US20070156121A1 - Robotic surgical systems with fluid flow control for irrigation, aspiration, and blowing - Google Patents
Robotic surgical systems with fluid flow control for irrigation, aspiration, and blowing Download PDFInfo
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- US20070156121A1 US20070156121A1 US11/454,359 US45435906A US2007156121A1 US 20070156121 A1 US20070156121 A1 US 20070156121A1 US 45435906 A US45435906 A US 45435906A US 2007156121 A1 US2007156121 A1 US 2007156121A1
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- pump
- robotically controlled
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- valve
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- 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
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/71—Manipulators operated by drive cable mechanisms
-
- 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
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/74—Manipulators with manual electric input means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/71—Suction drainage systems
- A61M1/74—Suction control
- A61M1/743—Suction control by changing the cross-section of the line, e.g. flow regulating valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/71—Suction drainage systems
- A61M1/76—Handpieces
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/71—Suction drainage systems
- A61M1/77—Suction-irrigation systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M13/00—Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
- A61M13/003—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00203—Electrical control of surgical instruments with speech control or speech recognition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
-
- 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
- A61B2034/305—Details of wrist mechanisms at distal ends of robotic arms
-
- 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
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/007—Auxiliary appliance with irrigation system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/22—Valves or arrangement of valves
- A61M39/24—Check- or non-return valves
- A61M2039/2473—Valve comprising a non-deformable, movable element, e.g. ball-valve, valve with movable stopper or reciprocating element
Definitions
- the embodiments of the invention relate generally to surgical instruments for robotic surgery. More particularly, the embodiments of the invention relate to irrigation/aspiration/blowing devices for surgery.
- a surgical site with a fluid, such as water, to clean or clear away blood, tissue, or other items obscuring the vision of a surgeon in the surgical site.
- a fluid such as water
- Suction or aspiration in the surgical site may also be used to vacuum away blood, tissue, or other items obscuring the vision of the surgeon in the surgical site.
- Hand held surgical instruments have typically been used to provide irrigation and/or aspiration.
- the surgeon typically does not operate the hand held surgical instrument that provides irrigation and/or aspiration.
- An assistant surgeon or nurse handling such instruments may provide irrigation and/or aspiration of the surgical site.
- the surgeon gives verbal instructions to the assistant surgeon or nurse to provide irrigation and/or aspiration of the surgical site. If the surgeon could both control the surgical instruments and the irrigation and aspiration of the surgical site, verbal instructions could be reduced and surgical procedures may be more efficient.
- FIG. 1 is a block diagram of a robotic surgery system to perform minimally invasive robotic surgical procedures using an irrigation/aspiration/blowing robotic surgical tool.
- FIG. 2A is a perspective view of a robotic surgical manipulator with a plurality of robotic surgical arms at least one of which includes an irrigation/aspiration/blowing robotic surgical tool.
- FIG. 2B is a perspective view of the robotic surgical arm including the irrigation/aspiration/blowing robotic surgical tool mounted thereto.
- FIG. 2C illustrates mounting of the irrigation/aspiration/blowing robotic surgical tool to an adapter of the robotic surgical arm of FIG. 2B .
- FIG. 2D illustrates a top view of the adapter of the robotic surgical arm of FIG. 2C to which the irrigation/aspiration/blowing robotic surgical tool may be mounted.
- FIG. 3A is a perspective view of a robotic surgical master control console.
- FIG. 3B is a perspective view of an exemplary gimbaled device pivotally supporting a touch sensitive handle for the robotic surgical master control console of FIG. 3A to control robotic surgical tools including an irrigation/aspiration/blowing robotic surgical tool.
- FIG. 3C is a cross-sectional view schematically illustrating mounting of the touch sensitive handle of FIG. 3B with sensors to sense gripping and rotation of the handle to control robotic surgical tools, including an irrigation/aspiration/blowing robotic surgical tool.
- FIG. 4A is a perspective view of an irrigation/aspiration/blowing robotic surgical tool.
- FIG. 4B is a back side view of a portion of the irrigation/aspiration/blowing robotic surgical tool of FIG. 4A .
- FIG. 5A is a schematic flow diagram of an irrigation/aspiration robotic surgical tool using two-way two-position valves.
- FIG. 5B is a schematic flow diagram of an irrigation/aspiration robotic surgical tool using a three-way three-position valve.
- FIG. 5C is a schematic flow diagram of an irrigation/aspiration/blowing robotic surgical tool using a four-way four-position valve.
- FIG. 5D is a schematic flow diagram of an irrigation/aspiration/blowing robotic surgical tool using two-way two-position valves.
- FIGS. 6A-6C are top views of rotationally actuated rotatable valves for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
- FIGS. 7A-7C are cross-sections of linearly actuated linear valves for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
- FIG. 8 is a top view of exemplary linear actuation of a rotatable valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
- FIG. 9A is a top view of exemplary rotational actuation of a linear valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm with an optional manual push arm.
- FIG. 9B is a top view of exemplary rotational actuation of a linear valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm with an optional manual push side-arm.
- FIG. 10A is a top view to illustrate rotational actuation of a rotatable pinch valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
- FIG. 10B is a side view to illustrate linear actuation of a linear pinch valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
- FIG. 11A is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show a solid valve body.
- FIG. 11B is a bottom exploded of the irrigation/aspiration/blowing robotic surgical tool of FIG. 11A with the solid valve body.
- FIG. 11C is a cross sectional view of the valve assembly with the solid valve body in a closed position for the irrigation/aspiration/blowing robotic surgical tool of FIG. 11A .
- FIG. 11D is a cross sectional view of the valve assembly with the solid valve body in an open position for the irrigation/aspiration/blowing robotic surgical tool of FIG. 11A .
- FIG. 11E is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with a solid valve body including robotically actuated valves and manually actuated valves.
- FIG. 12 is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show the replaceable valves.
- FIG. 13A is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show rotatable pinch valves.
- FIG. 13B is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool of FIG. 13A with cover in place to show manual handles and a cleaning position of the handles.
- FIG. 14 is a top view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show the pinch valves and replaceable tubing.
- FIGS. 15A-15B are top views of irrigation/aspiration/blowing robotic surgical tools with covers removed to respectively show three-way and four-way couplers and replaceable tubing coupled thereto.
- FIG. 16A is a side view of the touch sensitive handle of the diagram of the touch sensitive handle illustrated in FIG. 3B for the robotic surgical master control console of FIG. 3A .
- FIGS. 16B-16D are side views of grip positions of the touch sensitive handle to control the irrigation/aspiration/blowing robotic surgical tool in a surgical site.
- FIG. 17 is a graph showing exemplary control of irrigation and aspiration using grip control of the touch sensitive handle corresponding to the side views of the touch sensitive handle illustrated in FIGS. 16B-16D .
- FIG. 18A is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with light emitting diodes at the distal end to provide user feedback.
- FIG. 18B is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a light pipe along side the flow tube that is coupled to a light emitting diode at the proximal end to provide user feedback.
- FIG. 18C is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a sliding sleeve around the flow tube that is moved to reveal a scale at the distal end to provide user feedback by mechanical means.
- FIG. 18D is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a rotational sleeve around the flow tube that rotates to reveal a scale at the distal end and provide user feedback by mechanical means.
- FIG. 18E is a perspective view of a first tip for the irrigation/aspiration/blowing robotic surgical tool of FIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback.
- FIG. 18F is a perspective view of a second tip for the irrigation/aspiration/blowing robotic surgical tool of FIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback.
- FIG. 18G is a perspective view of a third tip for the irrigation/aspiration/blowing robotic surgical tool of FIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback.
- FIG. 19 is a viewer of the robotic surgical master control console of FIG. 3A with an icon overlaid onto the displayed images to provide user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool.
- FIG. 20A illustrates a viewer of the master control console of FIG. 3A with an icon overlay in a single side to provide user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool.
- FIG. 20B illustrates a viewer of the master control console of FIG. 3A with an icon overlay in both left and right sides to provide three-dimensional user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool.
- the embodiments of the invention include a method, apparatus, and system for robotically controlled irrigation/aspiration/blowing of an internal or external surgical area or site where robotic surgery is being performed. Aspiration may also be referred to as suction.
- a robotic surgical system including a master control console, a surgical manipulator, a first hose, and a first pump.
- the master control console is used to generate control signals to cause one or more fluids to flow into or out of a surgical site.
- the surgical manipulator is coupled to the master control console to receive the control signals.
- the surgical manipulator includes at least one robotic arm to manipulate at least one robotic surgical instrument, and a surgical instrument coupled to the robotic arm.
- the surgical manipulator controls the surgical instrument in response to the control signals to control the flow of the one or more fluids into or out of the surgical site.
- the surgical instrument has a first robotically controlled valve responsive to the surgical manipulator and a hollow tube having an opening at one end to direct the flow of one or more fluids in the surgical site.
- the first robotically controlled valve has a first port and a second port and the hollow tube has a first end coupled to the second port of the first robotically controlled valve.
- the first hose has a first end coupled to the first port of the first robotically controlled valve.
- the first hose transports a first fluid to the first robotically controlled valve.
- the first pump has a port coupled to a second end of the first hose. The first pump pumps a first fluid through the first hose to the first robotically controlled valve of the surgical instrument.
- a robotic surgical system including a master control console, a surgical manipulator, and a first pump.
- the master control console generates control signals to cause a fluid to flow into or out of a surgical site.
- the surgical manipulator is coupled to the master control console to receive the control signals.
- the surgical manipulator includes at least one robotic arm to manipulate at least one surgical instrument.
- a surgical instrument is coupled to the robotic arm to control the flow of a fluid into or out of the surgical site.
- the surgical instrument has a first hose, a first robotically controlled pinch valve, and a hollow tube.
- the first hose is flexible and has a first end and a second end.
- the first robotically controlled pinch valve receives the first hose.
- the first robotically controlled pinch valve squeezes and pinches closed the first hose and releases and opens the first hose.
- the hollow tube has a first end to couple to the first end of the first hose.
- the first pump has a port coupled to the second end of the first hose.
- a method in another embodiment, includes generating a first control signal to control a robotic surgical instrument; coupling the first control signal into the robotic surgical instrument; and opening a first valve in the robotic surgical instrument to flow a first fluid over a surgical site in response to the first control signal.
- another method includes mounting an irrigation-aspiration robotic surgical instrument to a robotic arm of a robotic surgical manipulator; coupling at least one hose from the irrigation-aspiration robotic surgical instrument to at least one pump; inserting a tip of a hollow tube of the irrigation-aspiration robotic surgical instrument into a patient near a surgical site; controlling a flow of a fluid between the surgical site and the irrigation-aspiration robotic surgical instrument; and monitoring a level of the flow of the fluid between the surgical site and the irrigation-aspiration robotic surgical instrument.
- a robotic surgical instrument for the control of flows of one or more fluids into and out of a surgical site.
- the robotic surgical instrument includes a housing, a flow control system mounted in the housing, a hollow tube having a first end mounted in the housing, and one or more hose fittings having a first end coupled to the flow control system.
- the housing can couple the robotic surgical instrument to a robotic arm.
- the flow control system includes one or more controlled valves to control the flow of one or more fluids through the robotic surgical instrument.
- the first end of the hollow tube couples to the flow control system.
- the one or more hose fittings have a second end to respectively couple to one or more hoses.
- another robotic surgical instrument is provided for the control of flows of one or more fluids into and out of a surgical site.
- the robotic surgical instrument includes an interface base, a hollow tube having a proximal end mounted to the interface base, a three-way coupler having a first port coupled to the proximal end of the hollow tube, a first robotically controlled valve coupled to the interface base, and a second robotically controlled valve coupled to the interface base.
- the interface base can mechanically and electrically couple to an end of a robotic arm.
- the hollow tube further has a distal end for placement in a surgical site to allow the flow of fluids into and out of a surgical site.
- the three-way coupler further has a second port and a third port to couple the first port, the second port, and the third port together to flow fluids there-between.
- the first robotically controlled valve having a first port to couple to a first hose and a second port coupled to the second port of the three-way coupler.
- the first robotically controlled valve controls the flows of a first fluid.
- the second robotically controlled valve having a first port to couple to a second hose and a second port coupled to the third port of the three-way coupler.
- the second robotically controlled valve controls the flows of a second fluid.
- Robotic surgery generally involves the use of a robot manipulator that has multiple robotic manipulator arms.
- One or more of the robotic manipulator arms often support a surgical tool which may be articulated (such as jaws, scissors, graspers, needle holders, micro dissectors, staple appliers, tackers, suction/irrigation tools, clip appliers, or the like) or non-articulated (such as cutting blades, cautery probes, irrigators, catheters, suction orifices, or the like).
- One or more of the robotic manipulator arms are often used to support a surgical image capture device such as an endoscope (which may be any of a variety of structures such as a laparoscope, an arthroscope, a hysteroscope, or the like), or, optionally, some other imaging modality (such as ultrasound, fluoroscopy, magnetic resonance imaging, or the like).
- a surgical image capture device such as an endoscope (which may be any of a variety of structures such as a laparoscope, an arthroscope, a hysteroscope, or the like), or, optionally, some other imaging modality (such as ultrasound, fluoroscopy, magnetic resonance imaging, or the like).
- the arms will support at least two surgical tools corresponding to the two hands of a surgeon and one image capture device.
- Robotic surgery may be used to perform a wide variety of surgical procedures, including but not limited to open surgery, neurosurgical procedures (such as stereotaxy), endoscopic procedures (such as laparoscopy, arthroscopy, thoracoscopy), and the like.
- neurosurgical procedures such as stereotaxy
- endoscopic procedures such as laparoscopy, arthroscopy, thoracoscopy
- FIG. 1 a block diagram of a robotic surgery system 100 is illustrated to perform minimally invasive robotic surgical procedures using an irrigation/aspiration/blowing (IAB) robotic surgical tool 101 A.
- the irrigation/aspiration/blowing robotic surgical tool 101 A is a robotic endoscopic surgical instrument that is manipulated by a slaved robotic manipulator and remotely controlled by control signals received from a master control console. In contrast, manual endoscopic surgical instruments are directly controlled by hand.
- a user or operator O (generally a surgeon) performs a minimally invasive surgical procedure on patient P by manipulating input devices at a master control console 150 .
- a computer 151 of the console 150 directs movement of robotically controlled endoscopic surgical instruments (generally numbered 101 ), effecting movement of the instruments using a robotic surgical manipulator 152 .
- the robotic surgical manipulator 152 may also be referred to as robotic patient-side cart system or simply as a cart.
- the robotic surgical manipulator 152 has one or more robotic arms 153 .
- the robotic surgical manipulator 152 includes at least three robotic manipulator arms 153 supported by linkages, with a central arm supporting an endoscopic camera and the robotic arms 153 to left and right of center supporting tissue manipulation tools and the irrigation/aspiration/blowing robotic surgical tool 101 A such as the robotic manipulator arm 153 C.
- An assistant A may assist in pre-positioning of the robotic surgical manipulator 152 relative to patient P as well as swapping tools or instruments 101 for alternative tool structures, and the like, while viewing the internal surgical site via an assistant's display 154 .
- the image of the internal surgical site shown to A by the assistant's display 154 and operator O by surgeon's console 150 is provided by one of the surgical instruments 101 supported by the robotic surgical manipulator 152 .
- the robotic arms 153 of robotic surgical manipulator 152 include a positioning portion and a driven portion.
- the positioning portion of the robotic surgical manipulator 152 remains in a fixed configuration during surgery while manipulating tissue.
- the driven portion of the robotic surgical manipulator 152 is actively articulated under the direction of the operator O generating control signals at the surgeon's console 150 during surgery.
- the actively driven portion of the arms 153 is herein referred to as an end effector 158 .
- the positioning portion of the robotic arms 153 that are in a fixed configuration during surgery may be referred to as positioning linkage and/or “set-up joint” 56 , 56 ′.
- the robotic surgical system may further include one or more pumps 102 A- 102 C, one or more inline filters 104 A- 104 C, and one or more hoses 106 A- 106 C.
- the pump 102 A is a sterile fluid pump and may be an intravenous (IV) pump with an input port or inlet coupled to an IV bag 108 through a hose 106 D.
- the output port or outlet of the pump 102 A may couple to the robotic surgical instrument 101 A directly or through the inline filter 104 A.
- the IV bag 108 may have a pressure cuff.
- the pump 102 B is a vacuum pump 102 B with an output port 110 exhausting to atmosphere and an input port coupling to a suction canister 105 through the inline filter 104 B.
- suction may be provided to rooms at a wall inlet to isolate the noise of the vacuum pump 102 B.
- the pump 102 C is a gas compressor with an input port coupled to a source of gas 111 , such as oxygen or air, and an output port coupled to the instrument 101 A through the inline filter 104 C.
- the one or more hoses 106 A- 106 C may be joined together along a portion of their length and into one end to couple to the instrument 101 A for ease of coupling and to readily manage a plurality of hoses as one unit at the robotic manipulator 152 .
- the one or more hoses 106 A- 106 C may separate to couple to the inline filters, the pumps, the canister 105 , or other pipe fittings as the case may be.
- the master control console 150 may control the one or more pumps 102 A- 102 C and any valves thereat in order to control fluid flow between the pumps and the instrument 101 A into and out of the surgical site.
- One or more control signal lines 109 A- 109 C may couple between the computer 151 and the one or more pumps 102 A- 102 C and any valves thereat in order that they may be controlled by control signals from the master control console 150 .
- the hoses 106 A- 106 C may simply couple to a coupler within the instrument 101 A as is discussed further below with reference to FIGS. 15A-15B .
- the robotic surgical manipulator 152 has one or more robotic surgical arms 153 .
- the robotic arm 153 C includes an irrigation/aspiration/blowing robotic surgical tool 101 A coupled thereto at the end effector 158 .
- the robotic surgical manipulator 152 further includes a base 202 from which the robotic surgical instruments 101 may be supported. More specifically, the robotic surgical instruments 101 are each supported by the positioning linkage 156 and the end effector 158 of the arms 153 . It should be noted that these linkage structures are here illustrated with protective covers 206 , 208 extending over much of the robotic arms.
- these protective covers 206 , 208 are optional, and may be limited in size or entirely eliminated in some embodiments to minimize the inertia that is manipulated by the servomechanism, and to limit the overall weight of robotic surgical manipulator 152 .
- the robotic surgical manipulator 152 generally has dimensions suitable for transporting between operating rooms. It typically can fit through standard operating room doors and onto standard hospital elevators.
- the robotic surgical manipulator 152 may have a weight and a wheel (or other transportation) system that allows the cart to be positioned adjacent an operating table by a single attendant.
- the robotic surgical manipulator 152 may be sufficient stable during transport to avoid tipping, and to easily withstand overturning moments that may be imposed at the ends of the robotic arms during use.
- each of the robotic manipulating arms 153 preferably includes a linkage 212 that constrains the movement of the surgical tool 101 mounted thereto.
- linkage 212 includes rigid links coupled together by rotational joints in a parallelogram arrangement so that the robotic surgical tool 101 A rotates around a point 215 in space.
- the robotic arm can pivot the robotic surgical tool 101 A about a pitch axis 215 A and a yaw axis 215 B.
- the pitch and yaw axes intersect at the point 215 , which is aligned along a shaft 216 of robotic surgical tool 101 A.
- the shaft is a hollow tube as is further discussed below.
- the robotic arm provides further degrees of freedom of movement to the robotic surgical tool 101 A.
- the robotic surgical tool 101 A may slide into and out from a surgical site.
- the robotic surgical tool 101 A can also rotate about the insertion axis 215 C.
- the center point 215 is relatively fixed with respect to the base 218 . That is, the entire robotic arm is generally moved in order to maintain or re-position back to the center point 215 .
- the linkage 212 of the robotic arm 153 is driven by a series of motors 217 therein in response to commands from a processor or computer.
- the motors 217 in the robotic arm are also used to rotate and/or pivot the robotic surgical tool 101 A at the point 215 around the axes 215 A- 215 C. If a robotic surgical tool 101 further has end effectors to be articulated or actuated, still other motors 217 in the robotic arm may be used to do so.
- a flow control system in the IAB robotic surgical tool 101 A may be actuated by these other motors in the robotic arm 153 . However, alternative means may also be used to actuate or control the flow control system in the IAB robotic surgical tool 101 A.
- the motion provided by the motors 217 may be mechanically transferred to a different location such as by using pulleys, cables, gears, links, cams, cam followers, and the like or other known means of transfer, such as pneumatics, hydraulics, or electronics.
- the end effector 158 of the robotic arm 153 is often fitted with a hollow cannula 219 .
- the shaft or tube of the robotic surgical tool 101 may be inserted into the hollow cannula 219 .
- the cannula 219 which may be releasably coupled to the robotic arm 153 , supports the shaft or tube of the robotic surgical tool 101 , preferably allowing the tool to rotate around the axis 215 C and move axially through the central bore of the cannula along the axis 215 C.
- the robotic surgical tools 101 are generally sterile structures, often being sterilizable and/or being provided in hermetically sealed packages for use. As the robotic surgical tools 101 will be removed and replaced repeatedly during many procedures, a tool holder could potentially be exposed to contamination if the interface directly engages the tool holder. To avoid contamination to a tool holder and possible cross contamination between patients, an adaptor for coupling to robotic surgical tools 101 is provided in a robotic arm of the robotic surgical manipulator.
- the robotic surgical arm 153 may include an adapter 228 to which the IAB robotic surgical tool 101 A or other surgical tool 101 may be mounted.
- FIG. 2D illustrates a front side of an exemplary adapter 228 .
- the front side of the adaptor 128 is generally referred to as a tool side 230 and the opposite side is generally referred to as a holder side (not shown).
- FIG. 4B illustrates a back side of an exemplary IAB robotic surgical tool 400 as the IAB surgical robotic tool 101 A.
- the robotic surgical tool 400 includes an exemplary mountable housing 401 including an interface base 412 that can be coupled to the adapter 228 .
- the interface base 412 and the adapter 228 may be electrically and mechanically coupled together to actuate the flow control system of the IAB robotic surgical tool 101 A.
- Rotatably coupled to the interface base 412 are one or more rotatable receiving members 418 .
- Each of the one or more rotatable receiving members 418 includes a pair of pins 422 A and 422 B generally referred to as pins 422 .
- Pin 422 A is located closer to the center of each rotatable receive member 418 than pin 422 B.
- the one or more rotatable receiving members 418 can mechanically couple respectively to one or more rotatable drivers 234 of the adapter 228 .
- the robotic surgical tool 101 A may further include release levers 416 to
- the interface base 412 may further include one or more electrical contacts or pins 424 to electrically couple to electrical connector 242 of the adapter 228 .
- the interface base 412 may further include a printed circuit board 425 and one or more integrated circuits 426 coupled thereto and to the one or more pins 424 .
- the one or more integrated circuits 426 may be used to identify the type of robotic surgical tool coupled to the robotic arm, so that it may be properly controlled by the master control console 150 .
- the adapter 228 includes one or more rotatable drivers 234 rotatably coupled to a floating plate 236 .
- the rotatable drivers 234 are resiliently mounted to the floating plate 236 by resilient radial members which extend into a circumferential indentation about the rotatable drivers.
- the rotatable drivers 234 can move axially relative to floating plate 236 by deflection of these resilient structures.
- the floating plate 236 has a limited range of movement relative to the surrounding adaptor structure normal to the major surfaces of the adaptor. Axial movement of the floating plate helps decouple the rotatable drivers 234 from a robotic surgical tool 101 when its release levers 416 are actuated.
- the one or more rotatable drivers 234 of the adapter 228 may mechanically couple to a part of the surgical tools 101 .
- Each of the rotatable drivers 234 may include one or more openings 240 to receive protrusions or pins 422 of rotatable receiving members 418 of the robotic surgical tools 101 .
- the openings 240 in the rotatable drivers 234 are configured to accurately align with the rotatable receiving elements 418 of the surgical tools 101 .
- the inner pins 422 A and the outer pins 422 B of the rotatable receiving elements 418 respectively align with the opening 240 A and the opening 240 B in each rotatable driver.
- the pins 422 A and openings 240 A are at differing distances from the axis of rotation than the pins 422 B and openings 240 B so as to ensure that rotatable drivers 234 and the rotatable receiving elements 418 are not aligned 180 degrees out of phase from their intended position.
- each of the openings 240 in the rotatable drivers may be slightly radially elongated so as to fittingly receive the pins in the circumferential orientation.
- pins 422 This allows the pins 422 to slide radially within the openings 240 and accommodate some axial misalignment between the tool and the adapter 228 , while minimizing any angular misalignment and backlash between the rotatable drivers 234 and the rotatable receiving elements 418 . Additionally, the interaction between pins 422 and openings 240 helps restrain the robotic surgical tool 101 in the engaged position with the adapter 228 until the release levers 416 along the sides of the housing 401 push on the floating plate 236 axially from the interface so as to release the tool 101 .
- the rotatable drivers When disposed in a first axial position (away from the tool side 230 ) the rotatable drivers are free to rotate without angular limitation.
- the one or more rotatable drivers 234 may rotate clockwise or counter-clockwise to further actuate the systems and tools of the robotic surgical instruments 101 .
- tabs extending radially from the rotatable drivers
- This limited rotation can be used to help engage the rotatable drivers the rotating members of the tool as the pins 422 may push the rotatable bodies into the limited rotation position until the pins are aligned with (and slide into) the openings 140 in the rotatable drivers.
- rotatable drivers 234 are described here, other types of drivers or actuators may be provided in the adapter 228 to actuate systems or tools of the robotic surgical instruments 101 .
- the adapter 228 further includes an electrical connector 242 to electrically couple to surgical instruments 101 .
- the mounting of robotic surgical tool 101 A to the adapter 228 generally includes inserting the tip or distal end of the shaft or hollow tube of the robotic surgical tool through the cannula 219 and sliding the interface base 412 into engagement with the adapter 228 , as illustrated in FIG. 2C .
- a lip 232 on the tool side 130 of the adaptor 128 slidably receives the laterally extending portions of the interface base 412 of the robotic surgical tool.
- a catch 244 of adapter 228 may latch onto the back end of the interface base 412 to hold the tool 101 A in position.
- the protrusions or pins 422 extending from the one or more rotatable members 418 of the robotic surgical tool couple into the holes 240 in the rotatable drivers 234 of the adapter 228 .
- the range of motion of the rotatable receiving elements 418 in the robotic surgical tool may be limited.
- the operator O at the surgical master control console 150 may turn the rotatable drivers in one direction from center, turn the rotatable drivers in a second direction opposite the first, and then return the rotatable drivers to center.
- the adapter 228 and tool 101 A mounted thereto may be moved along the axis 215 C.
- the adapter 228 and tool 101 A mounted thereto may be moved to an initial position so that the tip or distal end of the shaft or hollow tube is disposed within the cannula 219 .
- the release levers 416 may be squeezed pushing out on the mountable housing 401 to release the pins 422 from the holes 240 and the catch 244 from the back end of the interface base.
- the mountable housing 401 is then pulled up to slide the interface base 412 up and out from the adapter 228 .
- the mountable housing 401 is continually pulled up to remove the tip or distal end of the shaft or hollow tube out from the cannula 219 .
- another robotic surgical tool may be mounted in its place, including a new or freshly sterilized IAB robotic surgical tool 101 A.
- the robotic surgical tool 101 A may include one or more integrated circuits 426 to identify the type of robotic surgical tool coupled to the robotic arm, such that it may be properly controlled by the master control console 150 .
- the robotic surgical system may determine whether or not the robotic surgical tool is compatible or not, prior to its use.
- the system verifies that the tool is of the type which may be used with the robotic surgical system 100 .
- the one or more integrated circuits 426 may signal to the computer 151 in the master control console 150 data regarding compatibility and tool-type to determine compatibility as well as control information.
