WO2011075693A1 - Modular and cooperative medical devices and related systems and methods - Google Patents

Modular and cooperative medical devices and related systems and methods Download PDF

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Publication number
WO2011075693A1
WO2011075693A1 PCT/US2010/061137 US2010061137W WO2011075693A1 WO 2011075693 A1 WO2011075693 A1 WO 2011075693A1 US 2010061137 W US2010061137 W US 2010061137W WO 2011075693 A1 WO2011075693 A1 WO 2011075693A1
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WIPO (PCT)
Prior art keywords
component
body segment
segment
medical device
cylindrical component
Prior art date
Application number
PCT/US2010/061137
Other languages
French (fr)
Inventor
Shane M. Farritor
Mark Rentschler
Amy Lehman
Original Assignee
Board Of Regents Of The University Of Nebraska
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Board Of Regents Of The University Of Nebraska filed Critical Board Of Regents Of The University Of Nebraska
Priority to EP10838323.3A priority Critical patent/EP2512754A4/en
Priority to CA2784883A priority patent/CA2784883A1/en
Priority to JP2012544922A priority patent/JP2013514835A/en
Publication of WO2011075693A1 publication Critical patent/WO2011075693A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/73—Manipulators for magnetic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00283—Type of minimally invasive operation with a device releasably connected to an inner wall of the abdomen during surgery, e.g. an illumination source
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/302—Surgical robots specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities

Definitions

  • the embodiments disclosed herein relate to various medical devices and related components, including robotic and/or in vivo medical devices and related components.
  • Certain embodiments include various modular medical devices, including modular in vivo and/or robotic devices. Other embodiments relate to modular medical devices in which the various modular components are segmented components or components that are coupled to each other. Further embodiment relate to methods of operating the above devices, including methods of using various of the devices cooperatively.
  • Invasive surgical procedures are essential for addressing various medical conditions. When possible, minimally invasive procedures such as laparoscopy are preferred.
  • FIG. 1A is a perspective view of a modular medical device, according to another embodiment.
  • FIG. IB is a perspective bottom view of the device of FIG. 1A.
  • FIG. 2A is a perspective top view of the device of FIG. 1A.
  • FIG. 2B is a perspective side view of the device of FIG. 1A.
  • FIG. 2C is a perspective close-up view of a portion of the device of FIG. 1A.
  • FIG. 3 is a perspective bottom view of the device of FIG. 1A.
  • FIG. 4 is a perspective side view of the device of FIG. 1A.
  • FIG. 5 is a top view of the device of FIG. 1A.
  • FIG. 6 is a perspective view of modular medical device control and visualization system, according to one embodiment. 80761-395640
  • FIG. 7 is a perspective view of a modular medical device, according to one embodiment.
  • FIGS. 8A-8C are schematic representations of various magnetic attachment mechanisms, according to various embodiments.
  • FIG. 9 is a perspective view of the device of FIG. 1A.
  • FIG. 10 is a schematic representation of various forces associated with the device of FIG. 1A, according to one embodiment.
  • FIG. 1 1 is a schematic representation of various forces associated with the device of FIG. 1A, according to another embodiment.
  • FIG. 12A is a schematic representation of various forces associated with a robotic device.
  • FIG. 12B is a schematic representation of various forces associated with another robotic device, according to one embodiment.
  • FIG. 13 is a schematic representation of various forces associated with another robotic device, according to another embodiment.
  • FIG. 14 is a schematic representation of various forces associated with yet another robotic device, according to a further embodiment.
  • the various systems and devices disclosed herein relate to devices for use in medical procedures and systems. More specifically, various embodiments relate to various modular or combination medical devices, including modular in vivo and robotic devices and related methods and systems, while other embodiments relate to various cooperative medical devices, including cooperative in vivo and robotic devices and related methods and systems.
  • Certain device implementations disclosed in the applications listed above can be positioned within a body cavity of a patient, including certain devices that can be positioned against or substantially adjacent to an interior cavity wall, and related systems.
  • An "in vivo device” as used herein means any device that can be positioned, operated, or controlled at least in part by a user while being positioned within a body cavity of a patient, including any device that is positioned substantially against or adjacent to a wall of a body cavity of a patient, further including any such device that is internally actuated (having no external source of motive force), and additionally including any device that may be used
  • robot and “robotic device” shall refer to any device that can perform a task either automatically or in response to a command.
  • both “combination device” and “modular device” shall mean any medical device having modular or interchangeable components that can be arranged in a variety of different configurations.
  • the modular components and combination devices disclosed herein also include segmented triangular or quadrangular-shaped combination devices. These devices, which are made up of modular components (also referred to herein as “segments") that are connected to create the triangular or quadrangular configuration, can provide leverage and/or stability during use while also providing for substantial payload space within the device that can be used for larger components or more operational components.
  • these triangular or quadrangular devices can be positioned inside the body cavity of a patient in the same fashion as those devices discussed and disclosed above.
  • FIGS. 1A-7 depict a multi-segmented medical device 10, in accordance with one implementation.
  • the device 10 is a robotic device 10 and further can be an in vivo device 10.
  • This device embodiment 10 as shown includes three segments 12A, 12B, 14. Segments 12A and 12B are manipulator segments, while segment 14 is a command and imaging segment.
  • the three segments can be any combination of segments with any combination of components and capabilities.
  • the device could have one manipulator segment, one command and imaging segment, and a sensor segment.
  • the various segments can be any type of module, including any of those modules described above with respect to other modular components discussed herein.
  • segments 12A, 12B are rotatably coupled with the segment 14 via joints or hinges 16A, 16B. More specifically, segment 12A is rotatable relative to segment 14 about joint 16A around an axis as indicated by arrow B in FIG. IB, while segment 12B is rotatable relative to segment 14 about joint 16B around an axis as indicated by arrow C in FIG. IB.
  • the device 10 has at least two configurations.
  • One configuration is an extended or insertion configuration as shown in FIG. 1 A in which the three segments 12A, 12B, 14 are aligned along the same axis.
  • the other configuration is a triangle configuration as shown in FIG. IB in which the manipulator segments 12 A, 12B are each coupled to the segment 14 via the joints 16A, 16B and further are coupled to each other at a coupleable connection 18 at the ends of the segments 12A, 12B opposite the joints 16A, 16B.
  • each of the manipulator segments 12A, 12B in this particular embodiment has an operational arm 20, 22 (respectively).
  • Each arm 20, 22 is moveably coupled to its respective segment 12A, 12B at a joint 24A, 24B (respectively) (as best shown in FIG. 4).
  • segment 14 has a pair of imaging components (each also referred to herein as a "camera") 26A, 26B (as best shown in FIG. 3).
  • each arm 20, 22 is configured to rotate at its joint 24A, 24B in relation to its segment 12A, 12B to move between an undeployed position in which it is disposed within its segment 12A, 12B as shown in FIG. IB and a deployed position as shown in FIG. 2A.
  • arm 20 is rotatable relative to segment 12A about joint 24A in 80761-395640 the direction shown by G in FIG. 4, while arm 22 is rotatable relative to segment 12B about joint 24B in the direction shown by H in FIG. 4.
  • the arms 20, 22 are moveable in relation to the segments 12A, 12B in any known fashion and by any known mechanism.
  • each arm 20, 22 has three components: a proximal portion 20A, 22A, a distal portion 20B, 22B, and an operational component 20C, 22C coupled with the distal portion 20B, 22B, respectively.
  • the distal portion 20B, 22B of each arm 20, 22 extends and retracts along the arm axis in relation to the proximal portion 20A, 22A while also rotating around that axis in relation to the proximal portion 20A, 22A. That is, distal portion 20B of arm 20 can move back and forth laterally as shown by the letter K in FIG.
  • distal portion 22B of arm 22 can move back and forth laterally as shown by the letter L in FIG. 4 and further can rotate relative to the proximal portion 22A as indicated by the letter I.
