Source: https://patents.justia.com/patent/10709516
Timestamp: 2020-08-08 13:17:26
Document Index: 171401904

Matched Legal Cases: ['Application No. 61', 'art 140', 'art 10', 'art 140', 'Application No. 20120538933', 'Application No. 20120538942', 'Application No. 20120538936', 'Application No. 20120538937', 'Application No. 20120538937', 'Application No. 20140179865', 'Application No. 2015213010']

US Patent for Curved cannula surgical system control Patent (Patent # 10,709,516 issued July 14, 2020) - Justia Patents Search
Justia Patents Stereotaxic DeviceUS Patent for Curved cannula surgical system control Patent (Patent # 10,709,516)
Apr 2, 2018 - INTUITIVE SURGICAL OPERATIONS, INC.
A robotic system includes a master device and a slave manipulator configured to support an instrument. The instrument includes an instrument shaft having a proximal end and a distal end, and an end effector coupled to the distal end. The instrument shaft is optionally configured to be inserted into an inserted position through a port so as to provide the end effector with access to a site. A control system is operably coupled to the master device and to the slave manipulator. In response to input at the master device, the control system controls the slave manipulator to move the instrument based on modeling the end effector as being positioned along a line coincident with a longitudinal axis of the distal end of the instrument shaft. The line does not intersect the port when the instrument shaft is in the inserted position through the port. Methods relate to robotic systems.
This application is a continuation of U.S. patent application Ser. No. 15/045,184 (filed Feb. 16, 2016), which is a continuation of U.S. patent application Ser. No. 14/523,270 (filed Oct. 24, 2014, now U.S. Pat. No. 9,283,050), which is a continuation of U.S. patent application Ser. No. 12/618,598 (filed Nov. 13, 2009, now U.S. Pat. No. 8,888,789), which is a continuation-in-part of Ser. No. 12/618,549 (filed Nov. 13, 2009), which claims the benefit of U.S. Patent Application No. 61/245,171 (filed Sep. 23, 2009), all of which are incorporated herein by reference.
This application may be related to the following applications: U.S. patent application Ser. No. 12/618,583, filed Nov. 13, 2009, now U.S. Pat. No. 8,545,515; U.S. patent application Ser. No. 14/015,302, filed Aug. 30, 2013 (disclosing “Curved Cannula Surgical System”); U.S. patent application Ser. No. 12/618,608, filed Nov. 13, 2009, now U.S. Pat. No. 8,551,115; U.S. patent application Ser. No. 14/025,138, filed Sep. 12, 2013 (disclosing “Curved Cannula Instrument”); U.S. patent application Ser. No. 14/073,485, filed Nov. 6, 2013 (disclosing “Surgical Port Feature”); U.S. patent application Ser. No. 12/618,631, filed Nov. 13, 2009, now U.S. Pat. No. 8,465,476; and U.S. patent application Ser. No. 13/898,753, filed May 21, 2013 (disclosing “Cannula Mounting Fixture”), each of which is incorporated herein by reference in its entirety.
Benefits of minimally invasive surgery are well known, and they include less patient trauma, less blood loss, and faster recovery times when compared to traditional open incision surgery. In addition, the use of robotic surgical systems (e.g., teleoperated robotic systems that provide telepresence), such as the da Vinci® Surgical System manufactured by Intuitive Surgical, Inc. of Sunnyvale, Calif. is known. Such robotic surgical systems may allow a surgeon to operate with intuitive control and increased precision when compared to manual minimally invasive surgeries.
FIG. 15B shows a detail of another seal.
Further, this description's terminology is not intended to limit the invention. For example, spatially relative terms-such as “beneath”, “below”, “lower”, “above”, “upper”, “proximal”, “distal”, and the like—may be used to describe one element's or feature's relationship to another element or feature as illustrated in the figures. These spatially relative terms are intended to encompass different positions (i.e., locations) and orientations (i.e., rotational placements) of a device in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features. Thus, the exemplary term “below” can encompass both positions and orientations of above and below. A device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Likewise, descriptions of movement along and around various axes includes various special device positions and orientations. In addition, the singular forms “a”, “an”, and “the” are intended to include the plural forms as well, unless the context indicates otherwise. And, the terms “comprises”, “comprising”, “includes”, and the like specify the presence of stated features, steps, operations, elements, and/or components but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups. Components described as coupled may be electrically or mechanically directly coupled, or they may be indirectly coupled via one or more intermediate components.