- One of the integrated circuits 426 may include a non-volatile memory to store and read out data regarding system compatibility, the tool-type and the control information.
- the data read from the memory includes a character string indicating tool compatibility with the robotic surgical system 100 .
- the data from the tool memory will often include a tool-type to signal to the master control console how it is to be controlled. In some cases, the data will also include tool calibration information. The data may be provided in response to a request signal from the computer 151 .
- Tool-type data will generally indicate what kind of tool has been attached in a tool change operation.
- the tool-type data might indicate that an IAB robotic surgical instrument 101 A has been mounted to the robotic arm.
- the tool-type data may include information on wrist axis geometries, tool strengths, grip force, the range of motion of each joint, singularities in the joint motion space, the maximum force to be applied via the rotatable receiving elements 418 , the tool transmission system characteristics including information regarding the coupling of rotatable receiving elements 418 to actuation or articulation of a system within the robotic surgical instrument.
- most of the tool-type data may optionally be stored in memory or a hard drive of the computer 151 in the robotic surgical system 100 .
- An identifier may be stored in the one or more integrated circuits 426 to signal the computer 151 to read the relevant portions of data in a look up table store in the memory or the hard drive of the computer.
- the tool-type data in the look-up table may be loaded into a memory of computer 151 by the manufacturer of the robotic surgical system 100 .
- the look-up table may be stored in a flash memory, EEPROM, or other type of non-volatile memory.
- the manufacturer can revise the look-up table to accommodate the new tool-specific information. It should be recognized that the use of tools which are not compatible with the robotic surgery system, for example, which do not have the appropriate tool-type data in an information table, could result in inadequate robotic control over robotic surgical tool by the computer 151 and the operator O.
- tool specific information may be stored in the integrated circuit 426 , such as for reconfiguring the programming of computer 151 to control the tool.
- the calibration information may be factored into the overall control of the robotic surgical tool.
- the storing of such calibration information can be used to overcome minor mechanical inconsistencies between tools of a single type.
- the tool-type data including the tool-specific data may be used to generate appropriate coordinate transformations and servo drive signals to manipulate the robotic arm and rotate the rotatable drivers 234 .
- Tool life and cumulative tool use information may also be stored on the tool memory and used by the computer to determine if the tool is still safe for use. Total tool life may be measured by clock time, by procedure, by the number of times the tool has been loaded onto a holder, and in other ways specific to the type of tool. Tool life data is preferably stored in the memory of the tool using an irreversible writing process.
- the master control console 150 of the robotic surgical system 100 includes the computer 151 , a binocular viewer 312 , an arm support 314 , a microphone 315 , a pair of control input wrists and control input arms in a workspace 316 , a speech recognizer 317 , foot pedals 318 (including foot pedals 318 A- 318 B), and a viewing sensor 320 .
- the computer 151 may include one or microprocessors 302 to execute instructions and a storage device 304 to store software with executable instructions that may be used to generate control signals to control the robotic surgical system 100 .
- the master control console 150 generates the control signals to control the fluid flows through the embodiments of the IAB robotic surgical instruments into and out of a surgical site.
- the viewer 312 has at least one display where images of a surgical site may be viewed to perform minimally invasive surgery. As discussed further below, the viewer 312 may be used to provide user-feedback to the operator O as to the control of the fluid flow through the IAB robotic surgical instruments into and out of a surgical site
- the arm support 14 can be used to rest the elbows or forearms of the operator O (typically a surgeon) while gripping touch sensitive handles 325 (see FIGS. 3B-3C ), one in each hand, of the pair of control input wrists 352 in the workspace 316 to generate control signals.
- the touch sensitive handles 325 are positioned in the workspace 316 disposed beyond the arm support 314 and below the viewer 312 .
- the operator O When using the master control console, the operator O typically sits in a chair, moves his or her head into alignment with the binocular viewer 312 , and grips the touch sensitive handles 325 of the control input wrists 352 , one in each hand, while resting their forearms against the arm support 314 . This allows the touch sensitive handles to be moved easily in the control space 316 in both position and orientation to generate control signals.
- the operator O can use his feet to control the foot-pedals to change the configuration of the surgical system and generate additional control signals to control robotic surgical instruments.
- the master control console 150 may include the viewing sensor 320 disposed adjacent the binocular display 312 .
- the viewing sensor 320 can disable or stop generating new control signals in response to movements of the touch sensitive handles in order to hold the state of the robotic surgical tools.
- the computer 151 interprets movements and actuation of the touch sensitive handles 325 (and other inputs from the operator O or other personnel) to generate control signals to control the robotic surgical instruments 101 in the surgical worksite.
- the computer 151 and the viewer 312 map the surgical worksite into the controller workspace 316 so it feels and appears to the operator that the touch sensitive handles 325 are working over surgical worksite.
- FIG. 3B a perspective view of a control input wrist 352 with a touch sensitive handle 325 is illustrated.
- the control input wrist 352 is a gimbaled device that pivotally supports the touch sensitive handle 325 of the master control console 150 to generate control signals that are used to control the robotic surgical manipulator 152 and the robotic surgical tools 101 , including an IAB robotic surgical tool 101 A.
- a pair of control input wrists 352 are supported by a pair of control input arms in the workspace 316 of the master control console 150 .
- the control input wrist 352 includes first, second, and third gimbal members 362 , 364 , and 366 .
- the third gimbal member is rotationally mounted to a control input arm (not shown).
- the touch sensitive handle 325 includes a tubular support structure 351 , a first grip 350 A, and a second grip 350 B.
- the first grip and the second grip are supported at one end by the structure 351 .
- the touch sensitive handle 325 can be rotated about axis G illustrated in FIGS. 3B-3C .
- the grips 350 A, 350 B can be squeezed or pinched together about the tubular structure 351 .
- the “pinching” or grasping degree of freedom in the grips is indicated by arrows Ha,Hb in FIG. 3B and arrows H in FIG. 3C .
- the touch sensitive handle 325 is rotatably supported by the first gimbal member 362 by means of a rotational joint 356 g .
- the first gimbal member 362 is in turn, rotatably supported by the second gimbal member 364 by means of the rotational joint 356 f .
- the second gimbal member 364 is rotatably supported by the third gimbal member 366 using a rotational joint 356 d .
- the control wrist allows the touch sensitive handle 325 to be moved and oriented in the workspace 316 using three degrees of freedom.
- the movements in the gimbals of the control wrist 352 to reorient the touch sensitive handle in space can be translated into control signals to control the robotic surgical manipulator 152 and the robotic surgical tools 101 .
- the rotational motion of the touch sensitive handle 325 about axis G in FIGS. 3B-3C may be used to control the flow of fluids through the IAB robotic surgical tools.
- the movements in the grips 350 A, 350 B of the touch sensitive handle 325 can also be translated into control signals to control the robotic surgical manipulator 152 and the robotic surgical tools 101 .
- the squeezing motion of the grips 350 A, 350 B over their freedom of movement indicated by arrows Ha,Hb or H may be used to control the flow of fluids through the IAB robotic surgical tools.
- one or a combination of both the rotational motion of the touch sensitive handle 325 and the squeezing motion of the grips 350 A, 350 B may be used to control the flow of fluids through the IAB robotic surgical tools.
- the rotational motion of the touch sensitive handle 325 may be used for the control of irrigation while the squeezing motion of the grips 350 A, 350 B may be used for controlling suction in a surgical site.
- sensors can be mounted in the handle 325 as well as the gimbal member 362 of the control input wrist 352 .
- Exemplary sensors may be a Hall effect transducer, a potentiometer, an encoder, or the like.
- FIG. 3C a cross-sectional view of the touch sensitive handle 325 and gimbal member 362 of the control input wrist 352 is illustrated.
- FIG. 3C provides an example as to how the touch sensitive handle 325 can be mounted to the control input wrist 352 to sense the gripping and rotation of the handle to control robotic surgical tools 101 , including IAB robotic surgical tools 101 A.
- the exemplary gimbal member 362 includes beveled gears 368 a , 368 b which can couple the rotational motion of the touch sensitive handle 325 to a roll sensor 370 .
- the roll sensor 370 may use a potentiometer or encoder 370 b included in a roll motor 370 a to sense the rotation.
- a separate roll sensor such as a potentiometer, may be directly coupled to the shaft 380 to sense the rotation of the touch sensitive handle.
- a roll sensor senses the roll motion of the touch sensitive handle 325 and generates control signals in response thereto to control the robotic surgical tools 101 .
- the control of IAB robotic surgical tools 101 A using the roll motion of the touch sensitive handle 325 is discussed below with reference to FIG. 16A .
- a remote sensing assembly 386 may be included by the gimbal member 362 .
- the first and second grips 350 A, 350 B are adapted to be squeezed together by a hand of an operator O so as to define a variable grip separation.
- the grip separation may be determined as a function of a variable grip angle with an axis or as a function of a variable grip separation distance, or the like.
- Alternative handle actuations, such as movement of a thumbwheel or knob may also be provided in the handle to control the robotic surgical instruments 101 .
- the remote sensor assembly 386 includes a circuit board 394 on which a first and a second Hall effect sensors, HE 1 , HE 2 are mounted.
- a magnet 396 is disposed distally beyond the circuit board 394 and the Hall effect sensors.
- a magnetic mass 398 is axially coupled to the proximally oriented surface 390 of a push rod 84 .
- the magnetic mass 398 moves (as shown by Arrow J) with the push rod 384 and varies the magnetic field at the Hall effect sensors in response actuation of the grips 350 A, 350 B.
- the gimbal member 362 includes a push rod 384 within the tubular handle structure 351 .
- Each of the grips 350 A, 350 B pivot about a respective pivot 334 a , 334 b in the tubular handle structure 351 .
- Urging links 335 a , 335 b respectively couple between the grips 350 A, 350 B and a first end of the push rod 384 .
- the squeezing action of the grips 350 A, 350 B is translated into a linear motion on the push rod 384 by means of urging links 335 a , 335 b as shown by arrow A in FIG. 3C .
- a second end of the push rod 384 couples to the sensor 386 .
- the magnetic mass 398 is axially coupled to the surface 390 of the push rod 384 in order to sense the linear motion in the push rod and the squeezing motion of the grips 350 A, 350 B.
- a biasing mechanism such as spring 392 applies a force against the squeezing motion of the grips to return them to full open when the grips are released.
- the biasing spring 392 may be a linear or non-linear elastic device biasing against the depression of grips 350 A, 350 B, e.g., a single or multiple element assembly including springs or other elastic members.
- spring 392 may comprise a concentric dual spring assembly whereby one spring provides a “softer” bias response as the grips 350 A, 350 B are initially depressed, and a second spring provides a superimposed “firm” bias response as the grips 350 A, 350 B approach a fully depressed state.
- Such a non-linear bias may provide a pseudo force-feedback to the operator.
- alternative sensing arrangements may be used to translate the mechanical actuation of the touch sensitive handle and control input wrist into control signals. While Hall effect sensors are included in the exemplary embodiment, alternative embodiments may include encoders, potentiometers, or a variety of alternative optical, electrical, magnetic, or other sensing structures.
- IAB irrigation/aspiration/blowing
- an irrigation/aspiration/blowing (IAB) robotic surgical tool or instrument 400 is illustrated in greater detail than that of instrument 101 A.
- the IAB robotic surgical instrument 400 has an interface that is backward compatible to the adapter 228 that is typically used for other types of robotic surgical instruments.
- the IAB robotic surgical instrument 400 has a reusable instrument housing with modular valve components that are disposable.
- the entire IAB robotic surgical instrument 400 is disposable.
- the IAB robotic surgical instrument 400 includes a mountable housing 401 at a proximal end and a hollow tube 404 coupled together as shown in FIG. 4A .
- the mountable housing 401 maybe a reusable housing including some reusable components therein.
- the mountable housing 401 is backward compatible and includes an interface base 412 that can couple to the adapter 228 to which other surgical tools may also couple.
- the mountable housing 401 may further include one or more tube fittings 410 A- 410 C, a cover 414 , and one or more release levers 416 .
- the hollow tube 404 is elongated and has an opening 424 at its tip 406 , the distal end of the instrument 400 .
- the hollow tube 404 may also be referred to as a hollow instrument shaft or a hollow probe.
- the hollow tube 404 may be reusable or disposable.
- the hollow tube 404 maybe coupled to the interface base 412 for additional support.
- the hollow tube 404 may couple directly to a modular disposable valve subassembly and avoid coupling to the interface base such that it too is disposable.
- the hollow tube 404 is a hollow circular cylindrical shape. Fluids (e.g., gas, liquid, with or without solids) may flow in the hollow tube 404 and into or out from a surgical site through the opening 424 at the tip 406 .
- the hollow tube 404 may further include one or more smaller openings 422 around its circumference substantially near the tip 406 to further allow fluid to flow into and out of a surgical site.
- the diameter of the opening 424 may be substantially same as the inner diameter of the tube 404 . In one embodiment of the invention, the diameter of the hollow tube 404 may be between 5 mm and 8 mm.
- the hollow tube 404 may be formed out of metal, plastic or other rigid material that can be hollow to allow fluid to flow therein while being positioned within a patient's body at a surgical site or over a surgical area.
- the interface base 412 is used to mount the instrument 400 to a robotic arm of a surgical robotic manipulator.
- the interface base 412 both mechanically and electrically couples the IAB robotic surgical instrument 400 to a robotic arm of the surgical robotic manipulator 152 .
- the release levers 416 are located at the sides of the mountable housing and may be used to release the robotic surgical instrument 400 from a robotic arm.
- a first end of the one or more tube fittings 410 A- 410 C may respectively couple to the one or more hoses 106 A- 106 C, respectively.
- the one or more tube fittings 410 A- 410 C may be barb fittings, luer fittings, or other types of hose or tube fittings.
- a second end of the one or more tube fittings 410 A- 410 C couples to a flow control system 417 within the mountable housing 401 .
- the one or more hoses 106 A- 106 C may directly couple to the flow control system without the one or more tube fittings 410 A- 410 C.
- the end of the hollow tube 404 opposite the tip 406 also couples to the flow control system 417 .
- the flow control system 417 controls the flow of fluids, including any solids that may be transported by the fluid, between the surgical site and the one or more hoses 106 A- 106 C through the IAB robotic surgical instrument 400 .
- the flow control system 417 may include one or more valves of a valve subassembly to control the flow of fluids and any solids that may be transported by the fluid.
- a fluid may be a liquid, a gas, a vacuum, or any combination thereof.
- the flow control system 417 may be controlled by control signals generated by an operator O at the master control console 150 to control the fluid flow through the IAB robotic surgical instrument 400 .
- a number of embodiments of the invention include an optional manual actuation of the valves of the IAB robotic surgical instrument 400 .
- an assistant A can manually operate the flow control system 417 and control the fluid flow
- the operator O at the master control console 150 may robotically operate the flow control system 417 to control the fluid flow through the IAB robotic surgical instrument 400 .
- the operator O at the master control console 150 can position the IAB robotic surgical instrument 400 where the operator wants it within the surgical site. Then, to free up the operator's hands to perform some other task at the master control console, the IAB robotic surgical instrument 400 may be controlled manually by an assistant, remaining attached to a robotic arm. The operator can then give verbal instructions to the assistant to manually control the irrigation/suction/blowing in the surgical site selected by the operator.
- the cover 414 covers over to protect the flow control system 417 such as a valve subassembly from damage and to maintain a sterile surgical environment during surgery.
- the surgical instrument 400 is used during an operation or surgery at a surgical site of human patient, it is important that its components be sterilized.
- the IAB robotic surgical instrument 400 As body fluids of a human patient will be flowing through the surgical instrument 400 during use, it may be desirable to re-sterilize the IAB robotic surgical tool for reuse. However, it may be difficult to re-sterilize portions of the flow control system 417 , such as valves, within the IAB robotic surgical tool 400 . Thus, portions of the flow control system 417 may be replaced instead of sterilized after usage. If components forming the IAB robotic surgical instrument 400 are relatively inexpensive, the IAB robotic surgical instrument 400 may be discarded in its entirety instead of re-sterilzing or replacing components.
- FIG. 4B illustrates a back side view of a portion of the IAB robotic surgical tool 400 , some elements of which were previously discussed.
- the interface base 412 is illustrated with rotatable receiving elements 418 rotatably coupled thereto.
- the rotatable receiving elements 418 provide a mechanical coupling to the rotatable drivers 234 and drive motors mounted of the robotic surgical manipulator 152 .
- Each of the rotatable receiving elements 418 include a pair of pins 422 extending from a surface thereof.
- An inner pin 422 A is closer to an axis of rotation of each rotatable receiving elements 418 than an outer pin 422 B, which helps to ensure positive angular alignment of the rotatable receiving elements 418 .
- the rotatable receiving elements 418 are disk shaped and may be referred to as rotatable disks.
- the interface base 412 further includes an array of electrical connecting pins 424 and one or more integrated circuits 426 coupled to a printed circuit board 425 within the mountable housing 401 .
- the interface base 412 is backward compatible to the adapter 228 , it maybe mechanically actuated by pre-existing driver motors found in the robotic surgical manipulator 152 . While the interface base 412 has been described herein with reference to mechanical and electrical coupling elements, it should be understood that other modalities maybe used, including infrared coupling, magnetic coupling, inductive coupling, or the like.
- FIGS. 5A-5D schematic flow diagrams of robotic surgical tools 500 A- 500 D are respectively illustrated to provide irrigation, suction, blowing, or any combination thereof within a surgical site.
- FIG. 5A is a schematic flow diagram of an irrigation/aspiration robotic surgical tool 500 A that uses a pair of valves mounted within a housing 501 A.
- the tool 500 A includes the hollow tube 504 , a valve subassembly 506 , a three-way coupler 508 , and tube fittings 509 A- 509 B.
- the tube fittings 509 A- 509 B may have an irrigation hose 106 A and a suction hose 106 B respectively coupled thereto.
- the valve subassembly 506 includes a first two-way two-position valve 510 A and a second two-way two-position valve 510 B. After use, the valve subassembly 506 may be removed and replaced by a new sterilized valve subassembly for reuse of the tool 500 A.
- the valves are a component of the tool that is more difficult to clean and sterilize for reuse.
- Each of the two way valves 510 A- 510 B includes two ports.
- a first port couples to the three-way coupler 508 while a second port couples to the fittings 509 A or 509 B, respectively.
- a three-way coupler 508 includes three ports one of which is coupled to the hollow tube 504 .
- the second port of the three-way coupler couples to a port of the valve 510 A.
- a third port of the three-way coupler 508 couples to a port of the valve 510 B.
- a fluid may flow in or out of the hollow tube 504 as illustrated by the double-headed arrow near the tip.
- Either valve 510 A or 510 B may be open so that a fluid may flow through the hollow tube 504 .
- valve 510 B open and valve 510 A substantially closed, a suction may be applied near the tip of the surgical instrument 500 A so that a surgical site may be aspirated.
- valve 510 B substantially closed and valve 510 A open a liquid may flow through the surgical instrument 500 A out through the hollow tube 504 into a surgical site so that it may be irrigated.
- the liquid is coupled to the surgical instrument 500 A by the hose 106 A.
- FIG. 5B is a schematic flow diagram of an irrigation/aspiration robotic surgical tool 500 B that uses a single valve mounted within a housing 501 B to provide irrigation, or aspiration.
- the surgical instrument 500 B includes a single three-way valve 516 with three ports, the hollow tube 504 , and the tube fittings 509 A- 509 B.
- the three way coupler 508 is not needed.
- the three-way valve 516 has three ports. A first port of the three-way valve couples to the proximal end of the hollow tube 504 . A second port couples to the tube fitting 509 A that may couple to the hose 106 A. A third port of the valve 516 couples to the tube fitting 509 B that may in turn couple to hose 106 B.
- the three-way valve 516 has three-positions of operation. In a closed position, the valve is completely shut off so that no fluid flows through the hollow tube 504 . In a second position suction is shut off, the first port and the second port of the valve couple together such that the surgical site may be irrigated by a liquid flowing through valve 516 and into the hollow tube 504 . In a third position irrigation is shut off, the first port and the third port of the valve couple together such that a vacuum or a suction may flow through valve 516 and a surgical site may be aspirated at the tip of the hollow tube 504 .
- FIG. 5C is a schematic flow diagram of an irrigation/aspiration/blowing robotic surgical tool 500 C that uses a single valve mounted within a housing 501 C to provide irrigation, aspiration or blowing.
- the surgical instrument 500 C includes a single four-way four position valve 526 , the hollow tube 504 , and the tube fittings 509 A- 509 B coupled together as illustrated in the mountable housing 501 C.
- a four way coupler 508 is not needed.
- the single four-way valve 526 includes four ports.
- a first port of the four-way valve 526 couples to the proximal end of the hollow tube 504 .
- a second port of the valve 526 couples to one end of the tube fitting 509 A.
- a third port of the valve 526 couples to an end of the tube fitting 509 B.
- a fourth port of the valve 526 couples to an end of the tube fitting 509 C.
- Hoses 106 A- 106 C may respectively couple to the tube fittings 509 A- 509 C. In this manner three of the four ports of valve 526 may receive a liquid for irrigation, a vacuum for suction and a pressurized gas for blowing, respectively.
- the four-way valve 526 has four positions of operation. In a closed position, the valve is completely shut off so that no fluid flows through the hollow tube 504 . In a second position suction/blowing are shut off, the first port and the second port of the valve couple together such that the surgical site may be irrigated by a liquid flowing through valve 526 and into the hollow tube 504 . In a third position irrigation/suction are shut off, the first port and the third port of the valve couple together such that a pressurized gas may flow through valve 516 and out through the tip of the hollow tube 504 to blow a surgical site with a pressurized gas.
- the first port and the fourth port of the valve couple together such that a vacuum may provide suction through the valve 516 and the hollow tube 504 to a surgical site to remove fluids and solids transported therein at the tip of the hollow tube 504 .
- FIG. 5D is a schematic flow diagram of an irrigation/aspiration/blowing robotic surgical tool 500 D that uses three two-way valves in a valve subassembly mounted within a housing 501 D to provide irrigation, aspiration or blowing.
- the robotic surgical instrument 500 D includes a valve subassembly 536 , a four-way coupler 538 , the hollow tube 504 , and the tube fittings 509 A- 509 C.
- the tube fittings 509 A- 509 C may couple to the hoses 106 A- 106 C, respectively.
- the valve subassembly 536 includes three two-way two-position valves 510 A- 510 C of a valve subassembly 536 in conjunction with a four-way coupler 538 .
- a third two-way valve 510 C is provided so that a third fluid may flow into and out of the hollow tube 504 .
- a pressurized gas may be supplied by hose 106 C, flow through valve 510 C when opened, flow through the four way coupler 538 , and into the hollow tube 504 to blow a pressurized gas near the surgical site.
- Each of the two way two position valves 510 A- 510 C includes two ports.
- a first port of each couples to respective ports of the four-way coupler 538 while a second port of each couples to the fittings 509 A, 509 B or 509 C, respectively.
- the four-way coupler 538 includes four ports one of which is coupled to the hollow tube 504 .
- the second port of the four-way coupler 538 couples to a port of the valve 510 A.
- a third port of the four-way coupler 538 couples to a port of the valve 510 B.
- a fourth port of the four-way coupler 538 couples to a port of the valve 510 C.
- Valve subassembly 536 may be replaceable with a sterile component while the other elements mounted in the housing 501 D may be separately sterilized and reused with a new valve subassembly 536 .
- valves may be used as part of the flow control system 417 in the IAB robotic surgical instrument 400 , 101 A to control the flow of fluids to provide irrigation, aspiration, or blowing.
- a linear motion type of valve (“linear valve”) may be used such as a spool-type valve, a trumpet-type valve, a piston-type valve, a poppet-type valve, or a sliding-plate-type valve.
- a rotational motion type of valve (“rotatable valve”) may be used such as a ball-type valve, a screw-type valve, a gate-type valve, a disc-type valve, a cock-type valve, a globe-type valve, or a rotary-plate-type valve.
- an IAB robotic surgical instrument may be actuated in different ways by the robotic surgical manipulator 152 . While three-way and two-way valves have been separately shown and described, any mixed combination of one or more two-way valves and one or more three-way valves, or other multi-port valve, may be used within an IAB robotic surgical instrument with different types of couplers to provide a flow control system therein.
- an IAB robotic surgical instrument may include a three-way valve 516 for gas pressure and suction and a two-way valve 510 A for irrigation by a liquid coupled to a three-way coupler 508 , which is in turn coupled to the tube 504 .
- valves used in the flow control system may be automatically returned to a closed position so that no fluid flows through the IAB robotic surgical tool when it is dismounted from the robotic arm or when the modular valve assembly is not mounted in the housing of the tool. That is, the valves may be spring loaded by a spring to return to a closed or fully off position when they are not actuated.
- FIGS. 6A-6C , 7 A- 7 C, 8 , 9 and 10 A- 10 B illustrate some of the various types of valves, various types of actuation means, and various types of automatic return means that may be used to control the flow of fluids through the robotic surgical instrument and into the surgical site. It is understood that other types of valves, actuation means, and automatic return means may be used to provide flow control for a flow control system of an IAB robotic surgical tool.
- FIGS. 6A-6C rotational actuators to actuate rotatable valves are illustrated for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
- the rotatable receiving element 418 A is directly coupled to the rotatable valve 604 A.
- a shaft of the rotatable valve rotates to a different position in order to open or close the valve and control the flow of fluids.
- the rotatable receiving element 418 A couples to the rotatable driver 234 of the adapter 228 in the robotic arm.
- the pins 422 A- 422 B of the rotatable receiving element 418 A couple into the respective openings 240 A- 240 B of the adapter 228 .
- a coil spring 606 may be used to return the rotatable valve 604 A to a closed or shut off position when the robotic surgical tool 101 A is dismounted from the robotic arm.
- a rotatable receiving element 418 B rotatably couples to the rotatable valve 604 B through a gearing provided by the gears 610 - 611 .
- the rotatable receiving element 418 B similarly couples to the rotatable driver 234 .
- the rotatable receiving element 418 B includes the gear 610 which also may be referred to as a driving gear 610 .
- Valve 604 B includes the pinion gear 611 coupled to a shaft 602 of the rotatable valve in order to rotate the valve from one position to another.
- the gearing may be use to reduce or increase the rotation in the driver gear 610 to rotate the valve.
- the rotatable receiving element 418 B may further include the coil spring 606 to return the three-way four position valve 604 B to a shut off position.
- the rotatable valve 604 B is a three-way valve including three ports and has three positions.
- the rotatable receiving element 418 C is linked to the rotatable valve 604 C by means of a linkage 620 .
- the rotatable receiving element 418 C includes a drive wheel with a notch 622 to receive a distal end of the linkage 620 .
- the rotatable valve 604 C is a three-way three position valve.
- the rotatable receiving element 418 C may move the valve 604 C into one of three positions. In position 620 A, the valve may be shut off so that no fluid flows through the robotic surgical tool 101 A, 400 . In position 620 B, a first fluid may flow between a first port and a second port. In position 620 C, a second fluid may flow between the first port and a third port.
- the rotatable receiving element 418 C may be moved counter clockwise, while the valve rotates clockwise. If the rotatable receiving element 418 C moves clockwise, the linkage 620 causes the valve to rotate counter clockwise. To actuate the rotatable valve, the rotatable receiving element 418 C couples to the rotatable driver 234 by means of the pins 422 A- 422 B coupling into the opening 240 A- 240 B respectively.
- FIGS. 7A-7C illustrate the linear actuation of linear motion valves that may be used in the flow control system 417 of IAB robotic surgical tools.