  • the operational components 20C, 22C (also referred to herein as "end effectors") depicted in FIG. 2A are a grasper 20C and a cautery hook 22C.
  • the operational component(s) used with the device 10 or any embodiment herein can be any known operational component for use with a medical device, including any of the operational components discussed above with other medical device embodiments and further including any operational components described in the applications incorporated above.
  • only one of the two arms 20, 22 has an operational component.
  • neither arm has an operational component.
  • each arm 20, 22 comprises one unitary component or more than two components. It is further understood that the arms 20, 22 can be any kind of pivotal or moveable arm for use with a medical device which may or may not have operational components coupled or otherwise associated with them. For example, the arms 20, 22 can have a structure or configuration similar to those additional arm embodiments discussed elsewhere herein or in any of the applications incorporated above. In a further alternative, the device 10 has only one arm. In a further alternative, the device 10 has no arms. In such alternative implementations, the segment(s) not having an arm can have other components associated with or coupled with the segment(s) such as sensors or other types of components that do not require an arm for operation.
  • the segment 14 of the embodiment depicted in FIG. 3 has a pair of cameras 26A, 26B.
  • the segment 14 can have a single camera or more than two cameras.
  • any known imaging component for medical devices 80761-395640 including in vivo devices, can be used with the devices disclosed herein and further can be positioned anywhere on any of the segments or on the arms of the devices.
  • the segment 14 as best shown in FIG. 3 can also include a lighting component 28.
  • the segment 14 has four lighting components 28.
  • the segment 14 can have any number of lighting components 28 or no lighting components.
  • the device 10 can have one or more lighting
  • each of the segments 12A, 12B, 14 has two cylindrical components - an outer cylindrical component and an inner cylindrical component - that are rotatable in relation to each other. More specifically, the segment 12A has an outer cylindrical component 30A and an inner cylindrical component 30B that rotates relative to the outer component 3 OA around an axis indicated by arrow F in FIG. 3. Similarly, the segment 12B has an outer cylindrical component 32A and an inner cylindrical component 32B that rotates relative to the outer component 32 A around an axis indicated by arrow E in FIG. 3. Further, the segment 14 has an outer cylindrical component 34A and an inner cylindrical component 34B that rotates relative to the outer component 34A around an axis indicated by arrow D in FIG. 3.
  • any segment having such rotatable components can provide for enclosing any arms, cameras, or any other operational components within any of the segments.
  • any segment having such rotatable components provide for two segment configurations: an open configuration and a closed configuration. More specifically, segment 12A has an outer cylindrical component 3 OA with an opening 36 as shown in FIG. 3 through which the arm 20 can move between its deployed and undeployed positions.
  • segment 12B has an outer cylindrical component 32A with an opening 38 as shown in FIG. 3 through which the arm 22 can move between its deployed and undeployed positions.
  • segment 14 has an outer cylindrical component 34A with an opening 40 as shown in FIG. 3 through which the imaging component(s) 26A, 26B can capture images of a procedural or target area adjacent to or near the device 10.
  • FIG. IB depicts the segments 12 A, 12B, 14 in their closed configurations. That is, each of the inner cylindrical components 30B, 32B, 34B are positioned in relation to the respective outer cylindrical component 30A, 32A, 34A such that each opening 36, 38, 40, respectively, is at least partially closed by the inner component 30B, 32B, 34B such that the 80761-395640 interior of each segment 12A, 12B, 14 is at least partially inaccessible from outside the segment.
  • inner cylindrical component 30B of segment 12A is positioned in relation to outer cylindrical component 3 OA such that the arm 20 is at least partially enclosed within the segment 12A.
  • the inner cylindrical component 30B is configured such that when it is in the closed position as shown in FIG. IB, it closes off the opening 36 entirely.
  • the inner cylindrical component 30B in the closed position fluidically seals the interior of the segment 12A from the exterior.
  • inner cylindrical component 32B of segment 12B is positioned in relation to the outer cylindrical component 32A such that the arm 22 is at least partially enclosed within the segment 12B.
  • the inner cylindrical component 32B is configured such that when it is in the closed position as shown in FIG. IB, it closes off the opening 38 entirely.
  • the inner cylindrical component 32B in the closed position fluidically seals the interior of the segment 12B from the exterior.
  • inner cylindrical component 34B of segment 14 is positioned in relation to the outer cylindrical component 34A such that the imaging component(s) is not positioned within the opening 40.
  • the inner cylindrical component 34B is configured such that when it is in the closed position as shown in FIG. IB, the imaging component(s) and any lighting component(s) are completely hidden from view and not exposed to the exterior of the segment 14.
  • the inner cylindrical component 34B in the closed position fluidically seals the interior of the segment 14 from the exterior.
  • FIGS. 2A and 3 depict the segments 12A, 12B, 14 in their open configurations.
  • each of the inner cylindrical components 30B, 32B, 34B are positioned such that the openings 36, 38, 40 are open.
  • the inner cylindrical components 30B, 32B, 34B can thus be actuated to move between their closed and their open positions and thereby convert the device 10 between a closed or non-operational configuration (in which the operational components such as the arms 20, 22 and/or the imaging components 26 and/or the lighting components 28 are inoperably disposed within the segments 12A, 12B, 14) and an open or operational configuration (in which the operational components are accessible through the openings 36, 38, 40 and thus capable of operating).
  • a closed or non-operational configuration in which the operational components such as the arms 20, 22 and/or the imaging components 26 and/or the lighting components 28 are inoperably disposed within the segments 12A, 12B, 14
  • an open or operational configuration in which the operational components are accessible through the openings 36, 38, 40 and thus capable of operating.
  • the device 10 can be in its closed or non-operational configuration during insertion into a patient's body and/or to a target area and then can be converted into the open or operational configuration by causing the inner cylindrical components 30B, 32B, 34B to rotate into the open configurations.
  • one or more or all of the segments do not have inner and outer components that rotate in relation to each other.
  • the various embodiments of the device 10 disclosed herein include appropriate actuation components to generate the force necessary to operate the arms and/or the rotatable cylinders in the segments.
  • the actuation components are motors.
  • segment 12A has a motor (not shown) operably coupled with the arm 20 and configured to power the movements of the arm 20.
  • segment 12B also has a motor (not shown) operably coupled with the arm 22 and configured to power the movements of the arm 20.
  • each of the segments 12A, 12B, 14 also have motors (not shown) operably coupled to one or both of the inner and outer cylinder of each segment to power the rotation of the cylinders in relation to each other.
  • each segment can have one motor to power all drivable elements (arms, cylinders, etc.) associated with that segment. Alternatively, a separate motor can be provided for each drivable element.
  • the joints 16A, 16B are configured to urge the segments 12A, 12B from the insertion configuration of FIG. 1A into the triangular configuration of FIG. IB. That is, the joints 16A, 16B have torsion springs or some other known mechanism for urging the segments 12 A, 12B to rotate around their joints 16A, 16B.
  • FIG. 2C depicts one embodiment in which the joint 16A has torsion springs 42 that are configured to urge segment 12A toward the triangular configuration.
  • the device 10 in the insertion configuration as shown in FIG. 1A can be inserted into a patient's body through an incision, a trocar port, or natural orifice in the direction indicated by arrow A.
  • the device 10 can be inserted in the other direction as well.
  • the joints 16A, 16B with the torsion springs urge the segments 12A, 12B from their insertion position to their triangular position.
  • the segments 12A, 12B contact each other to form joint 18, the two segments are coupled together with mating components that semi- lock the segments 12 A, 12B together.
  • the two segments 12 A, 12B can only be separated at the joint 18 by a force sufficient to overcome the semi- lock.
  • Any such known 80761-395640 mating component or coupling component, including any mechanical or magnetic mating component(s), can be incorporated into the device 10 for this purpose.
  • the device 10 can be in its insertion configuration during insertion into the patient. As the device 10 enters the target cavity and exits the port or incision, the torsion springs or other mechanisms at the joints 16A, 16B cause the two segments 12A, 12B to move toward each other until they couple to form the triangular configuration.
