Source: https://patents.justia.com/patent/7087049
Timestamp: 2019-09-19 13:30:41
Document Index: 508212852

Matched Legal Cases: ['application No. 60', 'art 300', 'art 300', 'art 300', 'art 300', 'art 300', 'art 300', 'art 300']

US Patent for Repositioning and reorientation of master/slave relationship in minimally invasive telesurgery Patent (Patent # 7,087,049 issued August 8, 2006) - Justia Patents Search
Justia Patents InstrumentsUS Patent for Repositioning and reorientation of master/slave relationship in minimally invasive telesurgery Patent (Patent # 7,087,049)
Jan 15, 2002 - Intuitive Surgical
The invention provides robotic surgical systems which allow selectable independent repositioning of an input handle of a master controller and/or a surgical end effector without corresponding movement of the other. In some embodiments, independent repositioning is limited to translational degrees of freedom. In other embodiments, the system provides an input device adjacent a manipulator supporting the surgical instrument so that an assistant can reposition the instrument at the patient's side.
The present application is a divisional of U.S. application Ser. No. 09/398,960, filed Sep. 17, 1999, now U.S. Pat. No. 6,459,926, which is a continuation-in-part of U.S. application Ser. No. 09/374,643, filed Aug. 16, 1999, now abandoned, which claims priority from U.S. Provisional Applic. No. 60/116,891, filed Jan. 22, 1999, U.S. Provisional Applic. No. 60/116,842, filed Jan. 22, 1999, and U.S. Provisional Applic. No. 60/109,359, filed Nov. 20, 1998, all of which are incorporated herein by this reference.
The present invention generally provides devices, systems, and methods which allow one or more of the components of a telesurgical robotic system to be selectively and independently repositioned. Generally, such telesurgical systems include a master controller having an input device which can be operatively associated with an articulated robotic manipulator arm supporting a surgical end effector in a master/slave system so that movement of the input device causes corresponding movement of the end effector. To allow independent movement of the input device or end effector in at least one degree of freedom, the surgeon will often activate an input device altering the mode of operation of the master/slave control system. In some embodiments, the control system will allow independent repositioning in at least one degree of freedom while inhibiting independent repositioning in at least one degree of freedom. For example, this allows an input handle of the master controller to be translationally repositioned relative to an image of the end effector shown on a display at the master controller workstation, while inhibiting rotational repositioning of the handle relative to the end effector. In other embodiments, a manipulator supporting a surgical instrument such as an endoscope or a tool for treating tissue may be manually repositioned independently of the input handle by actuating an input device on the manipulator, greatly facilitating both set-up and adjustment of the robotic surgical system during a surgical procedure.
FIGS. 3A–C show three-dimensional views of an input device including an articulated arm and wrist to be mounted on the arm for use in the master control station of FIG. 2.
FIGS. 8A–C illustrate alternative end effectors having surfaces for stabilizing and/or retracting tissue.
FIGS. 9A–E illustrate another cart supporting a fourth robotic manipulator arm in the telesurgical system of FIG. 1, and a bracket for mounting a tool on the manipulator arm.
FIGS. 11A–D schematically illustrate block diagrams and data transmission time lines of an exemplary controller for flexibly coupling master/slave pairs;
This application is related to the following patents and patent applications, the full disclosures of which are incorporated herein by reference: PCT International Application No. PCT/US98/19508, entitled “Robotic Apparatus”, filed on Sep. 18, 1998, U.S. patent application Ser. No. 60/111,713, entitled “Surgical Robotic Tools, Data Architecture, and Use”, filed on Dec. 8, 1998; U.S. patent application Ser. No. 60/111,711, entitled “Image Shifting for a Telerobotic System”, filed on Dec. 8, 1998; U.S. patent application Ser. No. 60/111,714, entitled “Stereo Viewer System for Use in Telerobotic System”, filed on Dec. 8, 1998; U.S. patent application Ser. No. 60/111,710, entitled “Master Having Redundant Degrees of Freedom”, filed on Dec. 8, 1998, U.S. patent application No. 60/116,891, entitled “Dynamic Association of Master and Slave in a Minimally Invasive Telesurgery System”, filed on Jan. 22, 1999; and U.S. Pat. No. 5,808,665, entitled “Endoscopic Surgical Instrument and Method for Use,” issued on Sep. 15, 1998.
