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made the due proportions...
INCY
Jakafi’s (a first-in-class JAK1/JAK2 inhibitor approved for polycythemiavera, myelofibrosis and refractory acute graft-versus-host disease) revenues came in at $619.5 million.
Jakafi® (ruxolitinib) net product revenues of $598 million in Q2’22 (+13% Y/Y) driven by volume growth; raising the bottom end of full year guidance to new range of $2.36 to $2.40 billion
Very well!
someone covers up?
BOOM!
Hand Grip Apparatus For Receiving Operator Input In A Robotic Surgery System
DOCUMENT ID
US 11484378 B2
DATE PUBLISHED
2022-11-01
INVENTOR INFORMATION
NAME
CITY
STATE
ZIP CODE
COUNTRY
Lutzow; Thomas Andrew
Providence
RI
N/A
US
Smith; Daniel P.
Portsmouth
RI
N/A
US
Cameron; Peter John Kenneth
Menlo Park
CA
N/A
US
APPLICANT INFORMATION
NAME
Titan Medical Inc.
CITY
Toronto
STATE
N/A
ZIP CODE
N/A
COUNTRY
CA
AUTHORITY
N/A
TYPE
assignee
ASSIGNEE INFORMATION
NAME
Titan Medical Inc.
CITY
Toronto
STATE
N/A
ZIP CODE
N/A
COUNTRY
CA
TYPE CODE
03
APPLICATION NO
15/737245
DATE FILED
2016-04-13
DOMESTIC PRIORITY (CONTINUITY DATA)
us-provisional-application US 62180312 20150616
US CLASS CURRENT:
1/1
CPC CURRENT
TYPE
CPC
DATE
CPCI
A 61 B 34/37
2016-02-01
CPCI
A 61 B 34/74
2016-02-01
CPCI
A 61 B 34/30
2016-02-01
CPCI
A 61 B 18/1445
2013-01-01
CPCA
A 61 B 2017/0042
2013-01-01
CPCA
A 61 B 90/361
2016-02-01
CPCA
A 61 B 2018/00595
2013-01-01
Abstract
A hand grip apparatus for receiving operator input includes a body having a proximal end and a distal interface end for coupling to an input apparatus. A first control lever is attached to the body and extends away from the proximal end and terminates in a finger grip for receiving one of the operator's fingers. A second control lever is attached to the body and extends away from the proximal end terminating in a thumb grip for receiving the operator's thumb. Movement of at least one of the control levers is operable to produce a first control signal representing the movement. An input control is included on the body between the grip ends and has an actuator surface angled towards the finger grip end and configured to produce a second control signal in response to actuation by one of the operator's fingers.
Background/Summary
CROSS-REFERENCE TO RELATED APPLICATION
(1) This application is a U.S. National Phase Application under 35 U.S.C. 371 of International Application No. PCT/CA2016/000112 filed on Apr. 13, 2016 and published as WO 2016/201544 A1 on Dec. 22, 2016. This application is based on and claims the benefit of priority from U.S. Provisional Application No. 62/180,312, filed Jun. 16, 2015. The entire disclosures of all of the above applications are incorporated herein by reference.
BACKGROUND
1. Field
(1) This disclosure relates generally to robotic surgery systems and more particularly to a hand grip apparatus for receiving operator input for controlling the robotic surgery system to perform surgical procedures.
2. Description of Related Art
(2) Robotic surgery systems generally include an operator interface that receives operator input from a surgeon and causes corresponding movements of surgical tools within a body cavity of a patient to perform a surgical procedure. For example, the operator may grasp and move a hand grip while the operator interface senses movements of the hand grip. The operator interface and hand grip may operate to sense inputs responsive to movement of the operator's hand in several different degrees of freedom, thus providing inputs for causing the surgical tool to mimic movements of the operator's hand. Additional movements such as opening and closing of jaws of an end effector associated with the surgical tool may also be initiated in response to additional operator inputs received at the operator interface.
SUMMARY
(3) In accordance with one disclosed aspect there is provided a hand grip apparatus for receiving operator input for controlling a surgical tool in a robotic surgery system. The apparatus includes a generally tubular body having a proximal end shaped to be grasped by a hand of the operator and a distally located interface end operably configured to be coupled to an input apparatus for controlling the surgical tool. The apparatus also includes a first control lever attached to the body at a first pivot joint and extending along the body away from the proximal end, the first control lever terminating in a finger grip end configured to receive one of the operator's fingers, the first control lever being laterally moveable away from the body about the first pivot joint. The apparatus further includes a second control lever attached to the body at a second pivot joint on a generally opposing side of the body to the first pivot joint, the second control lever extending along the body away from the proximal end and terminating in a thumb grip end configured to receive the operator's thumb, the second control lever being laterally moveable away from the body about the second pivot joint. Movement of at least one of the first and second control levers is operable to produce a first control signal representing the movement. The apparatus also includes an input control on an upper surface of the body and generally interposed between the finger and thumb grip ends, the input control having an actuator surface that is angled towards the finger grip end and being operably configured to produce a second control signal in response to actuation of the actuator surface by one of the operator's fingers.
(4) The first control signal may include an electrical control signal and the apparatus may further include a sensor for producing the electrical control signal in response to lateral movement of at least one of the first and second control levers.
(5) The first control signal may include a mechanical movement of a linkage coupled to at least one of the first and second control levers.
(6) The actuator surface of the input control may be oriented such that the operator's knuckles will be generally parallel to the actuator surface when grasped by the hand of the operator in a generally neutral position.
(7) The control button may be surrounded by a land disposed generally parallel to the actuator surface of the input control.
(8) The first and second pivot joints may be spaced apart on the body by a distance corresponding to a distance between the metacarpophalangeal joints of the thumb and index finger of an average operator.
(9) The first and second control levers may be sized such that when grasped by the hand of an average operator, the finger grip end and thumb grip end on the respective levers are positioned to receive distal phalanges of the operator's finger and thumb.
(10) The finger grip may be configured to receive the operator's index finger, and the actuator surface of the input control may be angled to be actuated by the index finger moving between the finger grip and the input control.
(11) The finger grip may be configured to receive the operator's middle finger, and the actuator surface of the input control may be angled to be actuated by the index finger.
(12) The proximal end of the body may be configured to receive one of a plurality of different removable end caps, the removable end cap facilitating configuration of the apparatus in accordance with the operator's preference.
(13) The proximal end of the body may have a rounded shape operable to receive and support a portion of the operator's palm when the body is grasped in the hand of the operator.
(14) The proximal end of the body may be angled with respect to the tubular body.
(15) The tubular body may have a neck portion interposed between the proximal end and the interface end, the neck portion having reduced cross sectional extent with respect to the proximal end.
(16) The first and second control levers may be mechanically coupled such that movement of one of the control levers causes a corresponding opposing lateral movement of the other of the control levers.
(17) The first and second control levers may be mounted to constrain the lateral movement of each of the levers to a range corresponding to an ergonomically comfortable lateral movement of the thumb and finger of an average operator.
(18) At least one of the finger and thumb grip ends may include a retaining loop operably configured to retain the operator's finger or thumb for actuating the respective levers.
(19) The retaining loop associated with the first control lever may include a loop portion and an open portion, the open portion being disposed to permit lateral movement of the operator's finger between the finger grip and the input control.
(20) The retaining loop of the at least one of the finger and thumb grip ends may be oriented downwardly at an angle corresponding to a natural orientation of the operator's thumb or finger when the body is grasped such that the operator's palm rests on an upper surface of the body.
(21) Each of the first and second control levers may be disposed within respective sculpted portions on generally opposing sides of the body, each extending forwardly from the proximal end toward the interface end, the respective sculpted portions being operable to receive the operator's finger and thumb when the body is grasped from behind the proximal end.
(22) The apparatus may include at least one proximity sensor disposed to sense one of the operator's hand grasping the hand grip apparatus, and a position of the operator's hand with respect to the tubular body.
(23) In accordance with another disclosed aspect there is provided a method for receiving operator input in a robotic surgery system. The method involves receiving a hand of the operator at a generally tubular body having a proximal end shaped for to be grasped by the operator's hand, the tubular body having a distally located interface end operably configured to be coupled to the input apparatus. The method also involves receiving one of the operator's fingers in a finger grip end of a first control lever attached to the body at a first pivot joint and extending along the body away from the proximal end, the first control lever being laterally moveable away from the body about the first pivot joint. The method further involves receiving the operator's thumb in a thumb grip end of a second control lever attached to the body at a second pivot joint on a generally opposing side of the body to the first pivot joint, the second control lever extending along the body away from the proximal end and being laterally moveable away from the body about the second pivot joint. The method also involves receiving one of the operator's fingers at an input control on an upper surface of the body and generally interposed between the finger and thumb grip ends, the input control having an actuator surface that is angled towards the finger grip end. The method further involves producing a first control signal at the interface in response to lateral opening and closing movements of the operator's finger and thumb causing corresponding lateral movement of the first and second control levers, and producing a second control signal at the interface end in response to actuation of the input control.
(24) The method may involve receiving the first control signal at an input apparatus for controlling a surgical tool, the first control signal being operable to control opening and closing functions open of a jaw of an end effector associated with the surgical tool.
(25) The method may involve receiving the second control signal at an input apparatus for controlling a surgical tool, the second control signal being operable to control additional functions associated with the surgical tool.
(26) The additional functions may include one of supply of an electrical current through the jaws of the surgical tool for electro-cauterization of tissue, and functions associated with a surgical viewing system for generating views of a surgical site.
(27) The method may involve receiving a signal from at least one proximity sensor disposed to sense one of the operator's hand grasping the hand grip apparatus and a position of the operator's hand with respect to the tubular body.
(28) Other aspects and features of the present invention will become apparent to those ordinarily skilled in the art upon review of the following description of specific embodiments of the invention in conjunction with the accompanying figures.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) In drawings which illustrate embodiments of the invention,
(2) FIG. 1A is a right side perspective view of a hand grip apparatus in accordance with one disclosed embodiment;
(3) FIG. 1B is a left side perspective view of the hand grip apparatus shown in FIG. 1A;
(4) FIG. 2 is a perspective view of an input apparatus including the hand grip shown in FIG. 1;
(5) FIG. 3A is a front view of the hand grip shown in FIG. 1 being grasped by an operator's hand;
(6) FIG. 3B is a side view of the hand grip shown in FIG. 1 being grasped by the operator's hand;
(7) FIG. 4A is a top cutaway view of the hand grip apparatus shown in FIG. 1 with first and second levers in a closed state;
(8) FIG. 4B is a top cutaway view of the hand grip apparatus shown in FIG. 1 with first and second levers in an open state;
(9) FIG. 5 is a right side perspective view of a hand grip apparatus in accordance with an alternative disclosed embodiment;
(10) FIG. 6 is a right side perspective view of a hand grip apparatus in accordance with another disclosed embodiment;
(11) FIG. 7A is a right side perspective view of a hand grip apparatus in accordance with yet another disclosed embodiment;
(12) FIG. 7B is a left side perspective view of a hand grip apparatus shown in FIG. 7A;
(13) FIG. 8 is a side view of the hand grip shown in FIGS. 7A and 7B being grasped by an operator's hand; and
(14) FIG. 9 is a pictorial representation of a robotic surgery system according to one disclosed embodiment.
DETAILED DESCRIPTION
(15) Referring to FIGS. 1A and 1B, a hand grip apparatus according to a first embodiment of the invention is shown generally at 100. The hand grip 100 is shown in a right side perspective view in FIG. 1A and a left side perspective view in FIG. 1B. The hand grip 100 includes a generally tubular body 102 having a proximal end 104 shaped to be grasped by a hand of an operator. In the embodiment shown the proximal end 104 of the body has a rounded shape operable to receive and support a portion of the operator's palm when the body 102 is grasped in the hand of the operator.
(16) The hand grip 100 also includes a distally located interface end 106. Referring to FIG. 2, the interface end 106 of the hand grip apparatus 100 is configured for coupling to an input apparatus 200 for controlling a surgical tool associated with a robotic surgery system (not shown). The input apparatus 200 includes an output 202 for producing signals in response to movements of the operator's hand 204. In one embodiment, the surgical tool may include an articulated tool positioner as described in detail in commonly owned patent application PCT/CA2013/001076 entitled “ARTICULATED TOOL POSITIONER AND SYSTEM EMPLOYING SAME”, which is incorporated herein by reference. The input apparatus 200 may be implemented using one of the Omega series of haptic devices available from Force Dimension, of Switzerland, for example.
(17) The input apparatus 200 and hand grip apparatus 100 are configured for operation by a right hand of the operator and in practice a left hand input apparatus and hand grip will also be provided. The left hand grip may be configured as a mirror image of the right hand grip 100 shown in FIG. 1, but may also be differently configured depending on the nature of the task the apparatus is to control.
(18) Referring back to FIG. 1A, the hand grip 100 also includes a first control lever 108 attached to the body 102 at a first pivot joint 110. The first control lever 108 extends along the body 102 away from the proximal end 104. The first control lever 108 terminates in a finger grip end 112 configured to receive one of the operator's fingers. In the embodiment shown the finger grip end 112 is configured as a retaining loop having a loop portion 132 and an open portion 134. The loop portion 132 is configured to retain the operator's finger while the open portion 134 allows the operator's finger to be easily removed from the finger grip end 112 to permit independent lateral movement of the operator's finger. Referring to FIG. 1B, the hand grip 100 also includes a second control lever 114 attached to the body 102 at a second pivot joint 116 on a generally opposing side of the body to the first pivot joint. The second control lever 114 also extends along the body away from the proximal end 104. The second control lever 114 terminates in a thumb grip end 118 configured to receive the operator's thumb.
(19) The first control lever 108 and the second control lever 114 are shown in an open position in FIG. 1A and in a closed position in FIG. 1B. Referring to FIG. 1A, in the embodiment shown the body 102 includes a cutout portion 120 for receiving the first control lever 108 when the first control lever is in the closed position. Referring to FIG. 1B, the body 102 also includes a cutout portion 119 and the lever 108 is received in the cutout such that a surface the lever is generally contiguous with surfaces of the body when the lever is in the closed position. The first control lever 108 is laterally moveable away from the body 102 about the first pivot joint 110 and the second control lever 114 is laterally moveable away from the body about the second pivot joint 116.
(20) Referring to FIG. 2, the operator's index finger 206 is shown engaging the finger grip end 112 and the operator's thumb 208 is shown engaging the thumb grip end 118 of the second control lever 114. The operator is able to open and close the first and second control levers 108 and 114 by making pincer movements with the index finger and thumb respectively. The first and second control levers 108 and 114 are sized such that when grasped by the hand 204 of an average operator, the finger grip end 112 and thumb grip end 118 on the respective levers are positioned to receive distal phalanges of the operator's finger 206 and thumb 208. In this embodiment the thumb grip end 118 is also configured as a retaining loop having a loop portion 136 and an open portion 138 and the loop portion is configured to retain the operator's thumb. Alternatively, the thumb grip end 118 may be configured as a closed loop in applications where it is not necessary for the operator to frequently remove the thumb from the grip end.
(21) The body 102 of the hand grip 100 includes a neck portion 103 portion interposed between the proximal end 104 and the interface end 106, the neck portion having a reduced cross sectional extent with respect to the proximal end 104. The neck portion 103 and the proximal end 104 together provide a bulb shaped grip, which when grasped from behind by the operator's hand is easily and comfortably retained.
(22) The hand grip 100 also includes an input control 122 on an upper surface of the body 102. The input control 122 is generally interposed between the finger grip end 112 and thumb grip end 118 and has an actuator surface 126 that is angled towards the finger grip end for actuation by one of the operator's fingers. The operator's hand 204 is shown grasping the hand grip 100 in FIGS. 3A and 3B. Referring to FIG. 3A, the angled actuator surface 126 of the input control 122 is comfortably located for actuation by the operator moving the index finger 206 from the finger grip end 112 to the input control 122. Alternatively, the operator may have a preference for operating the first control lever 108 using as middle finger, while the index finger 206 is held on or near the actuator surface 126 of the input control 122. In the embodiment shown the actuator surface 126 of the input control is oriented at an angle a such that the operator's knuckles 220 and 222 are generally parallel to the actuator surface 126 when the hand grip 100 is grasped by the operator's hand 204 in a generally neutral position. In one embodiment the angle a may be between about 20° and 30°. The neutral position of the hand 204 is a position in which there is a minimum of stress placed on the operator's wrist, forearm and shoulder, i.e. a comfortable position that does not induce undue fatigue.
(23) Referring to FIG. 3B, in this embodiment when the operator's hand grasps the hand grip 100 over the top of the body 102, the palm of the operator's hand 204 rests generally on an upper surface at the proximal end 104 of the body. The thumb grip end 118 is also angled downwardly at an angle ? when the body 102 is held in a horizontal orientation aligned with a horizontal axis 210. The angle ? is selected to correspond to a natural orientation of the thumb 208 when the operator's hand 204 is in a generally unstressed manner and the thumb engages the retaining loop portion of the thumb grip end 118. The finger grip end 112 may be similarly oriented at an angle corresponding to a natural orientation of the operator's finger when engaging the retaining loop portion of the finger grip 112 (not visible in FIG. 3B). In one embodiment the angle ? may be between about 10° and 25° for the operator's thumb 208 and between about 15° and 28° for the operator's index finger 206.
(24) Referring back to FIG. 1A, in the embodiment shown the input control 122 is surrounded by a land 124, which is disposed generally parallel to the actuator surface 126 of the input control. The input control 122 may be configured to control any of a number of functions any of the surgical tool or robotic surgery system. In the embodiment shown, the input control 122 is configured as a rocker button that is operable to control a first function when a forward area 128 of the input control is pressed by the operator's finger and a second function when a rearward area 130 of the input control is pressed by the operator's finger. In other embodiments the input control 122 may be implemented using an input device or sensor configured to detect various user inputs, for example a trackpad or touchpad, track ball, joystick, optical sensor, or thermal sensor. The input control 122 is configured to produce a control signal in response to for actuation of the actuator surface by one of the operator's fingers. In one embodiment, the input control 122 may be used to control operations of an illuminator and/or camera associated with the robotic surgery system.
(25) The hand grip 100 is shown in cutaway view in FIGS. 4A and 4B with a portion of an upper cover 250 removed to reveal mounting details associated with the first and second control levers 108 and 114. Referring to FIG. 4A, the first control lever 108 includes a pivot end 252 mounted on the first pivot joint 110 and an actuator arm 254 extending generally laterally into the body 102 of the hand grip 100. Similarly, the second control lever 114 includes a pivot end 256 mounted on the second pivot joint 116 and an actuator arm 258 extending generally laterally into the body 102 of the hand grip 100. The hand grip 100 further includes a linkage 260 including a slot 261. The hand grip 100 also includes a guide post 262, which is received in the slot 261 and permits reciprocating movement of the linkage 260 in the direction of arrow 268. The arms 254 and 256 are each coupled to a distal end 264 of the linkage 260 at a revolute joint 266, such that movement of either of the first or second control levers 108 or 114 causes movement of the respective arm, in turn causing movement of the linkage 260. Additionally movement of either one of the arms 254 and 256 also causes a corresponding movement of the other of the arms. 12. The first and second control levers 108 and 114 are thus mechanically coupled such that movement of one of the control levers causes a corresponding opposing lateral movement of the other of the control levers. An extent of lateral movement of the first and second control levers 108 and 114 is also constrained by the length of the slot 261. In one embodiment, the slot 261 is sized to constrain movement of the levers 108 and 114 to a range corresponding to an ergonomically comfortable lateral movement of the thumb 208 and finger 206 of an average operator.
(26) Referring to FIG. 4B, outward lateral movement of either or both of the first and second control levers 108 and 114 thus causes the linkage 260 to be advanced forwardly in the direction indicated by the arrow 268. In this embodiment, the hand grip 100 also includes a sensor 280 for producing a first control signal in response to movement of the linkage 260 caused by lateral movement of either of the first and second control levers. The sensor 280 may be implemented using a linear encoder. In other embodiments movement of the linkage 260 may be mechanically coupled through the body 102 and may mechanically interface with the input apparatus 200.
(27) Still referring to FIG. 4B the first and second pivot joints 110 and 116 are spaced apart on the body by a distance D. In one embodiment, the spacing D between the pivot joints is selected to correspond to a distance (for an average operator) between the metacarpophalangeal joints associated with the thumb and index finger thus reducing strain on the operator's hand when operating the first and second control levers 108 and 114. When the hand grip 100 is grasped in the operator's right hand with the operator's finger 206 engaging the finger grip end 112 and the operator's thumb 208 engaging the thumb grip end 118, the metacarpophalangeal joint of the thumb is located generally above the second pivot joint 116 and the metacarpophalangeal joint (i.e. the operator's knuckle 220) of the finger is located generally above the first pivot joint 110. In a hand grip 100 configured for the operators left hand, the thumb and finger grip ends 112 and 118 would be reversed.
(28) Referring to FIG. 5, an alternative embodiment of a hand grip apparatus is shown generally at 300. The hand grip 300 has a body 302 generally configured as shown in FIG. 1 but includes a proximal end 304 of the body that is angled with respect to the tubular body. In the embodiment shown the proximal end 304 is angled in a generally lateral direction with respect to the body 302 and is configured to provide a support surface for the operator's palm when grasping the hand grip 300. Referring to FIG. 6, another embodiment of the hand grip apparatus is shown generally at 320. In this embodiment the hand grip 320 includes a removable end cap 324, which has a generally similar shape to the proximal end 104 shown in FIG. 1. The removable end cap 324 may be made easily removable by the operator to permit the operator to select an end cap in accordance with their personal preferences. The removable end cap 324 is separable from the body 322 of the hand grip 320 and may be retained on the body by a snap connection, a fastener, or other securing means. For example, a set of end caps may be provided including different lengths of the removable end cap as shown at 324 and/or different shapes of and cap, such as shape of the proximal end 304 shown in FIG. 5. The set end caps may be fabricated relatively inexpensively and permit configuration for a variety of hand sizes and operator preferences.
(29) An alternative embodiment of a hand grip apparatus is shown generally at 350 in FIG. 7. A right hand side of the body is shown in FIG. 7A and a left hand side of the body is shown in FIG. 7B. Referring to FIG. 7A, the hand grip 350 includes a body 352 having a proximal end 354 and an interface end 356. The hand grip 350 also includes first and second control levers 358 and 360 and an input control 362 as generally described above in connection with the FIG. 1 embodiment. In this embodiment, the body 352 of the hand grip 350 includes a sculpted lateral portion 364 and the first control lever 358 is disposed on the sculpted portion. Referring to FIG. 7B, the body 352 also includes a sculpted lateral portion 366 and the second control lever 360 is disposed on the sculpted portion. The sculpted portions 364 and 366 are oriented generally parallel to a longitudinal axis 370 of the body 352. Referring to FIG. 8, the generally parallel sculpted portions 364 and 366 (only portion 366 is visible in FIG. 8) permit the operator to grasp the hand grip 350 from behind. In this embodiment, the palm of the operator's hand 204 does not rest on top of the body 352 as described in connection with the hand grip 100. Rather the palm of the operator's hand 204 is disposed behind and supported by the proximal end 354 of the hand grip 350. The proximal end 354 may be configured according to the operator's preferences as described above in connection with FIG. 5 and FIG. 6. In the embodiment shown in FIGS. 7A, 7B and 8 the hand grip 350 has a downwardly extending end cap portion while in other embodiments the hand grip may have a rounded end cap such as shown 324 in FIG. 6.
(30) In the embodiment shown in FIG. 7B, the hand grip 350 includes a plurality of proximity sensors 372, 374, and 376 located on the second control lever 360. When the operator's hand 204 grasps the hand grip 350 the operator's thumb 208 may be positioned forwardly or rearwardly with respect to the body 352 depending on the operator's preference. The proximity sensors 372-376 generate signals for detecting the position of the operator's thumb 208, which may be used to provide an indication that the hand grip 350 is being grasped by the operator's hand 204 and also to provide information regarding the position of the operators hand on body 352 the hand grip. The proximity sensors 372, 374, and 376 may be implemented using any of a variety of proximity sensor types, for example optical and/or capacitive sensors.
(31) Referring to FIG. 9, a robotic surgery system is shown generally at 400. The robotic surgery system 400 includes an input console 402 and a surgical robot 404. The input console 402 includes the input apparatus 200 and the hand grip apparatus 100 shown in FIG. 2 for operation by the operator's right hand. The input console 402 also includes an input apparatus 406 and a hand grip apparatus 408 for operation by an operator's left hand. The input console 402 also includes an interface 446 for generating control signals in response to movements and actuation of the input apparatus 200 and input apparatus 406 in response to inputs provided by the operator at the respective hand grips 100 and 408.
(32) The surgical robot 404 includes a robotic actuator 410 carried on a surgical platform 412. The robotic actuator 410 controls surgical tools 414 and 416, which may be inserted through an incision 418 in a body wall 419 of a patient 420 to access to the surgical site (not shown) within a body cavity of the patient. The surgical tools 414 and 416 are shown in greater detail in the insert 422. In the embodiment shown the tools 414 and 416 each include a pair of opposing jaws 424 and 426. The operator, such as a surgeon for example, performs surgery on a patient 420 by manipulating the first input apparatus 200 and the second input apparatus 406 via the respective hand grips 100 and 408 on the input console 402 to control movements and operations of the surgical tools 414 and 416. The robotic actuator 410 is controlled by a processor circuit 440, which receives control signals from the input console 402 via a cable 442 or other interface. The processor circuit 440 interprets the control signals for controlling movements and operations of the viewing system 428 and the tools 414 and 416. For example, movements of the hand grips 100 and 408 are transmitted by the interface 446 to the processor circuit 440 and cause corresponding movements of the tools 414 and 416. Exemplary tool positioning devices and tools for this purpose are described in PCT/CA2013/001076, which is incorporated herein by reference. Similarly, the operator also manipulates the control levers (i.e. 108 and 114 shown in FIG. 1A) to cause the jaws 424 and 426 to open and close for performing surgical tasks such as grasping tissue, cutting, and cauterizing etc.