- the dashed lines shown in FIGS. 7A-7C illustrate a dividing line between the robotic surgical tool 400 , 101 A and actuation in the robotic surgical arm 153 .
- a push rod 702 is linearly actuated in the robotic arm 153 .
- One end of the push rod 702 pushes on a button 703 of a linear motion trumpet valve 704 A to move a plunger 705 therein.
- the trumpet valve 704 A is a two-way two-position valve.
- the plunger 705 in its closed position blocks the first and second ports of the trumpet valve 704 A.
- a spring 706 is compressed and the plunger moves to a position 705 ′ such that the first and second ports are open to pass a fluid.
- the push rod 702 may be linearly actuated in robotic arm in a number of ways including, but not limited to, pneumatically, hydraulically, electromechanically, or electrically.
- a solenoid 701 may be used to linearly actuate the push rod 702 to linearly move the valve 704 A to an open position.
- the force of the spring 706 may push back on the push rod 702 and return the plunger of the valve to a closed plunger position 705 to shut off the first and second ports and stop a flow of a fluid.
- the spring 706 may also retain the plunger of the valve in a closed plunger position 705 to shut off the first and second ports when the IAB robotic surgical tool is dismounted.
- a spool valve 704 B linearly moves in response to a magnetic force generated by the electromagnet 710 in the robotic arm 153 .
- the electromagnet 710 may be formed out of coil of wire 711 wrapped around a magnetic core 712 .
- a spring 706 keeps the spool 715 in a closed position blocking the first and second ports of the spool valve 704 B.
- the electromagnet 710 is actuated to pull the spool 715 in a linear motion into position 715 ′ so that the center hourglass portion of the spool 715 is coincident with the first and second ports to allow fluid to flow through the valve 704 B.
- Spring 706 is compressed with the spool in position 715 ′ such that when the electromagnetic force of the electromagnet 710 is released the spring 706 pushes back on the spool 715 to close off the valve 704 B.
- a three-way spool valve 704 C is electrically actuated by the robotic arm 153 to move the spool 725 with a linear motion. Electrical contacts 242 in the robotic arm 153 couple to the pins 424 of the robotic surgical tool 400 , 101 A.
- the three-way valve 704 C includes the spool 725 , three ports, a first spring 706 A at a first end, and a second spring 706 B at a second end, a first wire coil 710 A at the first end, and a second wire coil 710 B at the second end.
- a current in the wires 721 A may flow through the coil 710 A to attract the spool 725 towards the first end of the valve so that the ports 726 and 728 of the valve are coincident with the center hourglass portion of the spool to allow fluid to flow there-between.
- the current flow in the wires 721 A is turned off and the spool 725 is pushed back into the closed position by the force of spring 706 A.
- Springs 706 A- 706 B maintain the spool in the center position shutting off the three ports in the valve from each other.
- a linear actuation is transformed into a rotational actuation for a rotatable valve by a rack and pinion gear system.
- a push rod 702 linearly pushes against a button 803 of the rack 801 in order to linearly move its teeth 810 and provide the initial linear actuation.
- the teeth 810 of the rack 801 are meshed with the pinion gear 811 to transform the initial linear actuation of the push rod into a rotational actuation.
- the pinion gear is coupled to a shaft 802 of the rotatable valve 804 .
- the pinion gear 811 transforms the linear motion into a rotational motion in order to rotate the rotatable valve 804 between open and closed positions to control the fluid flow.
- a spring may be coupled between an end of the rack 801 and a stop in order to linearly push on the rack and rotate and maintain the valve in a closed position when the IAB robotic surgical tool is dismounted.
- valves of the flow control system 417 of the IAB robotic surgical tools may also be manually controlled.
- Manual actuators may be provided that extend external to the housing so that a user's hand may open and/or close the valves.
- a rotational actuation is transformed into linear actuation by a cam and cam follower system for actuation of a linear motion trumpet valve 704 A.
- Trumpet valve 704 A illustrated in FIGS. 9A-9B operates similarly to trumpet valve 704 A of FIG. 7A but with a cam follower 903 in place of the button 703 to better couple to the rotating cam 902 .
- the cam follower 903 of FIG. 9A may further include a manual push arm 913 that may extend for a top side of a housing of the IAB robotic surgical tools for manual operation of the trumpet valve 704 A.
- the cam follower 903 of FIG. 9B may further include a manual push side arm 923 that may extend for a side of a housing of the IAB robotic surgical tools for manual operation of the trumpet valve 704 A.
- the rotatable receiving element 418 D of the IAB robotic surgical tools is coupled to the cam 902 .
- the rotatable receiving element 418 D couples to the rotatable driver 234 by means of the pins 422 A- 422 B within the openings 240 A- 240 B, respectively.
- the cam 902 includes a cam lobe 904 that pushes on the cam follower 903 to a position 903 ′ so that the plunger 705 is moved to an open position 705 ′.
- the plunger allows the first and second ports to couple together and allow a fluid to flow there-between.
- the spring 706 pushes on the plunger 705 to move it back into the closed position to close the valve 704 A.
- the cam 902 may rotate clockwise or counterclockwise so that the cam follower transforms a rotational motion into a linear motion to open and close the valve 704 A.
- a rotational actuation within the robotic surgical tool 400 , 101 A may be converted to linear actuation and actuate a linear motion valve, such as the trumpet valve 704 A.
- a coil spring may be coupled around the shaft of the cam 901 in order to rotate it so that the valve can close when the IAB robotic surgical tool is dismounted.
- valve 704 A With the cam 902 rotated to a position so that the valve 704 A is closed, the valve may be manually operated.
- a user pushes on the manual push arms 913 , 923 extending from the housing.
- the manual push arms 913 , 923 With the manual push arms 913 , 923 being coupled to the cam follower 903 , the force applied thereto manually forces open the valve 704 A. This decouples the cam follower 903 from the cam 902 .
- a user releases the force applied to the manual push arms 913 , 923 which allows the spring 706 to push back out the plunger 705 into a closed position and shut off the valve.
- pinch valves 1004 A- 1004 B for use in the flow control system of IAB robotic surgical tools are illustrated.
- the pinch valves 1004 A- 1004 B are used to pinch closed a hose 1002 , 1002 ′ to control the flow of fluids.
- a rotary pinch valve 1004 A is illustrated to pinch closed a hose 1002 and can be rotated to release and open the hose 1002 . Without the hose 1002 pinched off, a fluid is allowed to flow therein and through the IAB robotic surgical tools.
- the rotary pinch valve 1004 A pinches the hose 1002 closed against a backstop 1005 to shut off the flow of fluids.
- the hose 1002 may be a silicon rubber hose that is flexible in order that it may be readily pinched off and stop the fluid flow therein and flex back when released.
- the rotary pinch valve 1004 A is coupled to a shaft of the rotatable receiving element 418 E to receive a rotational actuation.
- the rotatable receiving element 418 E may couple to the rotatable driver 234 in a similar fashion as previously described with pins 422 A- 422 B inserted into the respective openings 240 A- 240 B.
- the rotary pinch valve 1004 A includes a rotatable pinch arm 1020 and a pinch roller 1022 coupled to the distal end of the rotatable pinch arm 1020 .
- the rotary pinch valve 1004 A may further include a spring 1006 coupled to the rotatable receiving element 418 E in order to bias the pinch valve to a closed position and pinch off the hose when the surgical tool 101 A, 400 is dismounted.
- the pinch roller 1022 pinches off the hose 1002 against the backstop 1005 .
- the pressure against the hose 1002 is released such that it flexes open and allows fluid to flow therein.
- a linear pinch valve 1004 B is illustrated to pinch closed a hose 1002 ′.
- the linear pinch valve 1004 B can be moved linearly to release and open the hose 1002 ′. Without the hose 1002 ′ pinched off, a fluid is allowed to flow therein and through the IAB robotic surgical tools.
- the linear pinch valve 1004 B pinches the hose 1002 ′ closed against a backstop 1015 to shut off the flow of fluids.
- the hose 1002 ′ may be a silicon rubber hose that is flexible in order that it may be readily pinched off and stop the fluid flow therein and flex back when released.
- a push rod 702 may be provided in the robotic arm 153 to provide linear actuation of the linear pinch valve 1004 B.
- the push rod 702 pushes on a button 1013 to a position 1013 ′′, compressing a spring 1016 , and linearly moving the linear pinch valve 1004 B and a linear pinch arm 1030 to position 1030 ′ to release the hose 1002 from the backstop 1015 .
- the linear pinch arm 1030 With the linear pinch arm 1030 in the open position 1030 ′, the linear pinch valve is open and fluid can flow within the hose 1002 ′.
- the spring 1016 forces back the linear pinch arm 1030 of the linear pinch valve 1030 to squeeze the hose 1002 against the backstop 1015 . In this manner, a linear actuating motion of the push rod 702 can activate a linear pinch valve 1004 B.
- FIGS. 11A-15B illustrate exemplary embodiments of IAB robotic surgical tools including varying types of flow control systems.
- irrigation/aspiration/blowing robotic surgical tools having a flow control system with a solid valve body are now discussed.
- FIG. 11A illustrates a top perspective view of an IAB robotic surgical tool 1100 with its cover removed to show the flow control system 417 therein.
- the IAB robotic surgical tool 1100 employs a solid valve body 1101 .
- the solid valve body 1101 is a three-dimensional solid body that includes hollow passages with open ports therein and a pair of valve openings to receive a pair of rotatable valves 1104 A- 1104 B.
- the solid valve body 1101 is a polyhedron shaped solid body.
- the flow control system 417 of the IAB robotic surgical tool 1100 is relatively inexpensive to manufacture such that the flow control system 417 may be discarded after use, instead of cleaned or sterilized.
- the remaining components of the tool 1100 may be cleaned and re-sterilized.
- the IAB robotic surgical tool 1100 is also relatively inexpensive to manufacture such that it may be discarded in its entirety after usage.
- a first port of the solid valve body 1101 couples to the proximal end of the hollow tube 404 .
- Second and third ports of the solid valve body 1101 may couple to the hose fittings 410 A- 410 B.
- the hose fittings 410 A- 410 B may respectively couple to hoses 106 A- 106 B.
- the solid valve body 1101 includes a three-way passage 1106 coupled between the proximal end of the hollow tube 404 and first ports of rotatable valves 1104 A- 1104 B.
- the solid valve body 1101 further includes passages 1108 A- 1108 B coupled between second ports of the rotatable valves 1104 A- 1104 B and the hose fittings 410 A- 410 B, respectively.
- the rotatable valves 1104 A- 1104 B are two-way two-position valves and each have an open flow channel that can be rotated and switched open or closed between the ports to the respective passages 1108 A- 1108 B and the ports to the three-way passage 1106 .
- FIG. 11A Although a third valve and a third set of passages are not illustrated in FIG. 11A , it is understood that it may be provided to provide flow control for a third type of fluid.
- the hollow tube 404 is mechanically supported in the mountable housing by having an end coupled into the first port of the solid valve body 1101 .
- the hollow tube 404 maybe further supported mechanically by being inserted into a bushing that is supported within the collar 1102 of the interface base 412 .
- the hollow tube 404 has an opening 424 at its tip 406 .
- the hollow tube 404 may further have openings around its circumference near its tip 406 .
- the solid valve body 1101 may be fitted to the interface base 412 so that it is readily replaceable.
- the hollow tube 404 may be fitted with a quick release fitting to the solid valve body 1101 so that it can be readily re-sterilized and reused.
- the solid valve body 1101 includes valve openings 1109 A- 1109 B to receive the rotatable valves 1104 A- 1104 B, respectively.
- the valve openings 1109 A- 1109 B in the solid valve body may include threads or rings to allow the rotatable valves 1104 A- 1104 B to rotate in a fixed axial position with respect to the passages 1106 , and 1108 A- 1108 B.
- the rotatable receiving element 418 of the rotatable valves 1104 A- 1104 B may further include a tab 1114 to abut against a stop within the interface base 412 .
- valves 1104 A- 1104 B may be molded together as one piece to further lower the cost of manufacture of the flow control system. As valves 1104 A- 1104 B are substantially similar, a further detailed description of valve 1104 A is only provided with valves 1104 A- 1104 B being collectively referred to as valves 1104 .
- the flow channel 1110 of the rotatable valves 1104 may be a slanted opening through the cylindrical shaft.
- the flow channel 1110 of the rotatable valves 1104 may be a slanted opening through the cylindrical shaft.
- Wrapped around the cylindrical shaft are one or more seals 1112 to seal off the flow channel 1110 within the valve body 1101 .
- a slanted seal 1113 may be provided above the slanted opening of the flow channel 1110 .
- an additional slanted seal 1113 may be provided below the slanted opening of the flow channel 1110 .
- the cylindrical shaft 1105 has circumferential channels to respectively receive a portion of the one or more seals 1112 .
- the cylindrical shaft 1105 has one or more slanted channels in its cylindrical surface to respectively receive a portion of the one or more slanted seals 1113 .
- the channels in the shaft 1105 keep the seals in position as the valve is moved.
- FIG. 11C a cross section of one of the rotatable valves 1104 is illustrated in a closed position.
- the rotatable valve 1104 includes the cylindrical shaft 1105 coupled at one end to the rotatable receiving element 418 .
- the cylindrical shaft 1105 includes the flow channel 1110 .
- the flow channel 1110 has a first port 1110 A at one end and a second port 1110 B at a second end. As discussed previously, the flow channel 1110 may be slanted from the first port 1110 A to the second port 1110 B. As valve 1104 is in a closed position in FIG. 11C , neither the first port 1110 A nor the second port 1110 B of the flow channel 1110 matches the ports into the passages 1106 or 1108 A, 1108 B.
- the cylindrical shaft 1105 further includes one or more seals 1112 near top and bottom portions to seal off the flow channel 1110 in the solid body 1101 .
- the cylindrical shaft 1105 further includes the slanted seal 1113 between a top seal 1112 and the slanted flow channel 1110 to further seal the rotatable valve within the solid body 1101 .
- the slanted seal 1113 around the cylindrical shaft 1105 allows for relaxed tolerances between the rotatable valve 1104 and the solid valve body 1101 .
- the slanted seal 1113 allows for a larger radial gap between the cylindrical shaft 1105 of the valve 1104 and the solid valve body 1101 while maintaining a leak-less seal.
- the top and bottom seals 1112 seal the valve 1404 with respect to the valve body
- the slanted seal 1113 seals the flow of fluids through the channel 1110 .
- the slanted seal 1113 seals the flow of fluids through the channel 1110 over the range of positions of the valve 1104 , from a fully closed position to a fully open position.
- the slanted seal 1113 particularly prevents leakage when the valve 1104 is in the closed position.
- the channel 1110 in the cylindrical shaft 1105 is replaced by narrowing the center diameter portion of the cylindrical shaft 1105 between the slanted seal 1113 and the bottom seal 1112 , such as into an hour glass shape, to form a channel for fluid flow when the valve 1104 is moved from a closed position.
- the slanted seal 1113 forms an end portion of the channel.
- the hollow tube 404 couples to a port of the three-way passage 1106 .
- the hose fittings 410 A, 410 B couple to the passages 1108 A, 1108 B, respectively.
- the hose fittings 410 A, 410 B and the hollow tube 404 may be press fitted into the solid valve body 1101 or have threads to be screwed into and mate with threads in passages 1106 , 1108 A, 1108 B of the solid valve body 1101 .
- FIG. 11D a cross section of one of the rotatable valves 1104 is illustrated in an open position.
- a fluid can flow between the hollow tube 404 and one of the hose fittings 410 A, 410 B by way of the passages in the solid valve body 1101 and the flow channel 1110 .
- the flow channel 1110 in the cylindrical shaft 1105 is reoriented to a position where its first port 1110 A matches a port of the three-way passage 1106 and its second port 1110 B matches a port of the passage 1108 A, 1108 B.
- a fluid can flow from the hollow tube into the three way passage 1106 , through the flow channel 1110 , into the passage 1108 A, 1108 B and out of the hose fitting 410 A, 410 B.
- a fluid can flow from the hose fitting 410 A, 410 B, into the passage 1108 A, 1108 B, through the flow channel 1110 , into the three way passage 1106 and out from the hollow tube 404 .
- FIGS. 11C-11D illustrate one or more seals 1112 near top and bottom portions of the shaft 1105 and the slanted seal 1113 in parallel with the slanted flow channel 1110 to seal the rotatable valves 1004 A- 1104 B in the solid body 1101 .
- the rotatable valves 1104 A and 1104 B may operate in the same rotational direction or in opposite rotational directions. That is, each rotatable valve may operate to open in a clockwise direction or a counterclockwise direction. Alternatively, rotatable valve 1104 A may open using a counterclockwise rotation while rotatable valve 1104 B opens using a clockwise rotation, for example.
- the flow control system 417 can be made relatively inexpensive such that it can be readily discarded with or without other components of the surgical tool 1100 .
- valves of the flow control system 417 of the IAB robotic surgical tools may also be manually controlled with manual actuators. Additional manually controlled valves may also be provided in parallel with robotically controlled valves in the flow control system in order to both manually and robotically control the fluid flows through an IAB robotic surgical instrument.
- Manual actuators are coupled to the manually controlled valves to extend external to the housing of the IAB robotic surgical tools so that a user's hand may open and/or close the valves.
- the solid valve body 1101 has been modified to solid valve body 1101 ′ that includes manually controlled valves 1124 A- 1124 B in parallel with the respective robotically controlled valves 1104 A- 1104 B in order that the fluid flows through the IAB robotic surgical instrument 1100 B may be controlled manually by hand and robotically from a master control console 150 .
- the manually controlled valves 1124 A- 1124 B are trumpet valves, a type of valve such as illustrated in FIG. 7A and previously described.
- the valves 1124 A- 1124 B each include a button 1125 on top that extends out from the housing 401 through the cover 414 (not illustrated in FIG. 11E ), such as illustrated in FIG. 13B .
- each of the manually controlled valves 1124 A- 1124 B includes a spring 706 to return the valve to a closed position when the force is released from the button 1125 . (see FIG. 7A ).
- the button 1125 is similar to the button 703 of the valve 704 A illustrated in FIG. 7A .
- the two way passages 1108 A- 1108 B and the three way passage 1106 in the solid valve body 1101 illustrated in FIG. 11A are modified respectively into three way passages 1108 A′- 1108 B′ and a five way passage 1106 ′ of the solid valve body 1101 ′ illustrated in FIG. 11E .
- the five way passage 1106 ′ includes one or more parallel passages 1126 to a port of the valves 1124 A- 1124 B.
- the five way passage 1106 ′ has a first port to couple to the tube 404 , a second port and a third port to respectively couple to valves 1104 A, 1104 B, and a fourth port and a fifth port to respectively couple to the valves 1124 A- 1124 B.
- the three way passages 1108 A′- 1108 B′ each include a side passage 1128 to a port of the valves 1124 A- 1124 B.
- the three way passage 1108 A′ has a first port to couple to the valve 1104 A, a second port to couple to the valve 1124 A, and a third port to couple to the hose fitting 410 A.
- the three way passage 1108 B′ has a first port to couple to the valve 1104 B, a second port to couple to the valve 1124 B, and a third port to couple to the hose fitting 4101 B.
- the solid valve body 1101 ′ further includes an additional pair of valve openings to receive the spring 706 and the plunger 705 of the trumpet valve 704 A. Additional seals may be provided around the shaft between the plunger 705 and the buttons 703 , 1125 .
- modified solid valve body 1101 ′ including the structure and function of the valves 1104 A- 1104 B, is similar to that of the solid valve body 1101 illustrated by FIGS. 11A-11D and described previously.
- FIG. 12 a top perspective view of an IAB robotic surgical tool 1200 is illustrated with its cover over the mountable housing removed.
- the IAB robotic surgical tool 1200 includes a modular valve subassembly 1201 .
- the modular valve assembly 1201 and coupling hoses 1208 A- 1208 B are readily replaceable with new used components.
- the remaining portion of the tool 1200 may be re-sterilized and then reused with a new modular valve assembly 1201 and coupling hoses 1208 A- 1028 B.
- the modular valve subassembly 1201 is mountable to and dismountable from the interface base 412 .
- a base 1211 of the modular valve subassembly 1201 may press fit into place to mount the valve subassembly to the interface base 412 .
- the base 1211 of the modular valve subassembly 1201 includes recesses for rigid attachment of the ports of the valves 1204 A- 1204 B and the ports of the hose fittings 410 A- 410 B.
- Hoses 106 A- 106 B may be coupled to ends of the hose fittings 410 A- 410 B.
- the control and actuation of the rotatable valves 1204 A- 1204 B was previously described with reference to FIG. 6A and the rotatable valve 604 A.
- the modular valve subassembly includes a first rotatable valve 1204 A and a second rotatable valve 1204 B.
- Each of the valves 1204 A- 1204 B are two-way, two-position valves having a pair of ports.
- the valves 104 A- 104 B may be trumpet valves, ball cock style valves, or other rotatable type of valve used to control the flow of gases or fluids.
- Coupled to the first ports of each valve 1204 A- 1204 B are the hose fittings 410 A- 410 B, respectively.
- Coupled to a second port of each of the valves 1204 A- 1204 B are first ends of the respective coupling hoses 1208 A- 1208 B. Second ends of the hoses 1208 A- 1208 B respectively couple to a pair of ports of a three-way coupler 1206 .
- a third port of the coupler 1206 couples to the hollow tube 404 .
- Shafts of the valves 1204 A- 1204 B can be coupled to and decoupled from a pair of rotatable receiving elements 418 .
- the modular valve subassembly 1201 is replaceable. After being used, the modular valve subassembly 1201 is dismounted from the interface base with shafts of the used valves 1204 A- 1204 B being decoupled from the rotatable receiving elements 418 . Similarly, shafts of new unused valves 1204 A- 1204 B may be coupled to the rotatable receiving elements 418 when mounting a new modular valve subassembly to the interface base.
- Coil springs may be wrapped around the shafts of the valves 1204 A- 1204 B and coupled to the pair of rotatable receiving elements 418 in order to spring load the valves 1204 A- 1204 B to automatically close so that neither suction nor irrigation are activated when the instrument housing is not mounted onto the robotic arm, or modular valve subassembly is not mounted to the interface base 412 in the mountable housing 401 .
- the hollow tube 404 is supported by the interface base.
- a bushing 1202 may be inserted over the hollow tube 404 and pressed into the collar 1102 of the interface base 412 .
- the printed circuit board 425 may also be mounted to the interface base 412 . Electrical pins 424 may couple to the printed circuit board 425 to provide an electrical connection to the adaptor 228 .
- the integrated circuit 426 is mounted to the printed circuit board may be reprogrammed to indicate that the tool 1200 has been re-sterilized and its components replaced.
- the modular valve subassembly 1201 and the coupling hoses 1208 A- 1208 B are removed and discarded.
- a new valve subassembly 1201 and new hoses 1208 A- 1208 B are installed and mounted in the robotic surgical tool.
- the remaining components including the interface base 412 , the three-way coupler 1206 and the hollow tube 404 are re-sterilized prior to fitting a new modular valve subassembly 1201 and new hoses 1208 A- 1208 B.
- the integrated circuit 426 may be programmed to indicate that the tool 1200 has been re-sterilized and its components replaced.
- FIGS. 13A-13B an IAB robotic surgical tool 1300 to control the flow of fluids into and out from a surgical site is illustrated.
- FIG. 13A illustrates the IAB robotic surgical tool 1300 with its cover removed to show that the IAB robotic surgical tool 1300 includes a flow control system that utilizes rotatable pinch valves 1304 A- 1304 B.
- a pair of flexible coupling hoses 1302 A- 1302 B are coupled to a pair of hose fittings 410 A- 410 B at a first end and a pair of ports of a three-way coupler 1206 at a second end.
- the third port of the three-way coupler 1206 is coupled to the proximal end of the hollow tubing 404 .
- the tool 1300 includes a rotatable pinch valves 1304 A- 1304 B rotatably mounted to the interface base 412 .
- Each of the pinch valves 1304 A- 1304 B is coupled to a rotatable receiving element 418 .
- the rotatable receiving element 418 may couple to a rotatable driver 234 .
- Each of the rotatable pinch valves 1304 A- 1304 B may include a coil spring 1306 , a rotatable pinch arm 1320 , a pinch wheel 1322 coupled to the end of the rotatable pinch arm 1320 , a tab 1324 , and a handle 1330 .
- the pinch valve 1304 A is illustrated as being open and allowing the flow of fluid through the tool 1300 .
- Rotatable pinch valve 1304 B is illustrated as being closed to pinch off hose 1302 B at a pinch point 1302 B′.
- a pinch wheel 1322 presses the hose 1302 B against the backstop 1315 B of bulkhead 1310 .
- the hose 1302 B collapses to a diameter of zero so that no fluid can flow through it at the pinch point 1302 B′.
- the rotatable pinch valve 1304 A may utilize the backstop 1315 A of bulkhead 1310 to close and pinch off hose 1302 A. The operation of a rotatable pinch valve is further discussed herein with reference to FIG. 10A .
- the tab 1324 When being opened from the closed position, the tab 1324 may be used to limit the rotation of each rotatable pinch valve 1304 A- 1304 B to a stop 1325 .
- the hoses 1302 A- 1302 B may be silicon hoses that are flexible with the capability of expanding to an open non-collapsed diameter from a collapsed state at the pinch point in response to opening the rotatable pinch valves.
- the pinch wheel 1322 rotates along the hose as its being pinched off so as to avoid damaging the hose and cause leeks.
- the coil spring 1306 wrapped around the shafts of the pinch valves 1304 A- 1304 B may be used to spring load the valves 1204 A- 1204 B to automatically close and pinch off the hoses 1302 A- 1302 B when the instrument housing is dismounted from the robotic arm or otherwise not being actuated.
- the handles 1330 A- 1330 B allow for manual use of the IAB robot surgical tool 1300 when it is not mounted to a robotic arm.
- the handles 1330 A- 1330 B are respectively coupled to the shafts 1330 A- 1330 B of the rotatable pinch valves 1304 A- 1304 B in order to manually rotate them open and closed by hand.
- the assistant surgeon or nurse may manually operate the IAB robotic surgical tool 1300 to control the fluid flows by using the handles 1330 A- 1330 B.
- the handles 1330 A- 1330 B allow for cleaning the flow control system as is described further below.
- the IAB robotic surgical tool 1300 is illustrated with its cover 1350 coupled to the interface base 412 .
- the cover 1350 provides protection to the flow control system 417 including the rotatable pinch valves in the hoses.
- the handles 1330 A- 1330 B extend through the cover 1350 so that they are accessible to manually control the pinch valves.
- the handle 1330 A includes a clip 1332 that may be swung around and fitted into a groove 1334 of the handle 1305 B. With the clip 1332 within the groove 1334 , both handles 1330 A- 1330 B are open such that neither hose 1302 A nor hose 1302 B is pinched closed. The handles are clipped together in the open position during a cleaning of the flow control system of the robotic surgical tool 1300 and to ease replacement of the hoses.
- the handle is rotated to the open position and the clip 1332 is swung to position 1332 ′.
- the handle 1330 B is rotated to position 1330 B′ so that the clip 1332 ′ may be inserted into its groove 1334 .
- the pinch valves are both open and the hoses 1302 A- 1302 B are not pinched off but are open so that they can be cleaned.
- FIG. 14 a top view of a IAB robotic surgical tool 1400 is illustrated with its cover removed to show the pinch valves and replaceable tubing.
- the tool 1400 is substantially similar to tool 1300 previously described but for use of the coupling hoses 1302 A- 1302 B to control the flow of fluids within the tool.
- Tool 1400 eliminates the hose fittings 410 A- 410 B and the short coupling hoses 1302 A- 1302 B between the hose fittings 410 A- 410 B and the three-way coupler 1206 .