FIG. 1A is a front elevation view of the patient side cart component 100 of the da Vinci® Surgical System. The patient side cart includes a base 102 that rests on the floor, a support tower 104 that is mounted on the base 102, and several arms that support surgical tools (which include a stereoscopic endoscope). As shown in FIG. 1A, arms 106a,106b are instrument arms that support and move the surgical instruments used to manipulate tissue, and arm 108 is a camera arm that supports and moves the endoscope. FIG. 1A also shows an optional third instrument arm 106c that is supported on the back side of support tower 104 and that can be positioned to either the left or right side of the patient side cart as necessary to conduct a surgical procedure. FIG. 1A further shows interchangeable surgical instruments 110a,110b,110c mounted on the instrument arms 106a, 106b,106c, and it shows endoscope 112 mounted on the camera arm 108. The arms are discussed in more detail below. Knowledgeable persons will appreciate that the arms that support the instruments and the camera may also be supported by a base platform (fixed or moveable) mounted to a ceiling or wall, or in some instances to another piece of equipment in the operating room (e.g., the operating table). Likewise, they will appreciate that two or more separate bases may be used (e.g., one base supporting each arm).
FIG. 1C is a front elevation view of a vision cart component 140 of the da Vinci® Surgical System. The vision cart 140 houses the surgical system's central electronic data processing unit 142 and vision equipment 144. The central electronic data processing unit includes much of the data processing used to operate the surgical system. In various other implementations, however, the electronic data processing may be distributed in the surgeon console and patient side cart. The vision equipment includes camera control units for the left and right image capture functions of the stereoscopic endoscope 112. The vision equipment also includes illumination equipment (e.g., Xenon lamp) that provides illumination for imaging the surgical site. As shown in FIG. 1C, the vision cart includes an optional 24-inch touch screen monitor 146, which may be mounted elsewhere, such as on the patient side cart 10X). The vision cart 140 further includes space 148 for optional auxiliary surgical equipment, such as electrosurgical units and insufflators. The patient side cart and the surgeon's console are coupled via optical fiber communications links to the vision cart so that the three components together act as a single teleoperated minimally invasive surgical system that provides an intuitive telepresence for the surgeon. And, as mentioned above, a second surgeon's console may be included so that a second surgeon can, e.g., proctor the first surgeon's work.
FIG. 2A is a side elevation view of an illustrative instrument arm 106. Sterile drapes and associated mechanisms that are normally used during surgery are omitted for clarity. The arm is made of a series of links and joints that couple the links together. The arm is divided into two portions. The first portion is the “set-up” portion 202, in which unpowered joints couple the links. The second portion is powered, robotic manipulator portion 204 (patient side manipulator, “PSM”) that supports and moves the surgical instrument. During use, the set-up portion 202 is moved to place the manipulator portion 204 in the proper position to carry out the desired surgical task. The set-up portion joints are then locked (e.g., with brake mechanisms) to prevent this portion of the arm from moving.
FIG. 3 illustrates the difficulty of using a multi-arm robotic surgical system for single port surgery. FIG. 3 is a diagrammatic view of multiple cannulas and associated instruments inserted through a body wall so as to reach a surgical site 300. As depicted in FIG. 3, a camera cannula 302 extends through a camera incision 304, a first instrument cannula 306 extends through a first instrument incision 308, and a second instrument cannula 310 extends through a second instrument incision 312. It can be seen that if each of these cannulas 302,306,310 were to extend through the same (slightly enlarged) port 304, due to the requirement that each move around a remote center of motion and also due to the bulk and movement of the manipulators described above that hold the cannulas at mounting fittings 302a,306a,310a, then very little movement of the instrument end effectors is possible, and the cannulas and instrument shafts can obscure the surgical site in the endoscope's field of view. In order to regain some triangulation of the instruments at the surgical site, attempts have been made to cross the instrument shafts and use the instrument wrists to provide some limited triangulation, but this configuration results in a “backwards” control scheme (right side master controls left side slave instrument in the endoscope's view, and vice-versa), which is non-intuitive and so loses some of the strong benefit of intuitive telerobotic control. Straight shaft wristed manual instruments likewise require a surgeon to move instruments in either a crossed-hands or cross-visual “backwards” way. And in addition, for laparoscopic surgery, there is a difficulty of maintaining a proper pneumoperitoncum due to the multiple instruments/cannulas placed through a single incision.
