Source: https://patents.google.com/patent/US6788999B2/en
Timestamp: 2019-08-20 22:53:17
Document Index: 680884415

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US6788999B2 - Surgical system - Google Patents
US6788999B2
US6788999B2 US10/379,302 US37930203A US6788999B2 US 6788999 B2 US6788999 B2 US 6788999B2 US 37930203 A US37930203 A US 37930203A US 6788999 B2 US6788999 B2 US 6788999B2
US10/379,302
US20030176948A1 (en
1992-01-21 Priority to US82393292A priority Critical
1996-09-09 Priority to US08/709,930 priority patent/US6963792B1/en
2003-03-03 Application filed by SRI International filed Critical SRI International
2003-03-03 Priority to US10/379,302 priority patent/US6788999B2/en
2003-09-18 Publication of US20030176948A1 publication Critical patent/US20030176948A1/en
2004-09-07 Publication of US6788999B2 publication Critical patent/US6788999B2/en
A teleoperator system with telepresence is shown which includes right and left hand controllers (72R and 72L) for control of right and left manipulators (24R and 24L) through use of a servomechanism that includes computer (42). Cameras (46R and 46L) view workspace (30) from different angles for production of stereoscopic signal outputs at lines (48R and 48L). In response to the camera outputs a 3-dimensional top-to-bottom inverted image (30I) is produced which, is reflected by mirror (66) toward the eyes of operator (18). A virtual image (30V) is produced adjacent control arms (76R and 76L) which is viewed by operator (18) looking in the direction of the control arms. By locating the workspace image (30V) adjacent the control arms (76R and 76L) the operator is provided with a sense that end effectors (40R and 40L) carried by manipulator arms (34R and 34L) and control arms (76R and 76L) are substantially integral. This sense of connection between the control arms (76R and 76L) and end effectors (40R and 40L) provide the operator with the sensation of directly controlling the end effectors by hand. By locating visual display (246) adjacent control arms (244R and 244L) image (240I) of the workspace is directly viewable by the operator. (FIGS. 12 and 13.) Use of the teleoperator system for surgical procedures also is disclosed. (FIGS. 7-9 and FIG. 13.)
This is a continuation-in-part patent application which claims priority from U.S. patent application No. 08/709,930 filed Sep. 9, 1996, which is a continuation of 07/823,932 filed Jan. 21, 1992 (ABN), the full disclosure of which is incorporated herein by reference.
Remote manipulators employing stereoscopic TV viewing together with force feedback also are well known as shown, for example, in an article entitled, “Controlling Remote Manipulators Through Kinesthetic Coupling,” Bejczy et al, Computers in Mechanical Engineering, July 1983, pps. 48-60, and in an article entitled, “Stereo Advantage for a Peg-In-Hole Task Using a Force-Feedback Manipulator” by E. H. Spain, SPIE Vol. 1256 Stereoscopic Displays and Applications, 1990, pps. 244-254. In the Bejczy et al. article, force-torque feedback is disclosed. Also, in U.S. Pat. No. 3,921,445, a manipulator which includes force, torque and slip sensors of a type which may be employed with the present invention is shown.
FIG. 4 is a simplified side elevational view which is similar to FIG. 1, and showing dimensional relationships between elements at the worksite and elements at the operator's station;
The vertical deflection coil connections for monitor 54 are reversed, causing the monitor to scan from bottom to top thereby creating a top-to-bottom inverted image 30I of workspace 30. Letters a, b, c, and d are used to identify corresponding corners of the workspace 30 and inverted workspace image 30I. The inverted workspace image 30I is viewed by the operator via a mirror 66 at the top of a table 68, which mirror inverts image 30I to return the image as viewed by the operator to an upright position. Looking downwardly in the direction of the mirror, the operator views a virtual image 30V of workspace 30. In accordance with one aspect of the present invention, the image viewed by the operator, which in the FIGS. 1-3 embodiment comprises a virtual image, is located adjacent controller means 70 used by the operator for control of manipulator means 24 at the worksite.
