WO2014176052A1 - Commande d'outil reposant sur un relais - Google Patents

Commande d'outil reposant sur un relais Download PDF

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Publication number
WO2014176052A1
WO2014176052A1 PCT/US2014/033903 US2014033903W WO2014176052A1 WO 2014176052 A1 WO2014176052 A1 WO 2014176052A1 US 2014033903 W US2014033903 W US 2014033903W WO 2014176052 A1 WO2014176052 A1 WO 2014176052A1
Authority
WO
WIPO (PCT)
Prior art keywords
handle
medical tool
tool
joint
local
Prior art date
Application number
PCT/US2014/033903
Other languages
English (en)
Inventor
Adi NAVVE
Shai Finkman
Doron Adler
Original Assignee
Gyrus Acmi, Inc. (D.B.A. Olympus Surgical Technologies America)
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
Priority claimed from US13/933,144 external-priority patent/US9271797B2/en
Application filed by Gyrus Acmi, Inc. (D.B.A. Olympus Surgical Technologies America) filed Critical Gyrus Acmi, Inc. (D.B.A. Olympus Surgical Technologies America)
Publication of WO2014176052A1 publication Critical patent/WO2014176052A1/fr

Links

Classifications

    • 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
    • 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
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/37—Master-slave robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00464—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for use with different instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/291—Handles the position of the handle being adjustable with respect to the shaft
    • 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
    • A61B34/74—Manipulators with manual electric input means
    • A61B2034/742—Joysticks
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation

Definitions

  • the present invention relates generally to manipulation of tools used for surgery, and specifically to local and remote manipulation of such tools.
  • An embodiment of the present invention provides medical apparatus, including:
  • a remote medical tool located remotely from the local medical tool
  • a lockable joint physically connected to the local medical tool, operable in a locked state or in an unlocked state;
  • a handle physically connected to the lockable joint, so that in the locked state of the joint, movements of the handle are directly transferred to corresponding movements of the local medical tool;
  • sensors configured, in the unlocked state of the joint to measure motions of the handle with respect to the lockable joint; and a controller, which in the unlocked state of the joint receives indications of the motions of the handle with respect to the lockable joint, and which is configured to apply the indications to generate corresponding motions for the remote medical tool.
  • the local medical tool is immobile.
  • At least one of the medical tools may include an endoscope.
  • the apparatus includes a selector, and the remote medical tool consists of multiple separate remote medical tools, each separate remote medical tool being located in a respective different position remote from the local medical tool, and the controller is configured to apply the indications to generate the corresponding motions for one of the separate remote medical tools selected by the selector.
  • the handle includes controls which, in the locked state of the lockable joint, generate signals used by the controller to operate the local medical tool.
  • the controls in the unlocked state of the lockable joint, generate signals used by the controller to operate the remote medical tool.
  • the controls may include a magnification/demagnification regulator which provides a ratio, and the controller, in the locked state of the lockable joint, may apply the ratio to the movements of the handle with respect to the corresponding movements of the local medical tool.
  • the controller in the unlocked state of the lockable joint, may apply the ratio to the motions of the handle with respect to the corresponding motions of the remote medical tool.
  • the apparatus includes a control connected to the handle, the control providing a motion consisting of at least one of a translation and a rotation, and the controller may be configured, in the unlocked state of the joint to apply the motion of the control to a corresponding motion of the remote medical tool, and in the locked state of the joint to apply the motion of the control to a corresponding movement of the local medical tool.
  • the sensors in the locked state of the joint are configured to measure selected motions of the handle with respect to the lockable joint, and the controller may receive respective indications of the selected motions, and may be configured to apply the respective indications to generate corresponding motions for the local medical tool.
  • the handle includes at least one sensor
  • Fig. 1 is a schematic diagram illustrating a relay based tool control system operating in a locked mode, according to an embodiment of the present invention
  • Fig. 2 is a schematic diagram of the relay based tool control system operating in an unlocked mode, according to an embodiment of the present invention
  • Fig. 3 A is a general schematic view of a tool handle
  • Fig. 3B is a schematic cross-sectional view of a portion of the tool handle
  • Fig. 3C is a schematic view of the tool handle in a locked mode of operation
  • Fig. 3D is a schematic view of the tool handle in an unlocked mode of operation, according to an embodiment of the present invention.
  • Fig. 4 is a schematic illustration of the use of the tool handle of Figs. 3A - 3D during a medical procedure, according to an embodiment of the present invention.
  • Embodiments of the present invention provide a system which enables a medical professional to single-handedly operate two or more tools used for performing a medical procedure, typically an invasive medical procedure.