- the tool 1400 includes replaceable hoses 106 B- 106 A directly coupled to the ports of the three-way coupler 1206 , as is illustrated in FIG. 14 .
- the replaceable hoses 106 B- 106 A extend beyond the robotic surgical tool in order to couple externally to sources of fluids.
- the coupling hoses 1302 A- 1302 B of the tool 1300 require cleaning and sterilization after each use of the tool 1300 in order for it to be reused.
- the hoses 106 A- 106 B are not cleaned, but replaced after each usage with new sterile hoses so that the tool 1400 may be reused.
- the interface base 412 is formed with bulkhead 1410 to allow the hoses 106 A- 106 B to be readily replaceable and coupled to the three-way coupled 1206 .
- the tool 1400 includes the rotatable pinch valves 1304 A- 1304 B with their pinch arms 1320 and pinch rollers 1322 coupled thereto to pinch off the hoses 106 A- 106 B and stop the flow of fluids.
- the rotatable pinch valves are rotatably mounted to the interface base 412 .
- the shaft of each rotatable valve is coupled to the rotatable receiving element 418 .
- rotatable pinch valve 1304 A is open such that hose 106 A may allow a fluid to flow therein.
- Rotatable pinch valve 1304 B is closed to pinch off hose 106 B at point 1402 B.
- Bulkhead 1410 is provided so that the hoses 106 A- 106 B may be readily replaced when the rotatable pinch valves 1304 A- 1304 B are held in their open positions.
- the bulkhead 1410 includes backstops 1415 A and 1415 B against which the rotatable pinch valves 1304 A- 1304 B may pinch off the respective hoses 106 A- 106 B.
- Hoses 106 A- 106 B may be formed of a silicon rubber compound so that they are flexible and can be readily collapsed and expanded in response to the opening and closing of the rotatable pinch valves.
- the replaceable hoses 106 B- 106 A are directly coupled to two of the three ports of the three-way coupler 1206 .
- the third port of the three-way coupler 1206 is coupled to the proximal end of the hollow tube 404 .
- the hollow tube 404 may be further supported by the interface base 412 by inserting a the hollow tube into a bushing mounted in the collar 1102 .
- the IAB robotic surgical tools may further include the printed circuit board 425 with one or more pins 424 and one or more interrelated circuits 426 coupled thereto to indicate its tool type, whether its new or refurbished, and if refurbished, the number of prior uses.
- IAB robotic surgical tools 1500 A- 1500 B are respectively illustrated without their covers.
- the tools 1500 A- 1500 B do not internally control the flow of fluids into and out of a surgical site. Instead, the control of the flow of fluids into and out of a surgical site is externally controlled away from the surgical tool.
- the control of fluids may be provided at the respective fluid pumps by the computer system 151 in the surgeons master control console 150 under the control of the operator O.
- the IAB robotic surgical tools 1500 A- 1500 B are mounted to a robotic arm of the robotic surgical manipulator 152 and can facilitate the flow of fluids into and out of a surgical site through couplers and the hollow tube 404 .
- the IAB robotic surgical tool 1500 A includes a three-way coupler 1206 mounted to the interface base 412 .
- a proximal end of the hollow tube 404 couples to a first port of the three-way coupler 1206 .
- Replaceable hoses 106 A- 106 B respectively couple to a second and a third port of the three-way coupler 1206 .
- the tool 1500 A may further include the printed circuit board 425 with the electrical pins 424 in one or more interrelated circuits 426 coupled thereto to indicate the tool type and that external fluid control is to be utilized.
- the IAB robotic surgical tool 1500 B includes a four-way coupler 1506 with a first port coupled to the hollow tube 404 , a second port coupled to an end of a first hose 106 A, a third port coupled to an end of a second hose 106 B, and a fourth port coupled to an end of a third hose 106 C.
- Tool 1500 B may also include the printed circuit board 425 with the electrical pins 424 and the one or more integrated circuits 426 coupled thereto to indicate the tool type and that external fluid control is to be utilized to control the flow of fluids flow in the hoses 106 A- 106 C.
- IAB robotic surgical tools 1500 A- 1500 B Cleaning and sterilization of the IAB robotic surgical tools 1500 A- 1500 B is fairly easy as there are no valves.
- used hoses 106 A- 106 C are removed.
- the remaining portions of the tools 1500 A and 1500 B, such as the couplers and the hollow tube 404 are then sterilized and then fitted with new sterile hoses 106 A- 106 C so that they may be reused.
- IAB robotic surgical tools 1500 A- 1500 B have been shown and described to include couplers 1206 , 1506 , respectively, the couplers can be removed and provided externally to the surgical tools 1500 A- 1500 B.
- a single hose would be routed from the external coupler to the IAB robotic surgical tool.
- the single hose may couple to a hose fitting, that in turn would be coupled to the hollow tube 404 .
- the proximal end of the hollow tube could be formed as a hose fitting and directly couple to an end of the hose. In this manner, reuse of the IAB robotic surgical tool may further simplified with fewer components to sterilize and a single hose to replace.
- irrigation and aspiration of a surgical site are manually controlled by an assisting surgeon or nurse using manual surgical tools.
- the primary surgeon can now control irrigation and aspiration of a surgical site.
- the flow control system of the IAB robotic surgical instrument may be controlled by the operator O seated at the robotic surgical master control console 150 in a number of ways.
- master axes of movement in a control handle that is normally used for controlling a wristed robotic surgical instrument may be used to activate irrigation, aspiration, and or blowing through an IAB robotic surgical instrument over a surgical site.
- one or a combination of both the rotational motion of the touch sensitive handle 325 and the squeezing motion of the grips 350 A, 350 B may be used to control the flow of fluids through the IAB robotic surgical tools.
- the rotational motion of the touch sensitive handle 325 may be used for the control of irrigation while the squeezing motion of the grips 350 A, 350 B may be used for controlling suction in a surgical site.
- FIG. 16A is a side view of the touch sensitive handle 325 of the robotic surgical master control console 150 .
- the touch sensitive handle 325 may be used by the operator O to control the fluid flow in IAB robotic surgical instruments.
- a rotational motion R (“roll”) of the touch sensitive handle may control the irrigation, aspiration, and/or blowing through IAB surgical instruments 101 A, 400 .
- the handle may rotated clockwise to open a first valve to have a fluid flow through the IAB surgical instrument into or out of a surgical site.
- the handle may then be rotated counter-clockwise to close the first valve and stop the flow of fluid through the IAB surgical instrument and into or out of the surgical site.
- a center detent point D of rotation in the touch sensitive handle 325 may be used to switch over from one type of fluid flow to another.
- the handle may rotated counter-clockwise to open a second valve or switch open the first valve to a different position to have a second fluid flow through the IAB surgical instrument and into or out of a surgical site.
- the handle 325 may then be rotated clockwise to the center detent point D to close the second valve and stop the flow of fluid through the IAB surgical instrument and into or out of the surgical site.
- the rotational motion of the handle 325 may typically control wrist motors in the robotic surgical manipulator 152 to control a wrist motion of a robotic surgical tool.
- the wrist motors in the robotic surgical manipulator 152 may be adapted for use to control one or move valves in the IAB robotic surgical instruments in response to the rotational motion of the handle 325 .
- a gripping or squeezing motion (“master grip”) on the grips 350 A- 350 B of the touch sensitive handle 325 may be used to control the flow of fluids through IAB robotic surgical instruments.
- squeezing the grip of touch sensitive handle may be used to turn on the suction of the I/A/B surgical instrument and the grip released to turn off the suction.
- the touch sensitive handle may include one or more springs 306 A- 306 C to provide differing spring constants or a single spring 306 with a progressive rate spring constant as the positions of the grips 350 A- 350 B change.
- An explanation as to how the touch sensitive handle 325 functions was previously describe with reference to FIG. 3C .
- the rotational motion of the handle may be used for further movement or control of the instrument.
- the position of the grips 350 A- 350 B can vary over a range of positions in order to control suction, blowing and irrigation of a surgical site such as from a fully released or fully open position to a fully squeezed or fully closed position.
- FIGS. 16B-16D illustrate different positions of the grips 350 A- 350 B of the touch sensitive handle 325 when squeezed by a hand H of the operator O to control the IAB robotic surgical tool at a surgical site.
- FIG. 16B illustrates a fully open grip position without any squeezing by the hand H.
- FIG. 16C illustrates the hand H squeezing the grips 350 A- 350 B to a half-way closed position.
- a first spring rate may be used over a range of positions, such as from the fully open to the half-way closed position.
- FIG. 16D illustrates the hand H squeezing the grips 350 A- 350 B to a fully closed position.
- a second spring rate somewhat greater than the first may be used over a range of positions, such as from the half-way closed position to the fully closed position.
- FIG. 17 is a graph showing exemplary control of irrigation and aspiration using the grip control of the touch sensitive handle 325 .
- the open, half, and closed positions along the X-axis of the graph correspond to the different positions of the grips 350 A- 350 B of the touch sensitive handle 325 illustrated in FIGS. 16B-16D .
- Curve 1701 illustrates a flow of vacuum or a percentage of suction.
- Curve 1710 illustrates a flow of irrigation fluid through the tool and into a surgical site.
- both suction and irrigation are turned off.
- suction is turned on and irrigation remains turned off.
- curve 1701 illustrates the flow of vacuum change from zero to one hundred percent.
- suction may be fully turned on with a negligible amount of irrigation.
- the vacuum flow tapers off toward zero and the irrigation begins from zero around the three-fourths closed position, as is illustrated by curves 1701 and 1710 .
- both the rotational motion of the touch sensitive handle 325 and the squeezing motion of the grips 350 A, 350 B may be used to control the flow of fluids through the IAB robotic surgical tools.
- foot pedals 18 of the surgeons master control console 150 may be used to further control the IAB robotic surgical tools.
- one of the foot pedals 18 may be used to switch from suction control to blow control in order to blow a pressurized gas over the surgical site.
- a gripping squeezing motion of the touch sensitive handle can also control the blowing provided by the I/A/B surgical instrument.
- the touch sensitive handle 325 may be modified to include buttons to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the robotic surgical manipulator 152
- the foot pedals 18 of the surgeons master control console 150 may be used to fully control the suction and irrigation provided by an IAB robotic surgical tool.
- a first foot pedal 18 A may be used to control suction and a second foot pedal 18 B may be used to control the irrigation provided by an IA or IAB surgical instrument.
- foot pedals on the right side of the footrest may be used, for example.
- Two pedals and a toggle switch on the master control console or the control handle may be used to control a variety of actuations in a plurality of surgical instruments knowing the context of the robotic surgical system in advance.
- foot pedals normally used for cautery may be switched to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the robotic surgical manipulator 152 .
- voice activation may be used to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the robotic surgical manipulator 152 .
- an operator's voice or speech may be used to control the suction, irrigation, and or blowing provided by an IA or IAB surgical instrument.
- spoken voice commands such as “suction ON”, “suction OFF”, “suction lightly”, “irrigation ON”, “irrigation OFF”, and “irrigate lightly” may be used to control the suction and irrigation provided by the IA or IAB surgical instrument.
- the master control console 150 includes a microphone 315 and a speech recognizer 317 .
- the speech recognizer 317 may generate the control signals that are provided to the IA or IAB surgical instrument.
- control means have been individually described here, two or more of these control means may be combined in order to control the flow of fluids through an IAB robotic surgical tool.
- the rotational motion of the touch sensitive handle 325 may be used for the control of irrigation while the squeezing motion of the grips 350 A, 350 B may be used for controlling suction in a surgical site.
- various types of user feedback may be provided to the IAB robotic surgical tools.
- the irrigation/aspiration/blowing robotic surgical tool 400 A includes a pair of light emitting diodes (LEDs) 1801 - 1802 near the tip 406 of the hollow tube 404 in order provide visible feedback to an operator O that a fluid is flowing through the tool.
- LEDs light emitting diodes
- One or more wires 1804 may couple between the light emitting diodes 1801 - 1802 and the printed circuit board 425 within the mountable housing 401 . Electrical signals can be transmitted towards the light emitting diodes from the printed circuit board to turn them on during the flow of fluids and off when no fluid flow occurs.
- the integrated circuit 426 may generate the electrical signals to control the light emitting diodes.
- the light emitting diode 1801 - 1802 may be activated by control signals received over the one or more wires 1804 from the master control console 150 .
- Additional light emitting diodes may be provided near the tip 406 of the hollow tube 404 in order provide additional visible feedback for additional fluid flows.
- the light emitting diodes 1801 - 1802 including any additional LEDs, may emit photons of different wavelengths in order that different colors can be provided corresponding to different types of fluid flow (e.g., suction, irrigation, gas pressure).
- the IAB robotic surgical tool 400 B includes a light pipe 1812 mounted externally to the hollow tube 404 to provide visible user feedback to the operator O that fluids are flowing into or out of the surgical site.
- the light pipe 1812 maybe a side lighting fiber optic cable with one end optically coupled to one or more light emitting diodes 1811 to receive photons.
- the light emitting diodes 1811 may emit photons of different wavelengths in order that different colors can be provided corresponding to different types of fluid flow (e.g., suction, irrigation, gas pressure).
- One or more wires 1814 may couple between the one or more light emitting diodes 1811 and the printed circuit board 425 mounted within the housing 401 .
- An integrated circuit such as integrated circuit 426 , may be used to drive the one or more light emitting diodes 1811 to turn them on or off. Alternatively when fluids flow, the one or more light emitting diodes 1811 may be activated directly by control signals received over the one or more wires 1814 from the master control console 150 or from the integrated circuit 426 . More than one light pipe 1812 may be provide along the circumference of the hollow tube 404 so that the side light may be visible at different viewing angles and positions of the IAB robotic surgical instrument.
- the light pipe 1812 provides a light that maybe visible along the entire length of the hollow tube 404 so that it can be seen, regardless of the position of the tip. Additionally, the light emitting diode 1811 is protected under the cover of the mountable housing 401 .
- the IAB robotic surgical tool 400 C includes a sliding sleeve 1820 and a visible scale 1824 coupled to the hollow tube 404 .
- the sliding sleeve 1820 is coaxial with the hollow tube 404 and covers over the scale 1824 when no fluid is flowing through the tool.
- the sliding sleeve 1820 can be slid along the hollow tube 404 and into the housing 401 to reveal the visible scale 1824 as fluids flow through the tool 400 C.
- the visible scale 1824 maybe different colored bands to indicate the level of fluid flow within the tool 400 C.
- the visible scale 1824 maybe bands of different thickness to reveal the amount of fluid flow within the tool 400 C.
- the sliding sleeve 1820 can be gradually received into the hosing 401 to reveal the appropriate scale in proportion to the amount of fluid flow in the tool 400 C.
- a tip 1822 of the sliding sleeve 1820 may completely cover over the visible scale 1824 .
- the sliding sleeve 1820 may be slid into the housing 401 such that its tip moves to a position 1822 ′ to fully reveal the visible scale 1824 .
- the opposite end 1823 of the sliding sleeve 1820 moves inward to position 1823 ′. In this manner, the level of fluid flow in the tool 400 C maybe provided to a user by mechanical means.
- the sliding sleeve 1820 may be pulled into the housing 401 and pushed back out in a variety of ways.
- a spring may be used to apply a force against the retraction of the sliding sleeve 1820 into the housing so that it can push it back out after the pulling force is released.
- a cable with one end coupled to and wrapped around a take up drum may be coupled to the sleeve 1820 through a pulley in order to pull the sleeve into the housing 401 .
- a gearing system may alternatively be used.
- a pinion gear may couple to a rotatable receiving element 418 and to a rack coupled to the sleeve 1820 .
- a ball screw and a lead screw may be used.
- a slider with a crank or lever arm may be used.
- An electrical means may also be used, such as a solenoid to pull in on the sliding sleeve 1820 .
- an IAB robotic surgical tool 400 D includes another mechanical structure to provide user feedback. However instead of a sliding sleeve, the IAB robotic surgical tool 400 D includes a rotating sleeve 1820 ′ coaxial with the hollow tube 404 .
- FIGS. 18E-18G illustrate various types of tips 406 and sleeves 1820 A′- 1820 C′ that may be used to provide user feedback.
- the IAB robotic surgical tool 400 D includes the hollow tube coupled to the solid valve body 1101 , 1101 ′ mounted to the interface base 412 .
- the tool 400 D further includes the hollow rotatable sleeve 1820 ′ coaxial around the hollow tube 404 .
- the rotatable sleeve 1820 ′ couples to a bearing assembly 1852 mounted to the collar 1102 to rotatably mount to the interface base 412 .
- the rotatable sleeve 1820 ′ includes a drum 1854 that extends from the bearing assembly 1852 into the housing 401 .
- the tool 400 D is backward compatible and includes a spool 1830 rotatably mounted to the interface base 412 .
- a rotatable receiving element 418 of the IAB robotic surgical tool is coupled to the spool 1830 .
- the rotatable receiving element 418 couples to the rotatable driver 234 by means of the pins 422 A- 422 B within the openings 240 A- 240 B, respectively.
- Coupled between the spool 1830 and the drum 1854 of the rotatable sleeve are a top cable 1832 and a bottom cable 1834 .
- One end of each cable couples to the spool 1830 .
- the opposite end of each cable couples to the drum 2854 .
- a single cable may be used by appropriately wrapping it around the drum 2834 and the spool 1830 .
- the top cable and the bottom cable wrap different from each other around the spool. They also wrap different from each other around the drum 1854 . In this manner, one cable is being let out while the other cable is being taken in by the rotation of the spool. 1854 .
- the spool 1854 is turning clockwise as indicated by arrow F 2 , the cable 1832 is taken in, the cable 1834 is let out, and the sleeve 1820 ′ rotates counter clockwise as illustrated by the letter G 2 . If the spool 1854 is turning counter-clockwise as indicated by arrow F 1 , the cable 1832 is let out, the cable 1834 is let out, and the sleeve 1820 ′ rotates clockwise as illustrated by the letter G 1 .
- a gear system may be used.
- a first worm gear may be used in place of the spool 1830 and a second worm gear coupling to the first may be used in place of the drum 1854 .
- the hollow rotatable sleeve 1820 A′ includes a plurality of narrow openings 1840 located around a circumference of a distal end of the sleeve 1820 A′. This way, the scale may be seen from different angles.
- the narrow window openings 1840 may be oval shaped as illustrated or rectangularly shaped.
- the hollow tube 404 includes a plurality of curved color stripes 1842 around its circumference that may be rectangularly shaped as illustrated by the dashed lines in FIG. 18E . As the sleeve 1820 A′ rotates, the stripes 1842 are positioned on the hollow tube 404 to be substantially aligned with the window openings 1840 .
- no color stripe or a color stripe representative of fluid flow being completely shut off is located within a window opening 1840 . This corresponds to all the valves being closed to shut off the fluid flow through the IAB robotic surgical tool.
- a first or second color stripe may begin to be revealed, such as illustrated in FIGS. 18E-18G , representative of a first fluid flow in an IAB robotic surgical instrument.
- the level of fluid flow can be indicated by the amount of color stripe 1842 that is exposed in the window opening 1840 . With the color stripe 1842 being completely exposed by the window opening 1840 , the corresponding valve of the flow control system may be fully open.
- a second or third color stripe may begin to be exposed by the window opening 1840 .
- the prior fluid flow may be substantially shut off and another valve opened to allow another fluid to flow through the IAB robotic surgical tool.
- the different color stripes 1842 indicate the flow of different fluids through the IAB robotic surgical. For example, a red color stripe may indicate that all fluid flows are fully shut off. A green color stripe may indicate pressurized gas flow. A blue color stripe may indicate irrigation, An orange color stripe may indicate suction or aspiration.
- the tool 400 D includes the rotatable sleeve 1820 B′ that is similar to the rotatable sleeve 1820 A′ but has triangular shaped window openings 1850 instead.
- the hollow tube 404 includes the plurality of color stripes 1842 . But for the shape of the window openings, the sleeve 1820 ′B operates substantially similar to that of sleeve 1820 A′ described previously.
- the hollow rotatable sleeve 1820 C′ includes a plurality of narrow rectangular openings 1860 located around a circumference of a distal end. With the plurality of openings 1860 , the scale may be seen from different angles and positions of the tool.
- the narrow window openings 1860 are rectangularly shaped.
- the hollow tube 404 includes a plurality of triangle stripes 1842 curving around its circumference as illustrated by the dashed lines in FIG. 18G .
- the colored triangle stripes 1862 are positioned on the hollow tube 404 to be substantially aligned with the window openings 186 , as the sleeve 1820 C′ rotates,
- the level of fluid flow can be indicated by the amount of color triangular stripe 1862 that is exposed in the window opening 1860 .
- the type of fluid flow may be indicated by the different colors.
- user feedback previously disclosed was implemented by the IAB robotic surgical tool.
- user feedback may be provided by the master control console 150 , such as through an electronic visual display of a graphical icon or image.
- FIG. 19 a simulated 3D image of a surgical site in a viewer 312 of the master control console 150 is illustrated when the operators eyes are in the viewer 312 .
- stereo optic images of a left image 1900 L and a right image 1900 R are provided at the viewer 312 , in order to provide a three-dimensional image when viewed by the operator O.
- the IAB robotic surgical tool 400 is located within the surgical site.
- icons 1902 are overlaid onto the images displayed in one or both of the displays 1900 L, 1900 R. The icons may use different colors overlaid on the image in order to display the function of the tool 400 .
- a scale maybe provided in the viewer to display the level of the fluid flow in the tool 400 .
- abbreviated letters maybe used to indicate the type of fluid flow (e.g., S—suction or A—aspiration, I—irrigation, B—blowing) in the tool 400 as well as its level, such as L, M, and H.
- the viewer 312 A includes stereo images for each eye including left image 400 L of the tool 400 and surgical site and a right image 400 R of the tool 400 and surgical site.
- One or more icons 2010 R may be overlaid onto the images in the right viewfinder 2001 R to indicate the functionality and the level of fluid flow in the IAB robotic surgical tool 400 .
- the images 400 R and 400 L in the viewfinders maybe provided by a right liquid crystal display 2002 R and a left liquid crystal display 2002 L, respectively.
- the one or more icons 2010 R in the viewer 312 A are provided in a single viewfinder of the stereo viewer, they are displayed as two-dimensional icons. However, three dimensional images of the icons maybe provided and overlaid onto stereo left and right images of the surgical site.
- one or more icons to provide user feedback of the control of the IAB robotic surgical tool are overlaid onto both the left image 400 L and right image 40 R of the surgical site.
- a right icon image 2010 R is overlaid onto the right image 400 R being displayed by the liquid crystal display 2002 R.
- a left icon image 2010 L is overlaid onto the left image 400 L of the surgical site provided by the liquid crystal display 2002 L.
- a stereo image of the icons may be used to provide user feedback of the control of the IAB robotic surgical tool maybe provided in the viewer 312 B.
- the IAB robotic surgical instrument is mounted to a robotic arm 153 of the robotic surgical manipulator 152 .
- One or more hoses 160 A- 160 C are coupled from the IAB robotic surgical instrument to one or more pumps 102 A- 102 C.
- the robotic surgical manipulator 152 is oriented with the patient P so that the tip of the hollow tube of the irrigation-aspiration robotic surgical instrument may be inserted into the patient near the desired surgical site.
- the operator O may control the flow of fluids between the surgical site and the IAB robotic surgical instrument from the master control console 150 using the flow control system 417 of the IAB robotic surgical tool.
- the operator may also control the flow of fluids between the IAB robotic surgical instrument and the one or more pumps.
- the operator O at the master control console 150 may generate one or more control signals to control the IAB robotic surgical instrument.
- the one or more control signals may be directly or indirectly coupled into the IAB robotic surgical instrument.
- the one or more control signals may be electrical signals that are directly coupled into the IAB robotic surgical instrument to electrically control one or more valves.
- the one or more control signals may be electrical signals that are translated into a mechanical motion. In this case, the mechanical motion may be directly coupled into IAB robotic surgical instrument while the electrical control signals are indirectly coupled into the IAB robotic surgical instrument.
- one or more valves in the IAB robotic surgical instrument may be opened to flow one or more fluids over a surgical site in response to the control signals. Similarly, one or more valves in the IAB robotic surgical instrument may be closed to reduce the flow of the one or more fluids over the surgical site in response to the control signals.
- the control of the flow of fluids between the surgical site and the IAB robotic surgical instrument is provided by controlling the one or more pumps.
- the control signals are coupled to the pumps and/or flow control valves located external to the IAB robotic surgical instrument.
- the IAB robotic surgical instrument may include a coupler to couple between the hoses from the one or more pumps and the hollow tube that is inserted into a patient.
- the one or more control signals may be generated in various ways including in response to movement of a touch sensitive handle of a master control console, squeezing of a grip of the touch sensitive handle, rotation of the touch sensitive handle, movement of a foot pedal, or a spoken command at the master control console.
- the level of flow of the fluids and the control thereof may be monitored between the surgical site and the IAB robotic surgical instrument through the user-feedback means previously described.
- One user-feedback means is one or more light emitting diodes coupled near the tip of the hollow tube of the IAB robotic surgical instrument. The one or more light emitting diodes generate a visible light in response to the control of a flow of a fluid through the IAB robotic surgical instrument.
- Another user-feedback means is a light pipe coupled along the length of the hollow tube of the irrigation-aspiration robotic surgical instrument with a light emitting diode. The light emitting diode couples photons into the light pipe and generates a visible side light in response to the control of a flow of a fluid through the irrigation-aspiration robotic surgical instrument.
- Still another user-feedback means is a sliding sleeve coaxial with the hollow tube and a scale coupled to the irrigation-aspiration robotic surgical instrument.
- the sliding sleeve slides along the hollow tube and reveals the scale in response to the control of a flow of a fluid through the irrigation-aspiration robotic surgical instrument.
- the IAB robotic surgical instrument After the using the IAB robotic surgical instrument, it is removed from the patient and can then be dismounted from the robotic arm of the robotic surgical manipulator 152 . If the IAB robotic surgical instrument is to be reused, a modular valve assembly and one or more hoses of the irrigation-aspiration robotic surgical instrument may be discarded and the remaining components of the IAB robotic surgical instrument sterilized for reuse. In the case that the IAB robotic surgical instrument includes a flow control system with an inexpensive valve subassembly, the irrigation-aspiration robotic surgical instrument can be removed from the patient; dismounted from the robotic arm; and then discarded.
- an irrigation/aspiration/blowing robotic surgical instrument has been shown and described in a number of embodiments of the invention, it may be modified into an irrigation robotic surgical instrument with a single valve to provide irrigation only or it may be modified into an aspiration robotic surgical instrument with a single valve to provide aspiration only.
- a pressurized gas may be provided instead, such as air by an air pump.
- the pressurized gas may be used to blow debris or cut tissue, if sufficient pressure is provided.
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Abstract
Description
- This non-provisional United States (U.S.) patent application claims the benefit of U.S. provisional patent Application No. 60/696,482 entitled “IRRIGATION, ASPIRATION, AND BLOWING FOR ROBOTIC SURGERY” filed on Jun. 30, 2005 by inventors Paul Millman et al.
- The embodiments of the invention relate generally to surgical instruments for robotic surgery. More particularly, the embodiments of the invention relate to irrigation/aspiration/blowing devices for surgery.
- During surgery on a patient, it is often desirable to irrigate a surgical site with a fluid, such as water, to clean or clear away blood, tissue, or other items obscuring the vision of a surgeon in the surgical site. Suction or aspiration in the surgical site may also be used to vacuum away blood, tissue, or other items obscuring the vision of the surgeon in the surgical site.
