control robotic arms 40.
  • the surgeon console further includes an armrest 33 used to support clinician’s arms while operating the handle controllers 38a and 38b.
  • the control tower 20 includes a display 23, which may be a touchscreen, and outputs on the graphical user interfaces (GUIs).
  • GUIs graphical user interfaces
  • the control tower 20 also acts as an interface between the surgeon console 30 and one or more robotic arms 40.
  • the control tower 20 is configured to control the robotic arms 40, such as to move the robotic arms 40 and the corresponding surgical instrument 50, based on a set of programmable instructions and/or input commands from the surgeon console 30, in such a way that robotic arms 40 and the surgical instrument 50 execute a desired movement sequence in response to input from the foot pedals 36 and the handle controllers 38a and 38b.
  • the foot pedals 36 may be used to enable and lock the hand controllers 38a and 38b, repositioning camera movement and electrosurgical activation/deactivation.
  • the foot pedals 36 may be used to perform a clutching action on the hand controllers 38a and 38b. Clutching is initiated by pressing one of the foot pedals 36, which disconnects (i.e., prevents movement inputs) the hand controllers 38a and/or 38b from the robotic arm 40 and corresponding instrument 50 or camera 51 attached thereto. This allows the user to reposition the hand controllers 38a and 38b without moving the robotic arm(s) 40 and the instrument 50 and/or camera 51. This is useful when reaching control boundaries of the surgical space.
  • Each of the control tower 20, the surgeon console 30, and the robotic arm 40 includes a respective computer 21, 31, 41.
  • the computers 21, 31, 41 are interconnected to each other using any suitable communication network based on wired or wireless communication protocols.
  • Suitable protocols include, but are not limited to, transmission control protocol/internet protocol (TCP/IP), datagram protocol/intemet protocol (UDP/IP), and/or datagram congestion control protocol (DCCP).
  • Wireless communication may be achieved via one or more wireless configurations, e.g., radio frequency, optical, Wi-Fi, Bluetooth (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs), ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-1203 standard for wireless personal area networks (WPANs)).
  • wireless configurations e.g., radio frequency, optical, Wi-Fi, Bluetooth (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs), ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-1203 standard for wireless personal area networks (WPANs)).
  • PANs personal area networks
  • ZigBee® a specification for a suite of high level communication protocols using small, low-power digital radios
  • the computers 21, 31, 41 may include any suitable processor (not shown) operably connected to a memory (not shown), which may include one or more of volatile, non-volatile, magnetic, optical, or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically-erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory.
  • the processor may be any suitable processor (e.g., control circuit) adapted to perform the operations, calculations, and/or set of instructions described in the present disclosure including, but not limited to, a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), a microprocessor, and combinations thereof.
  • FPGA field programmable gate array
  • DSP digital signal processor
  • CPU central processing unit
  • microprocessor e.g., microprocessor
  • each of the robotic arms 40 may include a plurality of links 42a, 42b, 42c, which are interconnected at joints 44a, 44b, 44c, respectively.
  • the joint 44a is configured to secure the robotic arm 40 to the movable cart 60 and defines a first longitudinal axis.
  • the movable cart 60 includes a lift 67 and a setup arm 61, which provides a base for mounting of the robotic arm 40.
  • the lift 67 allows for vertical movement of the setup arm 61.
  • the movable cart 60 also includes a display 69 for displaying information pertaining to the robotic arm 40.
  • the robotic arm 40 may include any type and/or number of joints.
  • the setup arm 61 includes a first link 62a, a second link 62b, and a third link 62c, which provide for lateral maneuverability of the robotic arm 40.
  • the links 62a, 62b, 62c are interconnected at joints 63a and 63b, each of which may include an actuator (not shown) for rotating the links 62b and 62b relative to each other and the link 62c.
  • the links 62a, 62b, 62c are movable in their corresponding lateral planes that are parallel to each other, thereby allowing for extension of the robotic arm 40 relative to the patient (e.g., surgical table).
  • the robotic arm 40 may be coupled to the surgical table (not shown).