As described in more detail in co-pending U.S. patent application Ser. No. 09/373,678 entitled “Camera Referenced Control In A Minimally Invasive Surgical Apparatus” and filed Aug. 13, 1999, the full disclosure of which incorporated herein by reference, a processor of master controller 200 will preferably coordinate movement of the input devices with the movement of their associated instruments so that the images of the surgical tools 100, as displayed to the operator, appear at least substantially connected to the input devices in the hands of the operator. Further levels of connection will also often be provided to enhance the operator's dexterity and ease of use of surgical instruments 100.
An example of one of the master control input devices is shown in FIGS. 3A–C, and is generally indicated by reference numeral 210. The master control device generally comprises an articulate positioning arm 210A supporting orientational gimbals 210B. Gimbals 210B (shown most clearly in FIG. 3B) have a plurality of members or links 212 connected together by joints 214, typically by rotational joints. The surgeon grips the master control 210 by positioning his or her thumb and index finger over a grip actuation handle, here in the form of a grip handle or pincher formation 216. The surgeon's thumb and index finger are typically held on the pincher formation by straps (not shown) threaded through slots 218. To move the orientation of the end effector, the surgeon simply moves the pincher formation 216 to the desired end effector orientation relative to the image viewed at the viewer 202, and the end effector orientation is caused to follow the orientation of the pincher formation. Appropriately positioned positional sensors, e.g., encoders, or potentiometers, or the like, are coupled to each joint of gimbals 210B, so as to enable joint positions of the master control to be determined as also described in greater detail herein below.
Gimbals 210B are similarly repositioned by movement of pincher formation 216, and this positional movement is generally sensed by articulation of input arm 210A as shown in FIG. 3A. Reference numerals 1–3 indicate orientational degrees of freedom of gimbals 210B, while numeral 4 in FIGS. 3A and 3B indicates the joint with which the master control and the articulated arm are connected together. When connected together, the master control 210 can also displace angularly about axis 4.
The articulated arm 210A includes a plurality of links 220 connected together at joints 222. Articulated arm 210A has appropriately positioned electric motors to provide for feedback as described in greater detail below. Furthermore, appropriately positioned positional sensors, e.g., encoders, or potentiometers, or the like, are positioned on the joints 222 so as to enable joint positions of the master control to be determined as further described herein below. Axes A, B, and C indicate the positional degrees of freedom of articulated arm 210A. In general, movement about joints of the master control 210B primarily accommodates and senses orientational movement of the end effector, and movement about the joints of arm 210A primarily accommodates and senses translational movement of the end effector. The master control 210 is described in greater detail in U.S. Provisional Patent Application Ser. No. 60/111,710, and in U.S. patent application Ser. No. 09/398,507, now U.S. Pat. No. 6,714,839, the full disclosures of which are incorporated herein by reference.
Tissue stabilizer end effectors 120a, b, and c, referred to generally as tissue stabilizers 120, are illustrated in FIGS. 8A–C. Tissue stabilizers 120 may have one or two end effector elements 122 that preferably are pivotally attached to the distal end of the shaft or wrist of a surgical instrument and are moveable with respect to one another, and that preferably comprise tissue-engaging surfaces 124. The tissue-engaging surfaces optionally include protrusions, ridges, vacuum ports, or other surfaces adapted so as to inhibit movement between the engaged tissue and the stabilizer, either through pressure applied to the engaged tissue or vacuum applied to draw the tissue into an at least partially stabilized position, or a combination of both pressure and vacuum. The ideal tissue engaging surface will constrain and/or reduce motion of the engaged tissue in the two lateral (sometimes referred to as the X and Y) axes, along the tissue-engaging surface, and the stabilizer configuration and engagement with the tissue will at least partially decrease motion normal to the surface. Other configurations for traditional stabilizers are known to those of skill in the art, such as the Octopus II of Medtronic, Inc. and various HeartPort, Inc. and CardioThoracic Systems stabilizers having multipronged and doughnut configurations. These manners of contacting tissue allow stabilizers 120 to firmly engage a moving tissue such as a beating heart of a patient and reduce movement of the tissue adjacent the stabilizer.