- Hand held surgical instruments have typically been used to provide irrigation and/or aspiration. The surgeon typically does not operate the hand held surgical instrument that provides irrigation and/or aspiration. An assistant surgeon or nurse handling such instruments may provide irrigation and/or aspiration of the surgical site. The surgeon gives verbal instructions to the assistant surgeon or nurse to provide irrigation and/or aspiration of the surgical site. If the surgeon could both control the surgical instruments and the irrigation and aspiration of the surgical site, verbal instructions could be reduced and surgical procedures may be more efficient.
- The embodiments of the invention are summarized by the claims that follow below.
-
FIG. 1 is a block diagram of a robotic surgery system to perform minimally invasive robotic surgical procedures using an irrigation/aspiration/blowing robotic surgical tool. -
FIG. 2A is a perspective view of a robotic surgical manipulator with a plurality of robotic surgical arms at least one of which includes an irrigation/aspiration/blowing robotic surgical tool. -
FIG. 2B is a perspective view of the robotic surgical arm including the irrigation/aspiration/blowing robotic surgical tool mounted thereto. -
FIG. 2C illustrates mounting of the irrigation/aspiration/blowing robotic surgical tool to an adapter of the robotic surgical arm ofFIG. 2B . -
FIG. 2D illustrates a top view of the adapter of the robotic surgical arm ofFIG. 2C to which the irrigation/aspiration/blowing robotic surgical tool may be mounted. -
FIG. 3A is a perspective view of a robotic surgical master control console. -
FIG. 3B is a perspective view of an exemplary gimbaled device pivotally supporting a touch sensitive handle for the robotic surgical master control console ofFIG. 3A to control robotic surgical tools including an irrigation/aspiration/blowing robotic surgical tool. -
FIG. 3C is a cross-sectional view schematically illustrating mounting of the touch sensitive handle ofFIG. 3B with sensors to sense gripping and rotation of the handle to control robotic surgical tools, including an irrigation/aspiration/blowing robotic surgical tool. -
FIG. 4A is a perspective view of an irrigation/aspiration/blowing robotic surgical tool. -
FIG. 4B is a back side view of a portion of the irrigation/aspiration/blowing robotic surgical tool ofFIG. 4A . -
FIG. 5A is a schematic flow diagram of an irrigation/aspiration robotic surgical tool using two-way two-position valves. -
FIG. 5B is a schematic flow diagram of an irrigation/aspiration robotic surgical tool using a three-way three-position valve. -
FIG. 5C is a schematic flow diagram of an irrigation/aspiration/blowing robotic surgical tool using a four-way four-position valve. -
FIG. 5D is a schematic flow diagram of an irrigation/aspiration/blowing robotic surgical tool using two-way two-position valves. -
FIGS. 6A-6C are top views of rotationally actuated rotatable valves for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm. -
FIGS. 7A-7C are cross-sections of linearly actuated linear valves for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm. -
FIG. 8 is a top view of exemplary linear actuation of a rotatable valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm. -
FIG. 9A is a top view of exemplary rotational actuation of a linear valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm with an optional manual push arm. -
FIG. 9B is a top view of exemplary rotational actuation of a linear valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm with an optional manual push side-arm. -
FIG. 10A is a top view to illustrate rotational actuation of a rotatable pinch valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm. -
FIG. 10B is a side view to illustrate linear actuation of a linear pinch valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm. -
FIG. 11A is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show a solid valve body. -
FIG. 11B is a bottom exploded of the irrigation/aspiration/blowing robotic surgical tool ofFIG. 11A with the solid valve body. -
FIG. 11C is a cross sectional view of the valve assembly with the solid valve body in a closed position for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 11A . -
FIG. 11D is a cross sectional view of the valve assembly with the solid valve body in an open position for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 11A . -
FIG. 11E is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with a solid valve body including robotically actuated valves and manually actuated valves. -
FIG. 12 is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show the replaceable valves. -
FIG. 13A is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show rotatable pinch valves. -
FIG. 13B is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool ofFIG. 13A with cover in place to show manual handles and a cleaning position of the handles. -
FIG. 14 is a top view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show the pinch valves and replaceable tubing. -
FIGS. 15A-15B are top views of irrigation/aspiration/blowing robotic surgical tools with covers removed to respectively show three-way and four-way couplers and replaceable tubing coupled thereto. -
FIG. 16A is a side view of the touch sensitive handle of the diagram of the touch sensitive handle illustrated inFIG. 3B for the robotic surgical master control console ofFIG. 3A . -
FIGS. 16B-16D are side views of grip positions of the touch sensitive handle to control the irrigation/aspiration/blowing robotic surgical tool in a surgical site. -
FIG. 17 is a graph showing exemplary control of irrigation and aspiration using grip control of the touch sensitive handle corresponding to the side views of the touch sensitive handle illustrated inFIGS. 16B-16D . -
FIG. 18A is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with light emitting diodes at the distal end to provide user feedback. -
FIG. 18B is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a light pipe along side the flow tube that is coupled to a light emitting diode at the proximal end to provide user feedback. -
FIG. 18C is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a sliding sleeve around the flow tube that is moved to reveal a scale at the distal end to provide user feedback by mechanical means. -
FIG. 18D is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a rotational sleeve around the flow tube that rotates to reveal a scale at the distal end and provide user feedback by mechanical means. -
FIG. 18E is a perspective view of a first tip for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback. -
FIG. 18F is a perspective view of a second tip for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback. -
FIG. 18G is a perspective view of a third tip for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback. -
FIG. 19 is a viewer of the robotic surgical master control console ofFIG. 3A with an icon overlaid onto the displayed images to provide user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool. -
FIG. 20A illustrates a viewer of the master control console ofFIG. 3A with an icon overlay in a single side to provide user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool. -
FIG. 20B illustrates a viewer of the master control console ofFIG. 3A with an icon overlay in both left and right sides to provide three-dimensional user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool. - In the following detailed description of the embodiments of the invention, numerous specific details are set forth in order to provide a thorough understanding of the embodiments of the invention. However, it will be obvious to one skilled in the art that the embodiments of the invention may be practiced without these specific details. In other instances well known methods, procedures, components, and circuits have not been described in detail so as not to unnecessarily obscure aspects of the embodiments of the invention.
- The embodiments of the invention include a method, apparatus, and system for robotically controlled irrigation/aspiration/blowing of an internal or external surgical area or site where robotic surgery is being performed. Aspiration may also be referred to as suction.
- In one embodiment of the invention a robotic surgical system is provided including a master control console, a surgical manipulator, a first hose, and a first pump. The master control console is used to generate control signals to cause one or more fluids to flow into or out of a surgical site. The surgical manipulator is coupled to the master control console to receive the control signals. The surgical manipulator includes at least one robotic arm to manipulate at least one robotic surgical instrument, and a surgical instrument coupled to the robotic arm. The surgical manipulator controls the surgical instrument in response to the control signals to control the flow of the one or more fluids into or out of the surgical site. The surgical instrument has a first robotically controlled valve responsive to the surgical manipulator and a hollow tube having an opening at one end to direct the flow of one or more fluids in the surgical site. The first robotically controlled valve has a first port and a second port and the hollow tube has a first end coupled to the second port of the first robotically controlled valve. The first hose has a first end coupled to the first port of the first robotically controlled valve. The first hose transports a first fluid to the first robotically controlled valve. The first pump has a port coupled to a second end of the first hose. The first pump pumps a first fluid through the first hose to the first robotically controlled valve of the surgical instrument.
- In another embodiment of the invention, a robotic surgical system is provided including a master control console, a surgical manipulator, and a first pump. The master control console generates control signals to cause a fluid to flow into or out of a surgical site. The surgical manipulator is coupled to the master control console to receive the control signals. The surgical manipulator includes at least one robotic arm to manipulate at least one surgical instrument. A surgical instrument is coupled to the robotic arm to control the flow of a fluid into or out of the surgical site. The surgical instrument has a first hose, a first robotically controlled pinch valve, and a hollow tube. The first hose is flexible and has a first end and a second end. The first robotically controlled pinch valve receives the first hose. The first robotically controlled pinch valve squeezes and pinches closed the first hose and releases and opens the first hose. The hollow tube has a first end to couple to the first end of the first hose. The first pump has a port coupled to the second end of the first hose.
- In another embodiment of the invention, a method is provided. The method includes generating a first control signal to control a robotic surgical instrument; coupling the first control signal into the robotic surgical instrument; and opening a first valve in the robotic surgical instrument to flow a first fluid over a surgical site in response to the first control signal.
- In another embodiment of the invention, another method is provided. The method includes mounting an irrigation-aspiration robotic surgical instrument to a robotic arm of a robotic surgical manipulator; coupling at least one hose from the irrigation-aspiration robotic surgical instrument to at least one pump; inserting a tip of a hollow tube of the irrigation-aspiration robotic surgical instrument into a patient near a surgical site; controlling a flow of a fluid between the surgical site and the irrigation-aspiration robotic surgical instrument; and monitoring a level of the flow of the fluid between the surgical site and the irrigation-aspiration robotic surgical instrument.
- In yet another embodiment of the invention, a robotic surgical instrument is provided for the control of flows of one or more fluids into and out of a surgical site. The robotic surgical instrument includes a housing, a flow control system mounted in the housing, a hollow tube having a first end mounted in the housing, and one or more hose fittings having a first end coupled to the flow control system. The housing can couple the robotic surgical instrument to a robotic arm. The flow control system includes one or more controlled valves to control the flow of one or more fluids through the robotic surgical instrument. The first end of the hollow tube couples to the flow control system. The one or more hose fittings have a second end to respectively couple to one or more hoses.
- In still another embodiment of the invention, another robotic surgical instrument is provided for the control of flows of one or more fluids into and out of a surgical site.
- The robotic surgical instrument includes an interface base, a hollow tube having a proximal end mounted to the interface base, a three-way coupler having a first port coupled to the proximal end of the hollow tube, a first robotically controlled valve coupled to the interface base, and a second robotically controlled valve coupled to the interface base. The interface base can mechanically and electrically couple to an end of a robotic arm. The hollow tube further has a distal end for placement in a surgical site to allow the flow of fluids into and out of a surgical site. The three-way coupler further has a second port and a third port to couple the first port, the second port, and the third port together to flow fluids there-between. The first robotically controlled valve having a first port to couple to a first hose and a second port coupled to the second port of the three-way coupler. The first robotically controlled valve controls the flows of a first fluid. The second robotically controlled valve having a first port to couple to a second hose and a second port coupled to the third port of the three-way coupler. The second robotically controlled valve controls the flows of a second fluid.
- Robotic surgery generally involves the use of a robot manipulator that has multiple robotic manipulator arms. One or more of the robotic manipulator arms often support a surgical tool which may be articulated (such as jaws, scissors, graspers, needle holders, micro dissectors, staple appliers, tackers, suction/irrigation tools, clip appliers, or the like) or non-articulated (such as cutting blades, cautery probes, irrigators, catheters, suction orifices, or the like). One or more of the robotic manipulator arms are often used to support a surgical image capture device such as an endoscope (which may be any of a variety of structures such as a laparoscope, an arthroscope, a hysteroscope, or the like), or, optionally, some other imaging modality (such as ultrasound, fluoroscopy, magnetic resonance imaging, or the like). Typically, the arms will support at least two surgical tools corresponding to the two hands of a surgeon and one image capture device.
- Robotic surgery may be used to perform a wide variety of surgical procedures, including but not limited to open surgery, neurosurgical procedures (such as stereotaxy), endoscopic procedures (such as laparoscopy, arthroscopy, thoracoscopy), and the like.
- Referring now to
FIG. 1 , a block diagram of arobotic surgery system 100 is illustrated to perform minimally invasive robotic surgical procedures using an irrigation/aspiration/blowing (IAB) roboticsurgical tool 101A. The irrigation/aspiration/blowing roboticsurgical tool 101A is a robotic endoscopic surgical instrument that is manipulated by a slaved robotic manipulator and remotely controlled by control signals received from a master control console. In contrast, manual endoscopic surgical instruments are directly controlled by hand. - A user or operator O (generally a surgeon) performs a minimally invasive surgical procedure on patient P by manipulating input devices at a
master control console 150. Acomputer 151 of theconsole 150 directs movement of robotically controlled endoscopic surgical instruments (generally numbered 101), effecting movement of the instruments using a roboticsurgical manipulator 152. The roboticsurgical manipulator 152 may also be referred to as robotic patient-side cart system or simply as a cart. The roboticsurgical manipulator 152 has one or morerobotic arms 153. Typically, the roboticsurgical manipulator 152 includes at least threerobotic manipulator arms 153 supported by linkages, with a central arm supporting an endoscopic camera and therobotic arms 153 to left and right of center supporting tissue manipulation tools and the irrigation/aspiration/blowing roboticsurgical tool 101A such as therobotic manipulator arm 153C. - An assistant A may assist in pre-positioning of the robotic
surgical manipulator 152 relative to patient P as well as swapping tools orinstruments 101 for alternative tool structures, and the like, while viewing the internal surgical site via an assistant'sdisplay 154. The image of the internal surgical site shown to A by the assistant'sdisplay 154 and operator O by surgeon'sconsole 150 is provided by one of thesurgical instruments 101 supported by the roboticsurgical manipulator 152. - Generally, the
robotic arms 153 of roboticsurgical manipulator 152 include a positioning portion and a driven portion. The positioning portion of the roboticsurgical manipulator 152 remains in a fixed configuration during surgery while manipulating tissue. The driven portion of the roboticsurgical manipulator 152 is actively articulated under the direction of the operator O generating control signals at the surgeon'sconsole 150 during surgery. The actively driven portion of thearms 153 is herein referred to as anend effector 158. The positioning portion of therobotic arms 153 that are in a fixed configuration during surgery may be referred to as positioning linkage and/or “set-up joint” 56, 56′. - To support the irrigation/aspiration/blowing robotic
surgical tool 101A, the robotic surgical system may further include one ormore pumps 102A-102C, one or moreinline filters 104A-104C, and one ormore hoses 106A-106C. For irrigation, thepump 102A is a sterile fluid pump and may be an intravenous (IV) pump with an input port or inlet coupled to anIV bag 108 through ahose 106D. The output port or outlet of thepump 102A may couple to the roboticsurgical instrument 101A directly or through theinline filter 104A. TheIV bag 108 may have a pressure cuff. For aspiration, thepump 102B is avacuum pump 102B with anoutput port 110 exhausting to atmosphere and an input port coupling to asuction canister 105 through theinline filter 104B. In an alternate embodiment of the invention, suction may be provided to rooms at a wall inlet to isolate the noise of thevacuum pump 102B. For blowing, thepump 102C is a gas compressor with an input port coupled to a source ofgas 111, such as oxygen or air, and an output port coupled to theinstrument 101A through theinline filter 104C. - The one or
more hoses 106A-106C may be joined together along a portion of their length and into one end to couple to theinstrument 101A for ease of coupling and to readily manage a plurality of hoses as one unit at therobotic manipulator 152. Towards the opposite end, the one ormore hoses 106A-106C may separate to couple to the inline filters, the pumps, thecanister 105, or other pipe fittings as the case may be. - In one embodiment of the invention, the
master control console 150 may control the one ormore pumps 102A-102C and any valves thereat in order to control fluid flow between the pumps and theinstrument 101A into and out of the surgical site. One or morecontrol signal lines 109A-109C may couple between thecomputer 151 and the one ormore pumps 102A-102C and any valves thereat in order that they may be controlled by control signals from themaster control console 150. In which case, thehoses 106A-106C may simply couple to a coupler within theinstrument 101A as is discussed further below with reference toFIGS. 15A-15B . - Referring now to
FIG. 2A , a perspective view of the roboticsurgical manipulator 152 is illustrated. The roboticsurgical manipulator 152 has one or more roboticsurgical arms 153. Therobotic arm 153C includes an irrigation/aspiration/blowing roboticsurgical tool 101A coupled thereto at theend effector 158. The roboticsurgical manipulator 152 further includes a base 202 from which the roboticsurgical instruments 101 may be supported. More specifically, the roboticsurgical instruments 101 are each supported by thepositioning linkage 156 and theend effector 158 of thearms 153. It should be noted that these linkage structures are here illustrated withprotective covers protective covers surgical manipulator 152. - The robotic
surgical manipulator 152 generally has dimensions suitable for transporting between operating rooms. It typically can fit through standard operating room doors and onto standard hospital elevators. The roboticsurgical manipulator 152 may have a weight and a wheel (or other transportation) system that allows the cart to be positioned adjacent an operating table by a single attendant. The roboticsurgical manipulator 152 may be sufficient stable during transport to avoid tipping, and to easily withstand overturning moments that may be imposed at the ends of the robotic arms during use. - Referring now to
FIG. 2B , a perspective view of the roboticsurgical arm 153C is illustrated including the irrigation/aspiration/blowing roboticsurgical tool 101A mounted thereto. Each of the robotic manipulatingarms 153 preferably includes alinkage 212 that constrains the movement of thesurgical tool 101 mounted thereto. More specifically,linkage 212 includes rigid links coupled together by rotational joints in a parallelogram arrangement so that the roboticsurgical tool 101A rotates around apoint 215 in space. At thepoint 215, the robotic arm can pivot the roboticsurgical tool 101A about apitch axis 215A and ayaw axis 215B. The pitch and yaw axes intersect at thepoint 215, which is aligned along ashaft 216 of roboticsurgical tool 101A. In the case of the IAB roboticsurgical tool 101A, the shaft is a hollow tube as is further discussed below. - The robotic arm provides further degrees of freedom of movement to the robotic
surgical tool 101A. Along aninsertion axis 215C, parallel to the central axis of theshaft 216 of the roboticsurgical tool 101A, the roboticsurgical tool 101A may slide into and out from a surgical site. The roboticsurgical tool 101A can also rotate about theinsertion axis 215C. As the roboticsurgical tool 101A slides along or rotates about theinsertion axis 215C, thecenter point 215 is relatively fixed with respect to thebase 218. That is, the entire robotic arm is generally moved in order to maintain or re-position back to thecenter point 215. - The
linkage 212 of therobotic arm 153 is driven by a series ofmotors 217 therein in response to commands from a processor or computer. Themotors 217 in the robotic arm are also used to rotate and/or pivot the roboticsurgical tool 101A at thepoint 215 around theaxes 215A-215C. If a roboticsurgical tool 101 further has end effectors to be articulated or actuated, stillother motors 217 in the robotic arm may be used to do so. A flow control system in the IAB roboticsurgical tool 101A may be actuated by these other motors in therobotic arm 153. However, alternative means may also be used to actuate or control the flow control system in the IAB roboticsurgical tool 101A. Additionally, the motion provided by themotors 217 may be mechanically transferred to a different location such as by using pulleys, cables, gears, links, cams, cam followers, and the like or other known means of transfer, such as pneumatics, hydraulics, or electronics. - For endoscopic surgical procedures, the
end effector 158 of therobotic arm 153 is often fitted with ahollow cannula 219. The shaft or tube of the roboticsurgical tool 101 may be inserted into thehollow cannula 219. Thecannula 219, which may be releasably coupled to therobotic arm 153, supports the shaft or tube of the roboticsurgical tool 101, preferably allowing the tool to rotate around theaxis 215C and move axially through the central bore of the cannula along theaxis 215C. - The robotic
surgical tools 101 are generally sterile structures, often being sterilizable and/or being provided in hermetically sealed packages for use. As the roboticsurgical tools 101 will be removed and replaced repeatedly during many procedures, a tool holder could potentially be exposed to contamination if the interface directly engages the tool holder. To avoid contamination to a tool holder and possible cross contamination between patients, an adaptor for coupling to roboticsurgical tools 101 is provided in a robotic arm of the robotic surgical manipulator. - Referring now to
FIGS. 2C, 2D , and 4B, the mounting of the irrigation/aspiration/blowing roboticsurgical tool 101A to anadapter 228 of the robotic surgical arm is now briefly described. - The robotic
surgical arm 153 may include anadapter 228 to which the IAB roboticsurgical tool 101A or othersurgical tool 101 may be mounted.FIG. 2D illustrates a front side of anexemplary adapter 228. The front side of the adaptor 128 is generally referred to as atool side 230 and the opposite side is generally referred to as a holder side (not shown). -
FIG. 4B illustrates a back side of an exemplary IAB roboticsurgical tool 400 as the IAB surgicalrobotic tool 101A. The roboticsurgical tool 400 includes an exemplarymountable housing 401 including aninterface base 412 that can be coupled to theadapter 228. Theinterface base 412 and theadapter 228 may be electrically and mechanically coupled together to actuate the flow control system of the IAB roboticsurgical tool 101A. Rotatably coupled to theinterface base 412 are one or more rotatable receivingmembers 418. Each of the one or more rotatable receivingmembers 418 includes a pair ofpins Pin 422A is located closer to the center of each rotatable receivemember 418 thanpin 422B. The one or more rotatable receivingmembers 418 can mechanically couple respectively to one or morerotatable drivers 234 of theadapter 228. The roboticsurgical tool 101A may further include release levers 416 to release it from theadapter 228. - The
interface base 412 may further include one or more electrical contacts or pins 424 to electrically couple toelectrical connector 242 of theadapter 228. Theinterface base 412 may further include a printedcircuit board 425 and one or moreintegrated circuits 426 coupled thereto and to the one or more pins 424. The one or moreintegrated circuits 426 may be used to identify the type of robotic surgical tool coupled to the robotic arm, so that it may be properly controlled by themaster control console 150. - The
adapter 228 includes one or morerotatable drivers 234 rotatably coupled to a floatingplate 236. Therotatable drivers 234 are resiliently mounted to the floatingplate 236 by resilient radial members which extend into a circumferential indentation about the rotatable drivers. Therotatable drivers 234 can move axially relative to floatingplate 236 by deflection of these resilient structures. - The floating
plate 236 has a limited range of movement relative to the surrounding adaptor structure normal to the major surfaces of the adaptor. Axial movement of the floating plate helps decouple therotatable drivers 234 from a roboticsurgical tool 101 when its release levers 416 are actuated. - The one or more
rotatable drivers 234 of theadapter 228 may mechanically couple to a part of thesurgical tools 101. Each of therotatable drivers 234 may include one ormore openings 240 to receive protrusions or pins 422 of rotatable receivingmembers 418 of the roboticsurgical tools 101. Theopenings 240 in therotatable drivers 234 are configured to accurately align with therotatable receiving elements 418 of thesurgical tools 101. - The
inner pins 422A and theouter pins 422B of therotatable receiving elements 418 respectively align with theopening 240A and theopening 240B in each rotatable driver. Thepins 422A andopenings 240A are at differing distances from the axis of rotation than thepins 422B andopenings 240B so as to ensure thatrotatable drivers 234 and therotatable receiving elements 418 are not aligned 180 degrees out of phase from their intended position. Additionally, each of theopenings 240 in the rotatable drivers may be slightly radially elongated so as to fittingly receive the pins in the circumferential orientation. This allows thepins 422 to slide radially within theopenings 240 and accommodate some axial misalignment between the tool and theadapter 228, while minimizing any angular misalignment and backlash between therotatable drivers 234 and therotatable receiving elements 418. Additionally, the interaction betweenpins 422 andopenings 240 helps restrain the roboticsurgical tool 101 in the engaged position with theadapter 228 until the release levers 416 along the sides of thehousing 401 push on the floatingplate 236 axially from the interface so as to release thetool 101. - When disposed in a first axial position (away from the tool side 230) the rotatable drivers are free to rotate without angular limitation. The one or more
rotatable drivers 234 may rotate clockwise or counter-clockwise to further actuate the systems and tools of the roboticsurgical instruments 101. However, as the rotatable drivers move axially toward thetool side 230, tabs (extending radially from the rotatable drivers) may laterally engage detents on the floating plates so as to limit the angular rotation of the rotatable drivers about their axes. This limited rotation can be used to help engage the rotatable drivers the rotating members of the tool as thepins 422 may push the rotatable bodies into the limited rotation position until the pins are aligned with (and slide into) the openings 140 in the rotatable drivers. - While
rotatable drivers 234 are described here, other types of drivers or actuators may be provided in theadapter 228 to actuate systems or tools of the roboticsurgical instruments 101. Theadapter 228 further includes anelectrical connector 242 to electrically couple tosurgical instruments 101. - The mounting of robotic
surgical tool 101A to theadapter 228 generally includes inserting the tip or distal end of the shaft or hollow tube of the robotic surgical tool through thecannula 219 and sliding theinterface base 412 into engagement with theadapter 228, as illustrated inFIG. 2C . Alip 232 on the tool side 130 of the adaptor 128 slidably receives the laterally extending portions of theinterface base 412 of the robotic surgical tool. Acatch 244 ofadapter 228 may latch onto the back end of theinterface base 412 to hold thetool 101A in position. The protrusions or pins 422 extending from the one or morerotatable members 418 of the robotic surgical tool couple into theholes 240 in therotatable drivers 234 of theadapter 228. - The range of motion of the
rotatable receiving elements 418 in the robotic surgical tool may be limited. To complete the mechanical coupling between the rotatable drivers of the adapter and therotatable receiving elements 418, the operator O at the surgicalmaster control console 150 may turn the rotatable drivers in one direction from center, turn the rotatable drivers in a second direction opposite the first, and then return the rotatable drivers to center. Further, to ensure that thepins 422enter openings 240 ofadapter 228, theadapter 228 andtool 101A mounted thereto may be moved along theaxis 215C. Theadapter 228 andtool 101A mounted thereto may be moved to an initial position so that the tip or distal end of the shaft or hollow tube is disposed within thecannula 219. - To dismount and remove the robotic
surgical tool 101A, the release levers 416 may be squeezed pushing out on themountable housing 401 to release thepins 422 from theholes 240 and thecatch 244 from the back end of the interface base. Themountable housing 401 is then pulled up to slide theinterface base 412 up and out from theadapter 228. Themountable housing 401 is continually pulled up to remove the tip or distal end of the shaft or hollow tube out from thecannula 219. After the roboticsurgical tool 101A is dismounted, another robotic surgical tool may be mounted in its place, including a new or freshly sterilized IAB roboticsurgical tool 101A. - As previously discussed, the robotic
surgical tool 101A may include one or moreintegrated circuits 426 to identify the type of robotic surgical tool coupled to the robotic arm, such that it may be properly controlled by themaster control console 150. However, the robotic surgical system may determine whether or not the robotic surgical tool is compatible or not, prior to its use. - The system verifies that the tool is of the type which may be used with the robotic
surgical system 100. The one or moreintegrated circuits 426 may signal to thecomputer 151 in themaster control console 150 data regarding compatibility and tool-type to determine compatibility as well as control information. One of theintegrated circuits 426 may include a non-volatile memory to store and read out data regarding system compatibility, the tool-type and the control information. In an exemplary embodiment, the data read from the memory includes a character string indicating tool compatibility with the roboticsurgical system 100. Additionally, the data from the tool memory will often include a tool-type to signal to the master control console how it is to be controlled. In some cases, the data will also include tool calibration information. The data may be provided in response to a request signal from thecomputer 151. - Tool-type data will generally indicate what kind of tool has been attached in a tool change operation. For example, the tool-type data might indicate that an IAB robotic
surgical instrument 101A has been mounted to the robotic arm. The tool-type data may include information on wrist axis geometries, tool strengths, grip force, the range of motion of each joint, singularities in the joint motion space, the maximum force to be applied via therotatable receiving elements 418, the tool transmission system characteristics including information regarding the coupling of rotatable receivingelements 418 to actuation or articulation of a system within the robotic surgical instrument. - Instead of storing all of the tool-type date in the one or more
integrated circuits 426, most of the tool-type data may optionally be stored in memory or a hard drive of thecomputer 151 in the roboticsurgical system 100. An identifier may be stored in the one or moreintegrated circuits 426 to signal thecomputer 151 to read the relevant portions of data in a look up table store in the memory or the hard drive of the computer. The tool-type data in the look-up table may be loaded into a memory ofcomputer 151 by the manufacturer of the roboticsurgical system 100. The look-up table may be stored in a flash memory, EEPROM, or other type of non-volatile memory. As a new tool-type is provided, the manufacturer can revise the look-up table to accommodate the new tool-specific information. It should be recognized that the use of tools which are not compatible with the robotic surgery system, for example, which do not have the appropriate tool-type data in an information table, could result in inadequate robotic control over robotic surgical tool by thecomputer 151 and the operator O. - In addition to the tool-type data, tool specific information may be stored in the
integrated circuit 426, such as for reconfiguring the programming ofcomputer 151 to control the tool. There may be calibration information, such an offset, to correct a misalignment in the robotic surgical tool. The calibration information may be factored into the overall control of the robotic surgical tool. The storing of such calibration information can be used to overcome minor mechanical inconsistencies between tools of a single type. For example, the tool-type data including the tool-specific data may be used to generate appropriate coordinate transformations and servo drive signals to manipulate the robotic arm and rotate therotatable drivers 234. - Additionally, some robotic surgical tools have a limited life span. Tool life and cumulative tool use information may also be stored on the tool memory and used by the computer to determine if the tool is still safe for use. Total tool life may be measured by clock time, by procedure, by the number of times the tool has been loaded onto a holder, and in other ways specific to the type of tool. Tool life data is preferably stored in the memory of the tool using an irreversible writing process.