  • the device 10 can then be attached to the abdominal wall by some method such as an external magnetic handle.
  • the device 10 can be positioned anywhere in the cavity of the patient as desired by the user. The device 10 is then used to perform some sort of procedure.
  • the device 10 can be retracted from the cavity.
  • the surgeon uses a grasping or retrieval tool such as a Endo Babcock grasper made by Covidien in Mansfield, MA, to attach to or otherwise grasp the ball 44 at the joint 18 and apply sufficient force to overcome the semi-lock of the joint 18.
  • a grasping or retrieval tool such as a Endo Babcock grasper made by Covidien in Mansfield, MA, to attach to or otherwise grasp the ball 44 at the joint 18 and apply sufficient force to overcome the semi-lock of the joint 18.
  • any retrieval component can be positioned at the end of segment 12A or elsewhere on the device 10 for grasping or otherwise coupling to for purposes of removing the device 10 from the patient's body.
  • the force urges the segments 12A, 12B away from each other, thereby making it possible for the surgeon to pull the ball 44 through a port or incision and out of the patient, thereby forcing the device 10 into its insertion configuration.
  • FIG. 2B depicts a side view of the device 10 according to one embodiment that shows the payload space available in segment 12B.
  • segment 12B and its coupled arm 22 have payload spaces 46, 48, 50, 52, 54 that can be used to accommodate motors, operational components, sensors, magnets (as described below) or any other type of component that could be useful for a procedural device.
  • each segment 12A, 12B, 14 can have such payload spaces.
  • the segments 12A, 12B, 14 allow for maximization of the payload space available across the segments 12A, 12B, 14 by distributing the components such as motors, operational components, or magnets to maximize their effectiveness while minimizing the amount of 80761-395640 space required by each such component. For example, it might maximize effectiveness of the device 10 while minimizing the utilized space to have one large motor in one segment that provides force for operation of components in more than one segment.
  • an external controller is also provided that transmits signals to the device 10 to control the device 10 and receives signals from the device 10.
  • the controller communicates with the device 10 wirelessly.
  • the controller and the device 10 are coupled via a flexible communication component such as a cord or wire (also referred to as a "tether") that extends between the device 10 and the controller.
  • the attachment components are one or more magnets, disposed within the device, that communicate magnetically with one or more magnets positioned outside the patient's body.
  • the device magnets can be positioned on or in the device in any suitable configuration.
  • the device magnets in one embodiment can be positioned within the segments 12A, 12B, 14 at positions 56, 58, 60 as shown in FIG. 5.
  • the external magnets can be used outside the body to position and/or move the device 10 inside the body.
  • console 70 depicted in FIG. 6.
  • the console 70 has a display 72 and magnets 74 and is positioned outside the patient such that the magnets 74 can be in magnetic communication with the device magnets (not shown) disposed within or otherwise coupled with the device 10.
  • the console 70 can be used to move the device 10 by moving the console 70 outside the body such that the device 10 is urged to move inside the body, because the console magnets 10 are magnetically coupled with the device magnets (not shown) within the device 10 such that the device 10 remains substantially fixed in relation to the console 70.
  • the triangular (and quandrangular) devices disclosed and described in relation to FIGS. 1A-7 can be used in conjunction with any of the external controller or visualization components and systems disclosed and discussed above and in the applications incorporated above. 80761-395640
  • the segmented device 10 provides greater stability and operability for the device 10 in comparison to other in vivo devices. That is, a device having more than one segment such as device 10 provides for a configuration with a larger "footprint" for the device 10, thereby resulting in greater stability and leverage during use of the device 10. For example, the device 10 with the triangular configuration in FIG.
  • the device 10 can have at least three magnets (not shown) disposed at the three corners of the triangular configuration such that when the device 10 is magnetically positioned against the interior cavity wall, the arms of the device 10 can apply greater force to the target tissues while maintaining the position of the device 10 than a corresponding single cylindrical device body.
  • FIG. 7 depicts a device 80 having a quadrangular configuration with four segments.
  • devices are contemplated herein having any number of segments ranging from two segments to any number of segments that can be used for a device that can be positioned inside a patient's body.
  • a device incorporating the components and structures disclosed herein could have six or eight segments or more.
  • a mechanical rod or elongate member having a cross-section of any shape or configuration could be used to support the robot.
  • the elongate member could be rigid or flexible.
  • the robot could also be placed at the end of other instruments and manual tools as well as at the end of another robot.
  • the attachment mechanism includes magnets. Attaching the robot with magnets can be accomplished in many different ways; some are shown in FIGS. 8A-8C. This can include a magnet external to the patient that is placed against the abdominal wall. This magnet then interacts with the robot to support the robot and hold it in place. The external magnet can interact with a high permeability material on the inside of the patient and attached to the robot as shown in FIG. 8A. The roles could also be reversed and the high permeability material could also be external to the patient and the magnet could be internal.
  • the external magnet can also interact with a second magnet inside the patient and attached to the robot. This can be done so that opposite poles of the magnet attract using a single pole on each magnet (as shown in FIG. 8B) or by using both poles on each magnet (as shown in FIG. 8C). 80761-395640
  • the magnet (or high permeability material) associated with the robot does not even need to be attached to the robot. It only needs to interact in such a way as to create a force to stabilize the robot (this stability is described below). For example, when a piece of paper is attached to a refrigerator with a magnet, the magnet is not attached to the paper, but it does create a force that stabilizes the paper on the refrigerator. A similar approach could be used with the robot.
  • any number of magnets (0, 1 , 2, 3, ) can be used to attach the robot.
  • One obvious approach would be to place a magnet in each corner (or in each segment) of the triangle of the robot, with a trio of external magnets being used external to the patient.
  • the triangle (or other open or closed polygons (from 2 sides on up)) is especially well suited to be supported by several different combinations of magnets.
  • a single magnet can be used inside the triangle since the shape of the triangle will provide multi axis support to react the force applied by this single magnet. This is further described in the next section.
  • a "V" configuration or other polygon could give similar support.
  • Certain embodiments disclosed herein relate to maximization of stability of the various device embodiments while positioned inside the patient's body.
  • a single magnet 90 is attached to the robot 10 so that it is attracted to a magnet 92 on the outside of the patient.
  • the magnet 90 on the robot produces a force on the robot 10 in the upward direction.
  • a simplified Free Body Diagram showing a simplified interpretation of the reaction forces is shown in FIG. 10.
  • the magnet 90 produces an upward force on the body of the robot 10 (assumed rigid) F m .
  • the weight of the robot 10, W is also shown acting at the center of mass of the robot 10.
  • Each corner of the robot is labeled A, B, and C and reaction forces are shown at each corner (FA, FB, FC).
  • FH, F L H end effector forces
  • the stability of the robot 10 in FIG. 10 created by the single magnet 90 can be determined using various mathematical techniques.
  • One example of such techniques is set forth in Papadopoulos, E. and Rey, D., "A New Measure of Tipover Stability Margin for Mobile Manipulators," Proc. of the IEEE International Conference on Robotics and
  • FIG. 1 A simplified example is shown in FIG. 1 1.
  • the robot 10 is assumed mass-less and is not applying forces with its end effectors. It can be clearly seen that a large magnetic force, FM, produces moment about the line AB that will cause the robot to rotate into the abdominal wall and therefore make a stable configuration for the robot. The same is true about lines BC and CA.
  • FIG. 1 1 is further exemplified by the two possible configurations shown in FIGS. 12A and 12B.
  • the robot 94 in FIG. 12A could be created by simply using one segment of the triangle configuration as shown back in FIG. 10 (with attachment magnets at A and B).
  • FIG. 12 A there are two attachment points (A and B) that hold the robot 94 to the upper abdominal wall (one segment).
  • the robot's end effector (or hand) 96 applies a force in an arbitrary direction, there will be non-zero moments about the contact line AB. This will cause the robot 94 to rotate about the line AB and could result in some instability.