Auxiliary arm 302A and arm 302 used to support endoscope 304 need not necessarily include a drive system for articulating a wrist and/or end effectors within the patient body, unless, e.g., a wrist is to be used in connection with a stabilizer to improve positioning of the particular tissue to be stabilized. When auxiliary cart 300A is to be used to actively drive an articulated tool under the direction of an operator O or assistant via a processor, arm 302 may optionally be replaced by arm 312. Alternatively, where the auxiliary cart is to be used as a passive structure to hold an articulated surgical instrument at a fixed position and configuration within a patient body, a manual tool articulation bracket 370 may be used to mount the tool 100 to auxiliary arm 302A. The manual tool bracket 370 is illustrated in FIGS. 9C–9E.
An exemplary controller block diagram and data flow to flexibly couple pairs of master controllers with manipulator arms are shown in FIGS. 11A–11D. As described above, the operator 402 manipulates manipulators 404, here inputting actuation forces against both the left and right master manipulators fh (L, R). Similarly, both left and right positions of the master input devices will also be accommodated by the control system, as will forces and positions of four or more slave manipulator arms fe (1, 2, 3, and 4), xe (1, 2, 3, and 4). Similar left, right, and slave notations apply throughout FIGS. 11A–11D.
It should be noted that the control system of FIGS. 11A–11D may accommodate flexible tool mountings on the various manipulators. As described above, the first and second controllers CE1, CE2 may be used to manipulate tools for treating tissue, while the third controller CE3 is dedicated to tool movements using inputs from both master input devices. In general surgical procedures, it may desirable to remove the endoscope or other image capture device from a particular manipulator and instead mount it on a manipulator which was initially used to support a treatment tool. By appropriate commands sent via the control processor CTP to the servo timing generator STG, the pair assignments for the three controllers may be revised to reflect this change without otherwise altering the system operator's control over the system.
During pair re-assignment, appropriate data sets and/or transformations reflecting the kinematics of the master/slave pairs, the relationship of the image capture device with the end effectors, and the like, may be transmitted to the controller. To facilitate swapping the image capture device from one manipulator to another, it may be beneficial to maintain a common manipulator structure throughout the system, so that each manipulator includes drive motors for articulating tools, endoscope image transfer connectors, and the like. Ideally, mounting of a particular tool on a manipulator will automatically transmit signals identifying the tool to the control system, as described in co-pending U.S. patent application Ser. No. 60/111,719, filed on Dec. 8, 1998, entitled “Surgical Robotic Tools, Data Architecture, and Use.” This facilitates changing of tools during a surgical procedure.
Since the orientation of the end effector was held at the same position, and since the master orientation was caused to remain in a corresponding orientation, realignment of the end effector and master is normally not necessary. Re-connection of master and slave takes place upon release of the foot pedal as indicated at 456. The reconnection will now be described with reference to FIG. 19.
The step indicated at 502 will now be described in greater detail with reference in particular to FIG. 15, and also with reference to FIG. 11. When the button 480 is depressed, the position θd of the slave in joint space immediately before depression of the button is recorded in a memory of the slave joint controller 420, and as indicated at 460. As the slave is moved thereafter, its position in joint space indicated by θu is compared with θd at 462. As θa deviates from θd error signals corresponding to the positional deviation in joint space is determined at 462 and is passed to 464. At 464 required torques for the electric motors on the slave are determined to cause the slave to return to the θd position. The torques thus determined which relate to translational torques of the slaves are zeroed at 466 to permit the slave translational movements to float. The torques corresponding to orientational movement are not zeroed. Thus, any environmental forces on the end effector urging an orientational position change are fed back to the end effector to cause it to retain its orientation. In this way the orientation of the end effector relative to the end of the instrument shaft 104 is locked in position. Although the orientation of the end effector does not change relative to the end of the shaft, it does change in position in Cartesian space as a result of translational position change. It should be understood that zeroing of the outer joint torques at step 466 may be effected by a variety of methods, including zeroing of the appropriate gains in P.I.D. controller 464, continually updating the appropriate elements in memory 460 so as to compute a zero error signal at comparison 462, or the like.