  • the setup arm 61 includes controls 65 for adjusting movement of the links 62a, 62b, 62c as well as the lift 67.
  • the setup arm 61 may include any type and/or number of joints.
  • the third link 62c may include a rotatable base 64 having two degrees of freedom.
  • the rotatable base 64 includes a first actuator 64a and a second actuator 64b.
  • the first actuator 64a is rotatable about a first stationary arm axis which is perpendicular to a plane defined by the third link 62c and the second actuator 64b is rotatable about a second stationary arm axis which is transverse to the first stationary arm axis.
  • the first and second actuators 64a and 64b allow for full three-dimensional orientation of the robotic arm 40.
  • the actuator 48b of the joint 44b is coupled to the joint 44c via the belt 45a, and the joint 44c is in turn coupled to the joint 46b via the belt 45b.
  • Joint 44c may include a transfer case coupling the belts 45a and 45b, such that the actuator 48b is configured to rotate each of the links 42b, 42c and a holder 46 relative to each other. More specifically, links 42b, 42c, and the holder 46 are passively coupled to the actuator 48b which enforces rotation about a pivot point “P” which lies at an intersection of the first axis defined by the link 42a and the second axis defined by the holder 46. In other words, the pivot point “P” is a remote center of motion (RCM) for the robotic arm 40.
  • RCM remote center of motion
  • the actuator 48b controls the angle 0 between the first and second axes allowing for orientation of the surgical instrument 50. Due to the interlinking of the links 42a, 42b, 42c, and the holder 46 via the belts 45a and 45b, the angles between the links 42a, 42b, 42c, and the holder 46 are also adjusted in order to achieve the desired angle 0. In embodiments, some or all of the joints 44a, 44b, 44c may include an actuator to obviate the need for mechanical linkages.
  • the joints 44a and 44b include an actuator 48a and 48b configured to drive the joints 44a, 44b, 44c relative to each other through a series of belts 45a and 45b or other mechanical linkages such as a drive rod, a cable, or a lever and the like.
  • the actuator 48a is configured to rotate the robotic arm 40 about a longitudinal axis defined by the link 42a.
  • the holder 46 defines a second longitudinal axis and configured to receive an instrument drive unit (IDU) 52 (FIG. 1).
  • the IDU 52 is configured to couple to an actuation mechanism of the surgical instrument 50 and the camera 51 and is configured to move (e.g., rotate) and actuate the instrument 50 and/or the camera 51.
  • IDU 52 transfers actuation forces from its actuators to the surgical instrument 50 to actuate components an end effector 49 of the surgical instrument 50.
  • the holder 46 includes a sliding mechanism 46a, which is configured to move the IDU 52 along the second longitudinal axis defined by the holder 46.
  • the holder 46 also includes a joint 46b, which rotates the holder 46 relative to the link 42c.
  • the instrument 50 may be inserted through an endoscopic access port 55 (FIG. 3) held by the holder 46.
  • the holder 46 also includes a port latch 46c for securing the access port 55 to the holder 46 (FIG. 2).
  • the robotic arm 40 also includes a plurality of manual override buttons 53 (FIG. 1) disposed on the IDU 52 and the setup arm 61, which may be used in a manual mode. The user may press one or more of the buttons 53 to move the component associated with the button 53.
  • each of the computers 21, 31, 41 of the surgical robotic system 10 may include a plurality of controllers, which may be embodied in hardware and/or software.
  • the computer 21 of the control tower 20 includes a controller 21a and safety observer 21b.
  • the controller 21a receives data from the computer 31 of the surgeon console 30 about the current position and/or orientation of the handle controllers 38a and 38b and the state of the foot pedals 36 and other buttons.
  • the controller 21a processes these input positions to determine desired drive commands for each joint of the robotic arm 40 and/or the IDU 52 and communicates these to the computer 41 of the robotic arm 40.
  • the controller 21a also receives the actual joint angles measured by encoders of the actuators 48a and 48b and uses this information to determine force feedback commands that are transmitted back to the computer 31 of the surgeon console 30 to provide haptic feedback through the handle controllers 38a and 38b.