  • FIG. 12 depicts a device 98 that contains additional structure as represented by point C.
  • hand forces Fnand
  • Fc reaction force at point C
  • moments can be balanced and a stable configuration produced when other 80761-395640 lines of contact are considered (BC & AC in this case, with other possibilities described below).
  • discrete points A, B, & C
  • any line segment AB for example
  • FIG. 13 shows a configuration similar to FIG. 11 , but the "triangle" in FIG. 13 is in an "open” configuration 100 in which point A now becomes two points (A and A').
  • This configuration 100 will also produce stability if the moments about all contact lines (AB, BC, CA' and A'A) "pushes" the robot into the abdominal wall rather than “peeling" it away.
  • FIG. 14 depicts another example of a multi-sided polygon 102 that uses a single magnet for stable attachment.
  • the same analysis used above applies here and can be used to show that the robot 102 can be stable.
  • the stability provided by a single magnet as described with the configurations discussed above can also occur for shapes other than polygons. For example, a "V" or "T” configuration could be used. The shapes could be open or closed.
  • the robot could have a magnet at one corner of the robot and two pieces of high permeability material at the other two corners (or sides). Or the robot could have two magnets and one piece of high permeability material, or other combinations.

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Abstract

The various embodiments disclosed herein relate to modular medical devices, including various devices with detachable modular components and various devices with pivotally attached modular components. Additional embodiments relate to procedures in which various of the devices are used cooperatively. Certain embodiments of the medical devices are robotic in vivo devices.

Description

80761-395640
MODULAR AND COOPERATIVE MEDICAL DEVICES AND RELATED SYSTEMS AND METHODS
TECHNICAL FIELD
[0001] The embodiments disclosed herein relate to various medical devices and related components, including robotic and/or in vivo medical devices and related components.
Certain embodiments include various modular medical devices, including modular in vivo and/or robotic devices. Other embodiments relate to modular medical devices in which the various modular components are segmented components or components that are coupled to each other. Further embodiment relate to methods of operating the above devices, including methods of using various of the devices cooperatively.
BACKGROUND
[0002] Invasive surgical procedures are essential for addressing various medical conditions. When possible, minimally invasive procedures such as laparoscopy are preferred.
[0003] However, known minimally invasive technologies such as laparoscopy are limited in scope and complexity due in part to 1) mobility restrictions resulting from using rigid tools inserted through access ports, and 2) limited visual feedback Known robotic systems such as the da Vinci® Surgical System (available from Intuitive Surgical, Inc., located in Sunnyvale, CA) are also restricted by the access ports, as well as having the additional disadvantages of being very large, very expensive, unavailable in most hospitals, and having limited sensory and mobility capabilities.
[0004] There is a need in the art for improved surgical methods, systems, and devices.
BRIEF DESCRIPTION OF THE DRAWINGS
[0005] FIG. 1A is a perspective view of a modular medical device, according to another embodiment.
[0006] FIG. IB is a perspective bottom view of the device of FIG. 1A.
[0007] FIG. 2A is a perspective top view of the device of FIG. 1A.
[0008] FIG. 2B is a perspective side view of the device of FIG. 1A.
[0009] FIG. 2C is a perspective close-up view of a portion of the device of FIG. 1A.
[0010] FIG. 3 is a perspective bottom view of the device of FIG. 1A.
[0011] FIG. 4 is a perspective side view of the device of FIG. 1A.
[0012] FIG. 5 is a top view of the device of FIG. 1A.
[0013] FIG. 6 is a perspective view of modular medical device control and visualization system, according to one embodiment. 80761-395640
[0014] FIG. 7 is a perspective view of a modular medical device, according to one embodiment.
[0015] FIGS. 8A-8C are schematic representations of various magnetic attachment mechanisms, according to various embodiments.
[0016] FIG. 9 is a perspective view of the device of FIG. 1A.
[0017] FIG. 10 is a schematic representation of various forces associated with the device of FIG. 1A, according to one embodiment.
[0018] FIG. 1 1 is a schematic representation of various forces associated with the device of FIG. 1A, according to another embodiment.
[0019] FIG. 12A is a schematic representation of various forces associated with a robotic device.
[0020] FIG. 12B is a schematic representation of various forces associated with another robotic device, according to one embodiment.
[0021] FIG. 13 is a schematic representation of various forces associated with another robotic device, according to another embodiment.
[0022] FIG. 14 is a schematic representation of various forces associated with yet another robotic device, according to a further embodiment.
DETAILED DESCRIPTION
[0023] The various systems and devices disclosed herein relate to devices for use in medical procedures and systems. More specifically, various embodiments relate to various modular or combination medical devices, including modular in vivo and robotic devices and related methods and systems, while other embodiments relate to various cooperative medical devices, including cooperative in vivo and robotic devices and related methods and systems.
[0024] It is understood that the various embodiments of modular and cooperative devices and related methods and systems disclosed herein can be incorporated into or used with any other known medical devices, systems, and methods.
[0025] For example, the various embodiments disclosed herein may be incorporated into or used with any of the medical devices and systems disclosed in copending U.S. Applications 12/192,779 (filed on August 15, 2008 and entitled "Modular and Cooperative Medical Devices and Related Systems and Methods"), 1 1/932,441 (filed on October 31, 2007 and entitled "Robot for Surgical Applications"), 1 1/695,944 (filed on April 3, 2007 and entitled "Robot for Surgical Applications"), 1 1/947,097 (filed on November 27, 2007 and entitled "Robotic Devices with Agent Delivery Components and Related Methods), 11/932,516 (filed 80761-395640 on October 31, 2007 and entitled "Robot for Surgical Applications"), 1 1/766,683 (filed on June 21, 2007 and entitled "Magnetically Coupleable Robotic Devices and Related
Methods"), 11/766,720 (filed on June 21, 2007 and entitled "Magnetically Coupleable Surgical Robotic Devices and Related Methods"), 1 1/966,741 (filed on December 28, 2007 and entitled "Methods, Systems, and Devices for Surgical Visualization and Device Manipulation"), 12/171 ,413 (filed on July 1 1 , 2008 and entitled "Methods and Systems of Actuation in Robotic Devices"), 60/956,032 (filed on August 15, 2007), 60/983,445 (filed on October 29, 2007), 60/990,062 (filed on November 26, 2007), 60/990,076 (filed on
November 26, 2007), 60/990,086 (filed on November 26, 2007), 60/990,106 (filed on November 26, 2007), 60/990,470 (filed on November 27, 2007), 61/025,346 (filed on February 1, 2008), 61/030,588 (filed on February 22, 2008), and 61/030,617 (filed on February 22, 2008), all of which are hereby incorporated herein by reference in their entireties.
[0026] Certain device implementations disclosed in the applications listed above can be positioned within a body cavity of a patient, including certain devices that can be positioned against or substantially adjacent to an interior cavity wall, and related systems. An "in vivo device" as used herein means any device that can be positioned, operated, or controlled at least in part by a user while being positioned within a body cavity of a patient, including any device that is positioned substantially against or adjacent to a wall of a body cavity of a patient, further including any such device that is internally actuated (having no external source of motive force), and additionally including any device that may be used
laparoscopically or endoscopically during a surgical procedure. As used herein, the terms "robot," and "robotic device" shall refer to any device that can perform a task either automatically or in response to a command.
[0027] Certain implementations disclosed herein relate to "combination" or "modular" medical devices that can be assembled in a variety of configurations. For purposes of this application, both "combination device" and "modular device" shall mean any medical device having modular or interchangeable components that can be arranged in a variety of different configurations. The modular components and combination devices disclosed herein also include segmented triangular or quadrangular-shaped combination devices. These devices, which are made up of modular components (also referred to herein as "segments") that are connected to create the triangular or quadrangular configuration, can provide leverage and/or stability during use while also providing for substantial payload space within the device that can be used for larger components or more operational components. As with the various 80761-395640 combination devices disclosed and discussed above, according to one embodiment these triangular or quadrangular devices can be positioned inside the body cavity of a patient in the same fashion as those devices discussed and disclosed above.