- Referring now to
FIG. 3A , a perspective view of a robotic surgicalmaster control console 150 is illustrated. Themaster control console 150 of the roboticsurgical system 100 includes thecomputer 151, abinocular viewer 312, anarm support 314, amicrophone 315, a pair of control input wrists and control input arms in aworkspace 316, aspeech recognizer 317, foot pedals 318 (includingfoot pedals 318A-318B), and aviewing sensor 320. - The
computer 151 may include one ormicroprocessors 302 to execute instructions and astorage device 304 to store software with executable instructions that may be used to generate control signals to control the roboticsurgical system 100. Themaster control console 150 generates the control signals to control the fluid flows through the embodiments of the IAB robotic surgical instruments into and out of a surgical site. - The
viewer 312 has at least one display where images of a surgical site may be viewed to perform minimally invasive surgery. As discussed further below, theviewer 312 may be used to provide user-feedback to the operator O as to the control of the fluid flow through the IAB robotic surgical instruments into and out of a surgical site - The arm support 14 can be used to rest the elbows or forearms of the operator O (typically a surgeon) while gripping touch sensitive handles 325 (see
FIGS. 3B-3C ), one in each hand, of the pair ofcontrol input wrists 352 in theworkspace 316 to generate control signals. The touchsensitive handles 325 are positioned in theworkspace 316 disposed beyond thearm support 314 and below theviewer 312. - When using the master control console, the operator O typically sits in a chair, moves his or her head into alignment with the
binocular viewer 312, and grips the touchsensitive handles 325 of thecontrol input wrists 352, one in each hand, while resting their forearms against thearm support 314. This allows the touch sensitive handles to be moved easily in thecontrol space 316 in both position and orientation to generate control signals. - Additionally, the operator O can use his feet to control the foot-pedals to change the configuration of the surgical system and generate additional control signals to control robotic surgical instruments.
- To ensure that the operator is viewing the surgical site when controlling the robotic
surgical tools 101, themaster control console 150 may include theviewing sensor 320 disposed adjacent thebinocular display 312. When the system operator aligns his or her eyes with the binocular eye pieces of thedisplay 312 to view a stereoscopic image of the surgical worksite, the operator's head sets off theviewing sensor 320 to enable the control of the roboticsurgical tools 101. When the operator's head is removed the area of thedisplay 312, theviewing sensor 320 can disable or stop generating new control signals in response to movements of the touch sensitive handles in order to hold the state of the robotic surgical tools. - The
computer 151 with itsmicroprocessors 302 interprets movements and actuation of the touch sensitive handles 325 (and other inputs from the operator O or other personnel) to generate control signals to control the roboticsurgical instruments 101 in the surgical worksite. In one embodiment of the invention, thecomputer 151 and theviewer 312 map the surgical worksite into thecontroller workspace 316 so it feels and appears to the operator that the touchsensitive handles 325 are working over surgical worksite. - Referring now to
FIG. 3B , a perspective view of acontrol input wrist 352 with a touchsensitive handle 325 is illustrated. Thecontrol input wrist 352 is a gimbaled device that pivotally supports the touchsensitive handle 325 of themaster control console 150 to generate control signals that are used to control the roboticsurgical manipulator 152 and the roboticsurgical tools 101, including an IAB roboticsurgical tool 101A. A pair ofcontrol input wrists 352 are supported by a pair of control input arms in theworkspace 316 of themaster control console 150. - The
control input wrist 352 includes first, second, andthird gimbal members - The touch
sensitive handle 325 includes atubular support structure 351, afirst grip 350A, and asecond grip 350B. The first grip and the second grip are supported at one end by thestructure 351. The touchsensitive handle 325 can be rotated about axis G illustrated inFIGS. 3B-3C . Thegrips tubular structure 351. The “pinching” or grasping degree of freedom in the grips is indicated by arrows Ha,Hb inFIG. 3B and arrows H inFIG. 3C . - The touch
sensitive handle 325 is rotatably supported by thefirst gimbal member 362 by means of a rotational joint 356 g. Thefirst gimbal member 362 is in turn, rotatably supported by thesecond gimbal member 364 by means of the rotational joint 356 f. Similarly, thesecond gimbal member 364 is rotatably supported by thethird gimbal member 366 using a rotational joint 356 d. In this manner, the control wrist allows the touchsensitive handle 325 to be moved and oriented in theworkspace 316 using three degrees of freedom. - The movements in the gimbals of the
control wrist 352 to reorient the touch sensitive handle in space can be translated into control signals to control the roboticsurgical manipulator 152 and the roboticsurgical tools 101. In particular, the rotational motion of the touchsensitive handle 325 about axis G inFIGS. 3B-3C may be used to control the flow of fluids through the IAB robotic surgical tools. - The movements in the
grips sensitive handle 325 can also be translated into control signals to control the roboticsurgical manipulator 152 and the roboticsurgical tools 101. In particular, the squeezing motion of thegrips - In embodiments of the invention, one or a combination of both the rotational motion of the touch
sensitive handle 325 and the squeezing motion of thegrips sensitive handle 325 may be used for the control of irrigation while the squeezing motion of thegrips - To sense the movements in the touch sensitive handle and generate controls signals for the IAB robotic surgical tool, sensors can be mounted in the
handle 325 as well as thegimbal member 362 of thecontrol input wrist 352. Exemplary sensors may be a Hall effect transducer, a potentiometer, an encoder, or the like. - Referring now to
FIG. 3C , a cross-sectional view of the touchsensitive handle 325 andgimbal member 362 of thecontrol input wrist 352 is illustrated.FIG. 3C provides an example as to how the touchsensitive handle 325 can be mounted to thecontrol input wrist 352 to sense the gripping and rotation of the handle to control roboticsurgical tools 101, including IAB roboticsurgical tools 101A. - As illustrated in
FIG. 3C , theexemplary gimbal member 362 includes beveled gears 368 a, 368 b which can couple the rotational motion of the touchsensitive handle 325 to aroll sensor 370. Theroll sensor 370 may use a potentiometer orencoder 370 b included in aroll motor 370 a to sense the rotation. Alternatively, a separate roll sensor, such as a potentiometer, may be directly coupled to theshaft 380 to sense the rotation of the touch sensitive handle. In any case, a roll sensor senses the roll motion of the touchsensitive handle 325 and generates control signals in response thereto to control the roboticsurgical tools 101. The control of IAB roboticsurgical tools 101A using the roll motion of the touchsensitive handle 325 is discussed below with reference toFIG. 16A . - To sense a squeezing motion in the
grips sensitive handle 325, aremote sensing assembly 386 may be included by thegimbal member 362. The first andsecond grips surgical instruments 101. - In the exemplary embodiment, the
remote sensor assembly 386 includes acircuit board 394 on which a first and a second Hall effect sensors, HE1, HE2 are mounted. Amagnet 396 is disposed distally beyond thecircuit board 394 and the Hall effect sensors. Amagnetic mass 398 is axially coupled to the proximally orientedsurface 390 of a push rod 84. Thus, themagnetic mass 398 moves (as shown by Arrow J) with thepush rod 384 and varies the magnetic field at the Hall effect sensors in response actuation of thegrips - To translate the squeezing action of the
grips sensor 386, thegimbal member 362 includes apush rod 384 within thetubular handle structure 351. Each of thegrips respective pivot tubular handle structure 351. Urginglinks grips push rod 384. The squeezing action of thegrips push rod 384 by means of urginglinks FIG. 3C . A second end of thepush rod 384 couples to thesensor 386. As discussed previously, themagnetic mass 398 is axially coupled to thesurface 390 of thepush rod 384 in order to sense the linear motion in the push rod and the squeezing motion of thegrips - A biasing mechanism such as spring 392 applies a force against the squeezing motion of the grips to return them to full open when the grips are released. The biasing spring 392 may be a linear or non-linear elastic device biasing against the depression of
grips grips grips - It should be noted that a wide variety of alternative sensing arrangements may be used to translate the mechanical actuation of the touch sensitive handle and control input wrist into control signals. While Hall effect sensors are included in the exemplary embodiment, alternative embodiments may include encoders, potentiometers, or a variety of alternative optical, electrical, magnetic, or other sensing structures.
- A number of embodiments of irrigation/aspiration/blowing (IAB) robotic surgical tools that can be mounted to a robotic arm in a robotic surgical system are now described.
- Referring to
FIGS. 4A-4B , an irrigation/aspiration/blowing (IAB) robotic surgical tool orinstrument 400 is illustrated in greater detail than that ofinstrument 101A. In one embodiment of the invention, the IAB roboticsurgical instrument 400 has an interface that is backward compatible to theadapter 228 that is typically used for other types of robotic surgical instruments. In yet another embodiment of the invention, the IAB roboticsurgical instrument 400 has a reusable instrument housing with modular valve components that are disposable. In yet another embodiment of the invention, the entire IAB roboticsurgical instrument 400 is disposable. - The IAB robotic
surgical instrument 400 includes amountable housing 401 at a proximal end and ahollow tube 404 coupled together as shown inFIG. 4A . Themountable housing 401 maybe a reusable housing including some reusable components therein. Themountable housing 401 is backward compatible and includes aninterface base 412 that can couple to theadapter 228 to which other surgical tools may also couple. Themountable housing 401 may further include one ormore tube fittings 410A-410C, acover 414, and one or more release levers 416. - The
hollow tube 404 is elongated and has anopening 424 at itstip 406, the distal end of theinstrument 400. Thehollow tube 404 may also be referred to as a hollow instrument shaft or a hollow probe. Thehollow tube 404 may be reusable or disposable. Thehollow tube 404 maybe coupled to theinterface base 412 for additional support. Alternative, thehollow tube 404 may couple directly to a modular disposable valve subassembly and avoid coupling to the interface base such that it too is disposable. - In one embodiment of the invention, the
hollow tube 404 is a hollow circular cylindrical shape. Fluids (e.g., gas, liquid, with or without solids) may flow in thehollow tube 404 and into or out from a surgical site through theopening 424 at thetip 406. Thehollow tube 404 may further include one or moresmaller openings 422 around its circumference substantially near thetip 406 to further allow fluid to flow into and out of a surgical site. The diameter of theopening 424 may be substantially same as the inner diameter of thetube 404. In one embodiment of the invention, the diameter of thehollow tube 404 may be between 5 mm and 8 mm. Thehollow tube 404 may be formed out of metal, plastic or other rigid material that can be hollow to allow fluid to flow therein while being positioned within a patient's body at a surgical site or over a surgical area. - The
interface base 412 is used to mount theinstrument 400 to a robotic arm of a surgical robotic manipulator. Theinterface base 412 both mechanically and electrically couples the IAB roboticsurgical instrument 400 to a robotic arm of the surgicalrobotic manipulator 152. The release levers 416 are located at the sides of the mountable housing and may be used to release the roboticsurgical instrument 400 from a robotic arm. - A first end of the one or
more tube fittings 410A-410C may respectively couple to the one ormore hoses 106A-106C, respectively. The one ormore tube fittings 410A-410C may be barb fittings, luer fittings, or other types of hose or tube fittings. A second end of the one ormore tube fittings 410A-410C couples to aflow control system 417 within themountable housing 401. In some embodiments of the invention, the one ormore hoses 106A-106C may directly couple to the flow control system without the one ormore tube fittings 410A-410C. The end of thehollow tube 404 opposite thetip 406, also couples to theflow control system 417. - The
flow control system 417 controls the flow of fluids, including any solids that may be transported by the fluid, between the surgical site and the one ormore hoses 106A-106C through the IAB roboticsurgical instrument 400. Theflow control system 417 may include one or more valves of a valve subassembly to control the flow of fluids and any solids that may be transported by the fluid. Note that a fluid may be a liquid, a gas, a vacuum, or any combination thereof. Theflow control system 417 may be controlled by control signals generated by an operator O at themaster control console 150 to control the fluid flow through the IAB roboticsurgical instrument 400. In addition to robotic control, a number of embodiments of the invention include an optional manual actuation of the valves of the IAB roboticsurgical instrument 400. In which case, either an assistant A can manually operate theflow control system 417 and control the fluid flow or the operator O at themaster control console 150 may robotically operate theflow control system 417 to control the fluid flow through the IAB roboticsurgical instrument 400. The operator O at themaster control console 150 can position the IAB roboticsurgical instrument 400 where the operator wants it within the surgical site. Then, to free up the operator's hands to perform some other task at the master control console, the IAB roboticsurgical instrument 400 may be controlled manually by an assistant, remaining attached to a robotic arm. The operator can then give verbal instructions to the assistant to manually control the irrigation/suction/blowing in the surgical site selected by the operator. - The
cover 414 covers over to protect theflow control system 417 such as a valve subassembly from damage and to maintain a sterile surgical environment during surgery. As thesurgical instrument 400 is used during an operation or surgery at a surgical site of human patient, it is important that its components be sterilized. - As body fluids of a human patient will be flowing through the
surgical instrument 400 during use, it may be desirable to re-sterilize the IAB robotic surgical tool for reuse. However, it may be difficult to re-sterilize portions of theflow control system 417, such as valves, within the IAB roboticsurgical tool 400. Thus, portions of theflow control system 417 may be replaced instead of sterilized after usage. If components forming the IAB roboticsurgical instrument 400 are relatively inexpensive, the IAB roboticsurgical instrument 400 may be discarded in its entirety instead of re-sterilzing or replacing components. -
FIG. 4B illustrates a back side view of a portion of the IAB roboticsurgical tool 400, some elements of which were previously discussed. In particular, theinterface base 412 is illustrated with rotatable receivingelements 418 rotatably coupled thereto. Therotatable receiving elements 418 provide a mechanical coupling to therotatable drivers 234 and drive motors mounted of the roboticsurgical manipulator 152. Each of therotatable receiving elements 418 include a pair ofpins 422 extending from a surface thereof. Aninner pin 422A is closer to an axis of rotation of each rotatable receivingelements 418 than anouter pin 422B, which helps to ensure positive angular alignment of therotatable receiving elements 418. In one embodiment of the invention, therotatable receiving elements 418 are disk shaped and may be referred to as rotatable disks. - The
interface base 412 further includes an array of electrical connectingpins 424 and one or moreintegrated circuits 426 coupled to a printedcircuit board 425 within themountable housing 401. As theinterface base 412 is backward compatible to theadapter 228, it maybe mechanically actuated by pre-existing driver motors found in the roboticsurgical manipulator 152. While theinterface base 412 has been described herein with reference to mechanical and electrical coupling elements, it should be understood that other modalities maybe used, including infrared coupling, magnetic coupling, inductive coupling, or the like. - Referring now to
FIGS. 5A-5D , schematic flow diagrams of roboticsurgical tools 500A-500D are respectively illustrated to provide irrigation, suction, blowing, or any combination thereof within a surgical site. -
FIG. 5A is a schematic flow diagram of an irrigation/aspiration roboticsurgical tool 500A that uses a pair of valves mounted within ahousing 501A. Thetool 500A includes thehollow tube 504, avalve subassembly 506, a three-way coupler 508, andtube fittings 509A-509B. Thetube fittings 509A-509B may have anirrigation hose 106A and asuction hose 106B respectively coupled thereto. - The
valve subassembly 506 includes a first two-way two-position valve 510A and a second two-way two-position valve 510B. After use, thevalve subassembly 506 may be removed and replaced by a new sterilized valve subassembly for reuse of thetool 500A. The valves are a component of the tool that is more difficult to clean and sterilize for reuse. - Each of the two
way valves 510A-510B includes two ports. A first port couples to the three-way coupler 508 while a second port couples to thefittings way coupler 508 includes three ports one of which is coupled to thehollow tube 504. The second port of the three-way coupler couples to a port of thevalve 510A. A third port of the three-way coupler 508 couples to a port of thevalve 510B. - A fluid may flow in or out of the
hollow tube 504 as illustrated by the double-headed arrow near the tip. Eithervalve hollow tube 504. Withvalve 510B open andvalve 510A substantially closed, a suction may be applied near the tip of thesurgical instrument 500A so that a surgical site may be aspirated. Withvalve 510B substantially closed andvalve 510A open, a liquid may flow through thesurgical instrument 500A out through thehollow tube 504 into a surgical site so that it may be irrigated. The liquid is coupled to thesurgical instrument 500A by thehose 106A. -
FIG. 5B is a schematic flow diagram of an irrigation/aspiration roboticsurgical tool 500B that uses a single valve mounted within ahousing 501B to provide irrigation, or aspiration. Thesurgical instrument 500B includes a single three-way valve 516 with three ports, thehollow tube 504, and thetube fittings 509A-509B. The threeway coupler 508 is not needed. - The three-
way valve 516 has three ports. A first port of the three-way valve couples to the proximal end of thehollow tube 504. A second port couples to the tube fitting 509A that may couple to thehose 106A. A third port of thevalve 516 couples to the tube fitting 509B that may in turn couple tohose 106B. - The three-
way valve 516 has three-positions of operation. In a closed position, the valve is completely shut off so that no fluid flows through thehollow tube 504. In a second position suction is shut off, the first port and the second port of the valve couple together such that the surgical site may be irrigated by a liquid flowing throughvalve 516 and into thehollow tube 504. In a third position irrigation is shut off, the first port and the third port of the valve couple together such that a vacuum or a suction may flow throughvalve 516 and a surgical site may be aspirated at the tip of thehollow tube 504. -
FIG. 5C is a schematic flow diagram of an irrigation/aspiration/blowing roboticsurgical tool 500C that uses a single valve mounted within ahousing 501C to provide irrigation, aspiration or blowing. Thesurgical instrument 500C includes a single four-way fourposition valve 526, thehollow tube 504, and thetube fittings 509A-509B coupled together as illustrated in themountable housing 501C. A fourway coupler 508 is not needed. - The single four-
way valve 526 includes four ports. A first port of the four-way valve 526 couples to the proximal end of thehollow tube 504. A second port of thevalve 526 couples to one end of the tube fitting 509A. A third port of thevalve 526 couples to an end of the tube fitting 509B. A fourth port of thevalve 526 couples to an end of the tube fitting 509C.Hoses 106A-106C may respectively couple to thetube fittings 509A-509C. In this manner three of the four ports ofvalve 526 may receive a liquid for irrigation, a vacuum for suction and a pressurized gas for blowing, respectively. - The four-
way valve 526 has four positions of operation. In a closed position, the valve is completely shut off so that no fluid flows through thehollow tube 504. In a second position suction/blowing are shut off, the first port and the second port of the valve couple together such that the surgical site may be irrigated by a liquid flowing throughvalve 526 and into thehollow tube 504. In a third position irrigation/suction are shut off, the first port and the third port of the valve couple together such that a pressurized gas may flow throughvalve 516 and out through the tip of thehollow tube 504 to blow a surgical site with a pressurized gas. In a fourth position irrigation/blowing are shut off, the first port and the fourth port of the valve couple together such that a vacuum may provide suction through thevalve 516 and thehollow tube 504 to a surgical site to remove fluids and solids transported therein at the tip of thehollow tube 504. -
FIG. 5D is a schematic flow diagram of an irrigation/aspiration/blowing roboticsurgical tool 500D that uses three two-way valves in a valve subassembly mounted within ahousing 501D to provide irrigation, aspiration or blowing. The roboticsurgical instrument 500D includes a valve subassembly 536, a four-way coupler 538, thehollow tube 504, and thetube fittings 509A-509C. Thetube fittings 509A-509C may couple to thehoses 106A-106C, respectively. - In place of the four-
way valve 526 illustrated inFIG. 5C , the valve subassembly 536 includes three two-way two-position valves 510A-510C of a valve subassembly 536 in conjunction with a four-way coupler 538. In comparison with thetool 500A ofFIG. 5A , a third two-way valve 510C is provided so that a third fluid may flow into and out of thehollow tube 504. In this case, a pressurized gas may be supplied byhose 106C, flow throughvalve 510C when opened, flow through the fourway coupler 538, and into thehollow tube 504 to blow a pressurized gas near the surgical site. - Each of the two way two
position valves 510A-510C includes two ports. A first port of each couples to respective ports of the four-way coupler 538 while a second port of each couples to thefittings way coupler 538 includes four ports one of which is coupled to thehollow tube 504. The second port of the four-way coupler 538 couples to a port of thevalve 510A. A third port of the four-way coupler 538 couples to a port of thevalve 510B. A fourth port of the four-way coupler 538 couples to a port of thevalve 510C. - Valve subassembly 536 may be replaceable with a sterile component while the other elements mounted in the
housing 501D may be separately sterilized and reused with a new valve subassembly 536. - Various types of valves may be used as part of the
flow control system 417 in the IAB roboticsurgical instrument surgical manipulator 152. While three-way and two-way valves have been separately shown and described, any mixed combination of one or more two-way valves and one or more three-way valves, or other multi-port valve, may be used within an IAB robotic surgical instrument with different types of couplers to provide a flow control system therein. For example, an IAB robotic surgical instrument may include a three-way valve 516 for gas pressure and suction and a two-way valve 510A for irrigation by a liquid coupled to a three-way coupler 508, which is in turn coupled to thetube 504. - Moreover, the valves used in the flow control system may be automatically returned to a closed position so that no fluid flows through the IAB robotic surgical tool when it is dismounted from the robotic arm or when the modular valve assembly is not mounted in the housing of the tool. That is, the valves may be spring loaded by a spring to return to a closed or fully off position when they are not actuated.