  • the safety observer 21b performs validity checks on the data going into and out of the controller 21a and notifies a system fault handler if errors in the data transmission are detected to place the computer 21 and/or the surgical robotic system 10 into a safe state.
  • the computer 41 includes a plurality of controllers, namely, a main cart controller 41a, a setup arm controller 41b, a robotic arm controller 41c, and an instrument drive unit (IDU) controller 4 Id.
  • IDU instrument drive unit
  • the main cart controller 41a receives and processes joint commands from the controller 21a of the computer 21 and communicates them to the setup arm controller 41b, the robotic arm controller 41c, and the IDU controller 4 Id.
  • the main cart controller 41a also manages instrument exchanges and the overall state of the movable cart 60, the robotic arm 40, and the IDU 52.
  • the main cart controller 41a also communicates actual joint angles back to the controller 21a.
  • Each of joints 63a and 63b and the rotatable base 64 of the setup arm 61 are passive joints (i.e., no actuators are present therein) allowing for manual adjustment thereof by a user.
  • the joints 63a and 63b and the rotatable base 64 include brakes that are disengaged by the user to configure the setup arm 61.
  • the setup arm controller 41b monitors slippage of each of joints 63a and 63b and the rotatable base 64 of the setup arm 61, when brakes are engaged or can be freely moved by the operator when brakes are disengaged, but do not impact controls of other joints.
  • the robotic arm controller 41c controls each joint 44a and 44b of the robotic arm 40 and calculates desired motor torques required for gravity compensation, friction compensation, and closed loop position control of the robotic arm 40.
  • the robotic arm controller 41c calculates a movement command based on the calculated torque.
  • the calculated motor commands are then communicated to one or more of the actuators 48a and 48b in the robotic arm 40.
  • the actual joint positions are then transmitted by the actuators 48a and 48b back to the robotic arm controller 41c.
  • the IDU controller 41d receives desired joint angles for the surgical instrument 50, such as wrist and jaw angles, and computes desired currents for the motors in the IDU 52.
  • the IDU controller 41d calculates actual angles based on the motor positions and transmits the actual angles back to the main cart controller 41a.
  • the robotic arm 40 is controlled in response to a pose of the handle controller controlling the robotic arm 40, e.g., the handle controller 38a, which is transformed into a desired pose of the robotic arm 40 through a hand eye transform function executed by the controller 21a.
  • the hand eye function as well as other functions described herein, is/are embodied in software executable by the controller 21a or any other suitable controller described herein.
  • the pose of one of the handle controllers 38a may be embodied as a coordinate position and roll-pitch -yaw (RPY) orientation relative to a coordinate reference frame, which is fixed to the surgeon console 30.
  • the desired pose of the instrument 50 is relative to a fixed frame on the robotic arm 40.
  • the pose of the handle controller 38a is then scaled by a scaling function executed by the controller 21a.
  • the coordinate position may be scaled down and the orientation may be scaled up by the scaling function.
  • the controller 21a may also execute a clutching function, which disengages the handle controller 38a from the robotic arm 40.
  • the controller 21a stops transmitting movement commands from the handle controller 38a to the robotic arm 40 if certain movement limits or other thresholds are exceeded and in essence acts like a virtual clutch mechanism, e.g., limits mechanical input from effecting mechanical output.
  • the desired pose of the robotic arm 40 is based on the pose of the handle controller 38a and is then passed by an inverse kinematics function executed by the controller 21a.
  • the inverse kinematics function calculates angles for the joints 44a, 44b, 44c of the robotic arm 40 that achieve the scaled and adjusted pose input by the handle controller 38a.
  • the calculated angles are then passed to the robotic arm controller 41c, which includes a joint axis controller having a proportional-derivative (PD) controller, the friction estimator module, the gravity compensator module, and a two-sided saturation block, which is configured to limit the commanded torque of the motors of the joints 44a, 44b, 44c.
  • PD proportional-derivative
  • the robotic system 10 may also be used with a multiple instrument movable cart 160 including a control drive assembly 100 configured to actuate a plurality of instruments 50 and the camera 51.
  • a control drive assembly 100 configured to actuate a plurality of instruments 50 and the camera 51.