[0028] FIGS. 1A-7 depict a multi-segmented medical device 10, in accordance with one implementation. According to one embodiment, the device 10 is a robotic device 10 and further can be an in vivo device 10. This device embodiment 10 as shown includes three segments 12A, 12B, 14. Segments 12A and 12B are manipulator segments, while segment 14 is a command and imaging segment. Alternatively, the three segments can be any combination of segments with any combination of components and capabilities. For example, according to an alternative embodiment, the device could have one manipulator segment, one command and imaging segment, and a sensor segment. In a further alternative, the various segments can be any type of module, including any of those modules described above with respect to other modular components discussed herein.
[0029] As best shown in FIGS. 1 A and IB, segments 12A, 12B are rotatably coupled with the segment 14 via joints or hinges 16A, 16B. More specifically, segment 12A is rotatable relative to segment 14 about joint 16A around an axis as indicated by arrow B in FIG. IB, while segment 12B is rotatable relative to segment 14 about joint 16B around an axis as indicated by arrow C in FIG. IB.
[0030] In accordance with one embodiment, the device 10 has at least two configurations. One configuration is an extended or insertion configuration as shown in FIG. 1 A in which the three segments 12A, 12B, 14 are aligned along the same axis. The other configuration is a triangle configuration as shown in FIG. IB in which the manipulator segments 12 A, 12B are each coupled to the segment 14 via the joints 16A, 16B and further are coupled to each other at a coupleable connection 18 at the ends of the segments 12A, 12B opposite the joints 16A, 16B.
[0031] As best shown in FIG. 2A, each of the manipulator segments 12A, 12B in this particular embodiment has an operational arm 20, 22 (respectively). Each arm 20, 22 is moveably coupled to its respective segment 12A, 12B at a joint 24A, 24B (respectively) (as best shown in FIG. 4). Further, segment 14 has a pair of imaging components (each also referred to herein as a "camera") 26A, 26B (as best shown in FIG. 3).
[0032] In one embodiment, each arm 20, 22 is configured to rotate at its joint 24A, 24B in relation to its segment 12A, 12B to move between an undeployed position in which it is disposed within its segment 12A, 12B as shown in FIG. IB and a deployed position as shown in FIG. 2A. In one example, arm 20 is rotatable relative to segment 12A about joint 24A in 80761-395640 the direction shown by G in FIG. 4, while arm 22 is rotatable relative to segment 12B about joint 24B in the direction shown by H in FIG. 4. Alternatively, the arms 20, 22 are moveable in relation to the segments 12A, 12B in any known fashion and by any known mechanism.
[0033] According to one embodiment as best shown in FIG. 2A, each arm 20, 22 has three components: a proximal portion 20A, 22A, a distal portion 20B, 22B, and an operational component 20C, 22C coupled with the distal portion 20B, 22B, respectively. In this embodiment, the distal portion 20B, 22B of each arm 20, 22 extends and retracts along the arm axis in relation to the proximal portion 20A, 22A while also rotating around that axis in relation to the proximal portion 20A, 22A. That is, distal portion 20B of arm 20 can move back and forth laterally as shown by the letter K in FIG. 4 and further can rotate relative to the proximal portion 20A as indicated by the letter J, while distal portion 22B of arm 22 can move back and forth laterally as shown by the letter L in FIG. 4 and further can rotate relative to the proximal portion 22A as indicated by the letter I.
[0034] In accordance with one implementation, the operational components 20C, 22C (also referred to herein as "end effectors") depicted in FIG. 2A are a grasper 20C and a cautery hook 22C. It is understood that the operational component(s) used with the device 10 or any embodiment herein can be any known operational component for use with a medical device, including any of the operational components discussed above with other medical device embodiments and further including any operational components described in the applications incorporated above. Alternatively, only one of the two arms 20, 22 has an operational component. In a further alternatively, neither arm has an operational component.
[0035] Alternatively, each arm 20, 22 comprises one unitary component or more than two components. It is further understood that the arms 20, 22 can be any kind of pivotal or moveable arm for use with a medical device which may or may not have operational components coupled or otherwise associated with them. For example, the arms 20, 22 can have a structure or configuration similar to those additional arm embodiments discussed elsewhere herein or in any of the applications incorporated above. In a further alternative, the device 10 has only one arm. In a further alternative, the device 10 has no arms. In such alternative implementations, the segment(s) not having an arm can have other components associated with or coupled with the segment(s) such as sensors or other types of components that do not require an arm for operation.
[0036] As discussed above, the segment 14 of the embodiment depicted in FIG. 3 has a pair of cameras 26A, 26B. Alternatively, the segment 14 can have a single camera or more than two cameras. It is understood that any known imaging component for medical devices, 80761-395640 including in vivo devices, can be used with the devices disclosed herein and further can be positioned anywhere on any of the segments or on the arms of the devices.
[0037] In a further embodiment, the segment 14 as best shown in FIG. 3 can also include a lighting component 28. In fact, the segment 14 has four lighting components 28.
Alternatively, the segment 14 can have any number of lighting components 28 or no lighting components. In a further alternative, the device 10 can have one or more lighting
components positioned elsewhere on the device, such as one or both of segments 12A, 12B or one or more of the arms, etc.
[0038] In accordance with a further embodiment as best shown in FIGS. IB and 3, each of the segments 12A, 12B, 14 has two cylindrical components - an outer cylindrical component and an inner cylindrical component - that are rotatable in relation to each other. More specifically, the segment 12A has an outer cylindrical component 30A and an inner cylindrical component 30B that rotates relative to the outer component 3 OA around an axis indicated by arrow F in FIG. 3. Similarly, the segment 12B has an outer cylindrical component 32A and an inner cylindrical component 32B that rotates relative to the outer component 32 A around an axis indicated by arrow E in FIG. 3. Further, the segment 14 has an outer cylindrical component 34A and an inner cylindrical component 34B that rotates relative to the outer component 34A around an axis indicated by arrow D in FIG. 3.
[0039] In use, the embodiments having rotatable cylindrical components as described in the previous paragraph can provide for enclosing any arms, cameras, or any other operational components within any of the segments. Further, any segment having such rotatable components provide for two segment configurations: an open configuration and a closed configuration. More specifically, segment 12A has an outer cylindrical component 3 OA with an opening 36 as shown in FIG. 3 through which the arm 20 can move between its deployed and undeployed positions. Similarly, segment 12B has an outer cylindrical component 32A with an opening 38 as shown in FIG. 3 through which the arm 22 can move between its deployed and undeployed positions. Further, segment 14 has an outer cylindrical component 34A with an opening 40 as shown in FIG. 3 through which the imaging component(s) 26A, 26B can capture images of a procedural or target area adjacent to or near the device 10.
[0040] FIG. IB depicts the segments 12 A, 12B, 14 in their closed configurations. That is, each of the inner cylindrical components 30B, 32B, 34B are positioned in relation to the respective outer cylindrical component 30A, 32A, 34A such that each opening 36, 38, 40, respectively, is at least partially closed by the inner component 30B, 32B, 34B such that the 80761-395640 interior of each segment 12A, 12B, 14 is at least partially inaccessible from outside the segment.
[0041] More specifically, in the closed position, inner cylindrical component 30B of segment 12A is positioned in relation to outer cylindrical component 3 OA such that the arm 20 is at least partially enclosed within the segment 12A. According to one embodiment, the inner cylindrical component 30B is configured such that when it is in the closed position as shown in FIG. IB, it closes off the opening 36 entirely. In a further embodiment, the inner cylindrical component 30B in the closed position fluidically seals the interior of the segment 12A from the exterior.
[0042] Similarly, in the closed position, inner cylindrical component 32B of segment 12B is positioned in relation to the outer cylindrical component 32A such that the arm 22 is at least partially enclosed within the segment 12B. According to one embodiment, the inner cylindrical component 32B is configured such that when it is in the closed position as shown in FIG. IB, it closes off the opening 38 entirely. In a further embodiment, the inner cylindrical component 32B in the closed position fluidically seals the interior of the segment 12B from the exterior.