FIG. 4A is a schematic view of a portion of a patient side robotic manipulator that supports and moves a combination of a curved cannula and a passively flexible surgical instrument. As depicted in FIG. 4A, a telerobotically operated surgical instrument 402a includes a force transmission mechanism 404a, a passively flexible shaft 406a, and an end effector 408a. Instrument 402a is mounted on an instrument carriage assembly 212a of a PSM 204a (previously described components are schematically depicted for clarity). Interface discs 414a couple actuation forces from servo actuators in PSM 204a to move instrument 402a components. End effector 408a illustratively operates with a single DOF (e.g., closing jaws). A wrist to provide one or more end effector DOF's (e.g., pitch, yaw; see e.g., U.S. Pat. No. 6,817,974 (tiled Jun. 28, 2002)(disclosing “Surgical Tool Having Positively Positionable Tendon-Actuated Multi-Disk Wrist Joint”), which is incorporated herein by reference) is optional and is not shown. Many instrument implementations do not include such a wrist. Omitting the wrist simplifies the number of actuation force interfaces between PSM 204a and instrument 402a, and the omission also reduces the number of force transmission elements (and hence, instrument complexity and dimensions) that would be necessary between the proximal force transmission mechanism 404a and the distally actuated piece.
In some implementations, however, shaft sections 506a-506c each have the same physical structure—each being composed of the same material(s), and the material(s) chosen to have a bending stiffness acceptable for each section-so the sections thus have the same stiffness. Such instrument shafts are generally lower cost because, e.g., they have fewer parts and are easier to assemble.
FIG. 6A is a diagrammatic view that illustrates aspects of a pull/pull instrument design. As shown in FIG. 6A, an instrument force transmission mechanism 602 is coupled to a grip-type end effector 604 by a flexible shaft body 606. A tension element 608 is routed through shaft body 606 and couples a movable component in end effector 604 to a component (not shown; see below) in transmission mechanism 602 that receives a robotic actuation force. Tension element 608 is routed through a force isolation component 610 that is coupled between the base 612 of the end effector and backing plate 614 in transmission mechanism 602. In one implementation, shaft body 606 is a plastic tube (e.g., polyaryletheretherketone (PEK)), tension element 608 is a hypotube (e.g., 316 Stainless Steel (face hardened), 0.028-inch OD×0.020 ID, with polytetrafluoroethylene (PTFE) dip coating) with cables (e.g., 0.018-inch tungsten) at each end that are coupled to the transmission mechanism and end effector components, and force isolation component 610 is a coil tube (e.g., 300 series stainless steel). In one implementation 304V (vacuum arc remelt) stainless steel is used, because its surface finish is relatively smoother than other 300 series stainless steels, which results in a lower friction for the interior of the coil tube. It can be seen that shaft body 606 does not experience the tension load on tension element 608 that moves the end effector component, because the tension force is offset by an equal and opposite reaction force in isolation component 610. Consequently, two such tension element and force isolation component pairs within shaft body tube 606 can be used for a pull/pull end effector actuation design, the instrument shaft remains flexible with no effective change in its designed stiffness or bend during pull/pull actuation, and the tension load on tension element 608 is effectively independent of shaft body 606 bending.
As shown in FIG. 8A, tension elements 804a,804b extend through support tubes 806a,806b respectively, which guide tension elements 804a,804b and keep them from buckling or kinking within shaft 506. In one implementation, support tubes 806a,806b are stainless steel (e.g., 304V (vacuum melt that reduces friction)) coil tubes (0.035-inch inner diameter, 0.065-inch outer diameter), and other materials and structures may be used. To reduce friction as each tension element slides inside its support tube, a friction reducing sheath 808a,808b is placed between the tension element and the inner wall of the support tube. In one implementation, sheaths 808a,808b are PTFE, and other materials may be used. Both support tubes 806a,806b are placed within a single inner shaft tube 810. In one implementation, a flat-spiral stainless steel wire is used for inner shaft tube 810 to provide torsional stiffness during roll. An outer shaft tube 812 (e.g., braided stainless steel mesh or other material suitable to protect the shaft components) surrounds inner shaft tube 810. An elastomer skin 814 (e.g., Pellothane®, or other suitable material) surrounds the outer shaft tube 812. Skin 814 protects the inner components of shaft 506 from direct contamination by, e.g., body fluids during surgery, and the skin facilitates shaft 506 sliding within the curved cannula. In some implementations shaft 506 is approximately 5.5 mm (0.220 inches) outer diameter.