  • a handle is physically connected to a lockable joint, which is in turn physically connected to one of the tools, herein termed the "local” tool, used in the procedure.
  • One or more other tools are positioned during the procedure remotely from the local tool.
  • the remote tool only one other tool, herein termed the "remote” tool, is assumed.
  • the system is configured to operate in two modes.
  • a locked mode of operation of the system the joint connecting the handle to the local tool is locked, so that any movement of the handle is transferred directly to the local tool.
  • the remote tool is maintained fixed in position with clamps, herein termed remote clamps.
  • the joint connecting the handle to the local tool is unlocked, so that the handle is able to move with respect to the joint.
  • the local tool is maintained fixed in its position with clamps (different from the remote clamps).
  • sensors detect motion of the handle with respect to the joint.
  • a system controller receives signals from the sensors representative of the motion, and the controller uses the signals to alter the position of the remote clamps, so as to transfer motions of the handle to respective corresponding motions of the remote tool.
  • the professional using the system is able to toggle between the two modes, for example by depressing a trigger incorporated in the handle.
  • the professional is thus single-handedly able operate two separate tools in the procedure using one handle.
  • the system may be easily adapted to operate more than two tools with the one handle, and the system may be used for a variety of different types of tools, such as laparoscopes or graspers.
  • Fig. 1 is a schematic diagram illustrating a relay based tool control system 10 operating in a locked mode
  • Fig. 2 is a schematic diagram of the system operating in an unlocked mode, after transferring from the locked mode, according to embodiments of the present invention.
  • System 10 comprises two medical tools, a local medical tool 12 and a remote medical tool 14.
  • local tool 12 is assumed to be any tool used in a surgical procedure, such as a retractor or a biopsy tool, and is herein also referred to as hand instrument 12.
  • Remote tool 14 is assumed by way of example to comprise a laparoscope and is also herein termed remotely- operated laparoscope 14 or just remote laparoscope 14.
  • embodiments of the present invention enable both tools to be operated single-handedly by a user 16 of the tools.
  • User 16 is typically a medical professional, and for simplicity, only a single hand 18 of the user, the hand operating the two tools, is shown in the figures.
  • System 10 includes a system controller 20, which may comprise a general purpose personal computer, and the controller is used to operate other elements of system 10.
  • the system controller communicates with the elements using wired or wireless transmissions.
  • the communication between the controller and the other elements, or directly between the elements themselves, is assumed to be by wireless transmission.
  • user 16 inserts local tool 12 and remote laparoscope 14 into a body cavity 22 via respective trocars 24 and 26 during a medical procedure, so that the two tools are located remotely from each other.
  • the remote laparoscope acquires an image, which is displayed, under control of system controller 20, on a screen 30.
  • the user arranges that the remote laparoscope is gripped by clamps 40.
  • Robotic actuators 42 that control the location and orientation of clamps 40, and thus the location and orientation of remote laparoscope 14, are coupled to the clamps, and the robotic actuators in turn are controlled by system controller 20.
  • Controller 20 uses software stored in a memory coupled to the controller to operate system 10. Results of the operations performed by controller 20 may be presented to user 16 on screen 30, which typically displays an image of body cavity 22.
  • the software used by the controller may be downloaded to the controller in electronic form, over a network, for example, or it may, alternatively or additionally, be provided and/or stored on non-transitory tangible media, such as magnetic, optical, or electronic memory.
  • hand instrument 12 In contrast to remote laparoscope 14, the location and orientation of which is controlled by controller 20, the location and orientation of hand instrument 12 is under the direct control of user 16.
  • hand instrument 12 In order to achieve such direct control, hand instrument 12 is fixedly connected, via a rotatable, lockable, ball joint 50, to a tool handle 52, also referred to herein as handle 52, which is gripped by hand 18.
  • handle 52 also referred to herein as handle 52, which is gripped by hand 18.
  • user 16 locks joint 50 so that it is in a locked state, wherein it does not rotate. In this state any movement of the handle is directly transferred to a corresponding movement of the local tool, i.e., hand instrument 12.
  • trigger 54 acts as a toggle switching system 10 between locked and unlocked modes of operation.
  • trigger 54 is configured to communicate with system controller 20 so that the controller is aware of the mode in which the system is operating. For simplicity, in the remaining description trigger 54 is assumed to be used to toggle between the locked and the unlocked modes of operation.
  • clamps 60 which are located in proximity to local tool 12, are positioned by the system controller so as not to interfere with the movement of the local tool actuated by handle 52. (Further functions of clamps 60 are described below.)