It should be also be understood that a variety of additional operation configurations may be implemented which allow slave transitional movements to float free of the master control. For example, slave transitional forces may be zeroed in Cartesian space (analogous to the master clutching algorithm described with reference to FIGS. 12 and 13). Alternatively, control system 400 and/or bilateral controller 410 may be interrupted only for translational motions, locking the master translational position and allowing the slave to float in translational position, all while connecting the master orientation to the slave orientation. Once the slave is at the desired position the button is released as indicated at 510 in FIG. 14.
It will furthermore be appreciated that the determination of master-slave association, which is computed automatically according to FIG. 22A and 22B, may be specified manually by way of a suitable input device, such as buttons, a foot pedal, voice control, mouse input, or any other suitable form. If the association is specified manually, only steps 911 and 916 need be performed to execute the association.
Referring now to FIGS. 1, 23A and 23B, many of the above steps may be used to selectively associate any of a plurality of tools with any of a plurality of input devices. Operator O may initiate a tool selection subroutine 910 by actuating a tool selector input, such as by depressing foot activated button 208a of workstation 200 (illustrated in FIG. 2). Assuming operator O is initially manipulating tools A and B with input devices 210L and 210R using his or her left and right hands LH and RH, respectively, tool selector procedure 910 will be described with reference to a change of association so that input device 210L is instead associated with a tool C, here comprising a tissue stabilizer 120.
Once the tool selector subroutine is activated, the operator will generally select the desired tools to be actively driven by the robotic system. The surgeon here intends to maintain control over Tool B, but wishes to reposition stabilizer 120. Optionally, operator O will select between the left and right input devices for association with the newly selected tool. Alternatively, the processor may determine the appropriate left/right association based on factors more fully described in co-pending U.S. patent application Ser. No. 60/116,891, filed on Jan. 22, 1999, and entitled “Dynamic Association Of Master And Slave In A Minimally Invasive Telesurgical System,” the full disclosure of which is incorporated herein by reference.
Once the selected master has been allowed to float, the master may be moved into alignment with the selected tool step 1000 as illustrated in FIG. 23A, as was described above with reference to FIG. 18. Often, this will occur while the surgeon keeps a hand on the input device, so that the drive motors of the master should move the master at a moderate pace and with a moderate force to avoid injury to the surgeon. Master input device 210L may then be coupled to tool C (stabilizer 120 in our example) while tool A is held in a fixed position. This allows the operator to reposition stabilizer 120 against an alternative portion of coronary artery CA. The tool selection process may then be repeated to re-associate the masters with tools A and B while tool C remains fixed. This allows the surgeon to control repositioning of stabilizer 120 without significantly interrupting anastomosis of the coronary artery CA with the internal mammary artery IMA.
Many of the steps described above will also be used when “handing-off” control of a tool between two masters in a tool hand-off subroutine 920, as illustrated in FIG. 24. Tool hand-off is again initiated by actuating an appropriate input device, such as by depressing foot pedal 208b shown in FIG. 2.
Once the toll and master are designated, the hand-off tool (and any tool previously associated with the designated master) is fixed, and the designated master is allowed to float step 924. The master is then aligned and connected with the tool step 926, as described above.
The following pertains to an exemplary robotic surgery procedure that may be performed with the foregoing apparatuses and methods. Referring now to FIGS. 1, 25A, and 25B, a single complex minimally invasive surgery will often involve interactions with tissues that are best viewed and directed from different viewing angles. For example, in performing a Coronary Artery Bypass Grafting (CABG) procedure on patient P, a portion of the internal mammary artery IMA will be harvested from along the internal surface of the abdominal wall. The internal mammary artery IMA can be used to supply blood to coronary artery CA downstream of an occlusion, often using an end-to-side anastomosis coupling the harvested end of the IMA to an incision in the side of the occluded coronary artery. To provide appropriate images to Operator O at master control station 200, the operator may sequentially select images provided by either a first scope 306a or a second scope 306b for showing on display 800 of the workstation. The camera switch procedure can be understood through a description of an exemplary CABG procedure in which different camera views may be used. Two scopes are shown in FIG. 25A for illustrative purposes only. If only one image is desired, however, the procedure need not employ two endoscopes but instead need only use one together with various instruments for actually performing the procedure.