[0043] Further, in the closed position, inner cylindrical component 34B of segment 14 is positioned in relation to the outer cylindrical component 34A such that the imaging component(s) is not positioned within the opening 40. According to one embodiment, the inner cylindrical component 34B is configured such that when it is in the closed position as shown in FIG. IB, the imaging component(s) and any lighting component(s) are completely hidden from view and not exposed to the exterior of the segment 14. In a further
embodiment, the inner cylindrical component 34B in the closed position fluidically seals the interior of the segment 14 from the exterior.
[0044] In contrast, FIGS. 2A and 3 depict the segments 12A, 12B, 14 in their open configurations. In these configurations, each of the inner cylindrical components 30B, 32B, 34B are positioned such that the openings 36, 38, 40 are open.
[0045] In use, according to one embodiment, the inner cylindrical components 30B, 32B, 34B can thus be actuated to move between their closed and their open positions and thereby convert the device 10 between a closed or non-operational configuration (in which the operational components such as the arms 20, 22 and/or the imaging components 26 and/or the lighting components 28 are inoperably disposed within the segments 12A, 12B, 14) and an open or operational configuration (in which the operational components are accessible through the openings 36, 38, 40 and thus capable of operating). Thus, according to one 80761-395640 implementation, the device 10 can be in its closed or non-operational configuration during insertion into a patient's body and/or to a target area and then can be converted into the open or operational configuration by causing the inner cylindrical components 30B, 32B, 34B to rotate into the open configurations.
[0046] Alternatively, one or more or all of the segments do not have inner and outer components that rotate in relation to each other.
[0047] It is understood that the various embodiments of the device 10 disclosed herein include appropriate actuation components to generate the force necessary to operate the arms and/or the rotatable cylinders in the segments. In one embodiment, the actuation components are motors. For example, segment 12A has a motor (not shown) operably coupled with the arm 20 and configured to power the movements of the arm 20. Similarly, segment 12B also has a motor (not shown) operably coupled with the arm 22 and configured to power the movements of the arm 20. In further embodiments, each of the segments 12A, 12B, 14 also have motors (not shown) operably coupled to one or both of the inner and outer cylinder of each segment to power the rotation of the cylinders in relation to each other. In one embodiment, each segment can have one motor to power all drivable elements (arms, cylinders, etc.) associated with that segment. Alternatively, a separate motor can be provided for each drivable element.
[0048] In one embodiment, the joints 16A, 16B are configured to urge the segments 12A, 12B from the insertion configuration of FIG. 1A into the triangular configuration of FIG. IB. That is, the joints 16A, 16B have torsion springs or some other known mechanism for urging the segments 12 A, 12B to rotate around their joints 16A, 16B. For example, FIG. 2C depicts one embodiment in which the joint 16A has torsion springs 42 that are configured to urge segment 12A toward the triangular configuration.
[0049] In use, in accordance with one implementation, the device 10 in the insertion configuration as shown in FIG. 1A can be inserted into a patient's body through an incision, a trocar port, or natural orifice in the direction indicated by arrow A. Alternatively, the device 10 can be inserted in the other direction as well. After insertion and/or as the device 10 enters the target area or procedural area in the patient's body, the joints 16A, 16B with the torsion springs (or other standard mechanisms) urge the segments 12A, 12B from their insertion position to their triangular position. As the segments 12A, 12B contact each other to form joint 18, the two segments are coupled together with mating components that semi- lock the segments 12 A, 12B together. That is, the two segments 12 A, 12B can only be separated at the joint 18 by a force sufficient to overcome the semi- lock. Any such known 80761-395640 mating component or coupling component, including any mechanical or magnetic mating component(s), can be incorporated into the device 10 for this purpose.
[0050] Thus, according to one embodiment, the device 10 can be in its insertion configuration during insertion into the patient. As the device 10 enters the target cavity and exits the port or incision, the torsion springs or other mechanisms at the joints 16A, 16B cause the two segments 12A, 12B to move toward each other until they couple to form the triangular configuration. The device 10 can then be attached to the abdominal wall by some method such as an external magnetic handle. Alternatively, the device 10 can be positioned anywhere in the cavity of the patient as desired by the user. The device 10 is then used to perform some sort of procedure.
[0051] Subsequently, when the procedure is complete, the device 10 can be retracted from the cavity. To do so, the surgeon uses a grasping or retrieval tool such as a Endo Babcock grasper made by Covidien in Mansfield, MA, to attach to or otherwise grasp the ball 44 at the joint 18 and apply sufficient force to overcome the semi-lock of the joint 18. Alternatively, any retrieval component can be positioned at the end of segment 12A or elsewhere on the device 10 for grasping or otherwise coupling to for purposes of removing the device 10 from the patient's body. When the coupling of the semi-lock is overcome, the force urges the segments 12A, 12B away from each other, thereby making it possible for the surgeon to pull the ball 44 through a port or incision and out of the patient, thereby forcing the device 10 into its insertion configuration.
[0052] The multiple segments provided in the various embodiments of the device disclosed herein result in significantly more payload space than a single cylindrical body. The increased payload space results in increased capabilities for the device in the form of more, bigger, or more complex operational components, more, bigger, or more complex motors, magnets (as described below) and other similar benefits relating to the availability of more space for more, bigger, or more complex components. For example, FIG. 2B depicts a side view of the device 10 according to one embodiment that shows the payload space available in segment 12B. More specifically, segment 12B and its coupled arm 22 have payload spaces 46, 48, 50, 52, 54 that can be used to accommodate motors, operational components, sensors, magnets (as described below) or any other type of component that could be useful for a procedural device. Similarly, each segment 12A, 12B, 14 can have such payload spaces. In addition, the segments 12A, 12B, 14 allow for maximization of the payload space available across the segments 12A, 12B, 14 by distributing the components such as motors, operational components, or magnets to maximize their effectiveness while minimizing the amount of 80761-395640 space required by each such component. For example, it might maximize effectiveness of the device 10 while minimizing the utilized space to have one large motor in one segment that provides force for operation of components in more than one segment.
[0053] It is understood that various embodiments of the segmented devices disclosed herein are in vivo devices that can be inserted into and positioned within a patient's body to perform a procedure. In one embodiment, an external controller is also provided that transmits signals to the device 10 to control the device 10 and receives signals from the device 10. In one embodiment, the controller communicates with the device 10 wirelessly. Alternatively, the controller and the device 10 are coupled via a flexible communication component such as a cord or wire (also referred to as a "tether") that extends between the device 10 and the controller.
[0054] It is also understood that various embodiments of the devices disclosed herein can be used in conjunction with known attachment components to attach or otherwise position the device near, against, or adjacent to an interior cavity wall inside the patient. In one embodiment, the attachment components are one or more magnets, disposed within the device, that communicate magnetically with one or more magnets positioned outside the patient's body. The device magnets can be positioned on or in the device in any suitable configuration. For example, the device magnets in one embodiment can be positioned within the segments 12A, 12B, 14 at positions 56, 58, 60 as shown in FIG. 5. It is understood that the external magnets can be used outside the body to position and/or move the device 10 inside the body.