Right and left controllers 72R and 72L are included in a servomechanism system wherein mechanical motion of control arms 76R and 76L controls the position of manipulator arms 34R and 34L, and pressure on sensor means 78R and 78L controls opening and closing of end effectors 40R and 40L, respectively. In FIG. 1, right and left hand controller interfaces 80R and 80L, respectively, are shown for connection of the controllers to computer 42. Servomechanisms for control of mechanical motion at a remote location are well known, including those which provide force and torque feedback from the manipulator to the hand-operated controller means. Any suitable prior art servomechanism may be used in the practice of the present invention, with those incorporating force and torque feedback being particularly preferred for telepresence operation of the system. In the illustrated system, right and left microphones are included at the worksite, outputs from which microphones are amplified by right and left amplifiers and supplied to right and left speakers at the operators' station for providing a stereophonic sound output to provide the operator with an audio perspective present at the workspace. In FIG. 1, only the right channel of the stereophonic system is shown including right microphone 82R, right amplifier 86R, and right speaker 88R. The left microphone and speaker are located directly behind the respective right microphone and speaker at the worksite and operator's control station as viewed in FIG. 1. Obviously, earphones may be provided for use by the operator in place of the speakers which would help to block out external noises at the operator's control station. Also, in FIG. 1 a light shield 54B at the monitor is shown for blocking direct viewing of the monitor face by the operator.
Reference now is made to FIG. 4 wherein a simplified diagrammatic view of the system illustrated in FIGS. 1-3 is shown and wherein various lengths and angular positions are identified by reference characters. In FIG. 4, the optical path length between the cameras and a point F at the workspace is identified by reference character L. A corresponding path length between the operator's eyes and point F at the virtual image of the workspace is identified by the distance a÷b, where a is the distance from the eyes of the operator to mirror 66, and b is the distance from the mirror to point F at the virtual image. Other dimensions shown include the height G of the cameras above the pivot point of manipulator arm 34R and corresponding height g of the operator's eyes above the pivot point of control arm 76R. With the control arm 76R at length d, the manipulator arm 34R adjusts to length D. Similarly, with the control arm 76R at an angle βA, with the vertical, the manipulator arm 34R is positioned at the same angle from vertical. The angle from vertical at which the cameras view the workspace and the eyes view the virtual image of the workspace is identified by α.
When k equals 1 such that a÷b=L, d=D and g=G, no scaling of worksite dimensions is required.
For small-scale manipulation, such as required for surgical applications, it is desired to replicate the visual experience that a miniature observer would have were he closely adjacent the actual worksite. In FIG. 5, the virtual eye 90 of a hypothetical miniature observer is shown viewing an actual workspace. Light from a source at a point X, Y, Z in the actual workspace produces a stimulus on the miniature observer's eye 90 at a point identified as X′/M. In FIG. 6, an eye 92 of an actual operator is shown viewing an enlarged image of the virtual workspace produced by means of a video camera 94 used to view the actual workspace. The illustrated camera includes a light-receiving lens 96 and solid state imaging device such as a charge-coupled-device (CCD) array 98 where the point light source at X, Y, Z is shown imaged at point Xi, Yi, Zi. With correct scaling, a corresponding light source is produced at point MXi, MYi, MZi at either the real or apparent position of the face of the visual display which, due to stereoscopic operation of the system appears to the operator to originate from point MX, MY, MZ corresponding to point X, Y, Z at the actual workspace. At the retina of the actual eye 92, a stimulus is produced at point X′ at proportionately the same position as point X′/M at eye 90 of the hypothetical observer. This relationship is ensured by selecting a correctly scaled camera distance and lens focal length such that the optical magnification Mo=M/Mv, where M is the desired overall magnification and Mv is the video magnification. A typical video magnification Mv, which equals the ratio of the CCD-array 98 width to the display width, is about 40.