-
FIGS. 6A-6C , 7A-7C, 8, 9 and 10A-10B illustrate some of the various types of valves, various types of actuation means, and various types of automatic return means that may be used to control the flow of fluids through the robotic surgical instrument and into the surgical site. It is understood that other types of valves, actuation means, and automatic return means may be used to provide flow control for a flow control system of an IAB robotic surgical tool. - Referring now to
FIGS. 6A-6C , rotational actuators to actuate rotatable valves are illustrated for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm. - In
FIG. 6A , therotatable receiving element 418A is directly coupled to therotatable valve 604A. As therotatable receiving element 418A is rotated, a shaft of the rotatable valve rotates to a different position in order to open or close the valve and control the flow of fluids. For actuation, therotatable receiving element 418A couples to therotatable driver 234 of theadapter 228 in the robotic arm. Thepins 422A-422B of therotatable receiving element 418A couple into therespective openings 240A-240B of theadapter 228. Acoil spring 606 may be used to return therotatable valve 604A to a closed or shut off position when the roboticsurgical tool 101A is dismounted from the robotic arm. - In
FIG. 6B , arotatable receiving element 418B rotatably couples to therotatable valve 604B through a gearing provided by the gears 610-611. Therotatable receiving element 418B similarly couples to therotatable driver 234. Therotatable receiving element 418B includes thegear 610 which also may be referred to as adriving gear 610.Valve 604B includes thepinion gear 611 coupled to ashaft 602 of the rotatable valve in order to rotate the valve from one position to another. The gearing may be use to reduce or increase the rotation in thedriver gear 610 to rotate the valve. Therotatable receiving element 418B may further include thecoil spring 606 to return the three-way fourposition valve 604B to a shut off position. Therotatable valve 604B is a three-way valve including three ports and has three positions. - In
FIG. 6C , therotatable receiving element 418C is linked to therotatable valve 604C by means of alinkage 620. Therotatable receiving element 418C includes a drive wheel with anotch 622 to receive a distal end of thelinkage 620. Therotatable valve 604C is a three-way three position valve. Therotatable receiving element 418C may move thevalve 604C into one of three positions. Inposition 620A, the valve may be shut off so that no fluid flows through the roboticsurgical tool position 620B, a first fluid may flow between a first port and a second port. Inposition 620C, a second fluid may flow between the first port and a third port. - To change positions of the valve using the
linkage 620, therotatable receiving element 418C may be moved counter clockwise, while the valve rotates clockwise. If therotatable receiving element 418C moves clockwise, thelinkage 620 causes the valve to rotate counter clockwise. To actuate the rotatable valve, therotatable receiving element 418C couples to therotatable driver 234 by means of thepins 422A-422B coupling into the opening 240A-240B respectively. -
FIGS. 7A-7C illustrate the linear actuation of linear motion valves that may be used in theflow control system 417 of IAB robotic surgical tools. The dashed lines shown inFIGS. 7A-7C illustrate a dividing line between the roboticsurgical tool surgical arm 153. - In
FIG. 7A , apush rod 702 is linearly actuated in therobotic arm 153. One end of thepush rod 702 pushes on abutton 703 of a linearmotion trumpet valve 704A to move aplunger 705 therein. Thetrumpet valve 704A is a two-way two-position valve. Theplunger 705 in its closed position blocks the first and second ports of thetrumpet valve 704A. When the valve is linearly pushed open, aspring 706 is compressed and the plunger moves to aposition 705′ such that the first and second ports are open to pass a fluid. - The
push rod 702 may be linearly actuated in robotic arm in a number of ways including, but not limited to, pneumatically, hydraulically, electromechanically, or electrically. For example, asolenoid 701 may be used to linearly actuate thepush rod 702 to linearly move thevalve 704A to an open position. When thepush rod 702 is not actuated, the force of thespring 706 may push back on thepush rod 702 and return the plunger of the valve to aclosed plunger position 705 to shut off the first and second ports and stop a flow of a fluid. Thespring 706 may also retain the plunger of the valve in aclosed plunger position 705 to shut off the first and second ports when the IAB robotic surgical tool is dismounted. - In
FIG. 7B , aspool valve 704B linearly moves in response to a magnetic force generated by theelectromagnet 710 in therobotic arm 153. Theelectromagnet 710 may be formed out of coil ofwire 711 wrapped around amagnetic core 712. When no electromagnetic field is generated by theelectromagnet 710, aspring 706 keeps thespool 715 in a closed position blocking the first and second ports of thespool valve 704B. To actuate the spool valve, theelectromagnet 710 is actuated to pull thespool 715 in a linear motion intoposition 715′ so that the center hourglass portion of thespool 715 is coincident with the first and second ports to allow fluid to flow through thevalve 704B.Spring 706 is compressed with the spool inposition 715′ such that when the electromagnetic force of theelectromagnet 710 is released thespring 706 pushes back on thespool 715 to close off thevalve 704B. - In
FIG. 7C , a three-way spool valve 704C is electrically actuated by therobotic arm 153 to move thespool 725 with a linear motion.Electrical contacts 242 in therobotic arm 153 couple to thepins 424 of the roboticsurgical tool spool 725, three ports, afirst spring 706A at a first end, and asecond spring 706B at a second end, a first wire coil 710A at the first end, and a second wire coil 710B at the second end. A current in thewires 721A may flow through the coil 710A to attract thespool 725 towards the first end of the valve so that theports wires 721A is turned off and thespool 725 is pushed back into the closed position by the force ofspring 706A.Springs 706A-706B maintain the spool in the center position shutting off the three ports in the valve from each other. By providing a current in thewires 721B and thecoil 720B, thespool 725 is moved towards the second end and compresses thespring 706B. This allows the center hourglass portion of thespool 725 to coincide with thesecond port 727 and thethird port 728 to allow a fluid to flow there-between. To shut off the valve, the current flow in thewires 721B is turned off and thespring 706B pushes thespool 725 back to its closed position. - Referring now to
FIG. 8 , a linear actuation is transformed into a rotational actuation for a rotatable valve by a rack and pinion gear system. When activated, apush rod 702 linearly pushes against abutton 803 of therack 801 in order to linearly move itsteeth 810 and provide the initial linear actuation. Theteeth 810 of therack 801 are meshed with thepinion gear 811 to transform the initial linear actuation of the push rod into a rotational actuation. The pinion gear is coupled to ashaft 802 of therotatable valve 804. As the teeth of therack 801 linearly move, thepinion gear 811 transforms the linear motion into a rotational motion in order to rotate therotatable valve 804 between open and closed positions to control the fluid flow. - A spring may be coupled between an end of the
rack 801 and a stop in order to linearly push on the rack and rotate and maintain the valve in a closed position when the IAB robotic surgical tool is dismounted. - In addition to being robotically controlled from the
master control console 150, the valves of theflow control system 417 of the IAB robotic surgical tools may also be manually controlled. Manual actuators may be provided that extend external to the housing so that a user's hand may open and/or close the valves. - Referring now to
FIGS. 9A-9B , a rotational actuation is transformed into linear actuation by a cam and cam follower system for actuation of a linearmotion trumpet valve 704A.Trumpet valve 704A illustrated inFIGS. 9A-9B operates similarly totrumpet valve 704A ofFIG. 7A but with acam follower 903 in place of thebutton 703 to better couple to therotating cam 902. Additionally, thecam follower 903 ofFIG. 9A may further include amanual push arm 913 that may extend for a top side of a housing of the IAB robotic surgical tools for manual operation of thetrumpet valve 704A. Thecam follower 903 ofFIG. 9B may further include a manualpush side arm 923 that may extend for a side of a housing of the IAB robotic surgical tools for manual operation of thetrumpet valve 704A. - The
rotatable receiving element 418D of the IAB robotic surgical tools is coupled to thecam 902. For robotic control from themaster control console 150, therotatable receiving element 418D couples to therotatable driver 234 by means of thepins 422A-422B within theopenings 240A-240B, respectively. - The
cam 902 includes acam lobe 904 that pushes on thecam follower 903 to aposition 903′ so that theplunger 705 is moved to anopen position 705′. In theopen position 705′, the plunger allows the first and second ports to couple together and allow a fluid to flow there-between. As the cam rotates to move the cam lobe to a different position so that the cam follower can move back to itsoriginal position 903, thespring 706 pushes on theplunger 705 to move it back into the closed position to close thevalve 704A. - The
cam 902 may rotate clockwise or counterclockwise so that the cam follower transforms a rotational motion into a linear motion to open and close thevalve 704A. In this manner, a rotational actuation within the roboticsurgical tool trumpet valve 704A. A coil spring may be coupled around the shaft of the cam 901 in order to rotate it so that the valve can close when the IAB robotic surgical tool is dismounted. - With the
cam 902 rotated to a position so that thevalve 704A is closed, the valve may be manually operated. To manually operatevalve 704A, a user pushes on themanual push arms manual push arms cam follower 903, the force applied thereto manually forces open thevalve 704A. This decouples thecam follower 903 from thecam 902. To close thevalve 704A, a user releases the force applied to themanual push arms spring 706 to push back out theplunger 705 into a closed position and shut off the valve. - Referring now to
FIGS. 10A-10B ,pinch valves 1004A-1004B for use in the flow control system of IAB robotic surgical tools are illustrated. Thepinch valves 1004A-1004B are used to pinch closed ahose - In
FIG. 10A , arotary pinch valve 1004A is illustrated to pinch closed ahose 1002 and can be rotated to release and open thehose 1002. Without thehose 1002 pinched off, a fluid is allowed to flow therein and through the IAB robotic surgical tools. Therotary pinch valve 1004A pinches thehose 1002 closed against abackstop 1005 to shut off the flow of fluids. Thehose 1002 may be a silicon rubber hose that is flexible in order that it may be readily pinched off and stop the fluid flow therein and flex back when released. - The
rotary pinch valve 1004A is coupled to a shaft of therotatable receiving element 418E to receive a rotational actuation. Therotatable receiving element 418E may couple to therotatable driver 234 in a similar fashion as previously described withpins 422A-422B inserted into therespective openings 240A-240B. - The
rotary pinch valve 1004A includes arotatable pinch arm 1020 and apinch roller 1022 coupled to the distal end of therotatable pinch arm 1020. Therotary pinch valve 1004A may further include aspring 1006 coupled to therotatable receiving element 418E in order to bias the pinch valve to a closed position and pinch off the hose when thesurgical tool - In the closed position, the
pinch roller 1022 pinches off thehose 1002 against thebackstop 1005. In rotating thepinch valve 1004A and the rotatable pinch arm from the closed position to aposition 1020′, the pressure against thehose 1002 is released such that it flexes open and allows fluid to flow therein. - In
FIG. 10B , alinear pinch valve 1004B is illustrated to pinch closed ahose 1002′. Thelinear pinch valve 1004B can be moved linearly to release and open thehose 1002′. Without thehose 1002′ pinched off, a fluid is allowed to flow therein and through the IAB robotic surgical tools. Thelinear pinch valve 1004B pinches thehose 1002′ closed against abackstop 1015 to shut off the flow of fluids. Thehose 1002′ may be a silicon rubber hose that is flexible in order that it may be readily pinched off and stop the fluid flow therein and flex back when released. - A
push rod 702 may be provided in therobotic arm 153 to provide linear actuation of thelinear pinch valve 1004B. Thepush rod 702 pushes on abutton 1013 to aposition 1013″, compressing aspring 1016, and linearly moving thelinear pinch valve 1004B and alinear pinch arm 1030 to position 1030′ to release thehose 1002 from thebackstop 1015. With thelinear pinch arm 1030 in theopen position 1030′, the linear pinch valve is open and fluid can flow within thehose 1002′. Upon releasing the linear force provided by thepush rod 702 within therobotic arm 153, thespring 1016 forces back thelinear pinch arm 1030 of thelinear pinch valve 1030 to squeeze thehose 1002 against thebackstop 1015. In this manner, a linear actuating motion of thepush rod 702 can activate alinear pinch valve 1004B. -
FIGS. 11A-15B illustrate exemplary embodiments of IAB robotic surgical tools including varying types of flow control systems. - Referring now to
FIGS. 11A-11E , irrigation/aspiration/blowing robotic surgical tools having a flow control system with a solid valve body are now discussed. -
FIG. 11A illustrates a top perspective view of an IAB robotic surgical tool 1100 with its cover removed to show theflow control system 417 therein. The IAB robotic surgical tool 1100 employs asolid valve body 1101. Thesolid valve body 1101 is a three-dimensional solid body that includes hollow passages with open ports therein and a pair of valve openings to receive a pair ofrotatable valves 1104A-1104B. In one embodiment of the invention, thesolid valve body 1101 is a polyhedron shaped solid body. - With a solid valve body, the
flow control system 417 of the IAB robotic surgical tool 1100 is relatively inexpensive to manufacture such that theflow control system 417 may be discarded after use, instead of cleaned or sterilized. The remaining components of the tool 1100 may be cleaned and re-sterilized. Alternatively, the IAB robotic surgical tool 1100 is also relatively inexpensive to manufacture such that it may be discarded in its entirety after usage. - A first port of the
solid valve body 1101 couples to the proximal end of thehollow tube 404. Second and third ports of thesolid valve body 1101 may couple to thehose fittings 410A-410B. Thehose fittings 410A-410B may respectively couple tohoses 106A-106B. Thesolid valve body 1101 includes a three-way passage 1106 coupled between the proximal end of thehollow tube 404 and first ports ofrotatable valves 1104A-1104B. Thesolid valve body 1101 further includespassages 1108A-1108B coupled between second ports of therotatable valves 1104A-1104B and thehose fittings 410A-410B, respectively. Therotatable valves 1104A-1104B are two-way two-position valves and each have an open flow channel that can be rotated and switched open or closed between the ports to therespective passages 1108A-1108B and the ports to the three-way passage 1106. - Although a third valve and a third set of passages are not illustrated in
FIG. 11A , it is understood that it may be provided to provide flow control for a third type of fluid. - The
hollow tube 404 is mechanically supported in the mountable housing by having an end coupled into the first port of thesolid valve body 1101. Thehollow tube 404 maybe further supported mechanically by being inserted into a bushing that is supported within thecollar 1102 of theinterface base 412. As previously discussed, thehollow tube 404 has anopening 424 at itstip 406. Thehollow tube 404 may further have openings around its circumference near itstip 406. - The
solid valve body 1101 may be fitted to theinterface base 412 so that it is readily replaceable. Thehollow tube 404 may be fitted with a quick release fitting to thesolid valve body 1101 so that it can be readily re-sterilized and reused. - Referring now to
FIG. 11B , a bottom exploded view of the IAB robotic surgical tool 1100 is illustrated. As illustrated byFIG. 11B , thesolid valve body 1101 includesvalve openings 1109A-1109B to receive therotatable valves 1104A-1104B, respectively. Thevalve openings 1109A-1109B in the solid valve body may include threads or rings to allow therotatable valves 1104A-1104B to rotate in a fixed axial position with respect to thepassages - Coupled to one end of a
cylindrical shaft 1105 of each of therotatable valves 1104A-1104B is arotatable receiving element 418 withpins 422A-422B. Therotatable receiving element 418 of therotatable valves 1104A-1104B may further include atab 1114 to abut against a stop within theinterface base 412. - Elements of the
rotatable valves 1104A-1104B may be molded together as one piece to further lower the cost of manufacture of the flow control system. Asvalves 1104A-1104B are substantially similar, a further detailed description ofvalve 1104A is only provided withvalves 1104A-1104B being collectively referred to asvalves 1104. - In the
cylindrical shaft 1105 of thevalves 1104 is theflow channel 1110. Theflow channel 1110 of therotatable valves 1104 may be a slanted opening through the cylindrical shaft. Theflow channel 1110 of therotatable valves 1104 may be a slanted opening through the cylindrical shaft. Wrapped around the cylindrical shaft are one ormore seals 1112 to seal off theflow channel 1110 within thevalve body 1101. Aslanted seal 1113 may be provided above the slanted opening of theflow channel 1110. In an alternate embodiment of the invention, an additionalslanted seal 1113 may be provided below the slanted opening of theflow channel 1110. Thecylindrical shaft 1105 has circumferential channels to respectively receive a portion of the one ormore seals 1112. Thecylindrical shaft 1105 has one or more slanted channels in its cylindrical surface to respectively receive a portion of the one or moreslanted seals 1113. The channels in theshaft 1105 keep the seals in position as the valve is moved. - Referring now to
FIG. 11C , a cross section of one of therotatable valves 1104 is illustrated in a closed position. As discussed previously, therotatable valve 1104 includes thecylindrical shaft 1105 coupled at one end to therotatable receiving element 418. - The
cylindrical shaft 1105 includes theflow channel 1110. Theflow channel 1110 has afirst port 1110A at one end and asecond port 1110B at a second end. As discussed previously, theflow channel 1110 may be slanted from thefirst port 1110A to thesecond port 1110B. Asvalve 1104 is in a closed position inFIG. 11C , neither thefirst port 1110A nor thesecond port 1110B of theflow channel 1110 matches the ports into thepassages cylindrical shaft 1105 further includes one ormore seals 1112 near top and bottom portions to seal off theflow channel 1110 in thesolid body 1101. Thecylindrical shaft 1105 further includes the slantedseal 1113 between atop seal 1112 and the slantedflow channel 1110 to further seal the rotatable valve within thesolid body 1101. - The slanted
seal 1113 around thecylindrical shaft 1105 allows for relaxed tolerances between therotatable valve 1104 and thesolid valve body 1101. In particular, the slantedseal 1113 allows for a larger radial gap between thecylindrical shaft 1105 of thevalve 1104 and thesolid valve body 1101 while maintaining a leak-less seal. While the top andbottom seals 1112 seal the valve 1404 with respect to the valve body, the slantedseal 1113 seals the flow of fluids through thechannel 1110. The slantedseal 1113 seals the flow of fluids through thechannel 1110 over the range of positions of thevalve 1104, from a fully closed position to a fully open position. The slantedseal 1113 particularly prevents leakage when thevalve 1104 is in the closed position. - In an alternate embodiment of the invention, the
channel 1110 in thecylindrical shaft 1105 is replaced by narrowing the center diameter portion of thecylindrical shaft 1105 between theslanted seal 1113 and thebottom seal 1112, such as into an hour glass shape, to form a channel for fluid flow when thevalve 1104 is moved from a closed position. In this case, the slantedseal 1113 forms an end portion of the channel. - The
hollow tube 404 couples to a port of the three-way passage 1106. Thehose fittings passages hose fittings hollow tube 404 may be press fitted into thesolid valve body 1101 or have threads to be screwed into and mate with threads inpassages solid valve body 1101. - Referring now to
FIG. 11D , a cross section of one of therotatable valves 1104 is illustrated in an open position. With therotatable valve 1104 in an open position, a fluid can flow between thehollow tube 404 and one of thehose fittings solid valve body 1101 and theflow channel 1110. - In comparison with
FIG. 11C , theflow channel 1110 in thecylindrical shaft 1105 is reoriented to a position where itsfirst port 1110A matches a port of the three-way passage 1106 and itssecond port 1110B matches a port of thepassage way passage 1106, through theflow channel 1110, into thepassage passage flow channel 1110, into the threeway passage 1106 and out from thehollow tube 404. -
FIGS. 11C-11D illustrate one ormore seals 1112 near top and bottom portions of theshaft 1105 and the slantedseal 1113 in parallel with the slantedflow channel 1110 to seal therotatable valves 1004A-1104B in thesolid body 1101. - The
rotatable valves rotatable valve 1104A may open using a counterclockwise rotation whilerotatable valve 1104B opens using a clockwise rotation, for example. - With a
solid valve body 1101 and one piecerotatable valves 1104, theflow control system 417 can be made relatively inexpensive such that it can be readily discarded with or without other components of the surgical tool 1100. - As discussed previously, the valves of the
flow control system 417 of the IAB robotic surgical tools may also be manually controlled with manual actuators. Additional manually controlled valves may also be provided in parallel with robotically controlled valves in the flow control system in order to both manually and robotically control the fluid flows through an IAB robotic surgical instrument. Manual actuators are coupled to the manually controlled valves to extend external to the housing of the IAB robotic surgical tools so that a user's hand may open and/or close the valves. - Referring now to
FIG. 11E , thesolid valve body 1101 has been modified tosolid valve body 1101′ that includes manually controlledvalves 1124A-1124B in parallel with the respective robotically controlledvalves 1104A-1104B in order that the fluid flows through the IAB roboticsurgical instrument 1100B may be controlled manually by hand and robotically from amaster control console 150. The manually controlledvalves 1124A-1124B are trumpet valves, a type of valve such as illustrated inFIG. 7A and previously described. Thevalves 1124A-1124B each include abutton 1125 on top that extends out from thehousing 401 through the cover 414 (not illustrated inFIG. 11E ), such as illustrated inFIG. 13B . However, thetrumpet valves 1124A-1124B are two-way two position valves that are linearly actuated by a finger or hand pushing on the button to open the valve and allow fluid to flow. As invalve 704A, each of the manually controlledvalves 1124A-1124B includes aspring 706 to return the valve to a closed position when the force is released from thebutton 1125. (seeFIG. 7A ). Thebutton 1125 is similar to thebutton 703 of thevalve 704A illustrated inFIG. 7A . - To support the
valves 1124A-1124B, the twoway passages 1108A-1108B and the threeway passage 1106 in thesolid valve body 1101 illustrated inFIG. 11A are modified respectively into threeway passages 1108A′-1108B′ and a fiveway passage 1106′ of thesolid valve body 1101′ illustrated inFIG. 11E . The fiveway passage 1106′ includes one or moreparallel passages 1126 to a port of thevalves 1124A-1124B. That is, the fiveway passage 1106′ has a first port to couple to thetube 404, a second port and a third port to respectively couple tovalves valves 1124A-1124B. The threeway passages 1108A′-1108B′ each include aside passage 1128 to a port of thevalves 1124A-1124B. The threeway passage 1108A′ has a first port to couple to thevalve 1104A, a second port to couple to thevalve 1124A, and a third port to couple to the hose fitting 410A. The threeway passage 1108B′ has a first port to couple to thevalve 1104B, a second port to couple to thevalve 1124B, and a third port to couple to the hose fitting 4101B. Thesolid valve body 1101′ further includes an additional pair of valve openings to receive thespring 706 and theplunger 705 of thetrumpet valve 704A. Additional seals may be provided around the shaft between theplunger 705 and thebuttons - Otherwise, the modified
solid valve body 1101′, including the structure and function of thevalves 1104A-1104B, is similar to that of thesolid valve body 1101 illustrated byFIGS. 11A-11D and described previously. - Referring now to
FIG. 12 , a top perspective view of an IAB roboticsurgical tool 1200 is illustrated with its cover over the mountable housing removed. The IAB roboticsurgical tool 1200 includes amodular valve subassembly 1201. After being used once, themodular valve assembly 1201 andcoupling hoses 1208A-1208B are readily replaceable with new used components. The remaining portion of thetool 1200 may be re-sterilized and then reused with a newmodular valve assembly 1201 andcoupling hoses 1208A-1028B. Themodular valve subassembly 1201 is mountable to and dismountable from theinterface base 412. Abase 1211 of themodular valve subassembly 1201 may press fit into place to mount the valve subassembly to theinterface base 412. Thebase 1211 of themodular valve subassembly 1201 includes recesses for rigid attachment of the ports of thevalves 1204A-1204B and the ports of thehose fittings 410A-410B.Hoses 106A-106B may be coupled to ends of thehose fittings 410A-410B. The control and actuation of therotatable valves 1204A-1204B was previously described with reference toFIG. 6A and therotatable valve 604A. - The modular valve subassembly includes a first
rotatable valve 1204A and a secondrotatable valve 1204B. Each of thevalves 1204A-1204B are two-way, two-position valves having a pair of ports. Thevalves 104A-104B may be trumpet valves, ball cock style valves, or other rotatable type of valve used to control the flow of gases or fluids. Coupled to the first ports of eachvalve 1204A-1204B are thehose fittings 410A-410B, respectively. Coupled to a second port of each of thevalves 1204A-1204B are first ends of therespective coupling hoses 1208A-1208B. Second ends of thehoses 1208A-1208B respectively couple to a pair of ports of a three-way coupler 1206. A third port of thecoupler 1206 couples to thehollow tube 404. - Shafts of the
valves 1204A-1204B can be coupled to and decoupled from a pair of rotatable receivingelements 418. Themodular valve subassembly 1201 is replaceable. After being used, themodular valve subassembly 1201 is dismounted from the interface base with shafts of the usedvalves 1204A-1204B being decoupled from therotatable receiving elements 418. Similarly, shafts of newunused valves 1204A-1204B may be coupled to therotatable receiving elements 418 when mounting a new modular valve subassembly to the interface base. - Coil springs may be wrapped around the shafts of the
valves 1204A-1204B and coupled to the pair of rotatable receivingelements 418 in order to spring load thevalves 1204A-1204B to automatically close so that neither suction nor irrigation are activated when the instrument housing is not mounted onto the robotic arm, or modular valve subassembly is not mounted to theinterface base 412 in themountable housing 401. - The
hollow tube 404 is supported by the interface base. Abushing 1202 may be inserted over thehollow tube 404 and pressed into thecollar 1102 of theinterface base 412. - The printed
circuit board 425 may also be mounted to theinterface base 412.Electrical pins 424 may couple to the printedcircuit board 425 to provide an electrical connection to theadaptor 228. Theintegrated circuit 426 is mounted to the printed circuit board may be reprogrammed to indicate that thetool 1200 has been re-sterilized and its components replaced. - In order to reuse the IAB robotic
surgical tool 1200, themodular valve subassembly 1201 and thecoupling hoses 1208A-1208B are removed and discarded. Anew valve subassembly 1201 andnew hoses 1208A-1208B are installed and mounted in the robotic surgical tool. The remaining components including theinterface base 412, the three-way coupler 1206 and thehollow tube 404 are re-sterilized prior to fitting a newmodular valve subassembly 1201 andnew hoses 1208A-1208B. - After re-sterilization, the
integrated circuit 426 may be programmed to indicate that thetool 1200 has been re-sterilized and its components replaced. - Referring now to
FIGS. 13A-13B , an IAB roboticsurgical tool 1300 to control the flow of fluids into and out from a surgical site is illustrated.FIG. 13A illustrates the IAB roboticsurgical tool 1300 with its cover removed to show that the IAB roboticsurgical tool 1300 includes a flow control system that utilizesrotatable pinch valves 1304A-1304B. - To control the flow of fluids through the robotic
surgical tool 1300, a pair offlexible coupling hoses 1302A-1302B are coupled to a pair ofhose fittings 410A-410B at a first end and a pair of ports of a three-way coupler 1206 at a second end. The third port of the three-way coupler 1206 is coupled to the proximal end of thehollow tubing 404. To pinch offhoses 1302A-1302B, thetool 1300 includes arotatable pinch valves 1304A-1304B rotatably mounted to theinterface base 412. Each of thepinch valves 1304A-1304B is coupled to arotatable receiving element 418. As discussed previously, therotatable receiving element 418 may couple to arotatable driver 234. - Each of the
rotatable pinch valves 1304A-1304B may include acoil spring 1306, arotatable pinch arm 1320, apinch wheel 1322 coupled to the end of therotatable pinch arm 1320, atab 1324, and a handle 1330. InFIG. 13A , thepinch valve 1304A is illustrated as being open and allowing the flow of fluid through thetool 1300.Rotatable pinch valve 1304B is illustrated as being closed to pinch offhose 1302B at apinch point 1302B′. - At a
pinch point 1302B′, apinch wheel 1322 presses thehose 1302B against thebackstop 1315B ofbulkhead 1310. Thehose 1302B collapses to a diameter of zero so that no fluid can flow through it at thepinch point 1302B′. Therotatable pinch valve 1304A may utilize thebackstop 1315A ofbulkhead 1310 to close and pinch offhose 1302A. The operation of a rotatable pinch valve is further discussed herein with reference toFIG. 10A . When being opened from the closed position, thetab 1324 may be used to limit the rotation of eachrotatable pinch valve 1304A-1304B to astop 1325. - In order to readily collapse and pinch off the flow of fluids, the
hoses 1302A-1302B may be silicon hoses that are flexible with the capability of expanding to an open non-collapsed diameter from a collapsed state at the pinch point in response to opening the rotatable pinch valves. Thepinch wheel 1322 rotates along the hose as its being pinched off so as to avoid damaging the hose and cause leeks. - The
coil spring 1306 wrapped around the shafts of thepinch valves 1304A-1304B may be used to spring load thevalves 1204A-1204B to automatically close and pinch off thehoses 1302A-1302B when the instrument housing is dismounted from the robotic arm or otherwise not being actuated. - While the IAB robotic
surgical tool 1300 is typically under control of themaster control console 150, thehandles 1330A-1330B allow for manual use of the IAB robotsurgical tool 1300 when it is not mounted to a robotic arm. Thehandles 1330A-1330B are respectively coupled to theshafts 1330A-1330B of therotatable pinch valves 1304A-1304B in order to manually rotate them open and closed by hand. When the IAB robotsurgical tool 1300 is not mounted to a robotic arm so that therotatable receiving elements 418 are not engaged with therotatable drivers 234, the assistant surgeon or nurse may manually operate the IAB roboticsurgical tool 1300 to control the fluid flows by using thehandles 1330A-1330B. Furthermore, thehandles 1330A-1330B allow for cleaning the flow control system as is described further below. - Referring now to
FIG. 13B , the IAB roboticsurgical tool 1300 is illustrated with itscover 1350 coupled to theinterface base 412. Thecover 1350 provides protection to theflow control system 417 including the rotatable pinch valves in the hoses. Thehandles 1330A-1330B extend through thecover 1350 so that they are accessible to manually control the pinch valves. - Additionally, the
handle 1330A includes aclip 1332 that may be swung around and fitted into agroove 1334 of thehandle 1305B. With theclip 1332 within thegroove 1334, bothhandles 1330A-1330B are open such that neitherhose 1302A norhose 1302B is pinched closed. The handles are clipped together in the open position during a cleaning of the flow control system of the roboticsurgical tool 1300 and to ease replacement of the hoses. - To clip the handles together, the handle is rotated to the open position and the
clip 1332 is swung toposition 1332′. Thehandle 1330B is rotated to position 1330B′ so that theclip 1332′ may be inserted into itsgroove 1334. In this position, the pinch valves are both open and thehoses 1302A-1302B are not pinched off but are open so that they can be cleaned. - Referring now to
FIG. 14 , a top view of a IAB roboticsurgical tool 1400 is illustrated with its cover removed to show the pinch valves and replaceable tubing. Thetool 1400 is substantially similar totool 1300 previously described but for use of thecoupling hoses 1302A-1302B to control the flow of fluids within the tool.Tool 1400 eliminates thehose fittings 410A-410B and theshort coupling hoses 1302A-1302B between thehose fittings 410A-410B and the three-way coupler 1206. Instead, thetool 1400 includesreplaceable hoses 106B-106A directly coupled to the ports of the three-way coupler 1206, as is illustrated inFIG. 14 . Thereplaceable hoses 106B-106A extend beyond the robotic surgical tool in order to couple externally to sources of fluids. - In contrast, the
coupling hoses 1302A-1302B of thetool 1300 require cleaning and sterilization after each use of thetool 1300 in order for it to be reused. Intool 1400, thehoses 106A-106B are not cleaned, but replaced after each usage with new sterile hoses so that thetool 1400 may be reused. With the rotatable pinch valves open, theinterface base 412 is formed withbulkhead 1410 to allow thehoses 106A-106B to be readily replaceable and coupled to the three-way coupled 1206. - The
tool 1400 includes therotatable pinch valves 1304A-1304B with theirpinch arms 1320 andpinch rollers 1322 coupled thereto to pinch off thehoses 106A-106B and stop the flow of fluids. The rotatable pinch valves are rotatably mounted to theinterface base 412. The shaft of each rotatable valve is coupled to therotatable receiving element 418. - In
FIG. 14 ,rotatable pinch valve 1304A is open such thathose 106A may allow a fluid to flow therein.Rotatable pinch valve 1304B is closed to pinch offhose 106B atpoint 1402B. Thus, withpinch valve 1304B closed, a fluid will not flow throughhose 106B.Bulkhead 1410 is provided so that thehoses 106A-106B may be readily replaced when therotatable pinch valves 1304A-1304B are held in their open positions. Thebulkhead 1410 includesbackstops rotatable pinch valves 1304A-1304B may pinch off therespective hoses 106A-106B.Hoses 106A-106B may be formed of a silicon rubber compound so that they are flexible and can be readily collapsed and expanded in response to the opening and closing of the rotatable pinch valves. - As discussed previously, the
replaceable hoses 106B-106A are directly coupled to two of the three ports of the three-way coupler 1206. The third port of the three-way coupler 1206 is coupled to the proximal end of thehollow tube 404. Thehollow tube 404 may be further supported by theinterface base 412 by inserting a the hollow tube into a bushing mounted in thecollar 1102. - The IAB robotic surgical tools, including
tool 1400, may further include the printedcircuit board 425 with one ormore pins 424 and one or moreinterrelated circuits 426 coupled thereto to indicate its tool type, whether its new or refurbished, and if refurbished, the number of prior uses. - Referring now to
FIGS. 15A-15B , IAB robotic surgical tools 1500A-1500B are respectively illustrated without their covers. The tools 1500A-1500B do not internally control the flow of fluids into and out of a surgical site. Instead, the control of the flow of fluids into and out of a surgical site is externally controlled away from the surgical tool. As previously discussed with reference toFIG. 1 , the control of fluids may be provided at the respective fluid pumps by thecomputer system 151 in the surgeonsmaster control console 150 under the control of the operator O. - Even though fluid flow is externally controlled, the IAB robotic surgical tools 1500A-1500B are mounted to a robotic arm of the robotic
surgical manipulator 152 and can facilitate the flow of fluids into and out of a surgical site through couplers and thehollow tube 404. - In
FIG. 15A , the IAB robotic surgical tool 1500A includes a three-way coupler 1206 mounted to theinterface base 412. A proximal end of thehollow tube 404 couples to a first port of the three-way coupler 1206.Replaceable hoses 106A-106B respectively couple to a second and a third port of the three-way coupler 1206. The tool 1500A may further include the printedcircuit board 425 with theelectrical pins 424 in one or moreinterrelated circuits 426 coupled thereto to indicate the tool type and that external fluid control is to be utilized. - In
FIG. 15B , the IAB roboticsurgical tool 1500B includes a four-way coupler 1506 with a first port coupled to thehollow tube 404, a second port coupled to an end of afirst hose 106A, a third port coupled to an end of asecond hose 106B, and a fourth port coupled to an end of athird hose 106C.Tool 1500B may also include the printedcircuit board 425 with theelectrical pins 424 and the one or moreintegrated circuits 426 coupled thereto to indicate the tool type and that external fluid control is to be utilized to control the flow of fluids flow in thehoses 106A-106C. - Cleaning and sterilization of the IAB robotic surgical tools 1500A-1500B is fairly easy as there are no valves. To reuse the tools 1500A-1500B, used
hoses 106A-106C are removed. The remaining portions of thetools 1500A and 1500B, such as the couplers and thehollow tube 404, are then sterilized and then fitted with newsterile hoses 106A-106C so that they may be reused. - While IAB robotic surgical tools 1500A-1500B have been shown and described to include
couplers hollow tube 404. Alternatively, the proximal end of the hollow tube could be formed as a hose fitting and directly couple to an end of the hose. In this manner, reuse of the IAB robotic surgical tool may further simplified with fewer components to sterilize and a single hose to replace. - Typically, irrigation and aspiration of a surgical site are manually controlled by an assisting surgeon or nurse using manual surgical tools. By allowing tele-operated or remote control and actuation of an IA or IAB robotic surgical instrument, the primary surgeon can now control irrigation and aspiration of a surgical site.