(33) In embodiments that include the proximity sensors 372, 374 and 376, the proximity signals may be used to more precisely interpret the operator input based on the hand position of the operator on the hand grip 350. For example, if the user grasps the body 352 of the hand grip 350 further back, the user inputs may be scaled to amplify smaller movements by the operator's hand that are likely in this position.
(34) In this embodiment, the surgical robot 404 also includes a viewing system 428, which may include an illuminator for illuminating the surgical site within the body cavity of the patient 420 and a camera for generating image signals. Image signals received from the viewing system are transmitted by the processor circuit 440 back to the input console 402. The input console 402 also includes a display 444 for displaying an image of the surgical site for the operator.
(35) In one embodiment the input console 402 produces a first control signal at the interface 446 in response to lateral opening and closing movements of the operator's finger and thumb causing corresponding lateral movement of the first and second control levers. Signals representing the movements are transmitted via the cable 442 and are received and interpreted by the processor circuit 440, which produces signals for controlling the opening and closing of the respective pair of opposing jaws 424 and 426 of the tools 414 and 416. Actuation of the input control 122 similarly produces a second control signal, which is received by the processor circuit 440 and interpreted to produce signals for controlling the viewing system 428. For example, activation of the forward area 128 of the input control 122 may cause the camera to zoom in on the surgical site while actuation of the rearward area 130 may cause the camera to zoom out.
(36) The embodiments of the hand grips 100, 300, and 350 described above provide an ergonomic interface between the operator and the input apparatus 200, 406 for receiving operator input. The respective bodies of the hand grips are shaped and configured to permit the operator to grasp the hand grips in a comfortable and strain fee manner, thus reducing operator fatigue.
(37) While specific embodiments have been described and illustrated, such embodiments should be considered illustrative of the invention only and not as limiting the invention as construed in accordance with the accompanying claims.
Claims
1. A hand grip apparatus for receiving operator input for controlling a surgical tool in a robotic surgery system, the apparatus comprising: a generally tubular body having a proximal end shaped to be grasped by a hand of the operator and a distally located interface end operably configured to be coupled to an input apparatus for controlling the surgical tool; a first control lever attached to the body at a first pivot joint and extending along the body away from the proximal end, the first control lever terminating in a finger grip end configured to receive one of the operator's fingers, the first control lever being laterally moveable away from the body about the first pivot joint; a second control lever attached to the body at a second pivot joint on a generally opposing side of the body to the first pivot joint, the second control lever extending along the body away from the proximal end and terminating in a thumb grip end configured to receive the operator's thumb, the second control lever being laterally moveable away from the body about the second pivot joint, wherein movement of at least one of the first and second control levers is operable to produce a first control signal representing the movement; and an input control on an upper surface of the body and generally interposed between the finger and thumb grip ends, the input control having an actuator surface that is angled towards the finger grip end and being operably configured to produce a second control signal in response to actuation of the actuator surface by one of the operator's fingers, wherein the proximal end of the body is configured to receive one of a plurality of different removable end caps, the removable end cap facilitating configuration of the apparatus in accordance with the operator's preference.
2. The apparatus of claim 1 wherein the first control signal comprises an electrical control signal and further comprising a sensor for producing the electrical control signal in response to lateral movement of at least one of the first and second control levers.
3. The apparatus of claim 1 wherein movement of the at least one of the first and second control levers causes a mechanical movement of a linkage coupled to at least one of the first and second control levers, the first control signal produced in response to the movement of the linkage.
4. The apparatus of claim 1 wherein the actuator surface of the input control is oriented such that the operator's knuckles will be generally parallel to the actuator surface when grasped by the hand of the operator in a generally neutral position.
5. The apparatus of claim 1 wherein the input control is surrounded by a land disposed generally parallel to the actuator surface of the input control.
6. The apparatus of claim 1 wherein the first and second pivot joints are spaced apart on the body by a distance corresponding to a distance between the metacarpophalangeal joints of the thumb and index finger of an operator.
7. The apparatus of claim 1 wherein the first and second control levers are sized such that when grasped by the hand of an operator, the finger grip end and thumb grip end on the respective levers are positioned to receive distal phalanges of the operator's finger and thumb.
8. The apparatus of claim 1 wherein: the finger grip is configured to receive the operator's index finger; and the actuator surface of the input control is angled to be actuated by the index finger moving between the finger grip and the input control.
9. The apparatus of claim 1 wherein: the finger grip is configured to receive the operator's middle finger; and the actuator surface of the input control is angled to be actuated by the index finger.
10. The apparatus of claim 1 wherein the proximal end of the body has a rounded shape operable to receive and support a portion of the operator's palm when the body is grasped in the hand of the operator.
11. The apparatus of claim 10 wherein the proximal end of the body is angled with respect to the tubular body.
12. The apparatus of claim 10 wherein the tubular body has a neck portion interposed between the proximal end and the interface end, the neck portion having reduced cross sectional extent with respect to the proximal end.
13. The apparatus of claim 1 wherein the first and second control levers are mechanically coupled such that movement of one of the control levers causes a corresponding opposing lateral movement of the other of the control levers.
14. The apparatus of claim 1 wherein the first and second control levers are mounted to constrain the lateral movement of each of the levers to a range corresponding to an ergonomically comfortable lateral movement of the thumb and finger of an operator.
15. The apparatus of claim 1 wherein at least one of the finger and thumb grip ends comprises a retaining loop operably configured to retain the operator's finger or thumb for actuating the respective levers.
16. The apparatus of claim 15 wherein the retaining loop associated with the first control lever comprises a loop portion and an open portion, the open portion being disposed to permit lateral movement of the operator's finger between the finger grip and the input control.
17. The apparatus of claim 15 wherein the retaining loop of the at least one of the finger and thumb grip ends is oriented downwardly at an angle corresponding to a natural orientation of the operator's thumb or finger when the body is grasped such that the operator's palm rests on an upper surface of the body.
18. The apparatus of claim 1 wherein each of the first and second control levers are disposed within respective sculpted portions on generally opposing sides of the body, each extending forwardly from the proximal end toward the interface end, the respective sculpted portions being operable to receive the operator's finger and thumb when the body is grasped from behind the proximal end.
19. The apparatus of claim 1 further comprising at least one proximity sensor disposed to sense one of: the operator's hand grasping the hand grip apparatus; and a position of the operator's hand with respect to the tubular body.
20. A method for receiving operator input in a robotic surgery system, the method comprising: receiving a hand of the operator at a generally tubular body having a proximal end shaped for to be grasped by the operator's hand, the tubular body having a distally located interface end operably configured to be coupled to the input apparatus; receiving one of the operator's fingers in a finger grip end of a first control lever attached to the body at a first pivot joint and extending along the body away from the proximal end, the first control lever being laterally moveable away from the body about the first pivot joint; receiving the operator's thumb in a thumb grip end of a second control lever attached to the body at a second pivot joint on a generally opposing side of the body to the first pivot joint, the second control lever extending along the body away from the proximal end and being laterally moveable away from the body about the second pivot joint; receiving one of the operator's fingers at a input control on an upper surface of the body and generally interposed between the finger and thumb grip ends, the input control having an actuator surface that is angled towards the finger grip end; producing a first control signal at the interface in response to lateral opening and closing movements of the operator's finger and thumb causing corresponding lateral movement of the first and second control levers; producing a second control signal at the interface end in response to actuation of the input control; and receiving a signal from at least one proximity sensor disposed to sense one of the operator's hand grasping the hand grip apparatus and a position of the operator's hand with respect to the tubular body.
21. The method of claim 20 further comprising receiving the first control signal at an input apparatus for controlling a surgical tool, the first control signal being operable to control opening and closing functions open of a jaw of an end effector associated with the surgical tool.
22. The method of claim 21 further comprising receiving the second control signal at an input apparatus for controlling a surgical tool, the second control signal being operable to control additional functions associated with the surgical tool.
23. The method of claim 22 wherein the additional functions comprise one of: supply of an electrical current through the jaws of the surgical tool for electro-cauterization of tissue; and functions associated with a surgical viewing system for generating views of a surgical site.
24. A hand grip apparatus for receiving operator input for controlling a surgical tool in a robotic surgery system, the apparatus comprising: a generally tubular body having a proximal end shaped to be grasped by a hand of the operator and a distally located interface end operably configured to be coupled to an input apparatus for controlling the surgical tool; a first control lever attached to the body at a first pivot joint and extending along the body away from the proximal end, the first control lever terminating in a finger grip end configured to receive one of the operator's fingers, the first control lever being laterally moveable away from the body about the first pivot joint; a second control lever attached to the body at a second pivot joint on a generally opposing side of the body to the first pivot joint, the second control lever extending along the body away from the proximal end and terminating in a thumb grip end configured to receive the operator's thumb, the second control lever being laterally moveable away from the body about the second pivot joint, wherein movement of at least one of the first and second control levers is operable to produce a first control signal representing the movement; and an input control on an upper surface of the body and generally interposed between the finger and thumb grip ends, the input control having an actuator surface that is angled towards the finger grip end and angled away from the thumb grip end so that the input control is closer to the finger grip end than the thumb grip end, the input control being operably configured to produce a second control signal in response to actuation of the actuator surface by one of the operator's fingers.
25. The apparatus of claim 24 wherein movement of the at least one of the first and second control levers causes a mechanical movement of a linkage coupled to at least one of the first and second control levers, the first control signal produced in response to the movement of the linkage.
will there be something interesting?
November 4(th), 2022, at 8:00 AM EDT / 2:00 PM CET. The call will include the Company’s third quarter results and an update on business activities.
he is quite slapped in the face and someone sees him for $ 2
in a while they will have to load money somehow ...
apparently they refused to bid when she was high
Cherry ferrovia! TOP
here are 77 (nice number) owners!
I count more than 72 million shares here!
https://fintel.io/so/us/epix
How the hell is that possible?
How are things?
Come on resurrect, go above 1!
2022-10-27 13F/A Morgan Stanley 3,669,680 https://fintel.io/so/us/epix
cover otherwise you will burn!
Here as it is a matter between shorts
waiting for pfizer or J&J
https://www.youtube.com/shorts/yPm0Yqx2mcE
Avidity Partners Management LP
3,750,000 8.50
https://fintel.io/sst/us/epix
Sure they are under $ 5!
Don't miss this pizza!
ESSA PHARMA INC - EPI-8207 SHOWS ROBUST POTENCY DEGRADING AR, INCLUDING AR SPLICE VARIANTS AND CLINICALLY RELEVANT AR MUTANTS
About ANITAC™ Degraders Androgen receptor signaling is the main driver of prostate cancer progression and remains a crucial target for therapeutic intervention in late stages of the disease. While current antiandrogen therapies that directly or indirectly target the AR ligand-binding domain (LBD) are initially effective, resistance ultimately develops and new methods of inhibiting the AR pathway are needed.
ESSA's novel approach of targeting the N-terminal domain of the AR represents a new method of blocking AR signaling. Leveraging ESSA's scientific foundation in successfully targeting the NTD of the AR with a new class of small molecules called anitens, ESSA is developing the first generation of ANITen bAsed Chimera degraders targeting the AR NTD. In preclinical models, the orally bioavailable ANITAC degraders can eliminate forms of AR protein found in castration-resistant prostate cancer that can potentially drive disease progression including LBD mutants and LBD truncated splice variants.
5
So beauty!
Wow
I took the order at 3.77
50% gone
I keep the rest
IMO it is very likely to shoot for a few days ...
It seems to me that the study with Bayer has to start
then there's that new agent
not to forget, someone liquid knows things first
https://finance.yahoo.com/news/epix-45-million-financing-includes-132200281.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAALg15cZWaXfx8YX3WUXfKt1Ap7rgt7pcJxQX8BopggAAD3-DNMv66pRg31833x3kVV3BSqCpoxbGEDVOVD7Hcj2e7c0lg_5wmvotdftG20G8sg2X5tXl8AxMdWryVrA00lSU_XJXlriwOLTjl8qYcWUYpBH11X-G5gYzmYeNeJuH
Insider Ownership 21.93% (purged 10/14%)
Institutional Shares (Long) - 95.17% (ex 13D/G)
Istitutions 77%
Found 29,69%
MC 90/100 mil
cash $174.6M reported at June 30, 2022
Current cash runway through 2024 funds
3 Posters
Today announced the presentation of updated clinical data from the first two cohorts of the Phase 1/2 study of ESSA's lead candidate EPI-7386 in combination with enzalutamide in patients with metastatic castration-resistant prostate cancer ("mCRPC"). Data will be presented in a poster format at the 2022 Prostate Cancer Foundation ("PCF") Scientific Retreat, taking place October 27-29, 2022 in Carlsbad, CA.
The safety of the combination was favorable with a safety profile consistent with second-generation antiandrogens and no dose limiting toxicities observed.
Two additional posters will be presented at the conference highlighting updated results from the first-in-human Phase 1a dose escalation study of EPI-7386 as a monotherapy in mCRPC patients failing current second-generation antiandrogens and preclinical data on ESSA's first-in-class N-terminal domain androgen receptor protein degrader ("ANITAC"™) program.
https://www.targetedonc.com/view/reactions-to-the-latest-data-on-jak-inhibition-for-myelofibrosis
Who knows what the plans are? nothing in europe?
Could PAC be used in the remautological space given the problem of other inhibitors?
liquid shit but maybe it's better than thrombotic events
BOOM!
SURGICAL INSTRUMENT APPARATUS, ACTUATOR, AND DRIVE
DOCUMENT ID
US 20220331037 A1
DATE PUBLISHED
2022-10-20
INVENTOR INFORMATION
NAME
CITY
STATE
ZIP CODE
COUNTRY
Genova; Perry A.
Chapel Hill
NC
N/A
US
Laakso; Aki Hannu Einari
Raleigh
NC
N/A
US
APPLICANT INFORMATION
NAME
Titan Medical Inc.
CITY
Toronto
STATE
N/A
ZIP CODE
N/A
COUNTRY
CA
AUTHORITY
N/A
TYPE
assignee
APPLICATION NO
17/859276
DATE FILED
2022-07-07
DOMESTIC PRIORITY (CONTINUITY DATA)
parent US continuation 17511658 20211027 parent-grant-document US 11382708 child US 17859276
parent US continuation 17406147 20210819 PENDING child US 17511658
parent US continuation 16427164 20190530 parent-grant-document US 11123146 child US 17406147
US CLASS CURRENT:
1/1
CPC CURRENT
TYPE
CPC
DATE
CPCI
A 61 B 34/71
2016-02-01
CPCI
A 61 B 17/00234
2013-01-01
CPCA
A 61 B 2017/00327
2013-01-01
CPCA
A 61 B 2017/00314
2013-01-01
Abstract
A surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient is disclosed and includes an elongate manipulator having a distal end for receiving an end effector and including a plurality of control links extending through the manipulator operable to cause movement of the distal end in response to movement of the control links in a longitudinal direction. An actuator chassis is disposed at a proximal end of the manipulator and includes a plurality of actuators slidingly mounted within the actuator chassis for linear movement in the longitudinal direction. Each actuator is coupled to a control link and adjacently disposed about a curved periphery of the actuator chassis. An outwardly oriented portion couples a drive force to the actuator to cause movement of the control link.
Background/Summary
TECHNICAL FIELD
[0001] This disclosure relates generally to a surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient.
DESCRIPTION OF RELATED ART
[0002] Surgical instruments used in laparoscopic and/or robotic surgery generally have a proximally located actuator that may be used to actuate a distal end effector for performing a surgical task within a body cavity of a patient. Such instruments may be used in applications where there is an area of limited access for an operator. The distal end of the instrument may be inserted into the area of limited access and the operator may remotely manipulate the instrument via the actuator. The actuator may be located outside the area of limited access, but there may still be constraints placed on the extents of the actuator. There remains a need for actuators and drivers that are suitable for laparoscopic and/or robotic instruments.
SUMMARY
[0003] In accordance with one disclosed aspect there is provided a surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient. The apparatus can include an elongate manipulator with a distal end configured to receive an end effector and including a plurality of control links extending through the manipulator and configured to cause movement of the distal end of the manipulator in response to movement of the control links in a longitudinal direction generally aligned with a length of the manipulator. The apparatus can also include an actuator chassis disposed at a proximal end of the manipulator, the actuator chassis including a plurality of actuators slidingly mounted within the actuator chassis and configured to move linearly in a direction aligned with the longitudinal direction, each actuator being coupled to one of the control links. The actuators are adjacently disposed about a curved periphery of the actuator chassis and including an outwardly oriented portion configured to couple a drive force to the actuator to cause movement of the control link.
[0004] The curved periphery of the actuator chassis may be cylindrically shaped and the plurality of actuators may be mounted within slots extending longitudinally along the periphery and radially arranged about the periphery.
[0005] The actuator chassis periphery may include a curved portion and a flat portion and the plurality of actuators may be mounted within slots extending longitudinally along the curved portion and radially arranged about the curved portion, the flat portion facilitating location of the surgical instrument apparatus adjacent (for example, closely adjacent) to another apparatus including a corresponding flat portion.
[0006] The another apparatus including the corresponding flat portion may include another of the surgical instrument apparatus and the respective flat portions may facilitate location of the respective elongate manipulators in proximity (for example, close proximity) for insertion through a common access port inserted or positioned to provide access to the body cavity of the patient.
[0007] The outwardly oriented portions of the plurality of actuators may be each shaped to engage a corresponding drive coupler configured to couple the drive force to the actuator.
[0008] The actuator coupling portion of the actuator may include a protrusion that extends outwardly beyond the curved periphery of the actuator chassis.
[0009] The apparatus may include a drive chassis including a respective plurality of drive couplers configured to couple drive forces to the plurality of actuators, the drive couplers arranged about the periphery of the actuator chassis, each drive coupler may include an open channel portion configured to receive the respective actuator protrusions when the actuator chassis is inserted into the drive chassis, and a retaining portion configured to receive and retain the respective actuator protrusions when the drive chassis and the actuator chassis are rotated thorough an angle to cause the retaining portions to engage the respective actuator protrusions.
[0010] The drive chassis may be configured to permit the manipulator to be inserted through the drive chassis to cause the open channel portions to receive the respective actuator protrusions.
[0011] The actuator chassis may include a transition portion between the manipulator and the actuator chassis, the transition portion configured to laterally displace the control links for coupling to the respective actuators.
[0012] The manipulator may include at least one end effector control link configured to couple to an end effector and the actuator chassis may include at least one end effector actuator coupled to the end effector control link to actuate movements of the end effector.
[0013] The at least one end effector actuator may be mounted within the actuator chassis to permit at least one of longitudinal movement configured to actuate opening or closing of an end effector, or rotational movement configured to cause a corresponding rotation of the end effector.
[0014] The at least one end effector actuator may include a single end effector actuator configured to perform both the longitudinal movement and the rotational movement.
[0015] The at least one end effector control link may be routed along a central bore of the actuator chassis and the end effector actuator may be mounted at a distal portion of the actuator chassis.
[0016] The manipulator may include a rigid portion connected to the actuator chassis, and an actuatable articulated portion configured to cause the movement of the distal end of the manipulator in response to the longitudinal movement of the control links.
[0017] The apparatus may include an unactuated articulated portion disposed between the rigid portion and the chassis, the unactuated articulated portion configured to permit the manipulator to be bent to reduce an overall length of the manipulator and actuator chassis during cleaning and sanitizing of the apparatus.
[0018] In accordance with another disclosed aspect there is provided a surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient. The apparatus can include an elongate manipulator with a distal end configured to receive an end effector and including a plurality of control links extending through the manipulator and configured to cause movement of a distal end of the manipulator in response to movement of the control links in a longitudinal direction generally aligned with a length of the manipulator. The apparatus can also include an actuator chassis disposed at a proximal end of the manipulator, the actuator chassis including a plurality of actuators mounted within the actuator chassis, each actuator being coupled to one of the control links configured to couple a drive force to the actuator to cause movement of the control link. The proximate end of the manipulator can be laterally offset to facilitate location or positioning of the surgical instrument apparatus adjacent (such as, closely adjacent) to another surgical instrument apparatus for insertion or positioning through a common access port inserted to provide access to the body cavity of the patient.
[0019] The manipulator may include a rigid portion connected to the actuator chassis, and an actuatable articulated portion configured to cause the movement of the distal end of the manipulator in response to longitudinal movement of the control links.
[0020] The apparatus may include an unactuated articulated portion disposed between the rigid portion and the actuator chassis, the unactuated articulated portion configured to permit the manipulator to be bent to reduce an overall length of the manipulator and actuator chassis during cleaning and sanitizing of the apparatus.
[0021] The proximate end of the manipulator can be laterally offset to facilitate positioning of the surgical instrument adjacent to the another surgical instrument apparatus so that spacing between the manipulator and another manipulator of the another surgical instrument is between about 10 millimeters and about 35 millimeters.
[0022] In accordance with another disclosed aspect there is provided a surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient. The apparatus can include an elongate manipulator with a distal end configured to receive an end effector and including a plurality of control links extending through the manipulator and configured to cause movement of a distal end of the manipulator in response to movement of the control links in a longitudinal direction generally aligned with a length of the manipulator. The apparatus can also include an actuator chassis disposed at a proximal end of the manipulator, the actuator chassis including a plurality of actuators mounted within the actuator chassis, each of the plurality of actuators being coupled to one of the control links configured to couple a drive force to the actuator to cause movement of the control link. The manipulator can include a rigid portion connected to the actuator chassis, and an actuatable articulated portion configured to cause the movement of the distal end of the manipulator in response to longitudinal movement of the control links. The apparatus can further include an unactuated articulated portion disposed between the rigid portion and the chassis, the unactuated articulated portion configured to permit the manipulator to be bent to reduce an overall length of the manipulator and actuator chassis during cleaning and sanitizing of the apparatus.
[0023] Other aspects and features will become apparent to those ordinarily skilled in the art upon review of the following description of specific disclosed embodiments in conjunction with the accompanying figures.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0024] In drawings which illustrate disclosed embodiments,
[0025] FIG. 1 is a perspective view of a surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient;
[0026] FIG. 2 is a partially cut away perspective view of an actuator chassis of the surgical instrument apparatus shown in FIG. 1;
[0027] FIG. 3A is a perspective view of an actuator of the actuator chassis shown in partial engagement with a drive coupler;
[0028] FIG. 3B is a perspective view of the actuator shown in full engagement with the drive coupler;
[0029] FIG. 4A is a perspective view of a drive chassis including a plurality of the drive couplers shown in FIGS. 3A and 3B and the actuator chassis of FIG. 2 being inserted into the drive chassis;
[0030] FIG. 4B is a perspective view of the drive chassis of FIG. 4A showing the actuator chassis in partial engagement with the drive chassis;
[0031] FIG. 4C is a perspective view of the drive chassis of FIG. 4B showing the actuator chassis in full engagement with the drive chassis;
[0032] FIG. 5A is a perspective view of a surgical instrument apparatus in accordance with another embodiment;
[0033] FIG. 5B is a perspective view of a pair of the surgical instrument apparatus shown in FIG. 5A disposed adjacently for insertion through a common access port;
[0034] FIG. 6 is a perspective view of a pair of surgical instruments disposed adjacently for insertion through a common access port operation in accordance with another embodiment; and
[0035] FIG. 7 is a perspective view a surgical instrument apparatus in accordance with another embodiment.
DETAILED DESCRIPTION
[0036] Referring to FIG. 1, a surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient is shown generally at 100. The apparatus 100 includes an elongate manipulator 102 having a distal end 104 for receiving an end effector 106. The manipulator 102 includes a plurality of control links 108 extending through the manipulator. The plurality of control links 108 are operable to cause movement of the distal end 104 of the manipulator in response to movement of the control links in a longitudinal direction 110 generally aligned with a length of the manipulator. The apparatus 100 also includes an actuator chassis 120 disposed at a proximal end 112 of the manipulator 102. The actuator chassis 120 includes a plurality of actuators 122 slidingly mounted within the actuator chassis for linear movement in a direction aligned with the longitudinal direction 110. In the embodiment shown, the actuators 122 are adjacently mounted within respective slots 124 disposed on a curved periphery 126 of the actuator chassis 120.
[0037] In the embodiment shown, the manipulator 102 includes a rigid portion 114 connected to the actuator chassis 120 and an articulated portion 116 that is actuatable to cause the movement of the distal end 104 of the manipulator in response to the longitudinal movement of the control links 108. The articulated portion 116 includes a plurality of coupled guides 118 mounted end-to-end and operable to move in response to pulling or pushing of the plurality of control links 108 as described in commonly owned PCT patent publication WO2014/201538 entitled “ARTICULATED TOOL POSITIONER AND SYSTEM EMPLOYING SAME” filed on Dec. 20, 2013 and incorporated herein by reference in its entirety. In other embodiments, the manipulator 102 may include structures other than the coupled guides 118 for causing movement of the distal end 104 of the manipulator.