The curved cannulas described herein are described as being rigid, which means that they are effectively rigid during use. It is well known that certain materials or mechanisms may be bent into one curve shape and then later bent again into another curve shape. For example, a flexible tube of many short links may be effectively rigidized by compressing the links along the tube's longitudinal axis, so that friction prevents the links from moving with reference to one another. Or, inner and outer tubes may be radially compressed together to prevent them from sliding with reference to one another. See e.g., U.S. Pat. No. 5,251,611 (filed May 7, 1991)(disclosing “Method and Apparatus for Conducting Exploratory Procedures”) and U.S. Patent Application Pub. No. US 2008/0091170 A1 (filed Jun. 30, 2006)(disclosing “Cannula System for Free-Space Navigation and Method of Use”), both of which are incorporated herein by reference. And so, in some implementations the curved sections of the curved cannulas as described herein may be re-bendable (repositionable) into various curve shapes. In order to determine the kinematic parameters for the curve shape, the parameters being necessary for control as described below, known sensing technologies may be used. Such technologies include measuring motor positions for tendons (or the displacements of the tendons themselves) used to re-bend the curved section, or the use of optical fiber shape sensing to determine the curve shape. See e.g., U.S. Pat. No. 5,798,521 (tiled Feb. 27, 1997)(disclosing “Apparatus and Method for Measuring Strain in Bragg Gratings”), U.S. Patent Application Pub. No. US 2006/0013523 A1 (filed Jul. 13, 2005)(disclosing “Fiber Optic Position and Shape Sensing Device and Method Relating Thereto), U.S. Patent Application Pub. No. US 2007/0156019 A1 (filed Jul. 20, 2006)(disclosing “Robotic Surgery System Including Position Sensors Using Fiber Bragg Gratings), and U.S. Patent Application Pub. No. US 2007/0065077 A1 (filed Sep. 26, 2006)(disclosing “Fiber Optic Position and Shape Sensing Device and Method Relating Thereto”), all of which are incorporated herein by reference.
An illustrative use of the cannula insertion fixture is with the single percutaneous/multi-facial incision, such as one described above. The surgeon first makes the single percutaneous incision. Next, the surgeon inserts a dissecting (e.g., sharp) obturator into an endoscope cannula and couples the endoscope cannula to the insertion fixture at a desired angle. At this time the surgeon may insert an endoscope through the endoscope cannula to observe further insertions, either mounting the endoscope cannula and endoscope to a robotic manipulator or temporarily supporting the endoscope by hand. The surgeon then many move the cannulas along their arc of insertion until they contact the body wall. Using a dissecting obturator, the surgeon may then insert each cannula through the fascia. The surgeon may then optionally remove the dissecting obturators from the cannulas and either leave the cannulas empty or insert blunt obturators. Then, the surgeon may continue to move the instrument cannulas to their fully inserted positions, with their distal ends positioned to appear in the endoscope's field of view. Once the cannulas are inserted, the robotic manipulators may be moved into position, and the instrument cannulas may then be mounted (docked) to their robotic manipulators. The insertion fixture is then removed, and flexible shaft instruments are inserted through the cannulas towards the surgical site under endoscopic vision. This illustrative insertion procedure is an example of many possible variations for using the insertion fixture to insert and support any number of cannulas through various incisions and body openings.
Control of minimally invasive surgical robotic systems is known (see e.g., U.S. Pat. No. 5,859,934 (filed Jan. 14, 1997)(disclosing method and apparatus for transforming coordinate systems in a telemanipulation system), U.S. Pat. No. 6,223,100 (filed Mar. 25, 1998)(disclosing apparatus and method for performing computer enhanced surgery with articulated instrument), U.S. Pat. No. 7,087,049 (filed Jan. 15, 2002)(disclosing repositioning and reorientation of master/slave relationship in minimally invasive telesurgery), and U.S. Pat. No. 7,155,315 (filed Dec. 12, 2005)(disclosing camera referenced control in a minimally invasive surgical apparatus), and U.S. Patent Application Publication No. US 2006/0178559 (filed Dec. 27, 2005)(disclosing multi-user medical robotic system for collaboration or training in minimally invasive surgical procedures), all of which are incorporated by reference). Control systems to operate a surgical robotic system may be modified as described herein for use with curved cannulas and passively flexible surgical instruments. In one illustrative implementation, the control system of a da Vinci® Surgical System is so modified.