- The flow control system of the IAB robotic surgical instrument may be controlled by the operator O seated at the robotic surgical
master control console 150 in a number of ways. For example, master axes of movement in a control handle that is normally used for controlling a wristed robotic surgical instrument may be used to activate irrigation, aspiration, and or blowing through an IAB robotic surgical instrument over a surgical site. As previously discussed, one or a combination of both the rotational motion of the touchsensitive handle 325 and the squeezing motion of thegrips sensitive handle 325 may be used for the control of irrigation while the squeezing motion of thegrips -
FIG. 16A is a side view of the touchsensitive handle 325 of the robotic surgicalmaster control console 150. The touchsensitive handle 325 may be used by the operator O to control the fluid flow in IAB robotic surgical instruments. In one embodiment of the invention, a rotational motion R (“roll”) of the touch sensitive handle may control the irrigation, aspiration, and/or blowing through IABsurgical instruments sensitive handle 325 may be used to switch over from one type of fluid flow to another. In which case, the handle may rotated counter-clockwise to open a second valve or switch open the first valve to a different position to have a second fluid flow through the IAB surgical instrument and into or out of a surgical site. Thehandle 325 may then be rotated clockwise to the center detent point D to close the second valve and stop the flow of fluid through the IAB surgical instrument and into or out of the surgical site. - The rotational motion of the
handle 325 may typically control wrist motors in the roboticsurgical manipulator 152 to control a wrist motion of a robotic surgical tool. In this case, the wrist motors in the roboticsurgical manipulator 152 may be adapted for use to control one or move valves in the IAB robotic surgical instruments in response to the rotational motion of thehandle 325. - In another embodiment of the invention, a gripping or squeezing motion (“master grip”) on the
grips 350A-350B of the touchsensitive handle 325 may be used to control the flow of fluids through IAB robotic surgical instruments. For example, squeezing the grip of touch sensitive handle may be used to turn on the suction of the I/A/B surgical instrument and the grip released to turn off the suction. In which case, the touch sensitive handle may include one ormore springs 306A-306C to provide differing spring constants or a single spring 306 with a progressive rate spring constant as the positions of thegrips 350A-350B change. An explanation as to how the touchsensitive handle 325 functions was previously describe with reference toFIG. 3C . By using the grip of the touchsensitive handle 325 to control the IAB robotic surgical instrument, the rotational motion of the handle may be used for further movement or control of the instrument. - The position of the
grips 350A-350B can vary over a range of positions in order to control suction, blowing and irrigation of a surgical site such as from a fully released or fully open position to a fully squeezed or fully closed position. -
FIGS. 16B-16D illustrate different positions of thegrips 350A-350B of the touchsensitive handle 325 when squeezed by a hand H of the operator O to control the IAB robotic surgical tool at a surgical site.FIG. 16B illustrates a fully open grip position without any squeezing by the hand H.FIG. 16C illustrates the hand H squeezing thegrips 350A-350B to a half-way closed position. To provide force feedback to a user, a first spring rate may be used over a range of positions, such as from the fully open to the half-way closed position.FIG. 16D illustrates the hand H squeezing thegrips 350A-350B to a fully closed position. To provide force feedback to a user, a second spring rate somewhat greater than the first may be used over a range of positions, such as from the half-way closed position to the fully closed position. -
FIG. 17 is a graph showing exemplary control of irrigation and aspiration using the grip control of the touchsensitive handle 325. The open, half, and closed positions along the X-axis of the graph correspond to the different positions of thegrips 350A-350B of the touchsensitive handle 325 illustrated inFIGS. 16B-16D .Curve 1701 illustrates a flow of vacuum or a percentage of suction.Curve 1710 illustrates a flow of irrigation fluid through the tool and into a surgical site. - With the
grips 350A-350B in the fully released or fully open position, both suction and irrigation are turned off. As the grip is initially squeezed, suction is turned on and irrigation remains turned off. As the grip position changes from fully-open to half-way closed,curve 1701 illustrates the flow of vacuum change from zero to one hundred percent. As the grip reaches half way, suction may be fully turned on with a negligible amount of irrigation. As the operator O squeezes further still, past the half-way closed position, the vacuum flow tapers off toward zero and the irrigation begins from zero around the three-fourths closed position, as is illustrated bycurves - In another embodiment of the invention, both the rotational motion of the touch
sensitive handle 325 and the squeezing motion of thegrips - In addition to the touch
sensitive handle 325 and itsgrips 350A-350B, foot pedals 18 of the surgeonsmaster control console 150, as illustrated inFIG. 3A , may be used to further control the IAB robotic surgical tools. For example, one of the foot pedals 18 may be used to switch from suction control to blow control in order to blow a pressurized gas over the surgical site. In which case, a gripping squeezing motion of the touch sensitive handle can also control the blowing provided by the I/A/B surgical instrument. - Alternatively, the touch
sensitive handle 325 may be modified to include buttons to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the roboticsurgical manipulator 152 - To avoid using a touch sensitive handle, the foot pedals 18 of the surgeons
master control console 150 may be used to fully control the suction and irrigation provided by an IAB robotic surgical tool. In one embodiment of the invention, a first foot pedal 18A may be used to control suction and a second foot pedal 18B may be used to control the irrigation provided by an IA or IAB surgical instrument. - With knowledge of other surgical instruments that are to be controlled by some of the foot pedals, foot pedals on the right side of the footrest may be used, for example. Two pedals and a toggle switch on the master control console or the control handle may be used to control a variety of actuations in a plurality of surgical instruments knowing the context of the robotic surgical system in advance. Additionally, foot pedals normally used for cautery (or another energy device) may be switched to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the robotic
surgical manipulator 152. - To avoid any use of hands or feet in controlling the I/A surgical instrument, voice activation may be used to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the robotic
surgical manipulator 152. In this case, an operator's voice or speech may be used to control the suction, irrigation, and or blowing provided by an IA or IAB surgical instrument. For example, spoken voice commands such as “suction ON”, “suction OFF”, “suction lightly”, “irrigation ON”, “irrigation OFF”, and “irrigate lightly” may be used to control the suction and irrigation provided by the IA or IAB surgical instrument. - To recognize the voice commands, the
master control console 150 includes amicrophone 315 and aspeech recognizer 317. Thespeech recognizer 317 may generate the control signals that are provided to the IA or IAB surgical instrument. - While various control means have been individually described here, two or more of these control means may be combined in order to control the flow of fluids through an IAB robotic surgical tool. For example, the rotational motion of the touch
sensitive handle 325 may be used for the control of irrigation while the squeezing motion of thegrips - Within a surgical site it may be difficult to determine if a valve is open and providing suction, blowing, or irrigation. User feedback may be provided to the surgeon at the console to provide information to him/her such as suction is on and at what level—high, medium, low, or otherwise off. User feedback information may also be provided regarding blowing and irrigation—whether its off or on, and if on at what level—high, medium, or low. However, it typically is easier to visually determine when a liquid is flowing for irrigation than when suction is provided for aspiration or a pressurized gas for blowing.
- Referring now to
FIGS. 18A-18G , various types of user feedback may be provided to the IAB robotic surgical tools. - In
FIG. 18A , the irrigation/aspiration/blowing roboticsurgical tool 400A includes a pair of light emitting diodes (LEDs) 1801-1802 near thetip 406 of thehollow tube 404 in order provide visible feedback to an operator O that a fluid is flowing through the tool. One ormore wires 1804 may couple between the light emitting diodes 1801-1802 and the printedcircuit board 425 within themountable housing 401. Electrical signals can be transmitted towards the light emitting diodes from the printed circuit board to turn them on during the flow of fluids and off when no fluid flow occurs. Theintegrated circuit 426 may generate the electrical signals to control the light emitting diodes. In this manner, the light emitting diode 1801-1802 may be activated by control signals received over the one ormore wires 1804 from themaster control console 150. Additional light emitting diodes may be provided near thetip 406 of thehollow tube 404 in order provide additional visible feedback for additional fluid flows. Moreover, the light emitting diodes 1801-1802, including any additional LEDs, may emit photons of different wavelengths in order that different colors can be provided corresponding to different types of fluid flow (e.g., suction, irrigation, gas pressure). - In
FIG. 18B , the IAB roboticsurgical tool 400B includes alight pipe 1812 mounted externally to thehollow tube 404 to provide visible user feedback to the operator O that fluids are flowing into or out of the surgical site. Thelight pipe 1812 maybe a side lighting fiber optic cable with one end optically coupled to one or morelight emitting diodes 1811 to receive photons. Thelight emitting diodes 1811 may emit photons of different wavelengths in order that different colors can be provided corresponding to different types of fluid flow (e.g., suction, irrigation, gas pressure). One ormore wires 1814 may couple between the one or morelight emitting diodes 1811 and the printedcircuit board 425 mounted within thehousing 401. An integrated circuit, such asintegrated circuit 426, may be used to drive the one or morelight emitting diodes 1811 to turn them on or off. Alternatively when fluids flow, the one or morelight emitting diodes 1811 may be activated directly by control signals received over the one ormore wires 1814 from themaster control console 150 or from theintegrated circuit 426. More than onelight pipe 1812 may be provide along the circumference of thehollow tube 404 so that the side light may be visible at different viewing angles and positions of the IAB robotic surgical instrument. - In comparison with the light emitting diodes 1801-1802 at the tip, the
light pipe 1812 provides a light that maybe visible along the entire length of thehollow tube 404 so that it can be seen, regardless of the position of the tip. Additionally, thelight emitting diode 1811 is protected under the cover of themountable housing 401. - Referring now to
FIG. 18C , an IAB roboticsurgical tool 400C is illustrated. Intools 400A-400B previously described, user feedback was provided by electro-optic means. In contrast, the user feedback provided by thetool 400C is provided mechanically. The IAB roboticsurgical tool 400C includes a slidingsleeve 1820 and avisible scale 1824 coupled to thehollow tube 404. The slidingsleeve 1820 is coaxial with thehollow tube 404 and covers over thescale 1824 when no fluid is flowing through the tool. The slidingsleeve 1820 can be slid along thehollow tube 404 and into thehousing 401 to reveal thevisible scale 1824 as fluids flow through thetool 400C. Thevisible scale 1824 maybe different colored bands to indicate the level of fluid flow within thetool 400C. Alternatively, thevisible scale 1824 maybe bands of different thickness to reveal the amount of fluid flow within thetool 400C. The slidingsleeve 1820 can be gradually received into the hosing 401 to reveal the appropriate scale in proportion to the amount of fluid flow in thetool 400C. - Without any flow of fluids within the
tool 400C, atip 1822 of the slidingsleeve 1820 may completely cover over thevisible scale 1824. With maximum fluid flow in thetool 400C, the slidingsleeve 1820 may be slid into thehousing 401 such that its tip moves to aposition 1822′ to fully reveal thevisible scale 1824. Theopposite end 1823 of the slidingsleeve 1820 moves inward toposition 1823′. In this manner, the level of fluid flow in thetool 400C maybe provided to a user by mechanical means. - The sliding
sleeve 1820 may be pulled into thehousing 401 and pushed back out in a variety of ways. A spring may used to apply a force against the retraction of the slidingsleeve 1820 into the housing so that it can push it back out after the pulling force is released. A cable with one end coupled to and wrapped around a take up drum may be coupled to thesleeve 1820 through a pulley in order to pull the sleeve into thehousing 401. A gearing system may alternatively be used. A pinion gear may couple to arotatable receiving element 418 and to a rack coupled to thesleeve 1820. Alternatively, a ball screw and a lead screw may be used. A slider with a crank or lever arm may be used. An electrical means may also be used, such as a solenoid to pull in on the slidingsleeve 1820. - Referring now to
FIGS. 18D-18G , an IAB roboticsurgical tool 400D includes another mechanical structure to provide user feedback. However instead of a sliding sleeve, the IAB roboticsurgical tool 400D includes arotating sleeve 1820′ coaxial with thehollow tube 404.FIGS. 18E-18G illustrate various types oftips 406 andsleeves 1820A′-1820C′ that may be used to provide user feedback. - In
FIG. 18D , the IAB roboticsurgical tool 400D includes the hollow tube coupled to thesolid valve body interface base 412. Thetool 400D further includes the hollowrotatable sleeve 1820′ coaxial around thehollow tube 404. Therotatable sleeve 1820′ couples to abearing assembly 1852 mounted to thecollar 1102 to rotatably mount to theinterface base 412. - For rotational purposes, the
rotatable sleeve 1820′ includes adrum 1854 that extends from thebearing assembly 1852 into thehousing 401. There are a number of ways to couple a rotational movement from the surgical manipulator to therotatable sleeve 1820′. In one embodiment of the invention, thetool 400D is backward compatible and includes aspool 1830 rotatably mounted to theinterface base 412. Arotatable receiving element 418 of the IAB robotic surgical tool is coupled to thespool 1830. For robotic control from themaster control console 150, therotatable receiving element 418 couples to therotatable driver 234 by means of thepins 422A-422B within theopenings 240A-240B, respectively. - Coupled between the
spool 1830 and thedrum 1854 of the rotatable sleeve are a top cable 1832 and abottom cable 1834. One end of each cable couples to thespool 1830. The opposite end of each cable couples to the drum 2854. Alternatively, a single cable may be used by appropriately wrapping it around the drum 2834 and thespool 1830. The top cable and the bottom cable wrap different from each other around the spool. They also wrap different from each other around thedrum 1854. In this manner, one cable is being let out while the other cable is being taken in by the rotation of the spool. 1854. If thespool 1854 is turning clockwise as indicated by arrow F2, the cable 1832 is taken in, thecable 1834 is let out, and thesleeve 1820′ rotates counter clockwise as illustrated by the letter G2. If thespool 1854 is turning counter-clockwise as indicated by arrow F1, the cable 1832 is let out, thecable 1834 is let out, and thesleeve 1820′ rotates clockwise as illustrated by the letter G1. - There rotational movement of the receiving
element 418 may be transmitted by other means to therotatable sleeve 1820′. For example, a gear system may be used. In which case, a first worm gear may be used in place of thespool 1830 and a second worm gear coupling to the first may be used in place of thedrum 1854. - The flow control system provided by the
solid valve bodies FIGS. 11A-11E and is incorporated here by reference. - Referring now to
FIG. 18E , the hollowrotatable sleeve 1820A′ includes a plurality of narrow openings 1840 located around a circumference of a distal end of thesleeve 1820A′. This way, the scale may be seen from different angles. The narrow window openings 1840 may be oval shaped as illustrated or rectangularly shaped. Thehollow tube 404 includes a plurality ofcurved color stripes 1842 around its circumference that may be rectangularly shaped as illustrated by the dashed lines inFIG. 18E . As thesleeve 1820A′ rotates, thestripes 1842 are positioned on thehollow tube 404 to be substantially aligned with the window openings 1840. - In one position of the
sleeve 1820A′, no color stripe or a color stripe representative of fluid flow being completely shut off is located within a window opening 1840. This corresponds to all the valves being closed to shut off the fluid flow through the IAB robotic surgical tool. Rotating thesleeve 1820A′ from a shut off position, a first or second color stripe may begin to be revealed, such as illustrated inFIGS. 18E-18G , representative of a first fluid flow in an IAB robotic surgical instrument. The level of fluid flow can be indicated by the amount ofcolor stripe 1842 that is exposed in the window opening 1840. With thecolor stripe 1842 being completely exposed by the window opening 1840, the corresponding valve of the flow control system may be fully open. With thesleeve 1820A′ being rotated still further, a second or third color stripe may begin to be exposed by the window opening 1840. In which case, the prior fluid flow may be substantially shut off and another valve opened to allow another fluid to flow through the IAB robotic surgical tool. - The
different color stripes 1842 indicate the flow of different fluids through the IAB robotic surgical. For example, a red color stripe may indicate that all fluid flows are fully shut off. A green color stripe may indicate pressurized gas flow. A blue color stripe may indicate irrigation, An orange color stripe may indicate suction or aspiration. - Referring now to
FIG. 18F , thetool 400D includes therotatable sleeve 1820B′ that is similar to therotatable sleeve 1820A′ but has triangular shapedwindow openings 1850 instead. Thehollow tube 404 includes the plurality ofcolor stripes 1842. But for the shape of the window openings, thesleeve 1820′B operates substantially similar to that ofsleeve 1820A′ described previously. - Referring now to
FIG. 18G , the hollowrotatable sleeve 1820C′ includes a plurality of narrowrectangular openings 1860 located around a circumference of a distal end. With the plurality ofopenings 1860, the scale may be seen from different angles and positions of the tool. Thenarrow window openings 1860 are rectangularly shaped. However, thehollow tube 404 includes a plurality oftriangle stripes 1842 curving around its circumference as illustrated by the dashed lines inFIG. 18G . Thecolored triangle stripes 1862 are positioned on thehollow tube 404 to be substantially aligned with the window openings 186, as thesleeve 1820C′ rotates, - As the
sleeve 1820C′ rotates, the level of fluid flow can be indicated by the amount of colortriangular stripe 1862 that is exposed in thewindow opening 1860. As discussed previously, the type of fluid flow may be indicated by the different colors. - The type of user feedback previously disclosed was implemented by the IAB robotic surgical tool. Alternatively, user feedback may be provided by the
master control console 150, such as through an electronic visual display of a graphical icon or image. - Referring now to
FIG. 19 , a simulated 3D image of a surgical site in aviewer 312 of themaster control console 150 is illustrated when the operators eyes are in theviewer 312. As illustrated inFIGS. 20A-20B , stereo optic images of aleft image 1900L and aright image 1900R are provided at theviewer 312, in order to provide a three-dimensional image when viewed by the operator O. In the left and right views, the IAB roboticsurgical tool 400 is located within the surgical site. To provide user feedback as to the fluid flow in thetool 400, icons 1902 are overlaid onto the images displayed in one or both of thedisplays tool 400. A scale maybe provided in the viewer to display the level of the fluid flow in thetool 400. Alternatively abbreviated letters maybe used to indicate the type of fluid flow (e.g., S—suction or A—aspiration, I—irrigation, B—blowing) in thetool 400 as well as its level, such as L, M, and H. - Referring now to
FIG. 20A , aviewer 312A of themaster control console 150 is illustrated. To provide a three-dimensional perspective, theviewer 312A includes stereo images for each eye includingleft image 400L of thetool 400 and surgical site and aright image 400R of thetool 400 and surgical site. One ormore icons 2010R may be overlaid onto the images in theright viewfinder 2001R to indicate the functionality and the level of fluid flow in the IAB roboticsurgical tool 400. Theimages liquid crystal display 2002R and a leftliquid crystal display 2002L, respectively. - As the one or
more icons 2010R in theviewer 312A are provided in a single viewfinder of the stereo viewer, they are displayed as two-dimensional icons. However, three dimensional images of the icons maybe provided and overlaid onto stereo left and right images of the surgical site. - In
FIG. 20B , one or more icons to provide user feedback of the control of the IAB robotic surgical tool are overlaid onto both theleft image 400L and right image 40R of the surgical site. In theright viewfinder 2001R, aright icon image 2010R is overlaid onto theright image 400R being displayed by theliquid crystal display 2002R. In theleft viewfinder 2001L, aleft icon image 2010L is overlaid onto theleft image 400L of the surgical site provided by theliquid crystal display 2002L. In this manner, a stereo image of the icons may be used to provide user feedback of the control of the IAB robotic surgical tool maybe provided in theviewer 312B. - In order to use the IAB robotic surgical tools, it is first undergoes an initial setup prior to surgery. The IAB robotic surgical instrument is mounted to a
robotic arm 153 of the roboticsurgical manipulator 152. One or more hoses 160A-160C are coupled from the IAB robotic surgical instrument to one ormore pumps 102A-102C. The roboticsurgical manipulator 152 is oriented with the patient P so that the tip of the hollow tube of the irrigation-aspiration robotic surgical instrument may be inserted into the patient near the desired surgical site. During the surgery, the operator O may control the flow of fluids between the surgical site and the IAB robotic surgical instrument from themaster control console 150 using theflow control system 417 of the IAB robotic surgical tool. Alternatively or conjunctively, the operator may also control the flow of fluids between the IAB robotic surgical instrument and the one or more pumps. To control the flow of fluids, the operator O at themaster control console 150 may generate one or more control signals to control the IAB robotic surgical instrument. The one or more control signals may be directly or indirectly coupled into the IAB robotic surgical instrument. For example, the one or more control signals may be electrical signals that are directly coupled into the IAB robotic surgical instrument to electrically control one or more valves. Alternatively, the one or more control signals may be electrical signals that are translated into a mechanical motion. In this case, the mechanical motion may be directly coupled into IAB robotic surgical instrument while the electrical control signals are indirectly coupled into the IAB robotic surgical instrument. In any case, one or more valves in the IAB robotic surgical instrument may be opened to flow one or more fluids over a surgical site in response to the control signals. Similarly, one or more valves in the IAB robotic surgical instrument may be closed to reduce the flow of the one or more fluids over the surgical site in response to the control signals. - In alternative embodiments of the invention, the control of the flow of fluids between the surgical site and the IAB robotic surgical instrument is provided by controlling the one or more pumps. In which case, the control signals are coupled to the pumps and/or flow control valves located external to the IAB robotic surgical instrument. The IAB robotic surgical instrument may include a coupler to couple between the hoses from the one or more pumps and the hollow tube that is inserted into a patient.
- The one or more control signals may be generated in various ways including in response to movement of a touch sensitive handle of a master control console, squeezing of a grip of the touch sensitive handle, rotation of the touch sensitive handle, movement of a foot pedal, or a spoken command at the master control console.
- The level of flow of the fluids and the control thereof may be monitored between the surgical site and the IAB robotic surgical instrument through the user-feedback means previously described. One user-feedback means is one or more light emitting diodes coupled near the tip of the hollow tube of the IAB robotic surgical instrument. The one or more light emitting diodes generate a visible light in response to the control of a flow of a fluid through the IAB robotic surgical instrument. Another user-feedback means is a light pipe coupled along the length of the hollow tube of the irrigation-aspiration robotic surgical instrument with a light emitting diode. The light emitting diode couples photons into the light pipe and generates a visible side light in response to the control of a flow of a fluid through the irrigation-aspiration robotic surgical instrument. Still another user-feedback means is a sliding sleeve coaxial with the hollow tube and a scale coupled to the irrigation-aspiration robotic surgical instrument. The sliding sleeve slides along the hollow tube and reveals the scale in response to the control of a flow of a fluid through the irrigation-aspiration robotic surgical instrument.
- After the using the IAB robotic surgical instrument, it is removed from the patient and can then be dismounted from the robotic arm of the robotic
surgical manipulator 152. If the IAB robotic surgical instrument is to be reused, a modular valve assembly and one or more hoses of the irrigation-aspiration robotic surgical instrument may be discarded and the remaining components of the IAB robotic surgical instrument sterilized for reuse. In the case that the IAB robotic surgical instrument includes a flow control system with an inexpensive valve subassembly, the irrigation-aspiration robotic surgical instrument can be removed from the patient; dismounted from the robotic arm; and then discarded. - While certain exemplary embodiments of the invention have been described and shown in the accompanying drawings, it is to be understood that such embodiments are merely illustrative of and not restrictive on the broad invention, and that the embodiments of the invention not be limited to the specific constructions and arrangements shown and described, since various other modifications may occur to those ordinarily skilled in the art. For example, while an irrigation/aspiration/blowing robotic surgical instrument has been shown and described in a number of embodiments of the invention, it may be modified into an irrigation robotic surgical instrument with a single valve to provide irrigation only or it may be modified into an aspiration robotic surgical instrument with a single valve to provide aspiration only. Furthermore, while aspiration or suction has been described as being provided by a vacuum pump, one would recognize that a pressurized gas maybe provided instead, such as air by an air pump. The pressurized gas may be used to blow debris or cut tissue, if sufficient pressure is provided. Rather, the embodiments of the invention should be construed according to the claims that follow below.
Claims (26)
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Also Published As
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US20070005002A1 (en) | 2007-01-04 |
US9446177B2 (en) | 2016-09-20 |
US10441370B2 (en) | 2019-10-15 |
US11517379B2 (en) | 2022-12-06 |
US20200022766A1 (en) | 2020-01-23 |
US8241271B2 (en) | 2012-08-14 |
US20090099520A1 (en) | 2009-04-16 |
US20120197182A1 (en) | 2012-08-02 |
US20070016174A1 (en) | 2007-01-18 |
US9216243B2 (en) | 2015-12-22 |
US20170000573A1 (en) | 2017-01-05 |
US20230054233A1 (en) | 2023-02-23 |
US20120277663A1 (en) | 2012-11-01 |
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