[0038] Referring to FIG. 2, the proximal end 112 of the manipulator 102 and the actuator chassis 120 are shown with the actuator chassis partially cut away. In one embodiment, the plurality of control links 108 are implemented as wires routed through respective bores 200 extending through the manipulator 102. The actuator chassis 120 has a transition portion 202 between the proximal end 112 of the manipulator 102 and the actuator chassis. In this embodiment the transition portion 202 includes a bulkhead 204 having openings 206 that cause the respective control links 108 to be laterally displaced toward the curved periphery 126 of the actuator chassis 120. The transition portion 202 facilitates the movement of the control links 108 along their respective axes while preventing drift of the control links 108. In one embodiment, the transition portion 202 may include curved conduit (not shown) extending between the proximal end 112 of the manipulator 102 and the bulkhead 204 for receiving and guiding control links 108 through the transition portion. Each actuator 122 is coupled to one of the control links 108. The control links 108 may be implemented using nitinol wire, which is capable of bending through an arc while still transmitting force in tension or compression. Nitinol is an alloy of nickel and titanium having shape memory and superelasticity and is capable of transmitting forces of about 200N. In other embodiments, the control links 108 may be implemented using other commonly used wires such as stranded cables used in laparoscopic instruments.
[0039] One actuator 208 of the plurality of actuators 122 is shown displaced longitudinally within the slot 124. The longitudinal displacement of the actuator 208 causes the coupled control link 108 to be correspondingly pulled rearwardly within the actuator chassis 120. Other actuators 122 such as the adjacent actuators 210 and 212 are similarly moveable within the respective slots 124 to push or pull the associated control link 108. In the embodiment shown, the curved periphery 126 of the actuator chassis 120 is cylindrically shaped and the slots 124 are radially arranged about the curved periphery.
[0040] Referring back to FIG. 1, in one embodiment pairs of the control links 108 are coupled to coupler segments 130, 132, and 134. Actuation of the control links 108 by the actuators 122 causes the coupled guides 118 between each of the coupler segments to be displaced laterally to cause the distal end 104 and the end effector 106 to be moved into a desired position and orientation. A portion of the coupler segment 132 is shown cut away in an insert 136. In this embodiment a first pair 138, 140 of the plurality of control links 108 terminate within the coupler segment 132 and when the control link 138 is pushed by advancing the associated actuator 122 while the control link 140 is pulled by rearwardly retracting the associated actuator 122 within its slot, the coupler segment 132 is moved laterally. Similarly, a second pair 142, 144 of the plurality of control links 108 terminate within the coupler segment 132 and when the control link 142 is pushed by advancing the associated actuator 122 within its slot while the control link 144 is pulled by rearwardly retracting the associated actuator 122 within its slot, the coupler segment 132 is moved vertically upward. Reversal of the pushing and pulling of the respective actuators 122 causes a respective lateral movement to the opposite side or downward movement.
[0041] In another embodiment, the first pair 138, 140 of the plurality of control links 108 may be respectively used for pulling motions without a corresponding pushing motion. In this embodiment when the control link 140 is pulled by rearwardly retracting the associated actuator 122 within its slot (while the control link 138 is let out by a corresponding amount, such as, for example, by advancing the associated actuator 122 or by allowing the actuator 122 to feely float), the coupler segment 132 is moved laterally. Similarly, in another embodiment, for the second pair 142, 144 of the plurality of control links 108 when the control link 144 is pulled by rearwardly retracting the associated actuator 122 within its slot (while the control link 142 is let out by a corresponding amount, such as, for example, by advancing the associated actuator 122 or by allowing the actuator 122 to freely float), the coupler segment 132 is moved vertically upward. Reversal of the pulling of the respective actuators 122 causes a respective lateral movement to the opposite side or downward movement.
[0042] Combinations of lateral and vertical movement will cause the 132 to move in any direction within a working volume of the manipulator 102. The coupler segment 134 may be similarly moved via other pairs of control links 108 actuated by the respective actuators 122 to point in any direction within the working volume. Further as described in commonly owned PCT patent publication WO2014/201538, the coupled guides 118 between the rigid portion 114 and the coupler segment 130 and the coupled guides between the coupler segment 130 and the coupler segment 132 may be configured to maintain the orientation of the coupler segment 132 substantially the same as the rigid portion 114. In this case, the guides 118 within these portions of the articulated portion 116 are constrained to move as a two-dimensional parallelogram by a set of wire links extending between the rigid portion 114 and the coupler segment 132.
[0043] Still referring to FIG. 1, each of the actuators 122 includes an outwardly oriented portion 150 that facilitates coupling a drive force to the actuator to cause movement of the coupled control link. In this embodiment, the outwardly oriented portions 150 also protrude outwardly with respect to the curved periphery 126. Referring to FIG. 3A, one of the actuators 122 is shown in isolation in engagement with a drive coupler 300. The drive coupler 300 may be part of an instrument drive of a robotic surgery system (not shown). The drive coupler 300 includes a curved outer wall 302 and a first end wall 304 extending radially inwardly from the curved outer wall and defining an open channel 306 in the drive coupler. The open channel 306 is sized to receive the protruding portion 150 of the actuator 122 when slid into the drive coupler 300 in the direction indicated by the arrow 308 in FIG. 3A. Once received within the opening 306, the drive coupler 300 is rotated in the direction of the arrow 310 to engage the outwardly oriented portion 150 of the actuator 122 as shown in FIG. 3B.
[0044] Referring to FIG. 3B, the drive coupler 300 further includes a second end wall 312 extending over the full length of the curved outer wall 302. The outwardly oriented portion 150 of the actuator 122 is engaged between the first end wall 304 and the second end wall, which define a retaining portion for receiving and retaining the actuator protrusion 150 when the drive coupler 300 is rotated thorough an angle to cause the retaining portions to engage the actuator protrusion. Once the drive coupler 300 is engaged, a force F applied to the drive coupler 300 is transmitted to the outwardly oriented portion 150 to cause longitudinal motion of the actuator 122 within the associated slot 124.
[0045] Referring to FIG. 4A, in the embodiment shown a plurality of the drive couplers 300 shown in FIGS. 3A and 3B are arranged to provide a drive chassis 400. The drive couplers 300 are annularly arranged about the periphery 126 of the actuator chassis 120 with the open channels 306 aligned with the outwardly oriented portions 150 of the actuators 122. The drive chassis 400 is configured to permit the manipulator 102 to be inserted through the drive chassis when loading the surgical instrument apparatus 100. The open channels 306 of the drive couplers 300 receive the respective actuator protrusions 150 as shown in FIG. 4B. Referring to FIG. 4B, the drive chassis 400 and/or actuator chassis 120 is then rotated thorough an angle in a direction indicated by the arrow 402 to cause the retaining portions (i.e. first and second end walls 304 and 312, shown in FIGS. 3A and 3B) to engage the respective actuator protrusions 150 as shown in FIG. 4C. Referring to FIG. 4C, once the drive couplers 300 are engaged, each drive coupler is able to independently move back and forward in the longitudinal direction 110 to couple drive forces to the respective actuators 122. In one embodiment the drive chassis 400 is part of an instrument drive (not shown) that generates and couples individual drive forces to the respective drive couplers 300. The instrument drive may be implemented as part of a robotic surgery system in which operator input received at an input device is used to generate drive signals, which are used to control the instrument drive for causing manipulation of the manipulator 102 via the drive chassis 400 and actuator chassis 120.
[0046] In the embodiment shown in FIG. 1, eight actuators 122 and associated control links 108 are provided. Four of these actuators 122 cause movement of the coupler segment 132, while the remaining four actuators cause movement of the coupler segment 134. Referring back to FIG. 2, the manipulator 102 further includes a central bore 220 that in this embodiment accommodates an end effector control link 222. The end effector control link 222 is coupled to the end effector 106 for causing opening of the actuator jaws and/or causing rotation of the actuator about a longitudinal axis of the manipulator 102. The end effector control link 222 is routed through the actuator chassis 120 and coupled to an end cap 224 at a distal end of the actuator chassis. In one embodiment, the end cap 224 is able to rotate in the direction of the arrow 226, which rotates the end effector control link 222 causing corresponding rotation of the end effector at the distal end 104 of the manipulator 102. Additionally, the end cap 224 may also be configured to move in the longitudinal direction 110 to actuate longitudinal back and forth movement of the end effector control link 222 for opening and closing the end effector. The single end effector control link 222 may thus be operable to actuate both rotation and opening/closing movements of the end effector 106. In other embodiments, the end effector control link 222 may be configured as a hollow torque tube that provides the rotational actuation to the end effector 106, while an additional control link may be routed through the central bore 220 to actuate the opening and closing movements of the end effector 106.
[0047] Referring to FIG. 5A, an actuator chassis in accordance with another embodiment is shown generally at 500. The periphery of the actuator chassis 500 includes a curved portion 502 and a flat portion 504. The actuator chassis 500 includes a plurality of actuators 506 configured generally as described above. The plurality of actuators 506 are mounted in respective slots 508 extending longitudinally along the curved portion 502 of the actuator chassis 500. The actuators 506 are radially arranged about the curved portion 502 and the actuator chassis 500 is coupled to a manipulator 102 (shown in part) as generally described above.
[0048] In many cases two or more of the surgical instrument apparatus 100 may be used during a surgical procedure performed through a single common access port (i.e. a single incision or opening to a body cavity of a patient). Referring to FIG. 5B, the flat portion 504 of the actuator chassis 500 facilitates closely spacing the actuator adjacent to a second actuator chassis 510 having a corresponding flat portion 512. The close spacing has the advantage of spacing the manipulator 102 and a manipulator 514 coupled to the actuator chassis 510 in relatively close proximity for insertion through a common access port and/or trocar (not shown). The spacing D between the manipulators may be less than about 10 millimeters, about 10 millimeters, about 20 millimeters, about 21.5 millimeters, about 35 millimeters, about 40 millimeters, or greater than about 35 millimeters or 40 millimeters, such as about 50 millimeters or 60 millimeters. The spacing D between the manipulators may be between about 10 millimeters (or less) and about 20 millimeters (or more), between about 10 millimeters (or less) and about 35 millimeters (or more), between about 10 millimeters (or less) and about 40 millimeters (or more), between about 20 millimeters (or less) and about 35 millimeters (or more), or between about 20 millimeters (or less) and about 40 millimeters (or more). The further off-center the manipulator 102 and the manipulator 514 are from the respective actuator chassis 500 and 510 such that the spacing D is reduced, the smaller the diameter of the common access port/trocar. Each of the actuator chassis 500 and the actuator chassis 510 would be received within a drive chassis (not shown) configured to accommodate and provide drive forces for operating the side-by-side surgical instruments.
[0049] Referring to FIG. 6, an alternative arrangement for side-by-side surgical instrument operation includes a first actuator chassis 600 disposed spaced apart from a second actuator chassis 602. Each actuator chassis 600, 602 has a respective manipulator 604 and 606 coupled to the chassis.
[0050] The manipulators 604 and 606 have respective actuatable articulated portions 608 and 610 configured generally as described above in connection with the FIG. 1 embodiment. The manipulators 604 and 606 each have respective rigid portions 612 and 614. The rigid portion 612 of the manipulator 604 has a leftward laterally offset portion 620 while the manipulator 606 has a rightward laterally offset portion 622. The left and right laterally offset portions 620 and 622 facilitate closely adjacent location of the respective articulated portions 608 and 610 of the manipulators 604 and 606 for insertion through a common access port.
[0051] Referring to FIG. 7, a surgical instrument apparatus in accordance with another embodiment is shown generally at 700. The surgical instrument apparatus 700 includes an actuator chassis 702 configured generally as disclosed above. The actuator chassis 702 is coupled to a manipulator 704 including a rigid portion 706 and an actuatable articulated portion 708 also configured generally as disclosed above. In this embodiment, the surgical instrument apparatus 700 further includes an articulated portion 712 disposed between the rigid portion 706 and the actuator chassis 702. The articulated portion 712 permits the manipulator to be bent as shown in FIG. 7 to reduce an overall length of the instrument (i.e. manipulator and actuator chassis). The articulated portion 712 may be actuated during a surgical procedure or may be a passive portion that is not actuated during the procedure.
[0052] In many cases the surgical instrument apparatus 700 may be reusable and cleaning and sanitization following use in a surgical procedure is thus required. The overall length of the surgical instrument apparatus 100 shown in FIG. 1 may prohibit its accommodation within the conventional sanitization equipment. The articulated portion 712 facilitates bending of the instrument to reduce the overall dimensions that may make the instrument more readily accommodated in a decontamination sink or a chamber of a washer/disinfector commonly used for cleaning and sanitization in surgical environments. Additional bending to accommodate limited space constraints during cleaning and sanitization may be enabled by having the actuatable articulated portion 708 at least partially bendable/flexible during cleaning and sanitization (i.e. when not in surgical use). This additional bending and/or the bending of articulated portion 712 may be facilitated by may allowing the control links extending through the manipulator 704 to move into a relaxed state, for example by maneuvering the actuators (such as actuators 506 shown in FIG. 5A).
[0053] Language of degree used herein, such as the terms “approximately,” “about,” “generally,” and “substantially” as used herein represent a value, amount, or characteristic close to the stated value, amount, or characteristic that still performs a desired function or achieves a desired result. For example, the terms “approximately”, “about”, “generally,” and “substantially” may refer to an amount that is within less than 10% of, within less than 5% of, within less than 1% of, within less than 0.1% of, or within less than 0.01% of the stated value.
[0054] While specific embodiments have been described and illustrated, such embodiments should be considered illustrative only and not as limiting the disclosed embodiments as construed in accordance with the accompanying claims.
Claims
1-20. (canceled)
21. A surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient, the apparatus comprising: an elongate manipulator having a distal end configured to support an end effector and including a plurality of control links extending through the manipulator and operatively engaged with the end effector, the manipulator defining a longitudinal axis; and an actuator chassis disposed at a proximal end of the manipulator, wherein the actuator chassis defines an outer profile having a curved periphery portion and a flat portion, the actuator chassis including: a plurality of actuators slidingly mounted within the actuator chassis and configured to move linearly in a direction aligned with the longitudinal axis, wherein: the actuators are adjacently radially disposed about the curved periphery portion of the actuator chassis; each actuator is coupled to a respective one of the control links; and each actuator includes an outwardly oriented portion configured to couple a drive force to the actuator to cause movement of the control link.
22. The apparatus of claim 21, wherein the plurality of actuators are mounted within slots extending longitudinally along the periphery and radially arranged about the periphery of the actuator chassis.
23. The apparatus of claim 21, wherein the outwardly oriented portions of the plurality of actuators are each shaped to engage a corresponding drive coupling configured to couple the drive force to the actuator.
24. The apparatus of claim 21, wherein the manipulator comprises at least one end effector control link configured to couple to an end effector, and wherein the actuator chassis comprises at least one end effector actuator coupled to the end effector control link to actuate movements of the end effector.
25. The apparatus of claim 24, wherein the at least one end effector actuator is mounted within the actuator chassis to permit at least one of: longitudinal movement configured to actuate opening or closing of an end effector; or rotational movement configured to cause a corresponding rotation of the end effector.
26. The apparatus of claim 25, wherein the at least one end effector actuator comprises a single end effector actuator configured to perform both the longitudinal movement and the rotational movement.
27. The apparatus of claim 24, wherein the at least one end effector control link is routed along a central bore of the actuator chassis and the end effector actuator is mounted at a distal portion of the actuator chassis.
28. The apparatus of claim 21, wherein at least a portion of a length of the manipulator is rigid.
29. The apparatus of claim 23, wherein each actuator includes an actuator coupling portion having a protrusion that extends outwardly beyond the periphery of the actuator chassis.
30. The apparatus of claim 29, further comprising: a drive chassis including a respective plurality of drive couplers configured to couple drive forces to the plurality of actuators, the drive couplers radially arranged about the periphery of the actuator chassis, each drive coupler including: an open channel portion configured to receive a respective actuator protrusion when the actuator chassis is inserted into the drive chassis; and a retaining portion configured to receive and retain the respective actuator protrusions when the drive chassis and the actuator chassis are rotated thorough an angle to cause the retaining portions to engage the respective actuator protrusions.
31. The apparatus of claim 21, wherein the actuator chassis defines a cylindrical profile.
32. A surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient, the apparatus comprising: an elongate manipulator including: a tubular rigid portion having a distal end and a proximal end, the tubular rigid portion defining a longitudinal axis; an end effector supported at the distal end of the tubular rigid portion; and a plurality of control links extending through the tubular rigid portion, wherein at least one control link is connected to the end effector to effect actuation of the end effector; and an actuator chassis disposed at the proximal end of the rigid tubular portion of the manipulator, wherein the actuator chassis defines a substantially D-shaped transverse cross-sectional profile, the actuator chassis including: a plurality of actuators slidingly mounted within the actuator chassis, each actuator being coupled to a respective one of the plurality of control links and being configured to couple a drive force to at least one of the actuators to cause movement of the respective control link and effectuate actuation of the end effector, wherein at least one actuator is radially disposed about a curved periphery of the actuator chassis.
33. The apparatus of claim 32, wherein the plurality of actuators are mounted within slots extending longitudinally along the periphery and radially arranged about the periphery of the actuator chassis.
34. The apparatus of claim 32, wherein the outwardly oriented portions of the plurality of actuators are each shaped to engage a corresponding drive coupling configured to couple the drive force to the actuator.
35. The apparatus of claim 32, wherein each actuator includes an actuator coupling portion having a protrusion that extends outwardly beyond the periphery of the actuator chassis.
36. The apparatus of claim 35, further comprising: a drive chassis including a respective plurality of drive couplers configured to couple drive forces to the plurality of actuators, the drive couplers radially arranged about the periphery of the actuator chassis, each drive coupler including: an open channel portion configured to receive a respective actuator protrusion when the actuator chassis is inserted into the drive chassis; and a retaining portion configured to receive and retain the respective actuator protrusions when the drive chassis and the actuator chassis are rotated thorough an angle to cause the retaining portions to engage the respective actuator protrusions.
37. The apparatus of claim 32, wherein the actuator chassis defines a flat portion.
38. A surgical instrument system for performing a surgical procedure within a body cavity of a patient, the surgical instrument system comprising: a first instrument apparatus, including: an elongate manipulator; an end effector supported at the distal end of the elongate manipulator; and a plurality of control links extending through the elongate manipulator, wherein at least one control link is connected to the end effector to effect actuation of the end effector; and an actuator chassis disposed at a proximal end of the elongate manipulator, wherein the actuator chassis defines an outer profile having a curved periphery portion and a flat portion, the actuator chassis including: a plurality of actuators slidingly mounted within the actuator chassis and configured to move linearly in a direction aligned with the longitudinal axis, wherein the actuators are adjacently radially disposed about the curved periphery portion of the actuator chassis; and a second instrument apparatus, including: an elongate manipulator; an end effector supported at the distal end of the elongate manipulator; and a plurality of control links extending through the elongate manipulator, wherein at least one control link is connected to the end effector to effect actuation of the end effector; and an actuator chassis disposed at a proximal end of the elongate manipulator, wherein the actuator chassis defines an outer profile having a curved periphery portion and a flat portion, the actuator chassis including: a plurality of actuators slidingly mounted within the actuator chassis and configured to move linearly in a direction aligned with the longitudinal axis, wherein the actuators are adjacently radially disposed about the curved periphery portion of the actuator chassis; wherein, the first instrument apparatus and the second instrument apparatus are adjacent to one another whereby the flat portion of the actuator chassis of the first instrument apparatus is adjacent the flat portion of the actuator chassis of the second instrument apparatus.
39. The surgical instrument system of claim 38, wherein each actuator includes an outwardly oriented portion configured to couple a drive force to the actuator to cause movement of the respective control link; and wherein the outwardly oriented portions of each of the plurality of actuators are shaped to engage a corresponding drive coupling configured to couple the drive force to the actuator.
40. The surgical instrument system of claim 39, wherein an actuator coupling portion of each actuator includes a protrusion that extends outwardly beyond the periphery of the actuator chassis.
41. The surgical instrument system of claim 39, wherein the actuator chassis of each of the first instrument apparatus and the second instrument apparatus defines a substantially D-shaped transverse cross-sectional profile.
Who knows if Elon will use salt batteries?
At least the cars do not catch fire and withstand low temperatures, as well as weigh a little less ...
Then I would consider an electric car
https://seekingalpha.com/news/3892442-intuitive-surgical-surges-10-after-hours-as-q3-resullts-beat-on-top-and-bottom-lines?utm_source=stck.pro&utm_medium=referral
they are just a little liquid
A decrease of cash and cash equivalents in the quarter of $783M to ~$7.4B was driven in large part by share repurchases of $1B and capital expenditures, as well as unrealized losses on interest-bearing debt securities, partially offset by cash from operations.
so careful!
I heard that Elon will call his first robot Enos, is that true?
it seems that he wants to make his arms like a snake
https://fintel.io/so/us/ctic
Institutional Shares (Long) 94,105,342 - 82.27%
Insider Ownership 13.84%
but someone….brrrrrr
https://fintel.io/sst/us/ctic
https://fintel.io/so/us/ctic
Institutional Shares (Long) 94,105,342 - 82.27%
Insider Ownership 13.84%
but someone….brrrrrr
https://fintel.io/sst/us/ctic
Jim Fong, the Company’s Chief Commercial Officer, has been promoted to Executive Vice President and Chief Commercial Officer, and will begin reporting directly to the Company’s Chief Executive Officer.
sounds good to me
Who knows why they promoted him?
Boom Boom!
Hand Grip Apparatus For Receiving Operator Input In A Robotic Surgery System
DOCUMENT ID
US 11464594 B2
DATE PUBLISHED
2022-10-11
INVENTOR INFORMATION
NAME
CITY
STATE
ZIP CODE
COUNTRY
Lutzow; Thomas Andrew
Providence
RI
N/A
US
Smith; Daniel P.
Portsmouth
RI
N/A
US
Cameron; Peter John Kenneth
Menlo Park
CA
N/A
US
APPLICANT INFORMATION
NAME
Titan Medical Inc.
CITY
Toronto
STATE
N/A
ZIP CODE
N/A
COUNTRY
CA
AUTHORITY
N/A
TYPE
assignee
ASSIGNEE INFORMATION
NAME
Titan Medical Inc.
CITY
Toronto
STATE
N/A
ZIP CODE
N/A
COUNTRY
CA
TYPE CODE
03
APPLICATION NO
17/399864
DATE FILED
2021-08-11
DOMESTIC PRIORITY (CONTINUITY DATA)
continuation parent-doc US 15737245 PENDING WO PCT/CA2016/000112 20160413 child-doc US 17399864
us-provisional-application US 62180312 20150616
US CLASS CURRENT:
1/1
CPC CURRENT
TYPE
CPC
DATE
CPCI
A 61 B 34/37
2016-02-01
CPCI
A 61 B 34/74
2016-02-01
CPCI
A 61 B 18/1445
2013-01-01
CPCI
A 61 B 34/30
2016-02-01
CPCA
A 61 B 2017/0042
2013-01-01
CPCA
A 61 B 2018/00595
2013-01-01
CPCA
A 61 B 90/361
2016-02-01
Abstract
A hand grip apparatus for receiving operator input includes a body having a proximal end and a distal interface end for coupling to an input apparatus. A first control lever is attached to the body and extends away from the proximal end and terminates in a finger grip for receiving one of the operator's fingers. A second control lever is attached to the body and extends away from the proximal end terminating in a thumb grip for receiving the operator's thumb. Movement of at least one of the control levers is operable to produce a first control signal representing the movement. An input control is included on the body between the grip ends and has an actuator surface angled towards the finger grip end and configured to produce a second control signal in response to actuation by one of the operator's fingers.
Background/Summary
INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS
(1) Any and all applications for which a foreign or domestic priority claim is identified in the Application Data Sheet as filed with the present application are hereby incorporated by reference under 37 CFR 1.57.
BACKGROUND
1. Field
(2) This disclosure relates generally to robotic surgery systems and more particularly to a hand grip apparatus for receiving operator input for controlling the robotic surgery system to perform surgical procedures.
2. Description of Related Art
(3) Robotic surgery systems generally include an operator interface that receives operator input from a surgeon and causes corresponding movements of surgical tools within a body cavity of a patient to perform a surgical procedure. For example, the operator may grasp and move a hand grip while the operator interface senses movements of the hand grip. The operator interface and hand grip may operate to sense inputs responsive to movement of the operator's hand in several different degrees of freedom, thus providing inputs for causing the surgical tool to mimic movements of the operator's hand. Additional movements such as opening and closing of jaws of an end effector associated with the surgical tool may also be initiated in response to additional operator inputs received at the operator interface.
SUMMARY
(4) In accordance with one disclosed aspect there is provided a hand grip apparatus for receiving operator input for controlling a surgical tool in a robotic surgery system. The apparatus includes a generally tubular body having a proximal end shaped to be grasped by a hand of the operator and a distally located interface end operably configured to be coupled to an input apparatus for controlling the surgical tool. The apparatus also includes a first control lever attached to the body at a first pivot joint and extending along the body away from the proximal end, the first control lever terminating in a finger grip end configured to receive one of the operator's fingers, the first control lever being laterally moveable away from the body about the first pivot joint. The apparatus further includes a second control lever attached to the body at a second pivot joint on a generally opposing side of the body to the first pivot joint, the second control lever extending along the body away from the proximal end and terminating in a thumb grip end configured to receive the operator's thumb, the second control lever being laterally moveable away from the body about the second pivot joint. Movement of at least one of the first and second control levers is operable to produce a first control signal representing the movement. The apparatus also includes an input control on an upper surface of the body and generally interposed between the finger and thumb grip ends, the input control having an actuator surface that is angled towards the finger grip end and being operably configured to produce a second control signal in response to actuation of the actuator surface by one of the operator's fingers.
(5) The first control signal may include an electrical control signal and the apparatus may further include a sensor for producing the electrical control signal in response to lateral movement of at least one of the first and second control levers.
(6) The first control signal may include a mechanical movement of a linkage coupled to at least one of the first and second control levers.
(7) The actuator surface of the input control may be oriented such that the operator's knuckles will be generally parallel to the actuator surface when grasped by the hand of the operator in a generally neutral position.