[0055] It is further understood that various embodiments of the devices disclosed herein can be used in conjunction with known visualization and control components, such as the console 70 depicted in FIG. 6. The console 70 has a display 72 and magnets 74 and is positioned outside the patient such that the magnets 74 can be in magnetic communication with the device magnets (not shown) disposed within or otherwise coupled with the device 10. The console 70 can be used to move the device 10 by moving the console 70 outside the body such that the device 10 is urged to move inside the body, because the console magnets 10 are magnetically coupled with the device magnets (not shown) within the device 10 such that the device 10 remains substantially fixed in relation to the console 70. In addition, it is understood that the triangular (and quandrangular) devices disclosed and described in relation to FIGS. 1A-7 can be used in conjunction with any of the external controller or visualization components and systems disclosed and discussed above and in the applications incorporated above. 80761-395640
[0056] The segmented device 10, according to one embodiment, provides greater stability and operability for the device 10 in comparison to other in vivo devices. That is, a device having more than one segment such as device 10 provides for a configuration with a larger "footprint" for the device 10, thereby resulting in greater stability and leverage during use of the device 10. For example, the device 10 with the triangular configuration in FIG. 6 that is urged against the interior cavity wall of the patient by the console magnets 74 has greater stability and leverage in comparison to a device that has a smaller "footprint." That is, the device 10 can have at least three magnets (not shown) disposed at the three corners of the triangular configuration such that when the device 10 is magnetically positioned against the interior cavity wall, the arms of the device 10 can apply greater force to the target tissues while maintaining the position of the device 10 than a corresponding single cylindrical device body.
[0057] It is understood that the device embodiments disclosed herein are not limited to a triangular configuration. FIG. 7 depicts a device 80 having a quadrangular configuration with four segments. Similarly, devices are contemplated herein having any number of segments ranging from two segments to any number of segments that can be used for a device that can be positioned inside a patient's body. For example, a device incorporating the components and structures disclosed herein could have six or eight segments or more.
[0058] Several methods of attachment are possible for the triangle robot. A mechanical rod or elongate member having a cross-section of any shape or configuration could be used to support the robot. The elongate member could be rigid or flexible. The robot could also be placed at the end of other instruments and manual tools as well as at the end of another robot.
[0059] In other embodiments, including some discussed above, the attachment mechanism includes magnets. Attaching the robot with magnets can be accomplished in many different ways; some are shown in FIGS. 8A-8C. This can include a magnet external to the patient that is placed against the abdominal wall. This magnet then interacts with the robot to support the robot and hold it in place. The external magnet can interact with a high permeability material on the inside of the patient and attached to the robot as shown in FIG. 8A. The roles could also be reversed and the high permeability material could also be external to the patient and the magnet could be internal.
[0060] The external magnet can also interact with a second magnet inside the patient and attached to the robot. This can be done so that opposite poles of the magnet attract using a single pole on each magnet (as shown in FIG. 8B) or by using both poles on each magnet (as shown in FIG. 8C). 80761-395640
[0061] The magnet (or high permeability material) associated with the robot does not even need to be attached to the robot. It only needs to interact in such a way as to create a force to stabilize the robot (this stability is described below). For example, when a piece of paper is attached to a refrigerator with a magnet, the magnet is not attached to the paper, but it does create a force that stabilizes the paper on the refrigerator. A similar approach could be used with the robot.
[0062] The methods of magnetic attachment described above can be used in many different combinations. For example, any number of magnets (0, 1 , 2, 3, ) can be used to attach the robot. One obvious approach would be to place a magnet in each corner (or in each segment) of the triangle of the robot, with a trio of external magnets being used external to the patient. However, the triangle (or other open or closed polygons (from 2 sides on up)) is especially well suited to be supported by several different combinations of magnets. For example, a single magnet can be used inside the triangle since the shape of the triangle will provide multi axis support to react the force applied by this single magnet. This is further described in the next section. A "V" configuration or other polygon could give similar support.
[0063] Certain embodiments disclosed herein relate to maximization of stability of the various device embodiments while positioned inside the patient's body. Consider the triangle configuration of the in vivo robot 10 described above in detail and shown in FIG. 9. This is one possible attachment method for the robot. Here a single magnet 90 is attached to the robot 10 so that it is attracted to a magnet 92 on the outside of the patient. The magnet 90 on the robot produces a force on the robot 10 in the upward direction.
[0064] A simplified Free Body Diagram (FBD) showing a simplified interpretation of the reaction forces is shown in FIG. 10. Here, the magnet 90 produces an upward force on the body of the robot 10 (assumed rigid) Fm. The weight of the robot 10, W, is also shown acting at the center of mass of the robot 10. Each corner of the robot is labeled A, B, and C and reaction forces are shown at each corner (FA, FB, FC). These reaction forces could occur along the length of each side in any distribution depending on the shape of the robot, stiffness of the abdominal wall, and other factors. However, for simplicity, these reaction forces are assumed to be lumped at each corner. Finally, end effector forces (FRH, FLH) are shown as the robot 10 applies forces to the tissue being manipulated during surgery. Also, any external applied moments or dynamic loads would also need to be included. This analysis could be extended to other robot configurations (e.g. a square robot with three manipulators), as will be described in further detail below. 80761-395640
[0065] The stability of the robot 10 in FIG. 10 created by the single magnet 90 can be determined using various mathematical techniques. One example of such techniques is set forth in Papadopoulos, E. and Rey, D., "A New Measure of Tipover Stability Margin for Mobile Manipulators," Proc. of the IEEE International Conference on Robotics and
Automation, Minneapolis, MN, April 1996 (which relates to the stability mathematics of large off-road vehicles). Similar techniques can be used to determine the stability of the robot 10. The simplified version of this analysis is to take sum moments from all external forces (and moments) about each contact line for the robot. A first step in this example would be to sum the moments about the contact line AB (in FIG. 10). If the resulting moment "pushes" the robot into the abdominal wall (such as would be caused by a large magnet force), the configuration is stable and the robot will not fall. If the resulting moment "peels" the robot away from the abdominal wall (such as would be caused by a small magnet force and a large robot weight), the robot would be unstable and would fall away from the abdominal wall. This would then need to be repeated for all contact lines (BC and CA in our example).
[0066] The above analysis shows that a single magnet can be used to hold the robot 10 in place.
[0067] A simplified example is shown in FIG. 1 1. Here, the robot 10 is assumed mass-less and is not applying forces with its end effectors. It can be clearly seen that a large magnetic force, FM, produces moment about the line AB that will cause the robot to rotate into the abdominal wall and therefore make a stable configuration for the robot. The same is true about lines BC and CA.
[0068] This example in FIG. 1 1 is further exemplified by the two possible configurations shown in FIGS. 12A and 12B. In this situation, the robot 94 in FIG. 12A could be created by simply using one segment of the triangle configuration as shown back in FIG. 10 (with attachment magnets at A and B). In FIG. 12 A, there are two attachment points (A and B) that hold the robot 94 to the upper abdominal wall (one segment). When the robot's end effector (or hand) 96 applies a force in an arbitrary direction, there will be non-zero moments about the contact line AB. This will cause the robot 94 to rotate about the line AB and could result in some instability.
[0069] In contrast, FIG. 12 depicts a device 98 that contains additional structure as represented by point C. In this embodiment, hand forces (Fnand) that produce a moment about the contact line AB can be balanced by a moment created by the reaction force at point C (Fc). Similarly, moments can be balanced and a stable configuration produced when other 80761-395640 lines of contact are considered (BC & AC in this case, with other possibilities described below). Again, discrete points (A, B, & C) are described to simplify the description, but any line segment (AB for example) could be a continuous line of contact.
[0070] This stability based on one magnet can be recreated in several robot configurations. For example, FIG. 13 shows a configuration similar to FIG. 11 , but the "triangle" in FIG. 13 is in an "open" configuration 100 in which point A now becomes two points (A and A'). This configuration 100 will also produce stability if the moments about all contact lines (AB, BC, CA' and A'A) "pushes" the robot into the abdominal wall rather than "peeling" it away.
[0071] FIG. 14 depicts another example of a multi-sided polygon 102 that uses a single magnet for stable attachment. The same analysis used above applies here and can be used to show that the robot 102 can be stable. In addition, the stability provided by a single magnet as described with the configurations discussed above can also occur for shapes other than polygons. For example, a "V" or "T" configuration could be used. The shapes could be open or closed.
[0072] It is understood that the concept of robot reaction forces (e.g. FA, FB, etc) occurring at a single point is an oversimplification for purposes of this discussion. These forces can occur at a continuum across any segment of any portion of the robot (or at discrete points).