  • system controller 20 uses actuators 42 and clamps 40 to maintain remote laparoscope 14 in a fixed location and orientation, so that the image acquired by the remote laparoscope, and displayed on screen 30, does not change.
  • User 18 toggles system 10 from the locked mode of operation to an unlocked mode of operation, illustrated by Fig. 2, by depressing trigger 54.
  • system controller 20 In entering the unlocked mode system controller 20 unlocks joint 50 so that it is in an unlocked state wherein it is free to rotate.
  • system controller 20 causes clamps 60 to grip local tool 12, so that the local tool is maintained immobile in a fixed orientation and location, regardless of any rotation or other motion of handle 52 with respect to joint 50.
  • a remote tool is manipulated using handle 52, and this mode may also be referred to herein as a remote mode of operation of the system.
  • the locked mode of operation of system 10 may also be referred to herein as the local mode of operation of the system.
  • System 10 comprises sensors 70 which measure motion of the handle with respect to joint 50 when the joint is in its unlocked state.
  • the sensors detect rotation of handle 52 about joint 50, as well as the equivalent of linear motions of handle 52 with respect to the joint.
  • the sensors detecting rotation measure the rotation in three rotational directions, i.e., pan, tilt, and yaw, and may be installed in joint 50.
  • Sensors measuring the equivalent of linear motion of the handle with respect to joint 50 in three linear directions may also be installed in the joint.
  • Such sensors typically comprise pressure sensors. Thus, as described in more detail below, pressure by user 16 in a given direction is detected by the sensors and causes a corresponding motion of remote tool 14.
  • sensors 70 measuring linear motion may be installed in handle 52.
  • at least some sensors 70 may be activated by controls 72, such as sliders, joysticks, or touch sensitive pads, installed in handle 52 and operated by user 16.
  • controls 72 such as sliders, joysticks, or touch sensitive pads
  • measurements of sensors 70 are encoded, and the encoded values are transmitted as signals indicative of the motion of the handle to system controller 20.
  • System controller 20 uses the encoded values to drive actuators 42, and thus clamps 40, so as to replicate the motions detected by sensors 70.
  • motions of handle 52 and/or relevant operations of controls 72 are reproduced by corresponding motions of remote laparoscope 14, so that handle 52 effectively acts as a robotic control for the remote laparoscope.
  • a clockwise rotation of handle 52 from an initial position of the handle shown as a broken outline 52' is replicated by a clockwise rotation of remote laparoscope 14 from an initial position of the laparoscope shown as a broken outline 14'.
  • pressure by user 16 in a direction towards joint 50 causes a corresponding "zoom" translation motion of remote laparoscope 14 into cavity 22.
  • the rotation of the remote laparoscope generates a different acquired image, as is evident by comparison of the images on screen 30 in Fig. 2 and Fig. 1.
  • user 16 may toggle system 10 between the locked and unlocked modes of operation substantially at will, so that the user is able to operate the two separate tools with one hand during the medical procedure referred to above.
  • a selector 80 may be incorporated into handle 52, and user 16 may use the switch to select, at any given time, which of the remote tools is to be controlled by movements of handle 52.
  • a setting of the selector is communicated to system controller 20, which uses the setting to decide which of the remote tools is to be moved.
  • Fig. 3 A is a general schematic view of a tool handle 152 and of different local medical tools which may be connected to the handle
  • Fig. 3B is a schematic cross- sectional view of a portion of tool handle 152 in two different orientations
  • Fig. 3C is a schematic view of the tool handle in a locked mode of operation
  • Fig. 3D is a schematic view of the tool handle in an unlocked mode of operation, according to an embodiment of the present invention.
  • the operation of handle 152 is generally similar to that of handle 52 (Figs. 1 and 2), and elements indicated by the same reference numerals in both handles 52 and 152 are generally similar in construction and in operation.
  • Tool handle 152 comprises a housing 154 which is configured to be gripped by a human hand, so that the housing is typically in the form of a pistol grip.
  • the housing may also be referred to herein as grip 154.
  • handle 152 is able to removably connect via a rotatable, lockable, ball joint 160 to any one of a number of different local tools 162 (there are three such tools 164, 166, and 168 illustrated by way of example in Fig. 3A).
  • tools 162 include, but are not limited to, an endoscope, a grasper, a retractor, and a biopsy tool.
  • joint 160 is generally similar in function and construction to joint 50.
  • one or more linear and/or rotational motors 170 for the operation of local tools 162, typically for implementing physical motion of the distal end of the tools, may be incorporated into the proximal end of the tools.