Laparoscope 108 for viewing the workspace 104 is shown comprising an outer operating section 108A and insertion section 108B. The outer end section 120 of insertion section 108B is axially and rotatably movable within the inner end 122 thereof, and is provided with a pair of image transmission windows 124, 124 for stereoscopic viewing of workspace 104. The laparoscope also is provided with illuminating means, not shown, for illuminating the workspace, and with liquid inlet and outlet means, not shown, for flow of liquid past the windows. Video camera means within section 108A are responsive to light received through the viewing windows for generation of left and right electronic images at output lines 48R and 48L for connection to image memory 50. A magnified 3-dimensional image 104I is produced at display means 54 for viewing by the operator wearing cross-polarized classes 60 via mirror 66. As with the embodiment shown in FIGS. 1-3, a virtual image 104V of the workspace 104 is produced adjacent control arms 130R and 130L of controllers 102R and 102L. Control arms 130R and 130L are of the same type as control arms 76R and 76L included in the FIGS. 1-3 embodiment described above. They include telescopic inner and outer sections 132R1 and 132R, and 132L1 and 132L2. Sensor means 134R and 134L located adjacent the outer ends of the control arms control operation of end effectors 114R and 114L, respectively, in the manner described above with reference to FIGS. 1-3. It here will be noted that the angle from vertical at which the image is viewed by the operator need not equal the angle from vertical at which the object is viewed by the cameras. In the arrangement illustrated in FIGS. 7-9, the operator is shown to view the image 104V at an angle θ from vertical (FIG. 7) whereas the object 116 is shown as viewed directly downwardly. With no external reference, the sense of vertical within a body is not particularly great, and no confusion is produced in the mind of the operator as a result of the different observer and camera viewing angles relative to vertical.
A control arm 150L comprising inner and outer sections 150L1 and 150L2, respectively, is mounted within housing l44 for pivotal movement in any pivotal direction as indicated by intersecting double-headed arrows 152 and 154. The outer section 150L2 is adapted for axial movement into and out of inner section 150L1 in the direction of double-headed arrow 156. It also is adapted for rotation about its longitudinal axis in the direction of double-headed arrow 158. In this embodiment, the control arm includes an end section 160 pivotally attached to outer section 150L2 by wrist joint 162 for pivotal movement in the direction of double-headed arrow 164. End section 160 comprises axially aligned inner and outer sections 160A and 160B, the outer section 160B of which is rotatable about its longitudinal axis in the direction of double-headed arrow 166. As with the above-described arrangements, sensor means 168 are located adjacent the free end of the control arm for operation of an end effector 170 at manipulator 142 shown in FIG. 11.
Reference now is made to FIG. 14 wherein the distal end portion, or tip, 260 of the insertion section of an endoscope is shown which is of substantially the same type as shown in the above-mentioned publication entitled “Introduction to a New Project for National Research and Development Program (Large-Scale Project) in FY 1991,” which endoscope may be used in the practice of the present invention. The insertion end of the endoscope includes a pair of spaced viewing windows 262R and 262L and an illumination source 264 for viewing and illuminating a workspace to be observed. Light received at the windows is focused by objective lens means, not shown, and transmitted through fiber-optic bundles to a pair of cameras at the operating end of the endoscope, not shown. The camera outputs are converted to a 3-dimensional image of the workspace which image is located adjacent hand-operated means at the operator's station, not shown. Right and left steerable catheters 268R and 268L pass through accessory channels in the endoscope body, which catheters are adapted for extension from the distal end portion, as illustrated. End effectors 270R and 270L are provided at the ends of the catheters which may comprise conventional endoscopic instruments. Force sensors, rot shown, also are inserted through the endoscope channels. Steerable catheters which include control wires for controlling bending of the catheters and operation of an end effector suitable for use with this invention are well known. Control motors for operation of the control wires are provided at the operating end of the endoscope, which motors are included in a servomechanism of a type described above for operation of the steerable catheters and associated end effectors from a remote operator's station. As with the other embodiments, the interfacing computer in the servomechanism system remaps the operator's hand motion into the coordinate system of the end effectors, and images of the end effectors are viewable adjacent the hand-operated controllers in a manner described above. With this embodiment, the operator has the sensation of reaching through the endoscope to put his hands directly on the end effectors for control thereof. Endoscopes of different types may be employed in this embodiment of the invention so long as they include one or more accessory channels for use in control of end effector means, and suitable viewing means for use in providing a visual display of the workspace. For example, gastric, colonscopic, and like type, endoscopes may be employed.