(8) The control button may be surrounded by a land disposed generally parallel to the actuator surface of the input control.
(9) The first and second pivot joints may be spaced apart on the body by a distance corresponding to a distance between the metacarpophalangeal joints of the thumb and index finger of an average operator.
(10) The first and second control levers may be sized such that when grasped by the hand of an average operator, the finger grip end and thumb grip end on the respective levers are positioned to receive distal phalanges of the operator's finger and thumb.
(11) The finger grip may be configured to receive the operator's index finger, and the actuator surface of the input control may be angled to be actuated by the index finger moving between the finger grip and the input control.
(12) The finger grip may be configured to receive the operator's middle finger, and the actuator surface of the input control may be angled to be actuated by the index finger.
(13) The proximal end of the body may be configured to receive one of a plurality of different removable end caps, the removable end cap facilitating configuration of the apparatus in accordance with the operator's preference.
(14) The proximal end of the body may have a rounded shape operable to receive and support a portion of the operator's palm when the body is grasped in the hand of the operator.
(15) The proximal end of the body may be angled with respect to the tubular body.
(16) The tubular body may have a neck portion interposed between the proximal end and the interface end, the neck portion having reduced cross sectional extent with respect to the proximal end.
(17) The first and second control levers may be mechanically coupled such that movement of one of the control levers causes a corresponding opposing lateral movement of the other of the control levers.
(18) The first and second control levers may be mounted to constrain the lateral movement of each of the levers to a range corresponding to an ergonomically comfortable lateral movement of the thumb and finger of an average operator.
(19) At least one of the finger and thumb grip ends may include a retaining loop operably configured to retain the operator's finger or thumb for actuating the respective levers.
(20) The retaining loop associated with the first control lever may include a loop portion and an open portion, the open portion being disposed to permit lateral movement of the operator's finger between the finger grip and the input control.
(21) The retaining loop of the at least one of the finger and thumb grip ends may be oriented downwardly at an angle corresponding to a natural orientation of the operator's thumb or finger when the body is grasped such that the operator's palm rests on an upper surface of the body.
(22) Each of the first and second control levers may be disposed within respective sculpted portions on generally opposing sides of the body, each extending forwardly from the proximal end toward the interface end, the respective sculpted portions being operable to receive the operator's finger and thumb when the body is grasped from behind the proximal end.
(23) The apparatus may include at least one proximity sensor disposed to sense one of the operator's hand grasping the hand grip apparatus, and a position of the operator's hand with respect to the tubular body.
(24) In accordance with another disclosed aspect there is provided a method for receiving operator input in a robotic surgery system. The method involves receiving a hand of the operator at a generally tubular body having a proximal end shaped for to be grasped by the operator's hand, the tubular body having a distally located interface end operably configured to be coupled to the input apparatus. The method also involves receiving one of the operator's fingers in a finger grip end of a first control lever attached to the body at a first pivot joint and extending along the body away from the proximal end, the first control lever being laterally moveable away from the body about the first pivot joint. The method further involves receiving the operator's thumb in a thumb grip end of a second control lever attached to the body at a second pivot joint on a generally opposing side of the body to the first pivot joint, the second control lever extending along the body away from the proximal end and being laterally moveable away from the body about the second pivot joint. The method also involves receiving one of the operator's fingers at an input control on an upper surface of the body and generally interposed between the finger and thumb grip ends, the input control having an actuator surface that is angled towards the finger grip end. The method further involves producing a first control signal at the interface in response to lateral opening and closing movements of the operator's finger and thumb causing corresponding lateral movement of the first and second control levers, and producing a second control signal at the interface end in response to actuation of the input control.
(25) The method may involve receiving the first control signal at an input apparatus for controlling a surgical tool, the first control signal being operable to control opening and closing functions open of a jaw of an end effector associated with the surgical tool.
(26) The method may involve receiving the second control signal at an input apparatus for controlling a surgical tool, the second control signal being operable to control additional functions associated with the surgical tool.
(27) The additional functions may include one of supply of an electrical current through the jaws of the surgical tool for electro-cauterization of tissue, and functions associated with a surgical viewing system for generating views of a surgical site.
(28) The method may involve receiving a signal from at least one proximity sensor disposed to sense one of the operator's hand grasping the hand grip apparatus and a position of the operator's hand with respect to the tubular body.
(29) Other aspects and features of the present invention will become apparent to those ordinarily skilled in the art upon review of the following description of specific embodiments of the invention in conjunction with the accompanying figures.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) In drawings which illustrate embodiments of the invention,
(2) FIG. 1A is a right side perspective view of a hand grip apparatus in accordance with one disclosed embodiment;
(3) FIG. 1B is a left side perspective view of the hand grip apparatus shown in FIG. 1A;
(4) FIG. 2 is a perspective view of an input apparatus including the hand grip shown in FIG. 1;
(5) FIG. 3A is a front view of the hand grip shown in FIG. 1 being grasped by an operator's hand;
(6) FIG. 3B is a side view of the hand grip shown in FIG. 1 being grasped by the operator's hand;
(7) FIG. 4A is a top cutaway view of the hand grip apparatus shown in FIG. 1 with first and second levers in a closed state;
(8) FIG. 4B is a top cutaway view of the hand grip apparatus shown in FIG. 1 with first and second levers in an open state;
(9) FIG. 5 is a right side perspective view of a hand grip apparatus in accordance with an alternative disclosed embodiment;
(10) FIG. 6 is a right side perspective view of a hand grip apparatus in accordance with another disclosed embodiment;
(11) FIG. 7A is a right side perspective view of a hand grip apparatus in accordance with yet another disclosed embodiment;
(12) FIG. 7B is a left side perspective view of a hand grip apparatus shown in FIG. 7A;
(13) FIG. 8 is a side view of the hand grip shown in FIGS. 7A and 7B being grasped by an operator's hand; and
(14) FIG. 9 is a pictorial representation of a robotic surgery system according to one disclosed embodiment.
DETAILED DESCRIPTION
(15) Referring to FIGS. 1A and 1B, a hand grip apparatus according to a first embodiment of the invention is shown generally at 100. The hand grip 100 is shown in a right side perspective view in FIG. 1A and a left side perspective view in FIG. 1B. The hand grip 100 includes a generally tubular body 102 having a proximal end 104 shaped to be grasped by a hand of an operator. In the embodiment shown the proximal end 104 of the body has a rounded shape operable to receive and support a portion of the operator's palm when the body 102 is grasped in the hand of the operator.
(16) The hand grip 100 also includes a distally located interface end 106. Referring to FIG. 2, the interface end 106 of the hand grip apparatus 100 is configured for coupling to an input apparatus 200 for controlling a surgical tool associated with a robotic surgery system (not shown). The input apparatus 200 includes an output 202 for producing signals in response to movements of the operator's hand 204. In one embodiment, the surgical tool may include an articulated tool positioner as described in detail in commonly owned patent application PCT/CA2013/001076 entitled “ARTICULATED TOOL POSITIONER AND SYSTEM EMPLOYING SAME”, which is incorporated herein by reference. The input apparatus 200 may be implemented using one of the Omega series of haptic devices available from Force Dimension, of Switzerland, for example.
(17) The input apparatus 200 and hand grip apparatus 100 are configured for operation by a right hand of the operator and in practice a left hand input apparatus and hand grip will also be provided. The left hand grip may be configured as a mirror image of the right hand grip 100 shown in FIG. 1, but may also be differently configured depending on the nature of the task the apparatus is to control.
(18) Referring back to FIG. 1A, the hand grip 100 also includes a first control lever 108 attached to the body 102 at a first pivot joint 110. The first control lever 108 extends along the body 102 away from the proximal end 104. The first control lever 108 terminates in a finger grip end 112 configured to receive one of the operator's fingers. In the embodiment shown the finger grip end 112 is configured as a retaining loop having a loop portion 132 and an open portion 134. The loop portion 132 is configured to retain the operator's finger while the open portion 134 allows the operator's finger to be easily removed from the finger grip end 112 to permit independent lateral movement of the operator's finger. Referring to FIG. 1B, the hand grip 100 also includes a second control lever 114 attached to the body 102 at a second pivot joint 116 on a generally opposing side of the body to the first pivot joint. The second control lever 114 also extends along the body away from the proximal end 104. The second control lever 114 terminates in a thumb grip end 118 configured to receive the operator's thumb.
(19) The first control lever 108 and the second control lever 114 are shown in an open position in FIG. 1A and in a closed position in FIG. 1B. Referring to FIG. 1A, in the embodiment shown the body 102 includes a cutout portion 120 for receiving the first control lever 108 when the first control lever is in the closed position. Referring to FIG. 1B, the body 102 also includes a cutout portion 119 and the lever 108 is received in the cutout such that a surface the lever is generally contiguous with surfaces of the body when the lever is in the closed position. The first control lever 108 is laterally moveable away from the body 102 about the first pivot joint 110 and the second control lever 114 is laterally moveable away from the body about the second pivot joint 116.
(20) Referring to FIG. 2, the operator's index finger 206 is shown engaging the finger grip end 112 and the operator's thumb 208 is shown engaging the thumb grip end 118 of the second control lever 114. The operator is able to open and close the first and second control levers 108 and 114 by making pincer movements with the index finger and thumb respectively. The first and second control levers 108 and 114 are sized such that when grasped by the hand 204 of an average operator, the finger grip end 112 and thumb grip end 118 on the respective levers are positioned to receive distal phalanges of the operator's finger 206 and thumb 208. In this embodiment the thumb grip end 118 is also configured as a retaining loop having a loop portion 136 and an open portion 138 and the loop portion is configured to retain the operator's thumb. Alternatively, the thumb grip end 118 may be configured as a closed loop in applications where it is not necessary for the operator to frequently remove the thumb from the grip end.
(21) The body 102 of the hand grip 100 includes a neck portion 103 portion interposed between the proximal end 104 and the interface end 106, the neck portion having a reduced cross sectional extent with respect to the proximal end 104. The neck portion 103 and the proximal end 104 together provide a bulb shaped grip, which when grasped from behind by the operator's hand is easily and comfortably retained.
(22) The hand grip 100 also includes an input control 122 on an upper surface of the body 102. The input control 122 is generally interposed between the finger grip end 112 and thumb grip end 118 and has an actuator surface 126 that is angled towards the finger grip end for actuation by one of the operator's fingers. The operator's hand 204 is shown grasping the hand grip 100 in FIGS. 3A and 3B. Referring to FIG. 3A, the angled actuator surface 126 of the input control 122 is comfortably located for actuation by the operator moving the index finger 206 from the finger grip end 112 to the input control 122. Alternatively, the operator may have a preference for operating the first control lever 108 using as middle finger, while the index finger 206 is held on or near the actuator surface 126 of the input control 122. In the embodiment shown the actuator surface 126 of the input control is oriented at an angle a such that the operator's knuckles 220 and 222 are generally parallel to the actuator surface 126 when the hand grip 100 is grasped by the operator's hand 204 in a generally neutral position. In one embodiment the angle a may be between about 20° and 30°. The neutral position of the hand 204 is a position in which there is a minimum of stress placed on the operator's wrist, forearm and shoulder, i.e. a comfortable position that does not induce undue fatigue.
(23) Referring to FIG. 3B, in this embodiment when the operator's hand grasps the hand grip 100 over the top of the body 102, the palm of the operator's hand 204 rests generally on an upper surface at the proximal end 104 of the body. The thumb grip end 118 is also angled downwardly at an angle ? when the body 102 is held in a horizontal orientation aligned with a horizontal axis 210. The angle ? is selected to correspond to a natural orientation of the thumb 208 when the operator's hand 204 is in a generally unstressed manner and the thumb engages the retaining loop portion of the thumb grip end 118. The finger grip end 112 may be similarly oriented at an angle corresponding to a natural orientation of the operator's finger when engaging the retaining loop portion of the finger grip 112 (not visible in FIG. 3B). In one embodiment the angle ? may be between about 10° and 25° for the operator's thumb 208 and between about 15° and 28° for the operator's index finger 206.
(24) Referring back to FIG. 1A, in the embodiment shown the input control 122 is surrounded by a land 124, which is disposed generally parallel to the actuator surface 126 of the input control. The input control 122 may be configured to control any of a number of functions any of the surgical tool or robotic surgery system. In the embodiment shown, the input control 122 is configured as a rocker button that is operable to control a first function when a forward area 128 of the input control is pressed by the operator's finger and a second function when a rearward area 130 of the input control is pressed by the operator's finger. In other embodiments the input control 122 may be implemented using an input device or sensor configured to detect various user inputs, for example a trackpad or touchpad, track ball, joystick, optical sensor, or thermal sensor. The input control 122 is configured to produce a control signal in response to for actuation of the actuator surface by one of the operator's fingers. In one embodiment, the input control 122 may be used to control operations of an illuminator and/or camera associated with the robotic surgery system.
(25) The hand grip 100 is shown in cutaway view in FIGS. 4A and 4B with a portion of an upper cover 250 removed to reveal mounting details associated with the first and second control levers 108 and 114. Referring to FIG. 4A, the first control lever 108 includes a pivot end 252 mounted on the first pivot joint 110 and an actuator arm 254 extending generally laterally into the body 102 of the hand grip 100. Similarly, the second control lever 114 includes a pivot end 256 mounted on the second pivot joint 116 and an actuator arm 258 extending generally laterally into the body 102 of the hand grip 100. The hand grip 100 further includes a linkage 260 including a slot 261. The hand grip 100 also includes a guide post 262, which is received in the slot 261 and permits reciprocating movement of the linkage 260 in the direction of arrow 268. The arms 254 and 256 are each coupled to a distal end 264 of the linkage 260 at a revolute joint 266, such that movement of either of the first or second control levers 108 or 114 causes movement of the respective arm, in turn causing movement of the linkage 260. Additionally movement of either one of the arms 254 and 256 also causes a corresponding movement of the other of the arms. 12. The first and second control levers 108 and 114 are thus mechanically coupled such that movement of one of the control levers causes a corresponding opposing lateral movement of the other of the control levers. An extent of lateral movement of the first and second control levers 108 and 114 is also constrained by the length of the slot 261. In one embodiment, the slot 261 is sized to constrain movement of the levers 108 and 114 to a range corresponding to an ergonomically comfortable lateral movement of the thumb 208 and finger 206 of an average operator.
(26) Referring to FIG. 4B, outward lateral movement of either or both of the first and second control levers 108 and 114 thus causes the linkage 260 to be advanced forwardly in the direction indicated by the arrow 268. In this embodiment, the hand grip 100 also includes a sensor 280 for producing a first control signal in response to movement of the linkage 260 caused by lateral movement of either of the first and second control levers. The sensor 280 may be implemented using a linear encoder. In other embodiments movement of the linkage 260 may be mechanically coupled through the body 102 and may mechanically interface with the input apparatus 200.
(27) Still referring to FIG. 4B the first and second pivot joints 110 and 116 are spaced apart on the body by a distance D. In one embodiment, the spacing D between the pivot joints is selected to correspond to a distance (for an average operator) between the metacarpophalangeal joints associated with the thumb and index finger thus reducing strain on the operator's hand when operating the first and second control levers 108 and 114. When the hand grip 100 is grasped in the operator's right hand with the operator's finger 206 engaging the finger grip end 112 and the operator's thumb 208 engaging the thumb grip end 118, the metacarpophalangeal joint of the thumb is located generally above the second pivot joint 116 and the metacarpophalangeal joint (i.e. the operator's knuckle 220) of the finger is located generally above the first pivot joint 110. In a hand grip 100 configured for the operators left hand, the thumb and finger grip ends 112 and 118 would be reversed.
(28) Referring to FIG. 5, an alternative embodiment of a hand grip apparatus is shown generally at 300. The hand grip 300 has a body 302 generally configured as shown in FIG. 1 but includes a proximal end 304 of the body that is angled with respect to the tubular body. In the embodiment shown the proximal end 304 is angled in a generally lateral direction with respect to the body 302 and is configured to provide a support surface for the operator's palm when grasping the hand grip 300. Referring to FIG. 6, another embodiment of the hand grip apparatus is shown generally at 320. In this embodiment the hand grip 320 includes a removable end cap 324, which has a generally similar shape to the proximal end 104 shown in FIG. 1. The removable end cap 324 may be made easily removable by the operator to permit the operator to select an end cap in accordance with their personal preferences. The removable end cap 324 is separable from the body 322 of the hand grip 320 and may be retained on the body by a snap connection, a fastener, or other securing means. For example, a set of end caps may be provided including different lengths of the removable end cap as shown at 324 and/or different shapes of and cap, such as shape of the proximal end 304 shown in FIG. 5. The set end caps may be fabricated relatively inexpensively and permit configuration for a variety of hand sizes and operator preferences.
(29) An alternative embodiment of a hand grip apparatus is shown generally at 350 in FIG. 7. A right hand side of the body is shown in FIG. 7A and a left hand side of the body is shown in FIG. 7B. Referring to FIG. 7A, the hand grip 350 includes a body 352 having a proximal end 354 and an interface end 356. The hand grip 350 also includes first and second control levers 358 and 360 and an input control 362 as generally described above in connection with the FIG. 1 embodiment. In this embodiment, the body 352 of the hand grip 350 includes a sculpted lateral portion 364 and the first control lever 358 is disposed on the sculpted portion. Referring to FIG. 7B, the body 352 also includes a sculpted lateral portion 366 and the second control lever 360 is disposed on the sculpted portion. The sculpted portions 364 and 366 are oriented generally parallel to a longitudinal axis 370 of the body 352. Referring to FIG. 8, the generally parallel sculpted portions 364 and 366 (only portion 366 is visible in FIG. 8) permit the operator to grasp the hand grip 350 from behind. In this embodiment, the palm of the operator's hand 204 does not rest on top of the body 352 as described in connection with the hand grip 100. Rather the palm of the operator's hand 204 is disposed behind and supported by the proximal end 354 of the hand grip 350. The proximal end 354 may be configured according to the operator's preferences as described above in connection with FIG. 5 and FIG. 6. In the embodiment shown in FIGS. 7A, 7B and 8 the hand grip 350 has a downwardly extending end cap portion while in other embodiments the hand grip may have a rounded end cap such as shown 324 in FIG. 6.
(30) In the embodiment shown in FIG. 7B, the hand grip 350 includes a plurality of proximity sensors 372, 374, and 376 located on the second control lever 360. When the operator's hand 204 grasps the hand grip 350 the operator's thumb 208 may be positioned forwardly or rearwardly with respect to the body 352 depending on the operator's preference. The proximity sensors 372-376 generate signals for detecting the position of the operator's thumb 208, which may be used to provide an indication that the hand grip 350 is being grasped by the operator's hand 204 and also to provide information regarding the position of the operators hand on body 352 the hand grip. The proximity sensors 372, 374, and 376 may be implemented using any of a variety of proximity sensor types, for example optical and/or capacitive sensors.
(31) Referring to FIG. 9, a robotic surgery system is shown generally at 400. The robotic surgery system 400 includes an input console 402 and a surgical robot 404. The input console 402 includes the input apparatus 200 and the hand grip apparatus 100 shown in FIG. 2 for operation by the operator's right hand. The input console 402 also includes an input apparatus 406 and a hand grip apparatus 408 for operation by an operator's left hand. The input console 402 also includes an interface 446 for generating control signals in response to movements and actuation of the input apparatus 200 and input apparatus 406 in response to inputs provided by the operator at the respective hand grips 100 and 408.
(32) The surgical robot 404 includes a robotic actuator 410 carried on a surgical platform 412. The robotic actuator 410 controls surgical tools 414 and 416, which may be inserted through an incision 418 in a body wall 419 of a patient 420 to access to the surgical site (not shown) within a body cavity of the patient. The surgical tools 414 and 416 are shown in greater detail in the insert 422. In the embodiment shown the tools 414 and 416 each include a pair of opposing jaws 424 and 426. The operator, such as a surgeon for example, performs surgery on a patient 420 by manipulating the first input apparatus 200 and the second input apparatus 406 via the respective hand grips 100 and 408 on the input console 402 to control movements and operations of the surgical tools 414 and 416. The robotic actuator 410 is controlled by a processor circuit 440, which receives control signals from the input console 402 via a cable 442 or other interface. The processor circuit 440 interprets the control signals for controlling movements and operations of the viewing system 428 and the tools 414 and 416. For example, movements of the hand grips 100 and 408 are transmitted by the interface 446 to the processor circuit 440 and cause corresponding movements of the tools 414 and 416. Exemplary tool positioning devices and tools for this purpose are described in PCT/CA2013/001076, which is incorporated herein by reference. Similarly, the operator also manipulates the control levers (i.e. 108 and 114 shown in FIG. 1A) to cause the jaws 424 and 426 to open and close for performing surgical tasks such as grasping tissue, cutting, and cauterizing etc.
(33) In embodiments that include the proximity sensors 372, 374 and 376, the proximity signals may be used to more precisely interpret the operator input based on the hand position of the operator on the hand grip 350. For example, if the user grasps the body 352 of the hand grip 350 further back, the user inputs may be scaled to amplify smaller movements by the operator's hand that are likely in this position.
(34) In this embodiment, the surgical robot 404 also includes a viewing system 428, which may include an illuminator for illuminating the surgical site within the body cavity of the patient 420 and a camera for generating image signals. Image signals received from the viewing system are transmitted by the processor circuit 440 back to the input console 402. The input console 402 also includes a display 444 for displaying an image of the surgical site for the operator.
(35) In one embodiment the input console 402 produces a first control signal at the interface 446 in response to lateral opening and closing movements of the operator's finger and thumb causing corresponding lateral movement of the first and second control levers. Signals representing the movements are transmitted via the cable 442 and are received and interpreted by the processor circuit 440, which produces signals for controlling the opening and closing of the respective pair of opposing jaws 424 and 426 of the tools 414 and 416. Actuation of the input control 122 similarly produces a second control signal, which is received by the processor circuit 440 and interpreted to produce signals for controlling the viewing system 428. For example, activation of the forward area 128 of the input control 122 may cause the camera to zoom in on the surgical site while actuation of the rearward area 130 may cause the camera to zoom out.
(36) The embodiments of the hand grips 100, 300, and 350 described above provide an ergonomic interface between the operator and the input apparatus 200, 406 for receiving operator input. The respective bodies of the hand grips are shaped and configured to permit the operator to grasp the hand grips in a comfortable and strain fee manner, thus reducing operator fatigue.
(37) While specific embodiments have been described and illustrated, such embodiments should be considered illustrative of the invention only and not as limiting the invention as construed in accordance with the accompanying claims.
Claims
1. A hand grip apparatus for receiving input from an operator for controlling a surgical tool in a robotic surgery system, the apparatus comprising: a body including a proximal end and a distally located interface end configured to be coupled to an input apparatus for controlling the surgical tool, the proximal end having a contoured surface configured to receive thereon at least a portion of a palm of a hand of the operator, the proximal end of the body with the contoured surface including a removable end cap; a first control lever pivotally coupled to the body via a first pivot joint, the first control lever extending away from the contoured surface and configured to receive at least a portion of an index finger of the operator's hand thereon, wherein a movement of the first control lever by the index finger of the operator's hand generates a first control signal representative of the movement of the first control lever; and a second control lever pivotally coupled to an opposite side of the body from the first control lever, the second control lever pivotally coupled to the body via a second pivot joint that is spaced from the first pivot joint by a distance, the second control lever extending away from the contoured surface and configured to receive at least a portion of a thumb of the operator's hand thereon, wherein a movement of the second control lever by the thumb of the operator's hand generates a second control signal representative of the movement of the second control lever, wherein the first and second pivot joints are configured to generally align with metacarpophalangeal joints of the index finger and the thumb of the operator's hand, respectively, when the operator's hand is disposed on the body so that the palm of the hand contacts the contoured surface, the thumb is disposed on the first control lever and the index finger is disposed on the second control lever, to thereby inhibit strain on the hand of the operator when operating the first and second control levers.
2. The apparatus of claim 1, wherein the distance between the first and second pivot joints is greater than a cross-sectional width of the body measured transverse to a longitudinal axis of the body and at a location between the interface end and the proximal end.
3. The apparatus of claim 1 wherein each of the first control lever and the second control lever include a contoured portion configured to receive and support at least a portion of the index finger and the thumb, respectively, of the operator's hand.
4. The apparatus of claim 3 wherein the contoured portion extends about an axis angled relative to a longitudinal axis of the body.
5. The apparatus of claim 1 further comprising an input control on a surface of the body, the input control being actuatable by the operator to produce a third control signal.
6. The apparatus of claim 1 wherein the body has a cross-sectional width measured transverse to a longitudinal axis of the body that is greater at the proximal end than at a location between the interface end and the proximal end.
7. The apparatus of claim 1 wherein the first control signal comprises an electrical control signal and further comprising a sensor for producing the electrical control signal in response to the movement of the first control lever.
8. A hand grip apparatus for receiving input from an operator for controlling a surgical tool in a robotic surgery system, the apparatus comprising: a body including a proximal end and a distally located interface end configured to be coupled to an input apparatus for controlling the surgical tool, the proximal end having a contoured surface configured to receive thereon at least a portion of a palm of a hand of the operator, the proximal end of the body with the contoured surface including a removable end cap; and a control lever pivotally coupled to the body via a pivot joint, the control lever extending away from the contoured surface and configured to receive at least a portion of a finger of the operator's hand thereon, wherein a movement of the control lever by the finger of the operator's hand generates a first control signal representative of the movement of the control lever, wherein the pivot joint is configured to generally align with a metacarpophalangeal joint of the finger of the operator's hand when the operator's hand is disposed on the body so that the palm of the hand contacts the contoured surface and the finger is disposed on the control lever to thereby inhibit strain on the hand of the operator when operating the control lever.