  • the movable cart 160 is used with a surgical port assembly 16 (FIG. 7) which can serve as a single access port for multiple instruments 50 and the camera 51.
  • control drive assembly 100 is pivotably mounted to a setup arm 161 of the movable cart 160.
  • Control drive unit 101 of control drive assembly 100 includes a housing 102 that supports instrument drive assembly 103, including instrument drive units 103a (e.g., three) and camera drive unit 103b.
  • the instrument drive units 103a are coupled to instruments 50 and the camera drive unit 103b is coupled to the endoscopic camera 51.
  • the instruments 50 and the camera 51 are inserted into the surgical port assembly 16 having a plurality of lumens as shown in FIG. 7 of any suitable shape or size configured for passage of the instruments 50 and the camera 51 through individual corresponding lumens. While four lumens are illustrated, it should be understood that more or less lumens may be provided.
  • Control drive unit 101 further includes a support bar assembly 104 that is mounted to housing 102.
  • Support bar assembly 104 may have a hollow construction configured to enable internal wiring and weight reduction.
  • Support bar assembly 104 includes a rear bar 104a having a U-shaped configuration that extends around sidewalls of a proximal portion of housing 102 and beneath housing 102.
  • the support bar assembly 104 also includes handles 104b, and a port arm 104c that extends from handles 104b distally to port latch assembly 105 on a distal end portion of port arm 104c.
  • Port arm 104c has an arched configuration and extends to a float on a proximal end portion of port latch assembly 105 to enable post manufacturing alignment of port latch assembly 105 and to help mitigate any assembly stack up errors.
  • Port latch assembly 105 is configured to secure the surgical portal assembly 16 and defines the RCM.
  • Support bar assembly 104 further includes a plurality of brake release buttons 104e on inner facing surfaces of rear bar 104a, handles 104b, and port arm 104c of support bar assembly 104 that are configured to stop linear movement of instrument drive and/or camera drive units 103a, 103b relative to control drive unit 101.
  • the control drive assembly 100 and its operation are described in further detail in U.S. Provisional Patent Application No. 63/341,459 filed on May 13, 2022, the entire contents of which are incorporated by reference herein.
  • the movable cart 160 includes a setup arm 161 having a first link 162a that is vertically movable allowing for height adjustment of the setup arm 161.
  • the setup arm 161 also includes second and third links 162b and 162c.
  • the second link 162b is coupled to the first link 162a via a rotational joint 163a and to the third link 162c via a second rotational joint 163b.
  • the joints 163a and 163b may be passive allowing for manual adjustment of the setup arm 161.
  • the setup arm 161 also includes a combined parallelogram joint 165 having a pair of links 165a and 165b rotationally coupled via a joint 166a.
  • the control drive assembly 100 is coupled to the link 165b via a joint 166b.
  • the parallelogram joint 165 is rotationally coupled to a third joint 163c of the setup arm 161 via ajoint 166c.
  • the joint 163c of the setup arm 161 and the joints 166a-c may be active and/or spring counterbalanced.
  • the term “active joint” denotes ajoint having an actuator, e g., motor.
  • the configuration of the parallelogram joint 165 provides for a mechanically constrained RCM.
  • the third joint 163 c of the setup arm 161 and the joint 166b of the parallelogram joint 165 are placed directly over the RCM.
  • the joint 163c alone sets the yaw of the control drive assembly 100.
  • the parallelogram joint 165 provides pitch motion of the control drive assembly 100, which may be from about +10° to about -50° with a mechanically constrained RCM.
  • the other joints 163a and 163b may remain passive, as they are not engaged during repositioning.
  • the vertical stage, i.e., the first link 162a can also remain passive, as it is only used for manual setup.
  • the first link 162a may be spring counterbalanced to address issues of high inertia.
  • the links 162a-c of the setup arm 161 and the links 165a-b of the parallelogram joint 165 may be rigid links rather than belt-driven.