1. An endoscopic surgical system comprising:
a control section and an insertion section, wherein the insertion section is insertable into a patient through an aperture in a body wall to a location adjacent a surgical worksite in the patient;
the insertion section comprising an elongate forearm portion having proximal and distal ends and a longitudinal centerline extending between the proximal and distal ends, and an end effector, the end effector coupled to the forearm portion distal end in such a manner as to provide the end effector with at least two degrees of freedom of movement within the patient;
the control section comprising an operator control station having a manual controller, and a drive system having plurality of control motors and linkages, the drive system operatively coupled to both the insertion section and the control station so that an operator is able to manually move the controller to operate the insertion section in such a manner as at least:
to move the forearm portion in at least one degree of freedom relative to a rotational center, wherein the rotational center is generally adjacent to the body wall aperture, and the rotational center is generally adjacent the centerline of to forearm portion,
to rotate the forearm portion about the proximal longitudinal centerline of the forearm portion,
to move the end effector in at least two degrees of freedom of movement within the patient relative to the forearm portion within the patient's body distal of the body wall during movement, and
to manipulate tissue at the surgical site with the end effector.
2. The surgical system of claim 1, wherein the drive system is further operatively coupled to the insertion section and the control station so that an operator is able to manually move the controller to operate the insertion section to rotate the end effector generally axially relative to the distal longitudinal centerline of the forearm portion within the patient's body distal of the body wall.
3. The surgical system of claim 1, wherein the coupling of the drive system to the insertion section restrains the motion of the forearm portion so that the longitudinal centerline of the forearm like remains substantially aligned to pass through the rotational center.
4. The surgical system of claim 1, wherein the drive system is further operatively coupled to the insertion section and the control station so that an operator is able to manually move the controller to operate the insertion section to move the end effector generally transversely in at least one degree of freedom relative to the distal longitudinal centerline of the forearm portion within the patients body distal of the body wall.
5. The surgical system of claim 4, wherein to end effector is couplable to the forearm portion by connection to a pivotal wrist member coupled to the forearm portion adjacent the distal end of the forearm portion, the wrist member actuatable to pivot in at least one degree of freedom of relative to the forearm portion.
6. The surgical system of claim 4, wherein the end effector is couplable to the forearm portion by connection to a bendable member coupled to the forearm portion.
7. The surgical system of claim 6, wherein the forearm portion includes at least one elongate steering control element coupled to the drive system and the bendable member, the control element actuatable to steer the bendable member in at least one degree of freedom of relative to the forearm portion.
8. The surgical system of claim 7, wherein the at least one elongate steering control element comprises a plurality of cables.
9. The surgical system of claim 1, wherein the distal longitudinal centerline of the forearm portion is generally aligned collinearly to the proximal longitudinal centerline of the forearm portion, the forearm portion defining a generally straight body.
10. An endoscopic surgical system having a control section operatively coupled to a surgical manipulator assembly;
the control section comprising an operator control station having a manual controller; and
the surgical manipulator assembly comprising a drive system and an insertion section insertable into a patient through an aperture in a body wall to a location adjacent a surgical worksite in the patient;
the insertion section including an end effector and an elongate forearm assembly having proximal end, a distal end and a longitudinal centerline extending between the proximal and distal ends;
the end effector being couplable to the forearm assembly in such a manner that the end effector is disposed adjacent the forearm assembly distal end;
the drive system having plurality of actuator motors and linkages, the drive system operatively coupled to both the insertion section and the control station so that an operator is able to manually move the controller to operate the insertion section in such a manner as at least:
to move the forearm assembly in at least one degree of freedom about an rotational center, wherein the rotational center is generally adjacent to, the body wall aperture, and the rotational center is generally adjacent the centerline of the proximal end of the forearm assembly;
to rotate the forearm assembly about the proximal longitudinal centerline; and
to provide the end effector with at least one motion actuation to manipulate tissue at the surgical site.
11. The surgical system of claim 10, wherein the drive system is further operatively coupled to the insertion section and to control station so that an operator is able to manually move the controller to operate the insertion section to rotate the end effector generally axially relative to the distal longitudinal centerline of the forearm assembly within the patient's body distal of to body wall.
12. The surgical system of claim 10, wherein the coupling of the drive system to the insertion section restrains the motion of the forearm assembly so that the longitudinal centerline of the forearm like remains substantially aligned to pass through the rotational center.
13. The surgical system of claim 10, wherein the drive system is further operatively coupled to the insertion section and the control station so that an operator is able to manually move the controller to operate the insertion section to move the end effector generally transversely in at least one degree of freedom relative to the distal longitudinal centerline of the forearm assembly within the patient's body distal of the body wall.