9. The apparatus of claim 8 wherein the contoured surface of the proximal end has a rounded shape.
10. The apparatus of claim 8, wherein the removable end cap is chosen from a plurality of end caps, each having a different shape.
11. The apparatus of claim 8 wherein the control lever includes a contoured portion configured to receive and support at least a portion of the finger of the operator's hand.
12. The apparatus of claim 11 wherein the contoured portion extends about an axis angled relative to a longitudinal axis of the body.
13. The apparatus of claim 8 further comprising an input control on a surface of the body, the input control being actuatable by the operator to produce a second control signal.
14. The apparatus of claim 8 wherein the body has a cross-sectional width measured transverse to a longitudinal axis of the body that is greater at the proximal end than at a location between the interface end and the proximal end.
15. The apparatus of claim 8 wherein the control signal comprises an electrical control signal and further comprising a sensor for producing the electrical control signal in response to the movement of the control lever.
16. A hand grip apparatus for receiving input from an operator for controlling a surgical tool in a robotic surgery system, the apparatus comprising: a body including a proximal end and a distally located interface end configured to be coupled to an input apparatus for controlling the surgical tool, the proximal end having a contoured surface configured to receive thereon at least a portion of a palm of a hand of the operator; a first control lever pivotally coupled to the body via a first pivot joint, the first control lever extending away from the contoured surface and configured to receive at least a portion of an index finger of the operator's hand thereon, wherein a movement of the first control lever by the index finger of the operator's hand generates a first control signal representative of the movement of the first control lever; and a second control lever pivotally coupled to an opposite side of the body from the first control lever, the second control lever pivotally coupled to the body via a second pivot joint that is spaced from the first pivot joint by a distance, the second control lever extending away from the contoured surface and configured to receive at least a portion of a thumb of the operator's hand thereon, wherein a movement of the second control lever by the thumb of the operator's hand generates a second control signal representative of the movement of the second control lever, wherein the body has a cross-sectional width measured transverse to a longitudinal axis of the body that is greater at the proximal end than at a location between the interface end and the proximal end, wherein at least a portion of the body between the proximal end and the interface end has a contoured surface and wherein the proximal end of the body with the contoured surface includes a removable end cap.
17. The apparatus of claim 16 wherein the removable end cap is chosen from a plurality of end caps, each having a different shape.
18. A hand grip apparatus for receiving input from an operator for controlling a surgical tool in a robotic surgery system, the apparatus comprising: a body including a proximal end and a distally located interface end configured to be coupled to an input apparatus for controlling the surgical tool, the proximal end having a contoured surface configured to receive thereon at least a portion of a palm of a hand of the operator, the body having a contoured surface along a length of the body between the proximal end and the interface end, the body having a width that decreases from the proximal end toward an intermediate location between the proximal end and the interface end, the width increasing between the intermediate location and the interface end; a first control lever pivotally coupled to the body via a first pivot joint, the first control lever extending away from the contoured surface and configured to receive at least a portion of an index finger of the operator's hand thereon, wherein a movement of the first control lever by the index finger of the operator's hand generates a first control signal representative of the movement of the first control lever; and a second control lever pivotally coupled to an opposite side of the body from the first control lever, the second control lever pivotally coupled to the body via a second pivot joint that is spaced from the first pivot joint by a distance defining a second width greater than a width of the body at the intermediate location, the second control lever extending away from the contoured surface and configured to receive at least a portion of a thumb of the operator's hand thereon, wherein a movement of the second control lever by the thumb of the operator's hand generates a second control signal representative of the movement of the second control lever, wherein the first and second pivot joints are configured to generally align with metacarpophalangeal joints of the index finger and the thumb of the operator's hand, respectively, when the operator's hand is disposed on the body so that the palm of the hand contacts the contoured surf ace, the thumb is disposed on the first control lever and the index finger is disposed on the second control lever, to thereby inhibit strain on the hand of the operator when operating the first and second control levers.
Boom!
Foot Pedal Apparatus For Use With A Workstation Controlling A Robotic Surgery System
DOCUMENT ID
US 11467618 B2
DATE PUBLISHED
2022-10-11
INVENTOR INFORMATION
NAME
CITY
STATE
ZIP CODE
COUNTRY
Walters; Chad C.
Apex
NC
N/A
US
Millard; Kyle R.
Youngsville
NC
N/A
US
Genova; Perry A.
Chapel Hill
NC
N/A
US
APPLICANT INFORMATION
NAME
Titan Medical Inc.
CITY
Toronto
STATE
N/A
ZIP CODE
N/A
COUNTRY
CA
AUTHORITY
N/A
TYPE
assignee
ASSIGNEE INFORMATION
NAME
Titan Medical Inc.
CITY
Toronto
STATE
N/A
ZIP CODE
N/A
COUNTRY
CA
TYPE CODE
03
APPLICATION NO
17/193262
DATE FILED
2021-03-05
DOMESTIC PRIORITY (CONTINUITY DATA)
continuation parent-doc US 15846986 20171219 US 10969817 child-doc US 17193262
US CLASS CURRENT:
1/1
CPC CURRENT
TYPE
CPC
DATE
CPCI
G 05 G 13/00
2013-01-01
CPCI
A 61 B 34/30
2016-02-01
CPCI
A 61 B 90/03
2016-02-01
CPCI
G 05 G 1/01
2013-01-01
CPCI
G 05 G 1/36
2013-01-01
CPCA
A 61 B 2017/00199
2013-01-01
CPCA
A 61 B 34/76
2016-02-01
CPCA
A 61 B 2017/00973
2013-01-01
CPCA
G 05 G 1/30
2013-01-01
Abstract
A foot pedal apparatus for use with a workstation operated by a seated user in controlling a robotic surgery system is disclosed. In some embodiments, the apparatus includes a platform mountable to the workstation proximate a floor surface on which the workstation is located. The apparatus also includes a first pedal mounted on the platform and having an upwardly disposed actuation surface, and a second pedal mounted vertically elevated with respect to the first pedal and having an upwardly disposed actuation surface, the second pedal having at least a proximate portion vertically overlapping a distal portion of the first pedal such that the first and second pedals have a mounted depth in a direction away from the user that is less than a sum of the respective individual depths of the first and second pedals.
Background/Summary
CROSS-REFERENCE TO RELATED APPLICATION
(1) This application is a continuation of U.S. application Ser. No. 15/846,986, filed on Dec. 19, 2017. The entire disclosure of the above application is incorporated herein by reference.
BACKGROUND
1. Field
(1) This disclosure relates generally to a workstation for controlling a surgical apparatus and more particularly to a foot pedal apparatus associated with the workstation.
2. Description of Related Art
(2) In robotic systems, such as surgical robotic systems, a workstation console may be provided to control a remotely located instrument through user input provided to an input device on the console. The user may be required to operate the workstation console for an extended period of time, and the comfort of the user may thus be of concern since user fatigue may result. Some workstations, in addition to hand controls that are grasped and operated by the user, may include one or more foot pedals that when actuated cause various surgical operations to be effected.
SUMMARY
(3) In accordance with some embodiments, there is provided a foot pedal apparatus for use with a workstation located on a floor surface and operated by a seated user in controlling a robotic surgery system. The apparatus includes a platform mountable to the workstation proximate the floor surface. The apparatus also includes a first pedal mounted on the platform and having an upwardly disposed actuation surface, and a second pedal mounted vertically elevated with respect to the first pedal and having an upwardly disposed actuation surface. The second pedal has at least a proximate portion vertically overlapping a distal portion of the first pedal such that the first and second pedals have a mounted depth in a direction away from the user that is less than a sum of the respective individual depths of the first and second pedals.
(4) The second pedal may be oriented at an angle to the floor surface to facilitate engagement of the actuation surface by a forefoot portion of the user's foot while the user's heel is resting on the floor surface and acting as a pivot for movement of the user's foot.
(5) The first pedal may be oriented at an angle to the floor surface and the vertical overlap between the proximate portion of the second pedal and the distal portion of the first pedal may be selected to prevent inadvertent engagement of the actuation surface of the first pedal while actuating the second pedal.
(6) The vertical overlap between the proximate portion of the second pedal and the distal portion of the first pedal may be selected to cause the mounted depth of the first and second pedals to be about 200 mm.
(7) The vertical overlap may be at least about 12 mm.
(8) The actuation surface of the second pedal may be oriented at an angle of about 14° with respect to the floor surface.
(9) The actuation surface of the first pedal may be oriented at an angle of about 7° with respect to the floor surface.
(10) The platform may be pivotably mounted to the workstation at a pivot point on the platform proximally located with respect to the user, thereby facilitating tilting of the platform to increase the respective angles of the actuation surfaces of the first and second pedals with respect to the floor surface to facilitate ergonomic operation of the first and second pedals by the feet of a user seated in the chair and having a seat portion at a reclining angle, the increase in the angles of the actuation surfaces generally corresponding to the reclining angle of the seat portion of the chair.
(11) The actuation surface of the second pedal may be oriented at an angle of about 14° with respect to the seat portion of the chair and the actuation surface of the first pedal may be oriented at an angle of about 7° with respect to the seat portion.
(12) The workstation may include an input device and hand controllers operable to generate input signals, and the platform may be configured to attach to the workstation at a position forward of the user's hands when seated in a chair in front of the workstation and grasping the hand controllers to permit the user's feet to be extended away from the chair for ergonomic operation of the first and second pedals.
(13) The platform may include a sliding mount for mounting to the workstation, the sliding mount being operable to facilitate positioning the first and second pedals in an ergonomic position in accordance with a user's preferences.
(14) The apparatus may include at least one additional pedal mounted on the platform spaced apart from the first and second pedals, and the first and second pedals may be mounted on the platform for accessibility by one foot of the user while the at least one additional pedal is mounted on the platform for accessibility by the other foot of the user.
(15) The apparatus may include a third pedal mounted on the platform and having an upwardly disposed actuation surface, the third pedal being adjacent to the first pedal and correspondingly oriented, and a fourth pedal mounted vertically elevated with respect to the third pedal and having an upwardly disposed actuation surface, the fourth pedal being adjacent to the second pedal and correspondingly oriented.
(16) The first, second, third and fourth pedals may be mounted closely adjacent on the platform for accessibility by the same foot of the user.
(17) The apparatus may further include a barrier disposed between the first and third pedals and a barrier disposed between the second and fourth pedals, the barriers each protruding above the actuation surfaces of the respective pedals.
(18) Each of the first, second, third and fourth pedals, when actuated, may produce respective input signals for controlling the robotic surgery system.
(19) The workstation may be supported on a wheeled base and the platform may be pivotably mounted to the workstation to facilitate raising the platform with respect to the floor surface when moving the workstation.
(20) Other embodiments and features will become apparent to those ordinarily skilled in the art upon review of the following description of specific disclosed embodiments in conjunction with the accompanying figures.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) In drawings which illustrate disclosed embodiments,
(2) FIG. 1 is a perspective view of a robotic surgery system in accordance with some embodiments;
(3) FIG. 2 is a side view of a workstation of the robotic surgery system shown in FIG. 1;
(4) FIG. 3 is a perspective view of a foot pedal apparatus of the workstation shown in FIG. 2;
(5) FIG. 4 is a cross sectional view of a platform portion of the foot pedal apparatus, taken along the lines 4-4 in FIG. 3;
(6) FIG. 5 is a schematic view of a user's foot and first and second pedals of the foot pedal apparatus shown in FIG. 3;
(7) FIG. 6 is another perspective view of the foot pedal apparatus of the workstation shown in FIG. 2 in accordance with some embodiments;
(8) FIG. 7 is a perspective view of the foot pedal apparatus with the platform in a raised position according to some embodiments;
(9) FIG. 8 is a side view of a workstation of the robotic surgery system shown in FIG. 1 in accordance with some embodiments; and
(10) FIG. 9 is a schematic view of a user's foot and first and second pedals of the foot pedal apparatus shown in FIG. 3 for the workstation shown in FIG. 8 according to some embodiments.
DETAILED DESCRIPTION
(11) Referring to FIG. 1, a robotic surgery system is shown generally at 100. The robotic surgery system 100 includes a workstation 102 and a robotic surgery apparatus 104. The robotic surgery apparatus 104 includes at least one instrument 106 mounted on a moveable instrument mount 108 that houses an instrument drive (not shown) for manipulating the instrument. The workstation 102 includes an input device 110 for use by a user (generally a surgeon) for controlling the instrument 106 via the instrument drive to perform surgical operations on a patient. The input device 110 may be implemented using a haptic interface device available from Force Dimension, of Switzerland, for example. The input device 110 shown in FIG. 1 includes a right input device 112 having a right hand controller 114 and a left input device 116 having a left hand controller 118, the hand controllers being mechanically coupled to the respective input devices. In some embodiments the instrument 106 includes a right side instrument and a left side instrument (not shown) and movement of the right and left hand controllers 114 and 118 controls movements of the respective right and left instruments.
(12) In this embodiment the workstation 102 is in communication with the robotic surgery apparatus 104 via an interface cable 120 for transmitting signals between the workstation and the instrument. Input signals are generated by the right and left input devices 112 and 116 in response to movement of the hand controllers 114 and 118 by the user and the instrument 106 is spatially positioned in response to the input signals.
(13) The workstation 102 also includes a display 122 for displaying real time images and/or other graphical depictions of the surgical workspace produced by a camera (not shown) associated with the instrument 106. The display 122 may further be operable to provide other visual feedback and/or instructions to the user. The workstation 102 is supported on a wheeled base 124 permitting the workstation to be moved over a floor surface 126 for relocating the workstation. The workstation 102 further includes a foot pedal apparatus 130 having a platform 132 that is mounted to the workstation proximate the floor surface 126.
(14) A side view of a user 200 seated in a chair 202 for operating the workstation 102 is shown in FIG. 2. Referring to FIG. 2, the user 200 grasps the hand controllers 114, 118 of the input device 110 and the user's right foot 204 is positioned to operate the foot pedal apparatus 130. In the embodiment shown, the foot pedal apparatus 130 is mounted to the workstation 102 at a position forward of the hands of the user 200 when seated in the chair 202 in front of the workstation and grasping the hand controllers 114, 118 causing the user's feet to be extended away from the chair for ergonomic operation of the workstation.
(15) The foot pedal apparatus 130 is shown in isolation in FIG. 3 and includes a first pedal 300 mounted on the platform 132 and having an upwardly disposed actuation surface 302. Referring to FIG. 3, the foot pedal apparatus 130 also includes a second pedal 304 mounted vertically elevated with respect to the first pedal 300 and having an upwardly disposed actuation surface 306. The platform 132 portion of the foot pedal apparatus 130 is shown in FIG. 4 in a cross sectional view taken along the lines 4-4 shown in FIG. 3. The second pedal 304 has at least a proximate portion 400 vertically overlapping a distal portion 402 of the first pedal 300. In the embodiment shown in FIG. 3 the degree of overlap is indicated by the overlap dimension d.sub.o. The first and second pedals thus have a mounted depth D in a direction away from the user. The depth D is less than a sum of the respective individual depths d.sub.1 and d.sub.2 of the first and second pedals 300 and 304. In some embodiments the vertical overlap d.sub.o may be selected to cause the mounted depth D of the first and second pedals 300 and 304 to be about 200 mm. The overlap dimension d.sub.o may be about 12 mm or greater. The platform 132 shown in FIG. 3 is a tiered platform, but in other embodiments it may be otherwise configured for mounting of the first pedal 300 and second pedal 304.
(16) Engagement of the first and second pedals 300 and 304 by the foot 204 of the user 200 is depicted in schematic view in FIG. 5. Referring to FIG. 5, the first pedal 300 is oriented at an angle to the floor surface 126. In this embodiment the first pedal 300 is oriented at an angle a.sub.1 to the floor surface 126. The angle a.sub.1 is selected to facilitate engagement of the actuation surface 306 of the second pedal 304 by a forefoot portion 500 of the user's foot 204 while the user's heel 502 is resting on the floor surface and acting as a pivot for movement of the user's foot. In the embodiment shown in FIG. 5, the second pedal 304 is oriented at an angle a.sub.2 to the floor surface 126. The angles a.sub.1, a.sub.2 and the vertical overlap d.sub.o (shown in FIG. 4) are selected to prevent inadvertent engagement of the actuation surface 302 of the first pedal 300 while actuating the second pedal 304 with the forefoot portion 500 of the user's foot. As shown in FIG. 5, the pivoting of the user's foot 204 at the heel 502 in combination with the location and angles of the first and second pedals 300 and 304 place the actuation surface 302 of the first pedal below an arch portion 504 of the user's foot. In the embodiment shown in FIG. 5, the angle a.sub.1 may be about 7° with respect to the floor surface 126 and the angle a.sub.2 may be about 14° with respect to the floor surface.
(17) As shown in FIG. 2, when the user 200 is seated in the chair 202 in front of the workstation 102 and the user's hands are grasping the left and right hand controllers 114 and 118, the user's feet will generally be extended away from the chair forward of the user's hands. This position facilitates ergonomic operation of the first and second pedals 300 and 304.
(18) Referring back to FIG. 3, in the embodiment shown the foot pedal apparatus 130 includes a pair of slide mounts 308 and 310 having respective tracks 312 and 314. The platform 132 is attached between the slide mounts, which are in turn mounted via the respective tracks 312 and 314 to the wheeled base 124 (shown in FIG. 1 and FIG. 2). The slide mounting of the foot pedal apparatus 130 to the wheeled base 124 facilitates positioning of the platform 132 in accordance with the preferences of the user 200 to permit the user's feet to be extended away from the chair for ergonomic operation of the first and second pedals 300 and 304. The tracks 312 and 314 on the respective slide mounts 308 and 310 provide for adjustment of the foot pedal apparatus 130 toward or away from the user 200 to facilitate a variety of users of differing height and/or differing preferences.
(19) Still referring to FIG. 3, in the embodiment shown the foot pedal apparatus 130 include additional pedals mounted on the platform 132. The foot pedal apparatus 130 includes a third pedal 320 mounted on the platform 132 and having an upwardly disposed actuation surface 322. The third pedal 320 is mounted adjacent to the first pedal 300 and has a corresponding orientation. The foot pedal apparatus 130 further includes a fourth pedal 324 mounted vertically elevated with respect to the third pedal 320 and having an upwardly disposed actuation surface 326 for actuation by the forefoot portion 500 of the user's foot. The fourth pedal 324 is adjacent to the second pedal 304 and correspondingly oriented.
(20) In the embodiment shown the foot pedal apparatus 130 includes an additional fifth pedal 328 mounted on the platform 132 and having an upwardly disposed actuation surface 330. The fifth pedal 328 is spaced apart from the first, second, third and fourth pedals 300, 304, 320 and 324. In this embodiment, the first and second pedals 300 and 304 are mounted on the platform for accessibility by the right foot 204 of the user 200. The additional fifth pedal 328 is mounted on the platform 132 for accessibility by the other foot of the user 200. The third pedal 320 and fourth pedal 324 would generally be ergonomically accessible by the user 200 moving the same right foot 204 between the respective actuation surfaces of these adjacently located pedals. In the embodiment shown, the pedals are located closely adjacent on the platform 132 such that minimal side to side movement of the user's foot 204 is required for actuating either the left pedals 300, 304 or right pedals 320, 324. In the embodiment shown, the first pedal 300 and third pedal 320 are separated by a barrier 332, which protrudes slightly above the respective actuation surfaces 302 and 322 and acts to prevent the user's foot inadvertently actuating both pedals at once and acts as a haptic feedback to help position the user's foot without having to look away from the display 122. A similar barrier is included between the second pedal 304 and fourth pedal 324.
(21) Each of the first, second, third, fourth, and fifth pedals 300, 304, 320, 324, and 328, when actuated, produce respective input signals, transmitted via the interface cable 120 to the robotic surgery apparatus 104 for controlling operation (FIG. 2). In embodiments where the instrument 106 includes left and right instruments, the pedals 300 and 304 may be associated with the right instrument and the pedals 320 and 324 may be associated with the left instrument.
(22) Some instruments used in robotic surgery are configured to receive an electrical current to provide cutting and/or coagulation functions. The electrical current may be supplied by an electrosurgical unit (not shown) at radio frequencies (RF) and concentrated on tissue being manipulated by the instruments to cause coagulation of blood and/or cauterization of blood vessels in tissue at lower current density and parting of tissue at higher current density. In some embodiments the pedals 300 and 320 are configured to cause low current to be supplied to the respective right and left instruments for coagulation purposes while the upper pedals 304 and 324 are configured to cause high current to be supplied to the respective right and left instruments for cutting purposes. In electrosurgical cutting, tissue is parted through generation of high temperatures (typically in the region of 400° C.) that cause tissue to vaporize as the instrument is passed through the tissue. The electrosurgical cut requires only minimal force when compared to conventional scalpel or scissor cuts as it is the current that delivers the energy for performing the work of the cutting. The high temperatures also have the effect of sealing the incision by cauterizing vessels and causing coagulation of blood. Lower current density may result in temperatures high enough to cause coagulation and/or cauterization but insufficient to produce vaporization of tissue. Examples of instruments that may be accommodated by the instrument mount 108 include scissors, a Maryland dissector, and a hook cautery.
(23) In the robotic surgery system embodiment shown in FIG. 1, the fifth pedal 328 acts as a clutch pedal configured to inhibit further movement of the instrument 106 when depressed by the foot of the user 200. When the fifth pedal 328 is depressed, the right and left hand controllers 114 and 118 are decoupled from the instrument 106. Further movement of the hand controllers therefore does not cause movement of the instrument 106 until the fifth pedal 328 is again released.
(24) In other robotic surgery systems the foot pedal apparatus 130 may be differently configured and may have a fewer or greater number of pedals.
(25) The foot pedal apparatus 130 is shown in a left side perspective view in FIG. 6 with part of a cover of the slide mount 310 cut away. Referring to FIG. 6, in the embodiment shown, the platform 132 is pivotably mounted between the respective slide mounts 308 and 310 on a circular rod 600 to facilitate raising the platform with respect to the floor surface 126 when moving the workstation 102. The rod 600 extends between the slide mounts 308 and 310 and is able to rotate freely. In FIG. 6 the platform 132 is shown in a lowered position making the foot pedals accessible for operation. Referring back to FIG. 4, the platform 132 has a pair of pivots mounted to an underside 404 of the platform. One of the pivots is shown in FIG. 4 at 406. The pivot 406 has a base portion 408 mounted to the underside 404 of the platform 132 and also includes a clamp portion 410. The base portion 408 and clamp portion 410 are configured to provide an opening 412, which receives the rod 600 for mounting the platform 132 to the rod. The clamp portion 410 engages the rod 600 and facilitates a pivoting motion of the platform between the slide mounts 308 and 310.
(26) Referring to FIG. 6, the foot pedal apparatus 130 also includes a spring pin 602 that extends through the slide mount 310 and is configured to secure the platform 132 in the raised position. The foot pedal apparatus 130 is shown in FIG. 7 with the platform 132 in the raised position, the spring pin 602 engaging with an opening in the side of the platform to retain the platform in the raised position for transport of the workstation 102. When the spring pin 602 is disengaged, the platform 132 is able to pivot downwardly toward the floor surface 126 to make the pedals accessible for operation, as shown in FIG. 6.
(27) Referring to FIG. 8, in some cases the user 200 may prefer a slightly reclining seated position where a seat portion 800 is disposed at a seat angle ? with respect to the floor surface 126. Under these reclining conditions, the engagement of the first and second pedals 300 and 304 by the foot 204 of the user 200 may be as depicted in schematic view in FIG. 8. The forefoot portion 500 of the user's foot 204 would naturally pivot upwardly about the heel 502, especially as the user extends the chair 202 away from the workstation 102 causing their legs to stretch out. The amount the user may extend the chair 202 away from the workstation console 102 would be dependent on the length of the user's arms and a reach of the input device 110. In this embodiment the first pedal 300 and second pedal 304 are configured to facilitate an increase in the angles a.sub.1 and a.sub.2 of the actuation surfaces 302 and 306 to facilitate ergonomic operation of the first and second pedals by the feet of the user 200 when seated in the chair 202 having the seat portion 800 at the reclining seat angle ?. The increase in the angles a.sub.1 and a.sub.2 may generally correspond to the seat angle ?. For example, in some embodiments the angles a.sub.1 and a.sub.2 may simply be increased by an amount corresponding to the seat angle ?. In other embodiments the increase in the angles a.sub.1 and a.sub.2 may be in proportion to the seat angle ?.
(28) To facilitate changing the angles a.sub.1 and a.sub.2, the foot pedal apparatus 130 may be configured to permit pivoting about a proximal portion of the platform 132. For example, a pivot similar to the pivot 406 shown in FIG. 4 may be mounted at a proximal location on the platform 132 (i.e. below the first pedal 300 in FIG. 4) thus facilitating tilting of the platform to increase the respective angles of the actuation surfaces 302 and 306. In some embodiments the actuation surface 306 of the second pedal may be oriented at an angle of about 14° with respect to a seat portion of a chair for seating the user and the actuation surface 302 of the first pedal may be oriented at an angle of about 7° with respect to the seat portion.
(29) The above disclosed embodiments provide a foot pedal apparatus for the workstation configured for ergonomic operation by the user in reducing the mounted depth of the apparatus which allows the foot pedals to be located in an optimal ergonomic position for the user. Further, the angle of the pedals facilitates comfortable operation for users in a variety of preferred seated positions. The angles of the pedals in combination with the mounted depth also prevent inadvertent actuation of a lower pedal when operating an upper pedal.
(30) While specific embodiments have been described and illustrated, such embodiments should be considered illustrative of the disclosure only and not as limiting the disclosure as construed in accordance with the accompanying claims.