  • one or more motors 172 for the operation of the local tools may be incorporated into handle 152, and the movements generated by the motors may be transferred by any suitable means, such as a magnetic linkage, to the tools. Control of motors 170 and/or 172 is described below. For simplicity, the following description assumes motors 170 are in respective tools 162, and those having ordinary skill in the art will be able to adjust the description, mutatis mutandis, for embodiments having one or motors in the handle.
  • a distal section 180 of handle 152 also referred to herein as joint holding section 180, is configured to accept and retain lockable joint 160.
  • Fig. 3B illustrates two possible orientations of joint 160 with respect to the distal section: a local mode orientation 182 of the joint, where distal section 180 aligns in a locked manner with the joint, and a remote mode orientation 184, where distal section 180 is free to move about the joint.
  • joint 160 comprises, at its distal side, a retaining cup 188, which is configured to accept and hold one of tools 162.
  • Fig. 3C illustrates handle 152 when joint 160 is locked in local mode orientation 182, so that the handle operates in a local mode.
  • Fig. 3D illustrates handle 152 when joint 160 is unlocked in remote mode orientation 184, so that the handle operates in a remote mode.
  • sensors 70 in handle 152 and/or in joint 160 measure motion of handle 152 with respect to the joint when the latter is in its unlocked state.
  • the sensors may be configured to detect adjustments of controls 72, and to apply the detected adjustments to respective motions of the specific local tool 162 connected via retaining cup 188 to joint 160, using motors 170.
  • Typical motions of a local tool, applied using signals from a given sensor, with joint in its locked state, include translation of the distal tip of the local tool in a distal direction.
  • Other motions of the local tool that may be effected when joint 160 is in its locked state are described in more detail in U. S. Patent Application 13/933,144, referenced above, but for brevity the motions are not described here.
  • an inset 190 is a schematic view of controls 72 that may be mounted on a proximal portion of handle 152. Depending on whether joint 160 is in its locked or unlocked mode of operation, at least some of controls 72, such as the control exemplified below, may operate a local tool or a remote tool.
  • one such control 72 comprises a joystick button 192 which is used to manipulate a distal end of the local or remote tool (according to whether joint 160 is in its locked or unlocked mode) controlled with handle 152.
  • Manipulations that may be implemented using button 192 typically vary according to the type of local or remote tool being controlled, but usually comprise translation of the tool tip, rotation of the tool tip about the distal end axis in a clockwise or counterclockwise direction, and/or bending of the tip from the axis.
  • a magnification/demagnification regulator 194 comprised in controls 72, also herein termed a mag/demag regulator, enables the user operating handle 152 to set a ratio of movement of another control 72 of the handle, such as joystick button 192, to the actual motion of the local or remote tool coupled to the handle.
  • the ratio may typically be set between a value of 4:1 and a value of 1:4, although other ratios are possible. If set to 4:1, movement of a tool is demagnified by a factor of 4 compared to the movement of the control or action of the handle. If set to 1:4, movement of the tool is magnified by a factor of 4.
  • a specific deflection of button 192 may rotate the distal tip of the coupled tool by 30°. If with regulator 194 set to a 2:1 ratio deflection of button 192 rotates the distal tip by 15°.
  • sensors 70 may be used to generate movements of a local tool, or of a remote tool, and the movements may be governed by mag/demag 194.
  • a specific pressure towards joint 160 from grip 154 may be configured to cause, using a given sensor 70, a corresponding translation of the distal tip of the coupled tool by 4 mm.
  • regulator 194 set to a 2:1 ratio the same pressure on the sensor causes a translation of 2 mm.
  • Controls 72 also include one or more indicator lamps 196 and selector 80. Functions of these elements are described in more detail with respect to Fig. 4 below.
  • Handle 152 has a flexible joint 174 between distal section 180 and housing 154, and the flexible joint is assumed to be included in controls 72.
  • the flexible joint permits relative motion between the housing and the distal section.
  • encoded signals from sensors 70 quantifying the relative motion, may be used to actuate one or more motors 170 of local tool 162 connected to the handle, typically so as to move the distal tip of the local tool according to the relative motion of the flexible joint.
  • the sensor's encoded signals, quantifying the relative motion may typically be used to move the distal tip of a remote tool being controlled by the handle, according to the relative motion applied to the flexible joint.
  • flexible joint 174 may be compressed or expanded linearly and may be configured, using sensors 70, to generate corresponding linear translations of extension or retraction of the distal tip of the local or remote tool being controlled by handle 152.
  • Flexible joint 174 may also be rotated about one or more axes, causing corresponding rotations in the local or remote tool. Motions generated by a flexible joint such as joint 174 are also described in U. S. Patent Application 13/933,144, referenced above.