14. The surgical system of claim 13, wherein to end effector is couplable to the forearm assembly by connection to a pivotal wrist member coupled to the forearm assembly adjacent the distal end of the forearm assembly, the wrist member actuatable to pivot in at least one degree of freedom of relative to the forearm assembly.
15. The surgical system of claim 13, wherein the end effector is couplable to the forearm assembly by connection to a bendable member coupled to the forearm assembly.
16. The surgical system of claim 15, wherein the forearm assembly includes at least one elongate steering control element coupled to the drive system and the bendable member, the control element actuatable to steer the bendable member in at least one degree of freedom of relative to the forearm assembly.
17. The surgical system of claim 16, wherein the at least one elongate steering control element coupled comprises a plurality of cables.
18. The surgical system of claim 15, wherein the forearm assembly includes a longitudinal channel, the bendable member and end effector being removably insertable through the longitudinal channel so that the end effector extends distally from the forearm assembly to a point adjacent the surgical site.
19. The surgical system of claim 10, wherein the distal longitudinal centerline of the forearm assembly is generally aligned collinearly to the proximal longitudinal centerline of the forearm assembly, the forearm assembly defining a generally straight body.
20. A robotic medical instrument system having a control section operatively coupled to an instrument manipulator assembly;
the control section comprising an operator control station having a operator input device; and
the instrument manipulator assembly comprising a drive system, and an insertion section at least a portion of which is insertable through an aperture in a patient to a location adjacent a worksite within the patient's body,
the insertion section including:
a body member having a proximal end, a distal end and a longitudinal centerline extending between the proximal and distal ends;
at least one steerable bendable member having a proximal end and a distal end, the steerable bendable member coupled to the body member and arranged to extend distally of the body member; and
an end effector coupled adjacent the distal end of the steerable bendable member;
the drive system including a plurality of actuator motors and linkages, the drive system operatively coupled to both the insertion section and the control station so that an operator is able use the input device to operate the insertion section in such a manner as at least to move the steerable bendable member so as to provide the end effector with at least one degree of freedom of motion relative to the body member.
21. The surgical system of claim 20, wherein the end effector is movably actuatable, and wherein the drive system is further operatively coupled to both the insertion section and the control station so that an operator is able use the input device to operate the insertion section in such a manner as to provide the end effector with at least one motion actuation to manipulate tissue at the surgical site.
22. The surgical system of claim 20, wherein:
the aperture in the patient comprises a minimally invasive incision;
at least a portion of the body member is insertable through the incision; and
the drive system is further operatively coupled to both the insertion section and the control station so that an operator is able use the input device to operate the insertion section in such a manner as to move the body member in at least one degree of freedom with respect to an insertion point adjacent to the incision, the motion of the body member coordinated so that the longitudinal centerline of the body member remains aligned to substantially pass through the insertion point.
23. The surgical system of claim 22, wherein the at least one degree of freedom of motion of the body member with respect to the insertion point includes one of:
(a) pivotal rotation of the body member in a first direction about the insertion point;
(b) pivotal rotation of the body member in a second direction about the insertion point, perpendicular to the first direction;
(c) translation of the body member so that insertion point moves substantially along the body member centerline relative to the body member;
(d) axial rotation of the body about the centerline; and
(e) a combination of two or more of motions (a) through (d).
24. The surgical system of claim 20, wherein the drive system is further operatively coupled to both the insertion section and the control station so that an operator is able use the input device to operate the insertion section in such a manner as to rotate the end effector generally axially relative to the distal longitudinal centerline of the body member within the patient's body distal of the body wall.
25. The surgical system of claim 20, wherein the drive system includes at least one elongate steering control element couplable to the bendable member, the control element actuatable to steer the bendable member in the a least one degree of freedom of relative to the body member.
26. The surgical system of claim 25, wherein the at least one elongate steering control element coupled comprises a plurality of cables.
27. The surgical system of claim 20, wherein the body member includes a longitudinal channel, the bendable member and end effector being removably insertable through the longitudinal channel so that the end effector is extendable distally from the forearm assembly to a point adjacent the worksite.
28. The surgical system of claim 20, wherein the distal longitudinal centerline of the body member is generally aligned collinearly to the proximal longitudinal centerline of the body member, the body member defining a generally straight body.
29. The surgical system of claim 20, wherein the insertion section comprises one of a surgical treatment instrument, a diagnostic probe, an endoscope, and a combination of one or more of these.
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