Claims
1. A foot pedal apparatus for use with a robotic surgery system workstation, the apparatus comprising: a first mount configured to be mounted to the workstation; a second mount configured to be mounted to the workstation; a pivotable platform extended between the first and second mounts, the pivotable platform being mounted on a rod extending between the first and second mounts; a first pedal mounted on the pivotable platform and including a first upwardly disposed actuation surface, the first actuation surface positioned at a first angle relative to a floor surface; and a second pedal mounted vertically elevated with respect to the first pedal and including a second upwardly disposed actuation surface, the second actuation surface positioned at a second angle relative to the floor surface, the second pedal including at least a proximal portion overlapping a distal portion of the first pedal, wherein the pivotable platform is configured to pivot and alter at least one of the first angle of the first actuation surface or the second angle of the second actuation surface relative to the floor surface to facilitate ergonomic operation of the first and second pedals, wherein the pivotable platform is configured to pivot on the rod between a first position in which the pivotable platform is lowered toward the floor surface to permit a user to engage first and second pedals and a second position in which the pivotable platform is at least partially raised away from the floor surface to permit transporting the workstation, and wherein the pivotable platform comprises an opening configured to receive a fastener of the first mount to retain the pivotable platform in the second position.
2. The apparatus of claim 1 wherein the proximal portion of the second pedal overlaps the distal portion of the first pedal such that a combined depth of the first and second pedals is 200 mm, and wherein a depth of overlap between the proximal portion and the distal portion is at least 12 mm.
3. The apparatus of claim 1 wherein the second angle of the second actuation surface is 14° relative to the floor surface.
4. The apparatus of claim 1 wherein the first angle of the first actuation surface is 7° relative to the floor surface.
5. The apparatus of claim 1 wherein the pivotable platform is mounted to the workstation to facilitate ergonomic operation of the first and second pedals by feet of a user seated in a chair that includes a seat portion positioned at a reclining angle, and wherein the pivotable platform is configured to pivot such that at least one of the first angle of the first actuation surface or the second angle of the second actuation surface generally corresponds to the reclining angle of the seat portion.
6. The apparatus of claim 5 wherein the second angle of the second actuation surface is 14° relative to the seat portion of the chair, and wherein the first angle of the first actuation surface is 7° relative to the seat portion.
7. The apparatus of claim 1 wherein the fastener comprises a spring pin configured to engage with the opening to maintain the pivotable platform in the second position and to disengage from the opening to cause the pivotable platform to pivot to the first position.
8. The apparatus of claim 1 wherein: the first mount comprises a first sliding track and the second mount comprises a second sliding track; the first and second mounts are configured to be attached to the workstation; and the first and second tracks configured to permit forward and backward movement of the first and second mounts.
9. The apparatus of claim 8 wherein the first and second tracks are configured to be received in first and second rails of the workstation.
10. The apparatus of claim 1 wherein the pivotable platform comprises first and second protrusions positioned on respective sides of a bottom portion of the pivotable platform, each of the first and second protrusions comprising an opening housing the rod.
11. The apparatus of claim 10 wherein each of the first and second protrusions comprises a base and a clamp connected to the base.
12. A workstation comprising: the foot pedal apparatus of claim 1; an input device; and hand controllers configured to generate input signals, wherein the pivotable platform is configured to attach to the workstation at a position forward of hands of a user when seated in a chair in front of the workstation and grasping the hand controllers to permit feet of the user to be extended away from the chair for ergonomic operation of the first and second pedals.
13. The workstation of claim 12 wherein the first and second mounts are configured to facilitate positioning the first and second pedals in an ergonomic position in accordance with a user preference.
14. The workstation of claim 12 further comprising at least one additional pedal mounted on the pivotable platform spaced apart from the first and second pedals, and wherein the first and second pedals are mounted on the pivotable platform for accessibility by one foot of the user while the at least one additional pedal is mounted on the pivotable platform for accessibility by another foot of the user.
15. The workstation of claim 12 further comprising: a third pedal mounted on the pivotable platform and including a third upwardly disposed actuation surface, the third pedal being adjacent to the first pedal and correspondingly oriented; and a fourth pedal mounted vertically elevated with respect to the third pedal and including a fourth upwardly disposed actuation surface, the fourth pedal being adjacent to the second pedal and correspondingly oriented.
16. The workstation of claim 15 wherein the first, second, third and fourth pedals are mounted closely adjacent on the pivotable platform for accessibility by a foot of the user.
17. The workstation of claim 16 further comprising a barrier disposed between the first and third pedals and a barrier disposed between the second and fourth pedals, the barriers each protruding above the actuation surfaces of the respective pedals.
18. A workstation comprising the foot pedal apparatus of claim 1 wherein the workstation is supported on a wheeled base.
19. A foot pedal apparatus for use with a robotic surgery system workstation, the apparatus comprising: a first mount configured to be mounted to the workstation; a second mount configured to be mounted to the workstation; a pivotable platform extended between the first and second mounts, the pivotable platform comprising a first protrusion and a second protrusion positioned on respective sides of a bottom portion of the pivotable platform, each of the first protrusion and the second protrusion comprising an opening housing a rod; a first pedal mounted on the pivotable platform and including a first upwardly disposed actuation surface, the first actuation surface positioned at a first angle relative to a floor surface; and a second pedal mounted vertically elevated with respect to the first pedal and including a second upwardly disposed actuation surface, the second actuation surface positioned at a second angle relative to the floor surface, the second pedal including at least a proximal portion overlapping a distal portion of the first pedal, wherein the pivotable platform is configured to pivot and alter at least one of the first angle of the first actuation surface or the second angle of the second actuation surface relative to the floor surface to facilitate ergonomic operation of the first and second pedals.
20. The apparatus of claim 19 wherein the proximal portion of the second pedal overlaps the distal portion of the first pedal such that a combined depth of the first and second pedals is 200 mm, and wherein a depth of overlap between the proximal portion and the distal portion is at least 12 mm.
21. The apparatus of claim 19 wherein the second angle of the second actuation surface is 14° relative to the floor surface.
22. The apparatus of claim 19 wherein the first angle of the first actuation surface is 7° relative to the floor surface.
23. The apparatus of claim 19 wherein the pivotable platform is mounted to the workstation to facilitate ergonomic operation of the first and second pedals by feet of a user seated in a chair that includes a seat portion positioned at a reclining angle, and wherein the pivotable platform is configured to pivot such that at least one of the first angle of the first actuation surface or the second angle of the second actuation surface generally corresponds to the reclining angle of the seat portion.
24. The apparatus of claim 23 wherein the second angle of the second actuation surface is 14° relative to the seat portion of the chair, and wherein the first angle of the first actuation surface is 7° relative to the seat portion.
25. The apparatus of claim 19 wherein: the first mount comprises a first sliding track and the second mount comprises a second sliding track; the first and second mounts are configured to be attached to the workstation; and the first and second tracks configured to permit forward and backward movement of the first and second mounts.
26. The apparatus of claim 25 wherein the first and second tracks are configured to be received in first and second rails of the workstation.
holy patience!
a lot of pain but the money is worth less and less and with these winds of war it is full of coyotes...
there will be better times!
Do not sell if you have a loss, wait a little while, in a few months this takes off!
IMO is promising!
https://journals.lww.com/neurosurgery/Fulltext/2022/06000/Acute_Implantation_of_a_Bioresorbable_Polymer.3.aspx
Do not sell if you have a loss, wait a little while, in a few months this takes off!
IMO is promising!
https://journals.lww.com/neurosurgery/Fulltext/2022/06000/Acute_Implantation_of_a_Bioresorbable_Polymer.3.aspx
BOOM!
ARTICULATED TOOL POSITIONER AND SYSTEM EMPLOYING SAME
DOCUMENT ID
US 20220313232 A1
DATE PUBLISHED
2022-10-06
INVENTOR INFORMATION
NAME
CITY
STATE
ZIP CODE
COUNTRY
Robert; Rene
East Greenwich
RI
N/A
US
Zitnick; David Allen
Providence
RI
N/A
US
Cameron; Peter John Kenneth
St. Louis Park
MN
N/A
US
Faria; Leonard M.
Bristol
RI
N/A
US
Bajo; Andrea
Fort Lauderdale
FL
N/A
US
APPLICANT INFORMATION
NAME
Titan Medical Inc.
CITY
Toronto
STATE
N/A
ZIP CODE
N/A
COUNTRY
CA
AUTHORITY
N/A
TYPE
assignee
APPLICATION NO
17/842889
DATE FILED
2022-06-17
DOMESTIC PRIORITY (CONTINUITY DATA)
parent US continuation 17242371 20210428 parent-grant-document US 11369353 child US 17842889
parent US continuation 16991423 20200812 PENDING child US 17242371
parent US continuation 16185788 20181109 parent-grant-document US 11026666 child US 16991423
parent US continuation 14899768 20151218 parent-grant-document US 10278683 WO continuation PCT/CA2013/001076 20131220 child US 16185788
us-provisional-application US 61837112 20130619
US CLASS CURRENT:
1/1
CPC CURRENT
TYPE
CPC
DATE
CPCI
A 61 B 46/10
2016-02-01
CPCI
A 61 B 50/13
2016-02-01
CPCI
A 61 B 1/0055
2013-01-01
CPCI
A 61 B 1/0057
2013-01-01
CPCI
A 61 B 34/30
2016-02-01
CPCI
A 61 B 17/00234
2013-01-01
CPCI
A 61 M 25/0147
2013-01-01
CPCI
A 61 B 17/29
2013-01-01
CPCA
A 61 B 2017/2905
2013-01-01
CPCA
A 61 B 90/361
2016-02-01
CPCA
A 61 B 2017/2906
2013-01-01
CPCA
A 61 B 2017/00323
2013-01-01
CPCA
A 61 B 1/00193
2013-01-01
CPCA
A 61 B 2017/00314
2013-01-01
CPCA
A 61 B 2034/301
2016-02-01
CPCA
A 61 B 2034/306
2016-02-01
CPCA
A 61 B 2017/2903
2013-01-01
Abstract
A laparoscopic surgical apparatus for performing a surgical procedure through a single incision in a patient's body includes a gross positioning arm supported on a moveable platform, the gross positioner including a head; at least one articulated tool positioning apparatus coupled via a tool controller to an underside of the head, the articulated tool positioning apparatus being configured to receive a tool for performing surgical operations, the tool controller being actuated by the head to cause movements of the articulated tool positioning apparatus for performing surgical operations; and wherein the gross positioner is configured to permit the head to be positioned to facilitate insertion of the articulated tool positioning apparatus through the incision into the patient's body.
Background/Summary
BACKGROUND OF THE INVENTION
1. Field of Invention
[0001] This invention relates to robotic manipulators and more particularly to an articulated tool positioner with an example of a use of the articulated tool positioner for laparoscopic surgery.
2. Related Art
[0002] Articulating surgical systems for laparoscopic surgery are gaining acceptance. Various systems exist including a system described in US Publication No. 2012/0253131 A1 published Oct. 4, 2012 to Malkowski et al.
[0003] Malkowski et al. describe a surgical system that includes one or more arms defining a passageway therethrough. The arm includes a proximal portion configured for positioning externally of a patient's body and a distal portion configured for positioning within an internal body cavity. The distal portion includes first and second articulatable segments spaced apart from one another and capable of independent articulation between a substantially straight configuration and an articulated configuration. A first articulation assembly is coupled to the proximal portion of the one arm and is transitionable between a first state and a second state for articulating the first articulatable segment between the substantially straight configuration and the articulated configuration. A second articulation assembly is coupled to the proximal portion of the arm and is configured to move between a plurality of positions for articulating the second articulatable segment between the substantially straight configuration and the articulated configuration. Links forming articulable segments of the articulation assemblies are biased by springs into a substantially straight position and cables are tensioned and untensioned to selectively pull on parts of the first and second articulation assemblies such that neutrality of tension between opposed internal cables is lost and this moves the arm between the plurality of positions.
[0004] The arrangement described by Malkowski et al. could be complicated to assemble due to the springs in the links and is likely to require careful manipulation by an operator who must be mindful to counteract the bias exerted by the springs to avoid undesired straightening of the articulable segments.
SUMMARY
[0005] The present invention provides an alternative articulated tool positioning apparatus that avoids the need for springs biasing articulated segments into a straight position through the use of cables capable of tension and compression connecting terminating members between articulating links, thereby supporting both pushing and pulling on the cables and providing for simpler assembly.
[0006] In accordance with one aspect of the invention, there is provided an articulated tool positioning apparatus. The apparatus includes a base member, an intermediate member, an end member and a first tool holder arranged in succession, each of the base member, intermediate member, end member and tool holder having a respective central opening. The apparatus further includes a first plurality of coupled guides between the base member and the intermediate member at least one of the first plurality of coupled guides is coupled to the base member and at least one of the first plurality of coupled guides is coupled to the intermediate member. Each coupled guide of the first plurality of coupled guides has a respective central opening. The apparatus further includes a second plurality of coupled guides between the intermediate member and the end member. At least one of the second plurality of coupled guides is coupled to the intermediate member and at least one of the second plurality of coupled guides is coupled to the end member. Each coupled guide of the second plurality of coupled guides also has a respective central opening. The apparatus further includes a third plurality of coupled guides between the end member and the tool holder. At least one of the third plurality of coupled guides is coupled to the end member and at least one of the third plurality of coupled guides is coupled to the tool holder. Each coupled guide of the third plurality of coupled guides also has a respective central opening. The apparatus further includes first guide openings in the base member and corresponding first guide openings in each coupled guide of the first plurality of coupled guides. A first plurality of flexible control links disposed in parallel spaced apart relation extend through respective openings of the first guide openings in the base member and through respective openings of the corresponding first guide openings in the first plurality of coupled guides. Each of the first plurality of flexible control links has respective first end portions connected to the intermediate member and respective second end portions extending away from the base member.
[0007] The apparatus further includes second guide openings in the intermediate member and corresponding second guide openings in each coupled guide of the first and second pluralities of coupled guides. The apparatus further includes a second plurality of flexible control links disposed in parallel spaced apart relation, each having a first end connected to the end member, a second end connected to at least one of the base member and an object spaced apart from the base member. Each of the second flexible control links includes an intermediate portion between the first and second ends. Each intermediate portion extends through a respective second guide opening in the intermediate member and through respective second guide openings in each guide of the first and second pluralities of coupled guides.
[0008] The apparatus further includes third guide opening in the base member and in each coupled guide of the first plurality of coupled guides and in the intermediate member and in each coupled guide of the second plurality of coupled guides and in the end member and in each coupled guide of the third plurality of coupled guides.
[0009] The apparatus further includes a third plurality of flexible control links disposed in parallel spaced apart relation and extending through respective third guide openings in the base member, in each coupled guide of the first plurality of coupled guides through respective third guide openings, in the intermediate member through respective third guide openings, in each coupled guide of the second plurality of coupled guides through respective third guide openings, in the end member and through respective third guide openings in each coupled guide of the third plurality of coupled guides. Each flexible control link of the third plurality of flexible control links has a first end connected to the tool holder and a second end extending away from the base member.
[0010] Pushing or pulling control links of the first plurality of control links causes the base member, the first plurality of coupled guides, the intermediate member, the second plurality of coupled guides and the end member to selectively define a continuous curve. The second plurality of control links causes the end member to maintain an orientation generally the same as the base member, when any of the first or third flexible control links is pushed or pulled. Pushing or pulling control links of the third plurality of control links causes the tool holder to be selectively moved into any of a plurality of orientations, such that the third plurality of coupled guides between the end member and the tool holder defines a continuous curve from the end member to the tool holder.
[0011] The first, second and third pluralities of flexible control links may include wires capable of experiencing about 200 N of tension and compression without yielding and up to about 2% to 4% strain.
[0012] The wires may be comprised of a metal alloy of nickel and titanium having shape memory and superelasticity.
[0013] The second plurality of control links may include wires having a common stiffness.
[0014] The base member, the intermediate member, the end member, the first tool holder and the coupled guides of the first, second and third pluralities of coupled guides may each have a generally circular cylindrical outer surface portion, and each the generally circular cylindrical outer surface portion may have a common diameter.
[0015] The base member, the intermediate member, the end member, the first tool holder and the coupled guides of the first, second and third pluralities of coupled guides may each have generally annular segments. At least one annular segment of the base member and at least one annular segment of each coupled guide of the first plurality of coupled guides may have the first guide openings. At least one annular segment of each coupled guide of the first and second pluralities of coupled guides and at least one annular segment of the intermediate member may have the second guide openings, and at least one annular segment of each of the base member, the intermediate member, the end member, and each coupled guide of the first, second and third pluralities of coupled guides may have the third guide openings.
[0016] Each of the annular segments of the coupled guides of the first plurality of coupled guides may have opposite faces disposed at acute angles to an axis of the central opening in the coupled guide.
[0017] Each of the annular segments of the second plurality of coupled guides may have opposite faces disposed at acute angles to an axis of the central opening in the coupled guide.
[0018] Each of the annular segments of the third plurality of coupled guides may have opposite faces disposed at acute angles to an axis of the central opening in the coupled guide.
[0019] The opposite faces of annular segments of the coupled guides of the first and second pluralities of coupled guides may be disposed at a first acute angle to the axis and the opposite faces of annular segments of the coupled guides of the third plurality of the coupled guides may be disposed at a second acute angle to the axis, the second acute angle may be different from the first acute angle.
[0020] The second acute angle may be greater than the first acute angle.
[0021] Adjacent pairs of coupled guides of the first, second and third pluralities of coupled guides may be coupled by at least one projection on one guide of the pair and a receptacle for receiving the projection on the other guide of the pair.
[0022] Each of the coupled guides of the first, second and third pluralities of coupled guides may have an axially extending projection having a truncated spherical portion and an axially aligned socket for receiving an axially extending projection of an adjacent coupled guide to permit adjacent coupled guides to spherically pivot relative to each other. The central opening of the coupled guide may have a first terminus on the projection and a second terminus in the socket so that central openings of adjacent coupled guides are in communication with each other so as to define a central channel operable to receive a portion of a tool held by the tool holder.
[0023] The apparatus may further include a first support conduit having first and second open ends, and the base may be connected to the first open end of the support conduit to support the base and the second end portions of the first and third control links may extend through the first support conduit to extend out of the second open end of the first support conduit.
[0024] In accordance with another aspect of the invention, there is provided a tool assembly comprising the apparatus described above and further including a first tool. The first tool may include a first end effector, a first coupler for coupling the first end effector to the first tool holder, the tool may further include a first flexible shaft portion having a length approximately the same as a length defined between the base member and the tool holder, and a first rigid shaft portion having a length approximately equal to a length of the first support conduit. The tool may further include a first tool control link having a first end connected to the first end effector and a second end extending from the first rigid shaft portion. The first rigid shaft portion may be received in the central opening of the first tool holder and may extend through the central openings in the third plurality of coupled guides through the central opening in the end member, through the central openings in the second plurality of coupled guides, through the central opening in the intermediate member, the central openings in the first plurality of coupled guides, and through the central openings in the base member and the first support conduit such that the first flexible shaft portion is coaxial with the tool positioning apparatus and such that the first rigid shaft portion is generally coaxial with the first support conduit and such that the second end of the first tool control link extends from the second end portion of the first support conduit.
[0025] In accordance with another aspect of the invention, there is provided a tool controller assembly including the tool assembly described above and further including a first control mount. The first support conduit of the tool positioning apparatus may be connected to the first control mount such that the first control mount may be on a first side of a first longitudinal axis of the first support conduit. The first control mount may have a first plurality of actuators connected to respective flexible control links of the first and third pluralities of flexible control links of the first tool positioning apparatus, for selectively pushing and pulling on the second end portions of the respective flexible control links to cause the base member, the first plurality of coupled guides, the intermediate member, the second plurality of coupled guides and the end member to selectively define a continuous curve and to cause the tool holder to be selectively moved into any of a plurality of orientations, such that the third plurality of coupled guides between the end member and the first tool holder apparatus may define a continuous curve from the end member to the first tool holder. The first control mount may include a first tool actuator connected to the first tool control link of the first tool, for selectively pushing and pulling on the second end portion of the first tool control link to effect operation of the end effector.
[0026] Each actuator of the first plurality of actuators and the first tool actuator may include a respective rotatable spool portion to which a respective control link is connected to permit a portion of the respective control link to be taken up or payed out from the spool portion in response to corresponding rotation of the spool portion, and a respective driver for selectively rotating the spool portion in first and second opposite directions. The respective control link may be pulled when the spool portion is rotated in the first direction to take up the portion of the respective control link and the respective control link may be pushed when the spool portion is rotated in the second direction to pay out the portion of the respective control link.
[0027] Each driver may include a gear segment.
[0028] The first control mount may have a first mounting surface and each gear segment may have a portion that projects beyond the first mounting surface to engage a corresponding drive gear on a first tool controller mount.
[0029] In accordance with another aspect of the invention, there is provided a tool controller mount including a first tool controller assembly as described above mounting interface for holding a first tool controller and may further include a first plurality of drive gears for engaging respective gear segments on the first tool controller assembly.
[0030] The drive gears of the first plurality of drive gears may include respective linear gear racks operably configured to slide linearly in parallel spaced apart relation.
[0031] The apparatus may include a first plurality of linear actuators connected to respective linear gear racks for sliding the linear gear racks linearly to impart movement to corresponding gears of the second plurality of drive gears.
[0032] The apparatus may include a second tool controller mounting interface comprising a second plurality of drive gears for engaging respective gear segments on a second tool controller similar to the first tool controller described above.
[0033] The drive gears of the second plurality of drive gears may include respective linear gear racks operably configured to slide linearly in parallel spaced apart relation.
[0034] The apparatus may include a second plurality of actuators connected to respective linear gear racks for sliding the linear gear racks linearly to impart movement to corresponding drive gears of the second plurality of drive gears.
[0035] In accordance with another aspect of the invention, there is provided a tool supervisory apparatus including a positioning tube positioned to receive at least one support conduit of a tool controller assembly as described above. The positioning tube may have a length approximately the same as or less than a length of the support conduit so that a tool holder supported by the support conduit extends from a distal end of the positioning tube. The tool supervisory apparatus further includes a camera holder in a position off an axis of the positioning tube such that the camera may be directed toward an end effector of a tool held by the tool holder to facilitate visual monitoring of movement of the end effector.
[0036] The camera holder may include the tool holder. The support conduit of the camera holder may extend inside the positioning tube and a tool positioner of the camera holder may extend from the distal end of the positioning tube and may be operably configured to hold and position the camera in a position off the second axis. The second axis may be generally perpendicular to the longitudinal axis of the support conduit.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0037] In drawings which illustrate embodiments of the invention,
[0038] FIG. 1 is a perspective view of an articulated tool positioning apparatus according to a first embodiment of the invention;
[0039] FIG. 2 is a perspective view of a distal end of a base member of the apparatus shown in FIG. 1;
[0040] FIG. 3 is a distal end view of the base member shown in FIG. 2;
[0041] FIG. 4 is a perspective view of a proximal side of a coupled guide of the apparatus shown in FIG. 1;
[0042] FIG. 5 is a top view of the coupled guide shown in FIG. 1;
[0043] FIG. 6 is an exploded view of two coupled guides of the apparatus shown in FIG. 1, including the coupled guide shown in FIGS. 4 and 5;
[0044] FIG. 7 is a side view of the coupled guides of FIG. 6 shown engaged;
[0045] FIG. 8 is a perspective view of the apparatus shown in FIG. 1 illustrating a bended configuration of the tool positioner shown in FIG. 1;
[0046] FIG. 9 is a perspective view of a proximal face of an intermediate member of the apparatus shown in FIG. 1;
[0047] FIG. 10 is a perspective view of a distal face of the intermediate member shown in FIG. 9;
[0048] FIG. 11 is a perspective view of a proximal side of an end member of the apparatus shown in FIG. 1;
[0049] FIG. 12 is a perspective view of a distal side of the side member shown in FIG. 11;
[0050] FIG. 13 is a perspective view of a proximal side of a tool holder of the apparatus shown in FIG. 1;
[0051] FIG. 14 is a perspective view of a distal side of the tool holder shown in FIG. 13;
[0052] FIG. 15 is a side view of a tool apparatus for use with the tool positioner shown in FIG. 1;
[0053] FIG. 16 is a perspective view of a tool assembly comprised of the apparatus shown in FIG. 1 with the tool apparatus shown in FIG. 15 connected thereto;
[0054] FIG. 17 is a perspective view of a tool controller shown connected to the tool assembly shown in FIG. 16;
[0055] FIG. 18 is a perspective view of a laparoscopic surgical apparatus employing the device shown in FIG. 17;
[0056] FIG. 19 is a side view of a head of the apparatus shown in FIG. 18 and a coupler operable to be coupled to the head;
[0057] FIG. 20 is a side view of the head and coupler of FIG. 19 with the coupler connected to the head;
[0058] FIG. 21 is a side view of the coupler connected to the head of FIGS. 19 and 20 with a sterile cover connected to the coupler draped over the head and nearby components;
[0059] FIG. 22 is a side view of the head and coupler of FIGS. 19-21 and a camera/delivery tube assembly operable to be coupled to the coupler;
[0060] FIG. 23 is a detailed view of the camera/delivery tube assembly shown in FIG. 22;
[0061] FIG. 24 is a side view of the camera/delivery tube assembly shown in FIG. 23 coupled to the coupler shown in FIGS. 19-22;
[0062] FIG. 25 is a side view of the camera/delivery tube assembly coupled to the coupler and a tool positioning device of the type shown in FIG. 17 being engaged therewith;
[0063] FIG. 26 is a perspective view from below of the tool controller of FIG. 17 connected to the coupler of FIGS. 19-22 with a tube associated with the tool positioning device inserted in the delivery tube shown in FIG. 23;
[0064] FIG. 27 is a side view of the delivery tube of FIG. 23 with a first tube supporting the tool positioner of FIG. 1 extending therethrough;
[0065] FIG. 28 is a side view of the apparatus of FIG. 27 further including a second tool support tube supporting a second tool positioner extending through the delivery tube of FIG. 23;
[0066] FIG. 29 is a side view of a laparoscopic surgical apparatus employing the apparatuses described in FIGS. 1-28; and
[0067] FIG. 30 is a perspective view of a surgeon's work-station for controlling the apparatus shown in FIG. 29.