[0073] In certain embodiments, different combinations of magnet "types" can also be used. For example, the robot could have a magnet at one corner of the robot and two pieces of high permeability material at the other two corners (or sides). Or the robot could have two magnets and one piece of high permeability material, or other combinations.
[0074] While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. As will be realized, the invention is capable of modifications in various obvious aspects, all without departing from the spirit and scope of the present invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
[0075] Although the present invention has been described with reference to preferred embodiments, persons skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention.

Claims

80761-395640 CLAIMS What is claimed is:
1. A segmented medical device, the system comprising:
(a) a first body segment configured to be disposed inside a cavity of a
patient, the segment comprising
(i) a first operational component associated with the first body segment; and
(ii) a first mating component at a first end of the first body segment;
(b) a second body segment configured to be disposed inside the cavity of the patient, the segment comprising
(i) a second operational component associated with the second body segment; and
(ii) a first pivotal coupling at a first end of the second body
segment, whereby the second body segment is pivotally coupled to the first body segment;
(c) a third body segment configured to be disposed inside the cavity of the patient, the segment comprising
(i) a third operational component associated with the third body segment;
(ii) a second pivotal coupling at a first end of the third body
segment, whereby the third body segment is pivotally coupled to the second body segment; and
(iii) a second mating component at a second end of the third body segment, the second mating component configured to be coupleable with the first mating component; and
(d) an attachment component associated with the segmented medical
device.
2. The segmented medical device of claim 1 , wherein the device is configured to move between an open position in which the first and second mating components are not 80761-395640 coupled together and a closed position in which the first and second mating components are coupled.
3. The segmented medical device of claim 2, wherein the first, second, and third body segments define an opening in the closed position.
4. The segmented medical device of claim 3, wherein the attachment component is disposed in the opening.
5. The segmented medical device of claim 1 , wherein the attachment component comprises a rod coupled to the segmented medical device, wherein the rod is configured to extend from the segmented medical device out of the cavity of the patient.
6. The segmented medical device of claim 1 , wherein the attachment component comprises a single magnet disposed in a substantially central location when the segmented medical device is in a closed configuration.
7. The segmented medical device of claim 1 , wherein the first pivotal coupling and the second pivotal coupling comprise tensioned components configured to urge the first mating component and the second mating component toward each other.
8. The segmented medical device of claim 1 , wherein the first body segment comprises a first inner cylindrical component disposed within a first outer cylindrical component, wherein the first inner cylindrical component is rotatable in relation to the first outer cylindrical component.
9. The segmented medical device of claim 8, wherein the first inner cylindrical component comprises a first inner opening and the first outer cylindrical component comprises a first outer opening, wherein the first inner cylindrical component and the first outer cylindrical component are rotatable such that the first inner opening and first outer opening align, thereby providing access to an interior portion of the first inner cylindrical component.
10. The segmented medical device of claim 9, wherein the first operational component is configured to move between an undeployed position disposed within the interior portion of the first inner cylindrical component and a deployed position in which a 80761-395640 portion of the first operational component is disposed outside of the first inner cylindrical component through the first inner opening and first outer opening.
11. A segmented medical device, the system comprising:
(a) a first body segment configured to be disposed inside a cavity of a
patient, the segment comprising
(i) a first operational component associated with the first body segment; and
(ii) a first mating component at a first end of the first body segment;
(b) a second body segment configured to be disposed inside the cavity of the patient, the segment comprising
(i) a second operational component associated with the second body segment; and
(ii) a first pivotal coupling at a first end of the second body
segment, whereby the second body segment is pivotally coupled to the first body segment;
(c) a third body segment configured to be disposed inside the cavity of the patient, the segment comprising
(i) a third operational component associated with the third body segment;
(ii) a second pivotal coupling at a first end of the third body
segment, whereby the third body segment is pivotally coupled to the second body segment; and
(iii) a second mating component at a second end of the third body segment, the second mating component configured to be coupleable with the first mating component; and
(d) an attachment component disposed in a substantially central location when the segmented medical device is in a closed configuration in which the first and second mating components are coupled, 80761-395640 wherein the segmented medical device is configured to move between the closed configuration and an open configuration in which the first and second mating components are not coupled together.
12. The segmented medical device of claim 2, wherein the first, second, and third body segments define an opening in the closed position, wherein the attachment component is disposed in the substantially central location in the opening.
13. The segmented medical device of claim 11 , wherein the attachment component comprises a rod coupled to the segmented medical device, wherein the rod is configured to extend from the segmented medical device out of the cavity of the patient.
14. The segmented medical device of claim 11 , wherein the attachment component comprises a single magnet disposed in a substantially central location when the segmented medical device is in a closed configuration.
15. The segmented medical device of claim 1, wherein
(a) the first body segment comprises a first inner cylindrical component disposed within a first outer cylindrical component, wherein the first inner cylindrical component is rotatable in relation to the first outer cylindrical component;
(b) the second body segment comprises a second inner cylindrical
component disposed within a second outer cylindrical component, wherein the second inner cylindrical component is rotatable in relation to the second outer cylindrical component; and
(c) the third body segment comprises a third inner cylindrical component disposed within a third outer cylindrical component, wherein the third inner cylindrical component is rotatable in relation to the third outer cylindrical component.
16. The segmented medical device of claim 15, wherein
(a) the first inner cylindrical component comprises a first inner opening and the first outer cylindrical component comprises a first outer opening, wherein the first inner cylindrical component and the first 80761-395640 outer cylindrical component are rotatable such that the first inner opening and first outer opening align, thereby providing access to an interior portion of the first inner cylindrical component;
(b) the second outer cylindrical component comprises a second outer
opening, wherein the second inner cylindrical component and the second outer cylindrical component are rotatable such that the second operational component is accessible through the second outer opening; and
(c) the third inner cylindrical component comprises a third inner opening and the third outer cylindrical component comprises a third outer opening, wherein the third inner cylindrical component and the third outer cylindrical component are rotatable such that the third inner opening and third outer opening align, thereby providing access to an interior portion of the third inner cylindrical component.
17. The segmented medical device of claim 16, wherein
(a) the first operational component is configured to move between an
undeployed position disposed within the interior portion of the first inner cylindrical component and a deployed position in which a portion of the first operational component is disposed outside of the first inner cylindrical component through the first inner opening and first outer opening; and
(b) the third operational component is configured to move between an undeployed position disposed within the interior portion of the third inner cylindrical component and a deployed position in which a portion of the third operational component is disposed outside of the third inner cylindrical component through the third inner opening and third outer opening.
18. The segmented device of claim 17, wherein the first operational component comprises a grasper and the second operational component comprises a cautery hook. 80761-395640
19. The segmented device of claim 11 , wherein the second operational component comprises at least one camera or at least one light.
20. A segmented medical device, the system comprising:
(a) a first body segment configured to be disposed inside a cavity of a
patient, the segment comprising
(i) a first operational component associated with the first body segment; and
(ii) a first mating component at a first end of the first body segment;
(b) a second body segment configured to be disposed inside the cavity of the patient, the segment comprising
(i) a second operational component associated with the second body segment; and
(ii) a pivotal coupling at a first end of the second body segment, whereby the second body segment is pivotally coupled to the first body segment;
(c) a third body segment configured to be disposed inside the cavity of the patient, the segment comprising
(i) a third operational component associated with the third body segment; and
(ii) a pivotal coupling at a first end of the third body segment,
whereby the third body segment is pivotally coupled to the second body segment;
(d) a fourth body segment configured to be disposed inside the cavity of the patient, the segment comprising
(i) a fourth operational component associated with the fourth body segment;
(ii) a pivotal coupling at a first end of the fourth body segment, whereby the fourth body segment is pivotally coupled to the third body segment; and (iii) a second mating component at a second end of the fourth body segment, the second mating component configured to be coupleable with the first mating component; and
an attachment component disposed in a substantially central location when the segmented medical device is in a closed configuration.
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