  • the rigid links may be carbon fiber reinforced plastic tubes, which are very rigid in bending and torsion. Cast and machined metal nodes may be used at the joints 163a-c and 166a-c. While a linkage-driven parallelogram is more limited in its rotation angles, it is significantly stiffer, simpler to assemble, and leaves more internal space for wiring These features make this design well suited to the single port robotic system which has long and highly loaded links but only has approximately 60 degrees of travel.
  • FIG. 6 another embodiment of a multiple instrument movable cart 260 which is substantially similar to the movable cart 160 with the exception of the parallelogram joint 165, which is replaced by a L-shaped link 265.
  • the setup arm 161 is coupled to the L-shaped link 265 via a first joint 266a providing rotation about a first axis, e.g., Y axis.
  • the L-shaped link 265 is coupled to the control drive assembly 100 via a second joint 266b providing rotation about a second axis, e g., X axis, that is perpendicular to the first axis.
  • the first joint 266a and the second joint 266b are controlled by the controller 21a to limit pitch and yaw motion thereby controlling RCM, i.e., software constrained RCM.
  • the first link 162a, the first joint 163a, and the second joint 163b are also motorized and controlled by the controller 21a.
  • the joints of the setup arm 161 may be spring-counterbalanced.
  • the actuators may be back- drivable.

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  • Health & Medical Sciences (AREA)
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  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Robotics (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Gynecology & Obstetrics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Manipulator (AREA)

Abstract

Un système robotique chirurgical comprend une unité d'entraînement de commande ayant une pluralité d'unités d'entraînement d'instrument et un instrument chirurgical et une unité d'entraînement de caméra. Le système comprend également une pluralité d'instruments dont chacun est couplé à une unité d'entraînement d'instrument et une caméra couplée à l'unité d'entraînement de caméra. Le système comprend en outre un ensemble orifice chirurgical configuré pour recevoir la pluralité d'instruments et la caméra et un bras d'installation ayant une pluralité de liaisons. Le bras d'installation est couplé à l'unité d'entraînement de commande et a un centre de mouvement distant contraint.
PCT/US2023/081251 2022-11-29 2023-11-28 Système robotique chirurgical avec système d'accès à orifice unique WO2024118547A1 (fr)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN208274620U (zh) * 2017-07-10 2018-12-25 佛山市碧盈医疗器材有限公司 一种微创手术机器人的手术器械末端
US20190328468A1 (en) * 2012-06-01 2019-10-31 Intuitive Surgical Operations, Inc. Surgical Instrument Manipulator Aspects
US20200405412A1 (en) * 2016-05-18 2020-12-31 Virtual Incision Corporation Robotic Surgical Devices, Systems and Related Methods
EP4088678A1 (fr) * 2021-05-14 2022-11-16 Titan Medical Inc. Ensembles de cassettes d'instruments pour instruments chirurgicaux robotisés
EP4154835A1 (fr) * 2021-09-24 2023-03-29 Covidien LP Système robotique chirurgical avec chaînage en guirlande
WO2023172759A1 (fr) * 2022-03-10 2023-09-14 Covidien Lp Attn: Ip Legal Système chirurgical robotique à ensemble d'entraînement de commande pour techniques chirurgicales à port unique

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20190328468A1 (en) * 2012-06-01 2019-10-31 Intuitive Surgical Operations, Inc. Surgical Instrument Manipulator Aspects
US20200405412A1 (en) * 2016-05-18 2020-12-31 Virtual Incision Corporation Robotic Surgical Devices, Systems and Related Methods
CN208274620U (zh) * 2017-07-10 2018-12-25 佛山市碧盈医疗器材有限公司 一种微创手术机器人的手术器械末端
EP4088678A1 (fr) * 2021-05-14 2022-11-16 Titan Medical Inc. Ensembles de cassettes d'instruments pour instruments chirurgicaux robotisés
EP4154835A1 (fr) * 2021-09-24 2023-03-29 Covidien LP Système robotique chirurgical avec chaînage en guirlande
WO2023172759A1 (fr) * 2022-03-10 2023-09-14 Covidien Lp Attn: Ip Legal Système chirurgical robotique à ensemble d'entraînement de commande pour techniques chirurgicales à port unique

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