[0068] FIG. 31 is a perspective view from below of two tool controllers of the type shown in FIG. 17 on a coupler according to an alternative embodiment of the invention;
[0069] FIG. 32 is a fragmented side view of first and second articulated tool positioning apparatuses extending at different distances from an end of a delivery tube of the coupler shown in FIG. 31, when first and second tool controllers thereon are disposed at different linear distances from the delivery tube.
DETAILED DESCRIPTION
[0070] Referring to FIG. 1, an articulated tool positioning apparatus according to a first embodiment of the invention is shown generally at 20. In this embodiment, the apparatus 20 includes a base member 22, an intermediate member 24, an end member 26 and a first tool holder 28 arranged in succession as shown in FIG. 1. The base member 22 may be considered to be in a proximal position while the tool holder may be considered to be in a distal position. Thus, the base member 22, intermediate member 24, end member 26 and first tool holder 28 are arranged in succession from a proximal position to a distal position.
[0071] The apparatus 20 further includes a first plurality 30 of coupled guides, disposed between the base member 22 and the intermediate member 24. At least one (32) of the first plurality 30 of coupled guides is coupled to the base member 22 and another one (34) of the first plurality 30 of coupled guides is coupled to the intermediate member 24. Each of the coupled guides of the first plurality 30 is coupled to an adjacent guide or to the base member 22 or intermediate member 24.
[0072] The tool positioning apparatus 20 further includes a second plurality 36 of coupled guides between the intermediate member 24 and the end member 26. At least one (38) of the second plurality 36 of coupled guides is coupled to the intermediate member 24 and another one (40) of the second plurality 36 of coupled guides is coupled to the end member 26. Each of the coupled guides of the second plurality 36 of coupled guides is thus connected to an adjacent guide of the second plurality or to the intermediate member 24 or the end member 26.
[0073] The apparatus 20 further includes a third plurality 42 of coupled guides between the end member 26 and the tool holder 28. At least one (44) of the third plurality 42 of coupled guides is coupled to the end member 26 and another one (46) of the third plurality 42 of coupled guides is coupled to the tool holder 28. Each of the coupled guides of the third plurality 42 is thus connected to an adjacent coupled guide of the third plurality or to the end member 26 or to the tool holder 28.
[0074] Referring to FIG. 2, the base member 22 has a generally circular cylindrical first outer surface portion 50 having a first diameter and a second coaxial, generally circular cylindrical surface portion 52 having a second diameter smaller than the first diameter. The surface portion 52 having the smaller diameter facilitates connection to an adjacent support conduit as will be described below.
[0075] Referring back to FIG. 1, the intermediate member 24 also has a generally circular cylindrical outer surface portion 54, the end member 26 has a similar outer surface portion 56 and the tool holder 28 has a similar outer surface portion 58 all having a diameter the same as the diameter of the first outer surface portion 50 of the base member 22. In addition, each coupled guide of the first, second, and third pluralities 30, 36 and 42 of coupled guides has an outer circular cylindrical surface portion, exemplary ones of which are shown at 60, 62 and 64 respectively. Thus, the tool positioning apparatus 20 has a plurality of generally coaxially aligned components all having outer surfaces of the same common diameter.
[0076] Referring to FIGS. 2 and 3, the base member 22 has a generally cylindrical body having a distal-facing end face 66 having an axially extending projection 68 with a truncated spherical portion 70 through which a central opening 72 is formed. The central opening 72 extends axially through the entire base member 22. The distal-facing end face 66 also has receptacles 74 and 76 disposed diametrically opposite each other and extending into the outer surface portion 50 to receive corresponding projections on coupled guide 32 shown in FIG. 1.
[0077] Referring to FIGS. 1 and 2 as will be explained below, the truncated spherical portion 70 and the receptacles 74 and 76 serve to couple the base member 22 to coupled guide 32 of the first plurality 30 of coupled guides.
[0078] Referring back to FIGS. 2 and 3, the distal-facing end face 66 further has a first plurality of guide openings 80, 82, 84, 86 through which a first plurality of flexible control links 88, 90, 92, 94 connected to the intermediate member 24 extend through the base member 22.
[0079] In the embodiment shown, the distal-facing end face 66 also has a plurality of receptacles 96, 98, 100 and 102 to which ends of respective ones of a second plurality of flexible control links 104, 106, 108, 110 extending between the base member 22 and the end member 26 are connected. In an alternate embodiment, the plurality of receptacles 96, 98, 100 and 102 may instead be a plurality of openings extending through the base member 22, allowing the second plurality of flexible control links 104, 106, 108, 110 to extend through and away from the base member 22. In this alternate embodiment, the ends of respective ones of the second plurality of flexible control links 104, 106, 108, 110 are connected to a fixed object (not shown), spaced apart from the base member 22. The fixed object may be a tool controller of the type described at 602 in FIG. 17, suitably modified such that the ends of respective ones of the second plurality of flexible control links 104, 106, 108, 110 are connected to the base plate 612 thereof, for example.
[0080] The distal-facing end face 66 also has a third plurality of guide openings 112, 114, 116, 118 through which respective ones of a third plurality of flexible control links 120, 122, 124, 126 connected to the tool holder 28 extend through the base member 22.
[0081] Each link of the first, second and third pluralities of flexible control links may be a single nitinol wire capable of about 200N in tension or compression without permanent deformation and capable of experiencing up to about 4% strain. Nitinol is an alloy of nickel and titanium having shape memory and superelasticity and its ability to support both tension and compression allows the links to be selectively pushed or pulled with similar forces without permanent deformation, which provides for precise control of the flexible control links, actuation redundancy and increased structural stiffness. Accordingly, only two flexible control links are required in each of the first, second, and third plurality of flexible control links to achieve a full range of movement of the tool holder relative to the base member 22.
[0082] Referring back to FIG. 1, the first plurality 30 of coupled guides are configured to cause the tool positioning apparatus 20 to have a flexible section while at the same time maintaining the first, second and third flexible control links 88, 90, 92, 94, 104, 106, 108, 110, 120, 122, 124, 126 in a pre-defined spaced apart relation relative to each other. Generally, the individual flexible control links in each plurality of flexible control links are spaced apart angularly on a circle such that the flexible control links of a given plurality are spaced apart from each other as far as possible. This reduces and balances actuation loads, increases the stiffness of the flexible section and reduces backlash effects as the direction of force on the flexible control links is changed in response to pushing and pulling of the flexible control links.
[0083] In the embodiment shown, the first plurality 30 of coupled guides includes fourteen coupled guides. Coupled guide 32 is an exemplary coupled guide of the first plurality 30 and is shown in greater detail in FIG. 4.
[0084] Referring to FIG. 4, coupled guide 32 has a body having proximal and distal-facing sides 130 and 132 and first and second annular segments 134 and 136.
[0085] The proximal facing side 130 has first and second projections 138 and 140 disposed diametrically opposite each other, the annular segments 134 and 136 being defined between the projections 138 and 140. The projections 138 and 140 are operably shaped to be received in receptacles 74 and 76 on the base member 22. The annular segments 134 and 136 have receptacles 142 and 144 disposed diametrically opposite each other and disposed in positions angularly offset by 90 degrees from the first and second projections 138 and 140.
[0086] The proximal facing side 130 also has a socket 146 having a shape complementary to the truncated spherical shape of the projection 68 on the base member 22 to receive that projection therein. The projection 68 on the base member 22 and the socket 146 on the coupled guide 32 allow the coupled guide to pivot about the projection 68 and such pivoting is constrained in a vertical or pitch direction (e.g. up and down in the plane of the drawing, FIG. 7) by the projections 138 and 140 received in the receptacles 74 and 76 on the distal facing end face 66 of the base member 22.
[0087] The socket 146 terminates in a cylindrical wall 148 disposed in a truncated spherical projection 150 seen in FIG. 5 extending from the distal facing side 132. The cylindrical wall 148 defines central opening 152 in the body of the coupled guide 32.
[0088] Referring back to FIG. 4, the annular segments 134 and 136 have a first plurality of guide openings 160, 162, 164 and 166 which are generally aligned with first guide openings 80, 82, 84 and 86 in the base member 22 to guide the first plurality of flexible control links (88, 90, 92 and 94) through the coupled guide 32.
[0089] The annular segments 134 and 136 also have a second plurality of guide openings 168, 170, 172 and 174 which are generally aligned with the second receptacles 96, 98, 100 and 102 (shown in FIGS. 2 and 3) in the base member 22 to guide the second plurality of flexible control links (104, 106, 108 and 110 shown in FIGS. 2 and 3) through the coupled guide 32.
[0090] The annular segments 134 and 136 also have a third plurality of guide openings 176, 178, 180 and 182 which are generally aligned with the third plurality of guide openings 112, 114, 116, 118 in the base member 22 to guide the third plurality of flexible control links (120, 122, 124, 126) through the coupled guide 32.
[0091] Referring to FIG. 5, the coupled guide 32 is shown from above looking in the direction of arrow 189 in FIG. 1. Annular segments 134 and 136 have portions 190 and 192 respectively having angled surfaces 194 and 196 that form an obtuse angle in a horizontal plane intersecting the axis 200 of the coupled guide 32. These surfaces 194 and 196 extend symmetrically at about a 6 degree angle to a first plane 198 perpendicular to the axis 200 of the coupled guide 32.
[0092] Referring back to FIG. 4, the coupled guide 32 also has proximal facing surfaces 202 and 204 defined between the receptacles 142 and 144 that form an obtuse angle in a vertical plane intersecting the axis 200 of the coupled guide 32. This can be seen as a slight incline in proximal facing surface 202 in FIG. 5, which forms an angle of about 6 degrees with a second plane 199 perpendicular to the axis 200 of the coupled guide 32 and provides for rotation of up to 6 degrees in the pitch direction, relative to the base member 22.
[0093] Referring to FIG. 6, the distal facing side 132 of the coupled guide 32 is shown along with an immediately distally-adjacent coupled guide 60. Immediately distally adjacent coupled guide 60 is similar to coupled guide 32 in that it includes annular segments having the same first plurality of guide openings 160, 162, 164 and 166, the same second plurality of guide openings 168, 170, 172 and 174 and the same third plurality of guide openings 176, 178, 180 and 182. It also has a truncated spherical projection 207 having a bore 209. It also has a socket (not shown) like socket 146 in the coupled guide 32, in its proximal facing side.
[0094] The immediately adjacent coupled guide 60 is different than the coupled guide 32 in that it has receptacles 210 and 212 where the projections 138 and 140 of the coupled guide 32 are located and has projections, only one of which is shown at 214, where the receptacles 142 and 144 of the coupled guide 32 are located.
[0095] In addition, referring to FIG. 7, the immediately adjacent coupled guide 60 has annular segments 216 and 218 extending between the receptacles 210 and 212 having portions 220 and 222 having distal facing surfaces 224 and 226 that form an obtuse angle in a vertical plane intersecting the axis of the immediately distally adjacent coupled guide 60 and proximal facing surfaces only one of which is seen at 227 in FIG. 7, extending between the receptacles 210 and 212 that form an obtuse angle in a horizontal plane intersecting the axis 230. The distal facing surfaces 224 and 226 are disposed at about a 6 degree angle to a first vertical plane 228 intersecting the axis 230 and perpendicular thereto and the proximal facing surfaces, only one of which is shown at 227, are disposed at about a 6 degree angle to a second vertical plane 229 intersecting the axis 230.
[0096] Still referring to FIG. 7, it can be seen that the coupled guide 32 and immediately distally adjacent coupled guide 60 are coupled together to form a pair of coupled guides by receiving the projection 150 of the coupled guide 32 in the socket (not shown) of the immediately distally adjacent coupled guide 60 and receiving the proximal facing projections of the immediately distally adjacent coupled guide 60, only one of which is shown at 214, in corresponding receptacles, only one of which is shown at 144 of the coupled guide 32. The projection 150 and socket arrangement provides for pivoting in any direction and the proximally facing projections 214 received in corresponding receptacles 144 prevent torsional movement about the axis 230, of the immediately distally adjacent coupled guide 60 relative to the coupled guide 32 and limit relative rotational movement to what is shown as a horizontal or yaw direction, i.e. into and out of the plane of the page. The angled surface 227 of the immediately distally adjacent coupled guide 60 faces angled surface 196 of the coupled guide 32 and this provides clearance for relative movement pivoting about the truncated spherical projection 150 of up to a total of 12 degrees in the yaw direction.
[0097] Similarly, the angled distal facing surfaces 224 and 226 on the immediately distally adjacent coupled guide 60 will face proximally facing surfaces like surfaces 202 and 204 on a next distally adjacent coupled guide 205 and this will provide for relative rotational movement between the immediately adjacent coupled guide 60 and the next distally adjacent coupled guide 205 of up to 12 degrees in the pitch direction. Thus each pair of coupled guides provides for limited defined movement in the pitch and yaw directions. More generally, every odd numbered coupled guide is operable to rotate in a vertical plane (pitch direction) and every even numbered coupled guide is operable to rotate in a horizontal plane (yaw direction).
[0098] Referring back to FIG. 1, in the embodiment shown the first plurality 30 of coupled guides includes seven pairs of coupled guides which enables the first plurality of coupled guides to have pitch and yaw bend components sufficient to define a continuous arc extending through up to 90 degrees. Thus, the intermediate member 24 can be positioned in an orientation in any direction relative to the axis of the base member 22 up to an angle of about 90 degrees off the axis of the base member such as shown in FIG. 8.
[0099] Referring to FIG. 9, the intermediate member 24 has a body having proximal and distal facing sides 250 and 252. The proximal facing side 250 has first and second annular segments 254 and 256 disposed between first and second projections 258 and 260 that project proximally toward the first plurality 30 of coupled guides. These projections 258 and 260 are received in receptacles like those shown at 210 and 212 in FIG. 6 in the immediately adjacent coupled guide 34 of the first plurality 30 of coupled guides as seen in FIG. 1. Referring back to FIG. 9, the proximal facing side 250 has a socket 262 terminating in an annular wall 264 defining a central opening 266 through the body. A projection like the one shown at 207 in FIG. 6 of the immediately adjacent coupled guide 32 of the first plurality 30 of coupled guides is operable to be received in the socket 262 and the projections 258 and 260 are received in receptacles similar to those shown at 210 and 212 in FIG. 6 of the immediately adjacent coupled guide 34. This permits the immediately adjacent coupled guide 34 to pivot about the projection 207 in a pitch direction.
[0100] The intermediate member 24 further includes first, second, third and fourth receptacles 270, 272, 274 and 276 disposed at locations aligned with the first set of guide openings 160, 162, 164 and 166 respectively in the immediately adjacent coupled guide 34 to receive and hold ends of the first plurality of flexible control links 88, 90, 92 and 94 respectively, extending through the first set of guide openings 160, 162, 164 and 166 of the immediately adjacent coupled guide 34.
[0101] The proximal facing side 250 further includes a second plurality of openings 280, 282, 284 and 288 which extend entirely through the intermediate member 24 for guiding the second plurality of flexible control links 104, 106, 108 and 110 therethrough. In addition, the proximal facing side 250 includes a third plurality of guide openings 290, 292, 294 and 296 that extend through the entire intermediate member 24 for guiding the third plurality of flexible control links 120, 122, 124, and 126 therethrough.
[0102] Referring to FIG. 10, the intermediate member 24 further includes a projection 300 projecting from the distal facing side 252 and has first and second receptacles 302 and 304 diametrically opposed and disposed in the outer surface portion 54 and terminating on an end face 306 of the distal facing side 252. Referring back to FIG. 1, the receptacles 302 and 304 receive corresponding projections on the immediately adjacent coupled guide 38 of the second plurality 36 of coupled guides. The second plurality 36 of coupled guides is the same as the first plurality of coupled guides, described above, in connection with FIGS. 4 through 7.
[0103] Referring to FIG. 11, the end member 26 has a body having proximal and distal facing sides 350 and 352. The proximal facing side 350 has first and second annular segments 354 and 356 disposed between first and second projections 358 and 360 that project proximally toward the second plurality 36 of coupled guides. These projections 358 and 360 are received in receptacles like those shown at 210 and 212 in FIG. 6 in the immediately adjacent coupled guide 40 of the second plurality of coupled guides 36 as seen in FIG. 1. Referring back to FIG. 11, the proximal facing side 350 has a socket 362 terminating in an annular wall 364 defining a central opening 366 through the body. A projection like the one shown at 207 in FIG. 6 of the adjacent coupled guide 40 of the second plurality of coupled guides 36 is operable to be received in the socket 362 and the projections 358 and 360 are received in receptacles similar to those shown at 210 and 212 in FIG. 6 of the immediately adjacent coupled guide 40. This permits the immediately adjacent coupled guide 40 to pivot about the projection (207) in a pitch direction.
[0104] The end member 26 further includes first, second, third and fourth receptacles 370, 372, 374 and 376 disposed at locations aligned with the second set of guide openings 168, 170, 172 and 174 respectively in the adjacent coupled guide 40 to receive and hold ends of the second plurality of flexible control links 104, 106, 108 and 110 respectively, extending through the second guide openings 168, 170, 172 and 174 of the immediately adjacent coupled guide 40.
[0105] The proximal facing side 350 further includes a third plurality of openings 380, 382, 384 and 386 which extend entirely through the end member 26 for guiding the third plurality of flexible control links 120, 122, 124 and 126 therethrough.
[0106] Referring to FIG. 12, the end member 26 further includes a projection 400 projecting from the distal facing side 352 and has first and second receptacles 402 and 404 disposed in the outer surface portion 56 and terminating on a flat annular end face 406 of the distal facing side 352. Referring back to FIG. 1, the receptacles 402 and 404 receive corresponding projections on the immediately adjacent coupled guide 44 of the third plurality 42 of coupled guides.
[0107] The third plurality 42 of coupled guides includes coupled guides the same as those shown in FIGS. 4 through 7 with the exception that the surfaces 194 and 196 extend symmetrically at about an 8.5 degree angle to the first plane 198 perpendicular to the axis of the coupled guide and the proximal facing surfaces 202 and 204 form angles of about 8.5 degrees with the second plane 199 perpendicular to the axis of the coupled guide. With the angles of the indicated surfaces on the third plurality of coupled guides being slightly greater than the angles on the first and second plurality of coupled guides, the third plurality of coupled guides can include fewer elements such as shown in this embodiment where there are only about 10 coupled guides and enable the portion extending from the end member 26 to be bent in a tighter radius than the coupled guides of the first and second pluralities 30 and 36 can be bent as shown in FIG. 8.
[0108] Referring to FIGS. 13 and 14, the tool holder 28 has a body having proximal and distal facing sides 450 and 452. The proximal facing side 450 has first and second annular segments 454 and 456 disposed between first and second projections 458 and 460 that project proximally toward the third plurality 42 of coupled guides. These projections 458 and 460 are received in receptacles like those shown at 210 and 212 in FIG. 6 in the immediately adjacent coupled guide 46 of the third plurality 42 of coupled guides as seen in FIG. 1. Referring back to FIG. 13, the proximal facing side 450 has a socket 462 terminating in an annular wall 464 defining a central bore 466 through the body. A projection like the one shown at 207 in FIG. 6 of the adjacent coupled guide 46 of the third plurality of coupled guides 42 is operable to be received in the socket 462 and the projections 458 and 460 are received in receptacles similar to those shown at 210 and 212 in FIG. 6 of the immediately adjacent coupled guide 46. This permits the immediately adjacent coupled guide 46 to pivot about the projection 207 in a pitch direction.
[0109] The tool holder 28 further includes first, second, third and fourth receptacles 470, 472, 474 and 476 disposed at locations aligned with the third set of guide openings 176, 178, 180 and 182 respectively in the adjacent coupled guide 46 to receive and hold ends of the third plurality of flexible control links 120, 122, 124 and 126 respectively, extending through the second set of guide openings 176, 178, 180 and 182 of the immediately adjacent coupled guide 46.
[0110] Referring to FIG. 14, the tool holder 28 has a flat annular end face 500 on the distal facing side 452 and the bore 466 is coterminous with the annular end face 500. Aligned openings 502 and 504, are aligned on a chord extending through the wall 464 and are operable to receive a threaded fastener, for example, for securing a tool in the tool holder 28, so that the tool can rotate axially in the tool holder.
[0111] Referring to FIG. 15, an exemplary tool for use in the tool holder shown in FIGS. 13 and 14 is shown generally at 550. In the embodiment shown, the tool 550 includes an end effector 552, which, in the embodiment shown includes a gripper having fixed and pivotal opposing jaws 554 and 556 extending from a base 558. Other tool arrangements could alternatively be employed. For example, the tool may alternatively be a cauterizing device, a suctions device, a retraction device or a grasping device. In the embodiment shown a flexible tool control link 560 is connected to the pivotal jaw 556 and extends through an axial opening in the base 558 to open and close the pivotal jaw 554 on the fixed jaw 556 in response to linear movement of the flexible control link 560.
[0112] The tool 550 further includes a coupler comprised of first and second spaced apart cylinders 562 and 564 rigidly connected to the base 558 and having outer cylindrical surfaces 563 and 565 slightly smaller than a diameter of the bore 466 in the tool holder 28 so that the tool 550 can be held snugly in the tool holder 28. A flexible conduit 566 having a length approximately equal to a distance between the tool holder 28 and the base member 22 has a first end 568 connected to the cylinder 564 and a second end 570 connected to a first end 572 of a rigid conduit 574 by a crimp connector 576. The flexible tool control link 560 extends through the cylinders 562 and 564, through the flexible conduit 566 and through the rigid conduit 574 and has a second end 578 that extends outwardly from a proximal end 580 of the rigid conduit 574. Accordingly, linear movement of the second end 578 of the flexible tool control link 560 relative to the proximal end 580 of the rigid conduit 574 opens and closes the pivotal jaw 556.
[0113] Referring to FIGS. 15 and 16, the tool 550 is shown installed in the tool holder 28 whereby only the base 558 and jaws 554 and 556 project distally from the tool holder and the flexible conduit 566 extends through the central openings 152 in the third plurality of coupled guides 42, the central opening 266 in the end member 26, the central openings 152 in the second plurality of coupled guides 36, the central opening 266 in the intermediate member 24, and the central openings (152) in the first plurality 30 of coupled guides. The crimp connector 576 is located in the central opening 72 in the base member 22 and is about the same length as the base member and the rigid conduit 574 extends outwardly from the base member in a proximal direction. The tool 550 installed in the tool holder thus forms a tool assembly 600 comprised of the tool 550 and the tool positioning apparatus 20.
[0114] Referring to FIG. 17, the tool assembly 600 is connected to a tool controller 602 comprising a second rigid conduit 604 having a first end 606 rigidly connected to the outer surface portion 52 of reduced diameter of the base member 22 and having a second end 608 connected to a drive mechanism 610. The drive mechanism 610 includes a base plate 612 having a conduit coupling 614 for rigidly connecting the second rigid conduit 604 to the base plate 612. In addition the drive mechanism includes a rotational coupling 616 connected to the proximal end 580 of the rigid conduit 574 whereupon rotation of the rotational coupling 616 causes a corresponding rotational movement of the rigid conduit 574 about its axis. A rotational flexible control link 618 is connected to the rotational coupling 616 and is routed to a rotational spool 620 which is connected to a gear segment 622 such that when the gear segment is rotated the rigid conduit 574 is rotated by a corresponding amount. Such rotation of the rigid conduit 574 rotates the tool 550 by a corresponding amount.
[0115] The first, third and tool flexible control links 88, 90, 92 and 94; 120, 122, 124 and 126; and 560 extend through the interior of the second rigid conduit 604 and emanate from the second end 608 of the second rigid conduit 604. The drive mechanism 610 has a link guide shown generally at 624 for guiding the tool control link 560 to a tool spool 626 connected to a tool gear segment 628. The tool control link 560 is wound on the tool spool 626 such that rotation of the tool gear in a first direction opens the end effector 552 of the tool 550 and rotation of the tool spool 626 in a second, opposite direction closes the end effector.
[0116] Two of the third flexible control links in a horizontal plane at the tool holder 28 such as links 120 and 126 or links 122 and 124 are wound in opposite directions on a horizontal tool control spool 630 connected to a horizontal tool control gear 632, such that rotation of the horizontal tool control gear 632 in a first direction pulls on, say, a left side link 120 or 122 while pushing on a corresponding right side link 126 or 124 and rotation of the horizontal tool control gear 632 in a second direction opposite to the first direction pushes on the left side link 120 or 122 while pulling the corresponding right side link 126 or 124. This has the effect of moving the tool holder 28 to the left or right.
[0117] Two of the third flexible control links in a vertical plane at the tool holder 28 such as links 120 and 122 or links 124 and 126, depending on which of these links are not already connected to the horizontal tool control spool 630, are wound in opposite directions on a vertical tool control spool 634 connected to a vertical tool control gear 636, such that rotation of the vertical tool control gear 636 in a first direction pulls on, say, an upper link 120 or 126 while pushing on a corresponding lower link 122 or 124 and rotation of the vertical control gear 636 in a second direction opposite to the first direction pushes on the upper link 120 or 122 while pulling the corresponding lower link 122 or 124. This has the effect of moving the tool holder 28 up or down.