In other implementations, however, force sensors may be used to provide the surgeon an accurate experience of an external force applied to either the cannula's curved section or the instrument's extended distal end. For example, force sensors that use optical fiber strain sensing are known (see e.g., U.S. Patent Application Pubs. No. US 2007/0151390 A1 (filed Sep. 29, 2006)(disclosing force torque sensing for surgical instruments), US 2007/0151391 A1 (filed Oct. 26, 2006)(disclosing modular force sensor), US 2008/0065111 A1 (filed Sep. 29, 2007)(disclosing force sensing for surgical instruments), US 2009/0157092 A1 (filed Dec. 18, 2007)(disclosing ribbed force sensor), and US 2009/0192522 A1 (filed Mar. 30, 2009)(disclosing force sensor temperature compensation), all of which are incorporated herein by reference). FIG. 22 is a diagrammatic view of a curved cannula and the distal portion of a flexible instrument, and it shows that in one illustrative implementation, one or more force sensing optical fibers 2202a,2202b may be positioned (e.g., four fibers equally spaced around the outside) on curved cannula 2204 (strain sensing interrogation and strain determination components for the optical fibers are omitted for clarity). Similarly, the distal section 2206 of the flexible instrument may incorporate (e.g., routed internally) one or more strain sensing optical fibers 2208 that sense bend at a location on, or the shape of, the distal section, and the amount of displacement and the location with reference to the cannula's distal end may be used to determine the external force on the extended instrument.
a slave manipulator configured to support an instrument, the instrument comprising:
an instrument shaft having a proximal end and a distal end, and
an end effector coupled to the distal end,
wherein the instrument shaft is configured to be inserted into an inserted position through a port so as to provide the end effector with access to a site; and
a control system operably coupled to the master device and to the slave manipulator, wherein:
in response to input at the master device, the control system controls the slave manipulator to move the instrument based on modeling the end effector as being positioned along a line coincident with a longitudinal axis of the distal end of the instrument shaft, wherein the line does not intersect the port when the instrument shaft is in the inserted position through the port.
2. The robotic system of claim 1, wherein the robotic system is a surgical system.
3. The robotic system of claim 2, wherein the port is configured to be at an incision in a patient's body wall.
4. The robotic system of claim 1, wherein:
the master device comprises a first master device;
the slave manipulator comprises a first slave manipulator;
the instrument comprises a first instrument;
the line comprises a first line; and
the robotic system further comprises: a second master device, and a second slave manipulator configured to support a second instrument, the second instrument comprising: a second instrument shaft having a proximal end and a distal end, and a second end effector coupled to the distal end of the second instrument shaft, wherein the second instrument shaft is configured to be inserted into a second inserted position through the port so as to provide the second end effector with access to the site; and in response to input at the second master device, the control system controls the second slave manipulator to move the second instrument based on modeling the second end effector as being positioned along a second line coincident with a longitudinal axis of the distal end of the second instrument shaft, wherein the second line does not intersect the port when the second instrument shaft is in the second inserted position through the port, and wherein the first line and the second line extend in different directions.
5. The robotic system of claim 1, wherein the instrument comprises an endoscopic camera.
6. The robotic system of claim 1, wherein the instrument shaft is flexible and is flexed in the inserted position.
7. The robotic system of claim 1, wherein the instrument shaft is bendable and is bent in the inserted position.
8. The robotic system of claim 1, wherein the instrument further comprises a wrist located between the distal and proximal ends of the instrument shaft.
9. The robotic system of claim 1, further comprising a second slave manipulator configured to support an endoscopic camera with an endoscopic reference frame, wherein in response to the input at the master device, the control system controls the slave manipulator to move the instrument by:
controlling the slave manipulator to move the end effector relative to the endoscopic reference frame.