As seen in FIG. 1 and 25A, it may generally be beneficial to access heart H primarily through a pattern of apertures 930 disposed along a right side of patient P. Although the heart is primarily disposed in the left side of the chest cavity, approaching the heart from the left side of the chest as is typically done for MIS heart surgery may limit the amount of working volume available adjacent the target coronary tissues. This lack of working volume can complicate thoracoscopic robotic procedures, as the lack of space can make it difficult to obtain a panoramic view of the heart surrounding the tissues targeted for treatment, to quickly insert and remove tools, and to retract the heart appropriately for multi-vessel cases.
11. The right internal mammary artery (RIMA) may be harvested using steps similar to 1–10 above, optionally through apertures disposed along the left side of the patient's chest.
14. Aorta is exposed by extending the pericardiotomy cephalad as desired. The pulmonary artery and any other adhesions may be dissected off so that the aorta can be clamped for cardiopulmonary bypass and/or proximal grafts. As can be understood with reference to the description above of FIG. 23A, cardioplegia may be avoided by using a manual or robotic cardiac tissue stabilizer mounted to, for example, auxiliary cart 300A during the anastomosis.
More easily implemented approaches might allow the operator O to switch views between scopes 306a and 306b without major software revisions. Using software developed to perform telesurgery with a single master control station 200 coupled to a single three arm cart 300 (see FIG. 1), switching the view to scope 306b from scope 306a might be accomplished while maintaining the substantially connected relationship by “fooling” the processor of the master control station into believing that it is still viewing the surgery through scope 306a. More accurately, the processor may be fed signals which indicate that the middle set-up joint 395 and/or manipulator arm 302 of cart 300 are supporting scope 306a at the actual orientation of scope 306b. This may be accomplished by decoupling the position sensing circuitry of the middle set-up joint and/or manipulator of cart 300 from the processor, and instead coupling an alternative circuit that transmits the desired signals. The alternative “fooling” circuit may optionally be in the form of a sensor system of an alternative set-up joint and/or manipulator 302, which might be manually configured to hold a scope at the orientation of scope 306b relative to cart 300, but which need not actually support anything. The image may then be taken from scope 306b supported by auxiliary cart 300A, while the slave position signals xs (See FIG. (11) are taken from the alternative set-up joint. As described above, so long as the orientation of the end effectors relative to the scope are accurately known, the system can easily accommodate positional corrections (such as by the translational clutching procedure described above).
a manipulator movably supporting at least one surgical instrument;
a controller comprising an input device, the controller operatively associated with the manipulator to cause selective movement of the instrument in response to inputs from an operator at the controller; and
a clutching assembly that is movable from a first mode to a second mode,
wherein the clutching assembly in the first mode is configured to interrupt the operative association between the controller and the manipulator so that one of the input device and the surgical instrument is moved from one position to another while the other of the input device and surgical instrument is held in a substantially fixed position and to inhibit independent repositioning of the input device in at least one rotational degree of freedom, and the clutching assembly in the second mode is configured to reestablish the operative association between the manipulator and the controller after the surgical instrument or input device has been repositioned.
Thring, “Robots and telechirs: Manipulators with memory; remote manipulators: machine limbs for the handicapped” (1993) M.W. Thring/Ellis Horwood Ltd. pp. 9-11, 122-131, 194-195, 235-257, 274-279.
Yan et al., “Desing and control of a motion scaling system for microsurgery experiments” Department of Electrical Engineering, University of British Columbia, pp. 211-216.
Patent number: 7087049
Patent Publication Number: 20020128552
Assignee: Intuitive Surgical (Sunnyvale, CA)
Inventors: William C. Nowlin (Los Altos, CA), Gary S. Guthart (Foster City, CA), J. Kenneth Salisbury, Jr. (Los Altos, CA), Gunter D. Niemeyer (Mountain View, CA)
Attorney: Townsend & Townsend
Application Number: 10/052,204
Current U.S. Class: Instruments (606/1); Stereotaxic Device (606/130); Robot Control (700/245)