[0118] Two of the first flexible control links in a horizontal plane at the intermediate member 24 such as links 88 and 94 or links 90 and 92 are wound in opposite directions on a horizontal s-curve control spool 638 connected to a horizontal s-curve gear 640, such that rotation of the horizontal s-curve control gear 640 in a first direction pulls on, say, a left side link 88 or 90 while pushing on a corresponding right side link 92 or 94 and rotation of the horizontal s-curve control gear 640 in a second direction opposite to the first direction pushes on the left side link 88 or 90 while pulling the corresponding right side link 92 or 94. This has the effect of moving the intermediate member 24 to the left or right.
[0119] Two of the first flexible control links in a vertical plane at the intermediate member 24 such as links 88 and 90 or links 92 and 94, depending on which of these links are not already connected to the horizontal s-curve control spool 638, are wound in opposite directions on a vertical s-curve control spool 642 connected to a vertical s-curve control gear 644, such that rotation of the vertical s-curve control gear 644 in a first direction pulls on, say, an upper link 88 or 94 while pushing on a corresponding lower link 90 or 92 and rotation of the vertical s-curve control gear 644 in a second direction opposite to the first direction pushes on the upper link 88 or 94 while pulling the corresponding lower link 90 or 92. This has the effect of moving the intermediate member 24 up or down.
[0120] While spools 626, 620, 630, 634, 638 and 642, and corresponding gear segments 628, 622, 632, 636, 640 and 644 are arranged in a particular order as depicted in FIG. 17, the ordering is not important. Thus, for example, spool 626 and corresponding gear segment 628 may be arranged such that they are positioned between spool 620 and corresponding gear segment 622, and spool 630 and corresponding gear segment 632.
[0121] The second flexible control links 104, 106, 108 and 110, being connected between the base member 22 and the end member 26, act as a kind of parallelogram in two dimensions, tending to keep the end member 26 at the same orientation as the base member 22. The first plurality of flexible control links 88, 90, 92 and 94 move the intermediate member 24 but parallelogram effect of the second plurality of control links tends to keep the end member 26 at the same orientation as the base member 22. Similarly, the third plurality of control links 120, 122, 124 and 126 moves the tool holder 28, but again the end member 26 is held under the constraints of the parallelogram formed by the second plurality of flexible control links and maintains the same orientation as the base member 22.
[0122] While the second plurality of flexible control links 104, 106, 108 and 110 have been shown as being connected between the base member 22 and the end member 26, it is only necessary that the proximal ends of the second plurality of flexible control links be fixed to some reference point. Thus, for example, they need not be connected to the base member 22 but could alternatively be connected to some other fixed structure located in the proximal direction away from the base member 22.
[0123] Therefore by rotating gear segments 622, 628, 632, 636, 640 and 644, the end effector can be moved with 5 degrees of freedom and the jaws can be opened and closed. As described below a suitable gear drive mechanism may be used to drive the gear segments 622, 628, 632, 636, 640 and 644 to manipulate the end effector 550 in space to perform an operation. Such operation may be a medical operation for example.
[0124] For example, the apparatus described herein may be used in performing laparoscopic surgery such as shown in FIG. 18. To do this, there is provided a movable platform 700 on which is secured a cabinet 702 housing a computer 704 either wired or wirelessly connected to a computer network such as an ethernet network. A gross positioning mechanism shown generally at 706 is connected to the cabinet 702 and has a head 708 to which the tool controller 602 shown in FIG. 17 is ultimately secured. The gross positioning mechanism 706 and the movable platform 700 allow the head 708 to be positioned at a location in space such that the tool positioning apparatus 20 can be placed inside the patient's body at a position that allows the desired laparoscopic surgery to be performed.
[0125] Referring to FIG. 19, to facilitate connection of the tool controller (602) to the head 708 while maintaining a sterile environment, the head is provided with a first portion 712 of a mechanical connector and first and second pluralities of spaced apart coaxial drive gear segments, only one gear segment of each plurality being shown at 710 and 711 in FIG. 19. As will be described below, the first plurality of drive gear segments controls the position of a camera and the second plurality of drive gear segments controls the tool controller (602). In this embodiment, respective separate motors, only two of which are shown at 714 and 715 are provided to independently drive each drive gear in a direction, at a speed and for a time responsive to control signals received from the computer 704 shown in FIG. 18.
[0126] The computer 704 may receive commands from the network to control the motors and a separate computer (shown in FIG. 30) connected to an input device controlled by a surgeon performing the surgery may generate the commands and transmit them on the network in response to hand, finger and arm movements, for example of the surgeon performing the surgery. The surgeon performing the surgery may be located in the operating room near the patient or may be located remotely anywhere in the world.
[0127] A coupler 720 comprising a housing 722 and having a second connector portion 724 of the mechanical connector has a plastic cover 726 connected around the perimeter of the housing 722 just below the second connector portion 724 of the mechanical connector. Before the second portion 724 of the mechanical connector is connected to the first connector portion 712, the plastic cover 726 is arranged to drape downwardly such that an open end portion 728 of the plastic cover 726 faces downwardly. The coupler 720 is then moved into place such that the second connector portion 724 mates with the first connector portion 712 as shown in FIG. 20. Then, referring to FIG. 21, the plastic cover 726 is raised up over the head 708 and onto a portion of the gross positioning arm 706, leaving only the portion of the coupler 720 below the perimeter line at which the plastic cover 726 is attached to the housing 722, exposed to the patient.
[0128] Referring to FIG. 22, the coupler 720 serves to couple a camera/delivery tube assembly 730 to the head 708 and further serves to connect one or more tool controllers of the type shown at 602 in FIG. 17 to the head 708.
[0129] The camera/delivery tube assembly comprises a base 732 having a connector portion 734 that mates with a corresponding connector portion 736 on the coupler 720. A clear plastic delivery tube 738 approximately about 1 inch (2.5 cm) in diameter, about 20 (51 cm) inches long and having a wall thickness of about 0.035 (0.1 cm) inches has a proximal end portion 740 connected to the base 732 and has a distal second end portion 742. A camera assembly 748 comprising a camera 750 and a camera positioner 752 are located at the distal end of the delivery tube and a rigid camera positioner support tube 754 extends from the camera positioner 752 up the delivery tube 738 from the distal second end portion 742 of the delivery tube 738 and is rigidly connected to the base 732.
[0130] Referring to FIG. 23 the camera positioner 752 may be the same as the tool positioner 20 and coupled to a camera controller 760 like the tool controller shown at 602 in FIG. 17 to enable the camera 750 to be positioned on or off the axis 762 of the delivery tube 738. The camera 750 need not have the same range of movement as the formerly described tool positioner 20 and therefore fewer flexible control links may be used in the camera positioner 752. For example, only two of the first flexible control links may be required to move the camera positioner 752 in a vertical direction off-axis of the delivery tube 738 and the flexible control link for rotating the tool may not be required. This simplifies the camera controller 760 in that it has fewer spools and gear segments. Only one gear segment is shown at 761 in FIG. 23 but there are as many gear segments are there are flexible control links for controlling the camera position. Referring back to FIG. 19, each gear segment is engaged with a corresponding linear gear rack 763 on the coupler. The linear gear rack 763 on the coupler 720 has a gear portion that faces upwardly so as to engage with the gear segment 711 on the head 708 and has a gear portion that faces downwardly to engage with the gear segment 761 shown in FIG. 23 on the camera/delivery tube assembly 730.
[0131] Referring back to FIG. 19, the coupler 720 also has a plurality of linear gear racks having upwardly facing gear portions 765 for engaging corresponding gear segments 710 on the head 708 and has downwardly facing gear portions 767 for engaging corresponding gear segments on at least one tool controller such as 602 in FIG. 17, as will be described below.
[0132] Referring back to FIG. 23, the base 732 further has an optical connector 770 and an electrical connector 772 that project in a proximal direction from the base 732 so that when the base is coupled to the coupling 720 shown in FIG. 22, they mate with corresponding optical and electrical connectors 774 and 776 on the head 708. The optical connector 774 on the head 708 provides light by way of an optical fiber 778 and a corresponding optical fiber 780 connected to the optical connector 770 on the base 732 is routed in the camera positioner and terminates at a location above a lens 781 on the camera 750 so as to illuminate the subject of the image taken by the camera 750. The electrical connector 772 on the base is connected to the camera 750 to receive image signals and passes these image signals to the electrical connector 776 on the head 708, which communicates them to the computer 704 shown in FIG. 18. The camera 750 may have two lenses or be otherwise configured to produce 3D image signals, for example. The computer 704 formats the image signals as necessary and transmits them on the network to enable capture of the image signals by devices connected to the network, including a display that may be located at or near the input device being operated by the surgeon.
[0133] Referring back to FIG. 23, the delivery tube 738 has a proximal end portion 782 that extends rearward of the base 732.
[0134] Referring to FIG. 24, the base 732 is shown coupled to the coupler 720, whereupon the gear segments, one of which is shown at 711, for controlling the camera positioner 752 engage with the linear gear racks 763 on the coupler 720. In addition, the gear segments 710 associated with the tool positioner engage with corresponding linear gear racks 765 on the coupler 720. A space is provided adjacent the linear gear racks 765 to enable at least one tool controller to be mounted in the space in a manner in which the gear segments (628, 622, 632, 636, 640 and 644 on a tool controller 602) are engaged with corresponding linear gear racks, only one of which is shown at 765 in FIG. 24. Also in the position shown in FIG. 24, the optical connectors (770) and (774) and electrical connectors (772) and (776) are connected to permit light to be transmitted to the camera head and to permit the camera to send image signals to the computer 704 in FIG. 18. Also, when the camera/delivery tube assembly 730 is connected to the coupler 720, the proximal end portion 782 of the delivery tube is disposed adjacent the space adjacent the linear gear racks 765.
[0135] Referring to FIG. 25, with the camera/delivery tube assembly 730 connected to the coupler 720, the tool controller 602 can be installed. Referring to FIG. 26, to install the tool controller 602, the tool controller is positioned such that the tool 550 is inserted into the proximal end portion 782 of the delivery tube (738) and is pushed all the way through the delivery tube until the tool 550 and tool positioner 20 extend outwardly from the distal second end portion 742 of the delivery tube as shown in FIG. 27. Thus, the second rigid conduit 606 extends inside the delivery tube parallel to the camera positioner support tube 754 and the tool positioner 20 can be freely moved about in the space adjacent the distal second end portion 742 of the delivery tube. Referring to FIGS. 26 and 27, the length of the second rigid conduit 606 is pre-configured so that when the gear segments 628, 622, 632, 636, 640 and 644 are engaged with their corresponding linear gear racks (629, 623, 633, 637, 641 and 645), the tool positioner 20 is completely outside the delivery tube 738.
[0136] Referring to FIG. 26, in the embodiment shown, the coupler 720 has first and second linear gear rack assemblies 800 and 802 that are operable to receive first and second tool controllers respectively. A first tool controller is shown at 602 and a second tool controller is shown in broken outline at 804. In the above-described design of the first tool controller 602 each gear segment 628, 622, 632, 636, 640 and 644 has a symmetrically opposite gear segment 928, 922, 932, 936, 940, and 944 on the same hub. These gear segments 928, 922, 932, 936, 940, and 944 lie in respective parallel planes at pre-defined distances from a parallel plane in which the base plate 612 lies and protrude beyond an edge 950 of the base plate 612 by the same amount by which their corresponding opposite gear segments protrude beyond an opposite edge 952 of the base plate 612. In the embodiment shown, the first tool controller 602 is installed on the coupler 720 to cooperate with the first linear gear rack assembly 800 and when installed to effect this cooperation, edge 952 of the first tool controller 602 is facing the first linear gear rack assembly 800.
[0137] The second tool controller 804 is the same as the first tool controller 602 but is installed in a mirror image orientation relative to the first tool controller 602 as shown in broken outline in FIG. 26. In this orientation, an edge 954 of the second tool controller 804 corresponding to edge 950 of the first tool controller 602 faces the second linear gear rack assembly 802 and gear segments (equivalent to 928, 922, 932, 936, 940, and 944 of the first tool controller 602) of the second tool controller 804 engage with corresponding linear gear racks of the second linear gear rack assembly 802. Thus, a second tool positioner 812 connected to a second tool controller 804 may be fed through the delivery tube 738 to extend outside the delivery tube as shown in FIG. 28.
[0138] Referring to FIG. 29, with the above described components connected together as described, the laparoscopic surgical apparatus shown in FIG. 18 is further described. The movable platform 700 can be used to move the head 708 into a position such as shown, wherein the tools 550 and 810 and camera 750 are positioned inside a patient (not shown) through a single, relatively small incision. Initially, the camera 750 and first and second tool positioners are positioned so as to be closely adjacent each other within the diameter of the delivery tube 738 to facilitate inserting the camera and first and second tool positioners 20 and 812 and tools 550 and 810 thereon into the patient through the small incision. Then the patient can be inflated with CO.sub.2 in the conventional manner and then the camera can be positioned off-axis of the delivery tube, upwardly, for example and positioned to have a field of view that encompasses the locations of the tools 550 and 810, for example. The camera 750 may also have zoom capability to zoom in on any area of particular interest inside the patient in the vicinity of the tools 550 and 810. Then, the tools 550 and 810 may be positioned and manipulated to perform surgery while the actions of the tools are viewed by the camera 750.
[0139] The positioning and manipulation of the tools 550 and 810 is directed by a surgeon operating a workstation such as shown at 860 in FIG. 30, having a 3D portal 862, for example, for viewing three-dimensional images produced by the camera 750 on a screen and having left and right input devices 864 and 866, a handrest 868 and a support cabinet 870 mounted on a movable platform 872. The movable platform may have first and second footswitches 874 and 876. The support cabinet 870 may include a computer 878 operably configured to receive signals from the left and right input devices 864 and 866 and from the first and second footswitches 874 and 876 and to produce and transmit command signals on the network to the computer of the laparoscopic surgical apparatus 850 shown in FIG. 29 to cause the liner gear racks to move in directions and distances that will effect a desired movement of the tool.
[0140] Above it was mentioned that the end effector or tool can be moved with 5 degrees of freedom by pulling or pushing on various links of the first, second and/or third pluralities of flexible control links 88, 90, 92, 94, 104, 106, 108, 110, 120, 122, 124, 126 by moving corresponding ones of the linear gear rack assemblies. A 6th degree of freedom of movement is provided by causing the tool assembly 600 and the tool controller 602 to move in a direction along the axis of the second rigid conduit 604. Such motion may be provided by moving the head 708 in a linear direction along a line coincident with the delivery tube 738, for example.
[0141] Alternatively, referring to FIGS. 26 and 31, in an alternative embodiment of the coupler 720 the first and second linear gear rack assemblies 800 and 802 can be formed on separate bases 900 and 902 and the cooperating gear racks (765 on the coupler 720) can be made long enough to permit the first and second linear gear racks 800 and 802 to be moved linearly relative to a base 904 of the coupler 720 to provide a 6.sup.th degree of freedom of movement in the direction of the axis of the delivery tube 738. To affect this movement, the base 904 can be provided with first and second gear racks 906 and 908 that engage with corresponding linear gear segments (not shown) on undersides of the first and second bases 900 and 902. The first and second gear racks can be actuated by corresponding mating gear racks (not shown) on the head (708) in a manner similar to that described in connection with the way individual racks of the first and second linear gear rack assemblies 800 and 802 are actuated.
[0142] In the alternative embodiment of the coupler 720 shown in FIG. 31, referring to FIG. 32, when the first and second tool controllers 602 and 804 are disposed at different distances from the proximal end portion 782 of the delivery tube, the respective tool positioners 20 and 812 are disposed at different distances from the distal end portion 742 of the delivery tube which positions the respective tools 550 and 810 at different distances from the distal end portion of the delivery tube.
[0143] Advantageously, the apparatus described herein provides for different types of tools to be held by the same type of tool positioning apparatus which separates the tool positioning function from the tool operation function. Thus, a single type of tool positioner can be provided and different types of tools can selectively be used in that tool positioning apparatus, as desired. In addition, the apparatus provides for left and right surgical tools to be received through the same incision in the patient and allows these tools to be positioned on opposite sides of an axis defined by the delivery tube. This enables access to the area in which surgery is taking place from either side, making it seem to the surgeon quite like directly performing the surgery in the conventional manner. In addition the same tools that are being used to perform the functions of the end effector are rotatable about their longitudinal axes which provides for more convenient and independent positioning of the end effectors.
[0144] While specific embodiments of the invention have been described and illustrated, such embodiments should be considered illustrative of the invention only and not as limiting the invention as construed in accordance with the accompanying claims.
Claims
1. (canceled)
2. A surgical tool apparatus comprising: a tool positioner capable of being articulated, the tool positioner having a central opening extending along a length thereof, wherein the tool positioner includes: a tool holder disposed at a distal end of the tool positioner, and wherein the tool holder defines a bore therethrough which is axially aligned with the central opening of the tool positioner; and a plurality of coupled guides extending proximally from the tool holder, each guide of the plurality of coupled guides includes: at least one pair of axially extending projections; at least one pair of axially extending receptacles, a spherical projection extending from one of a distal facing surface or a proximal facing surface thereof; and a socket formed in another one of the distal facing surface or the proximal facing surface, wherein the socket of one of the plurality of coupled guides is configured to receive the spherical projection of an adjacent one of the plurality of coupled guides therein; and an end effector coupled to a distal end of the tool holder of the tool positioner.
3. The surgical tool apparatus of claim 2, wherein, during an articulation of the surgical tool apparatus, the at least one pair of axially extending projections of one of the plurality of coupled guides slides at least partially into or at least partially out of the at least one pair of axially extending receptacles of an immediately adjacent one of the plurality of coupled guides for relative axial translation therebetween.
4. The surgical tool apparatus of claim 2, wherein the at least one pair of axially extending projections are in diametrically opposed relation to one another; and wherein the at least one pair of axially extending receptacles are in diametrically opposed relation to one another, wherein the at least one of the axially extending projections is substantially rectangular.
5. The surgical tool apparatus of claim 2, wherein the plurality of coupled guides includes at least a first guide, a second guide and a third guide; wherein: the first guide includes a pair of diametrically opposed axially extending projections and a pair of diametrically opposed axially extending receptacles; the second guide includes a pair of diametrically opposed axially extending projections and a pair of diametrically opposed axially extending receptacles; and the third guide includes a pair of diametrically opposed axially extending projections and a pair of diametrically opposed axially extending receptacles; wherein the pair of diametrically opposed axially extending projections of the second guide extend into the pair of diametrically opposed axially extending receptacles of the first guide; and wherein the pair of diametrically opposed axially extending projections of the third guide extend into the pair of diametrically opposed axially extending receptacles of the second guide.
6. The surgical tool apparatus of claim 5, wherein the axially extending projections and the axially extending receptacles are arranged in a radial array around their respective guide.
7. The surgical tool apparatus of claim 2, wherein the at least one pair of axially extending receptacles of one of the plurality of coupled guides is configured to at least partially receive the at least one pair of axially extending projections therein.
8. The surgical tool apparatus of claim 2, wherein at least a portion of at least one of the distal facing surface or proximal facing surface is oriented at an acute angle with respect to a plane oriented orthogonal to a central axis of the respective guide.
9. The surgical tool apparatus of claim 2, further comprising: a conduit received within the central opening of the tool positioner, wherein the conduit includes a distal end coupled to the end effector.
10. The surgical tool apparatus of claim 9, wherein the conduit is operable to actuate a second movement of the end effector.
11. The surgical tool apparatus of claim 9, further comprising: a coupler connected to the tool positioner, the coupler including first and second axially spaced apart cylinders sized to receive and be held in the bore of the tool holder.
12. The surgical tool apparatus of claim 11, further comprising: a control link extending through the tool positioner and through the tool holder, the control link having a distal end coupled to the end effector, the control link having a flexible portion at least at a distal end thereof to permit the tool positioner to move to position the end effector during a surgical operation, the control link being operable to actuate at least a first movement of the end effector
13. The surgical tool apparatus of claim 12, wherein the control link is a first control link operable to actuate at least a first movement of the end effector, and wherein the surgical tool apparatus further comprises: at least one second control link operable to actuate at least a second movement of the end effector.
14. The surgical tool apparatus of claim 13, wherein the second movement includes articulation of the end effector and of the tool positioner.
15. A surgical tool apparatus comprising: a tool positioner capable of being articulated, the tool positioner having a central opening extending along a length thereof, wherein the tool positioner includes: a tool holder disposed at a distal end thereof, and wherein the tool holder defines a bore therethrough which is axially aligned with the central opening of the tool positioner; a first plurality of coupled guides extending proximally from the tool holder, each guide of the first plurality of coupled guides includes: a spherical projection extending from one of a distal facing surface or a proximal facing surface thereof; and a socket formed in another one of the distal facing surface or the proximal facing surface, wherein the socket of one of the plurality of coupled guides is configured to receive the spherical projection of an adjacent one of the plurality of coupled guides therein; and a second plurality of coupled guides extending proximally from the tool holder, each guide of the second plurality of coupled guides includes: a spherical projection extending from one of a distal facing surface or a proximal facing surface thereof; and a socket formed in another one of the distal facing surface or the proximal facing surface, wherein the socket of one of the plurality of coupled guides is configured to receive the spherical projection of an adjacent one of the plurality of coupled guides therein; and an end effector coupled to a distal end of the tool holder of the tool positioner.
16. The surgical tool apparatus of claim 15: wherein each guide of the first plurality of coupled guides further includes: at least one pair of axially extending projections; and at least one pair of axially extending receptacles, wherein, during an articulation of the surgical tool apparatus, the at least one pair of axially extending projections of one of the first plurality of coupled guides slides at least partially into or at least partially out of the at least one pair of axially extending receptacles of an immediately adjacent one of the first plurality of coupled guides, wherein the at least one pair of axially extending projections of the first plurality of coupled guides are in diametrically opposed relation to one another; and wherein the at least one pair of axially extending receptacles of the first plurality of coupled guides are in diametrically opposed relation to one another; and wherein each guide of the second plurality of coupled guides further includes: at least one pair of axially extending projections; and at least one pair of axially extending receptacles, wherein, during an articulation of the surgical tool apparatus, the at least one pair of axially extending projections of one of the second plurality of coupled guides slides at least partially into or at least partially out of the at least one pair of axially extending receptacles of an immediately adjacent one of the second plurality of coupled guides, wherein the at least one pair of axially extending projections of the second plurality of coupled guides are in diametrically opposed relation to one another; and wherein the at least one pair of axially extending receptacles of the second plurality of coupled guides are in diametrically opposed relation to one another.
17. The surgical tool apparatus of claim 16, further comprising: a control link extending through the first plurality of coupled guides and the second plurality of coupled guides of the tool positioner, the control link having a distal end coupled to the end effector, the control link having a flexible portion at least at a distal end thereof to permit the tool positioner to move to position the end effector during a surgical operation, the control link being operable to actuate at least a first movement of the end effector.
18. A surgical tool apparatus comprising: a tool positioner capable of being articulated, the tool positioner having a central opening extending along a length thereof, wherein the tool positioner includes: a tool holder disposed at a distal end of the tool positioner, and wherein the tool holder defines a bore therethrough which is axially aligned with the central opening of the tool positioner; and a plurality of coupled guides extending proximally from the tool holder, wherein each guide of the plurality of coupled guides defines a distal facing surface and a proximal facing surface, each guide of the plurality of coupled guides includes: a pair of diametrically opposed axially extending projections, wherein the pair of axially extending projections define a projection axis extending therebetween; a pair of diametrically opposed axially extending receptacles, wherein the pair of axially extending receptacles define a receptacle axis extending therebetween; a spherical projection extending from one of the distal facing surface or the proximal facing surface; and a socket formed in another one of the distal facing surface or the proximal facing surface, wherein the socket of one of the plurality of coupled guides is configured to receive the spherical projection of an adjacent one of the plurality of coupled guides therein; wherein the surgical tool apparatus is articulatable along the plurality of guides whereby adjacent coupled guides pivot relative to one another such that the projection axis and the receptacle axis remain in a common plane while pivoting relative to one another, and such that an angle between the projection axis and the receptacle axis varies during the articulation of the surgical tool apparatus; and an end effector coupled to a distal end of the tool holder of the tool positioner.
19. The surgical tool apparatus of claim 18, wherein, during an articulation of the surgical tool apparatus, the pair of diametrically opposed axially extending projections of one of the plurality of coupled guides slides at least partially into or at least partially out of the pair of diametrically opposed axially extending receptacles of an immediately adjacent one of the plurality of coupled guides.
20. The surgical tool apparatus of claim 18, wherein at least a portion of at least one of the distal facing surface or the proximal facing surface is oriented at an obtuse angle with respect to a central axis of the respective guide.
21. The surgical tool apparatus of claim 18, further comprising: a control link extending through the tool positioner and through the tool holder, the control link having a distal end coupled to the end effector, the control link having a flexible portion at least at a distal end thereof to permit the tool positioner to move to position the end effector during a surgical operation, the control link being operable to actuate at least a first movement of the end effector.
22. A surgical tool apparatus comprising: a surgical tool positioner having a central opening extending along a length thereof, the surgical tool positioner including: a surgical tool holder disposed at a distal end of the surgical tool positioner, the surgical tool holder defining a bore therethrough which is axially aligned with the central opening of the surgical tool positioner; and a plurality of guides extending proximally from the surgical tool holder, at least two guides of the plurality of guides each including: a spherical projection extending from one of a distal facing surface or a proximal facing surface thereof; and a socket formed in another one of the distal facing surface or the proximal facing surface thereof, wherein the socket of one guide of the at least two guides is configured to receive therein the spherical projection of an adjacent guide of the at least two guides to thereby couple the one guide with the adjacent guide; and an end effector coupled to a distal end of the surgical tool holder of the surgical tool positioner.