10. The robotic system of claim 1, wherein in response to the input at the master device, the control system controls the slave manipulator to move the instrument by:
controlling the slave manipulator to move the instrument about a remote center of motion, the remote center of motion being located at a position of the port along the instrument shaft when the instrument shaft is in the inserted position through the port.
an instrument comprising: an instrument shaft having a proximal end and a distal end, an end effector coupled to the distal end, and a force transmission mechanism coupled to the instrument shaft, wherein the instrument shaft is configured to be inserted into an inserted position through a port so as to provide the end effector with access to a site; and a slave manipulator configured to support the instrument, wherein, when the force transmission mechanism is in an engaged position with the slave manipulator and the instrument shaft is in the inserted position through the port: a first length of the instrument shaft extends along a first line that intersects the port, a remote center of motion is located along the first length and proximate to the port, a second length of the instrument shaft extends along a second line that does not intersect the port, and the slave manipulator is configured to pivot the first length of the instrument shaft about the remote center of motion.
12. The robotic system of claim 11, wherein the robotic system comprises a surgical system, and wherein the port is configured to be positioned at an incision in a patient's body.
13. The robotic system of claim 11, wherein, when the instrument shaft is in the inserted position through the port:
the first length of the instrument shaft extends from the force transmission mechanism to a location along the instrument shaft distal to the port; and
the second length of the instrument shaft extends from the location along the instrument shaft to the end effector.
14. The robotic system of claim 11, wherein when the force transmission mechanism is in an engaged position with the slave manipulator and the instrument shaft is in the inserted position through the port, the slave manipulator is further configured to roll the instrument.
15. A method of moving a robotic system, the robotic system comprising a master device, an instrument, a slave manipulator supporting the instrument, and a control system operably coupled with the master device and the slave manipulator, wherein an instrument shaft of the instrument is inserted into an inserted position through a port to enable an end effector to access a site, the method comprising:
receiving, with the control system, input at the master device; and
controlling, with the control system, the slave manipulator to move the instrument in response to the input received at the master device by:
modeling the end effector as being positioned along a line coincident with a longitudinal axis of a distal end of an instrument shaft of the instrument, wherein the line does not intersect the port when the instrument shaft is in the inserted position through the port.
16. The method of claim 15, wherein the robotic system is a surgical system, wherein the port is at an incision in a patient's body wall, and wherein controlling the slave manipulator to move the instrument in response to the input received at the master device comprises:
controlling the slave manipulator to move the instrument about a remote center of motion, the remote center of motion located at a position of the port along the instrument shaft when the instrument shaft is in the inserted position through the port.
the line comprises a first line;
the robotic system further comprises: a second master device, a second instrument, a second instrument shaft of the second instrument inserted into a second inserted position through the port to enable a second end effector of the second instrument to access the site, and a second slave manipulator supporting the second instrument; and the method further comprises: receiving, with the control system, second input at the second master device; and controlling, with the control system, the second slave manipulator to move the second instrument in response to the second input received at the second master device by: modeling the second end effector as being positioned along a second line coincident with a second longitudinal axis of the distal end of the second instrument shaft, the second line not intersecting the port when the second instrument shaft is in the second inserted position through the port, and wherein the first line and the second line extend in different directions.
18. The method of claim 15, wherein the instrument shaft is flexible and is flexed in the inserted position.
19. The method of claim 15, wherein the instrument shaft is bendable and is bent in the inserted position.
the instrument further comprises a wrist positioned along the instrument shaft between proximal and distal ends of the instrument shaft, the wrist being located distal to the port when the instrument shaft is in an inserted position through the port, and
controlling the slave manipulator to move the instrument in response to the input received at the master device comprises: controlling the slave manipulator to actuate the wrist.
21. The method of claim 15, wherein controlling the slave manipulator to move the instrument in response to the input received at the master device comprises:
determining an endoscopic reference frame based on a configuration of an endoscope providing an image of the site; and
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Patent number: 10709516
Patent Publication Number: 20180221101
Inventors: Giuseppe Maria Prisco (Pisa), Samuel Kwok Wai Au (Sunnyvale, CA)
Application Number: 15/943,226
International Classification: A61B 34/37 (20160101); A61B 17/02 (20060101); A61B 17/34 (20060101); A61M 25/00 (20060101); A61M 25/01 (20060101); A61B 34/30 (20160101); A61B 34/00 (20160101); A61B 90/92 (20160101); A61B 34/10 (20160101); A61B 90/00 (20160101); A61B 17/29 (20060101); A61B 17/00 (20060101); A61B 17/04 (20060101); A61B 90/50 (20160101); A61B 90/90 (20160101); A61B 34/20 (20160101); A61B 1/00 (20060101); A61B 1/313 (20060101);