  • Fig. 4 is a schematic illustration of the use of tool handle 152 with local tool 166 during a medical procedure using relay based tool control system 10, according to an embodiment of the present invention.
  • an endoscope 200 has been inserted into body cavity 22, and is held in place by a clamping system 202 to which it is mounted.
  • An additional tool 204 has also been inserted into the body cavity, and is mounted in a clamping system 206.
  • Tool 204 may be generally similar in function and operation to tool 166.
  • Both clamping systems are adjustable, having movable joints, and the positions and orientations of endoscope 200 and of tool 204 may be modified using their respective clamping systems.
  • Both clamping systems, and consequently tool 204 and endoscope 200, are remotely controlled with actuators, generally similar to actuators 42 (Figs. 1 and 2).
  • the control is by controller 20, typically using a wireless system.
  • Tool handle 152 is also in communication, typically wireless communication, with controller 20.
  • Clamps 60 are aligned, and are available for use, with local tool 166.
  • clamps 60 are disengaged from tool 166, as is illustrated in Fig. 4, and user 16 may move tool 166 with handle 152.
  • clamps 60 engage with tool 166 so that the tool is immobilized.
  • Endoscope 200 acquires an image of the body cavity, and the image is presented to user 16 on screen 30.
  • Screen 30 shows a distal end of tool 166, and also shows a distal end of tool 204.
  • An alternative presentation of the image acquired by endoscope 200, such as a central portion of the image on screen 30, may be presented to physician 22 on a screen 210 attached to the endoscope.
  • user 16 operates a second tool handle 152', which is generally similar in construction and function to tool handle 152.
  • the user may operate tool handle 152 and tool handles 152' at the same time, the simultaneous operation being achieved by the user using his/her right hand to operate tool handle 152, and the left hand to operate tool handle 152'.
  • Operation of tool handle 152' enables the user to operate instruments attached to, i.e., local to, handle 152', as well as instruments remote from handle 152'.
  • Instruments local and remote from handle 152' are different from instruments local and remote from tool handle 152, and it will be understood that by using the two tool handles, a single user 16 may simultaneously manipulate two instruments locally, as well as control one, two, or even more instruments remotely.
  • selection image 220 In order to operate a remote instrument, user 16 may use controller 20 to call up a selection image 220 on screen 30.
  • the calling up of selection image 220 may be by any convenient method, and herein, by way of example, the user is assumed to use a foot switch (not shown).
  • Selection image 220 displays a menu of instruments that the user may choose from. By way of example, the menu is shown in iconical form in the figure, but it may also comprise text, or other graphics.
  • Fig. 4 gives as examples an imaging icon 232, a music icon 234, a patient bed icon 236, a remote tool icon 238, a toggle icon 240, and an operating theater illumination icon 242.
  • Imaging icon 232, music icon 234, patient bed icon 236, remote tool icon 238, toggle icon 240, and operating room illumination icon 242 respectively represent endoscope 200, a control for music, a control for the patient bed (not shown), a control for remote tool 204, a toggle control between local and remote modes of operation, the selection of which acts as an alternative to trigger 54, and a control for the operating room lights (not shown). Selection of music icon 234, patient bed icon 236, or illumination icon 242 allows user 16 to operate corresponding facilities of the operating theater.
  • selector 80 (Fig. 3A), herein assumed to be a rotary switch. Rotation of selector 80 sequentially highlights each of the icons of image 220 in turn. To select a particular element represented by an icon, the user stops rotating the selector, and after a preset time, say of 2 seconds, the highlighted element is automatically selected and a lamp 196 flashes to confirm to the user that the selection has been implemented.
  • controller 20 may/may not switch from local to remote operation mode.
  • illumination icon 242 some of controls 72 may be used to change the lights, while the remaining controls may operate as described above for local mode.
  • controller 20 toggles to the remote operation mode and controls 72 typically are all directed to operate the selected remote tool.
  • toggle icon 240 the system may toggle between the remote mode of operation on an already selected remote tool and the local mode of operation on the local tool connected to handle 152.
  • controls 72 and/or motion of handle 152 with respect to joint 160 may be used to manipulate the remote tool.
  • selector 80 is used to highlight icon 238, and thus select remote tool 204, the user may be able to use controls 72, rotations about joint 160, and motions with respect to flexible joint 174 to manipulate the distal end of tool 204.
  • screen 30 may display functions of controls 72 that correspond to the selected tool or instrument, and also indicate which controls (if any) are not functional. For example, if operating room illumination icon 242 is selected, screen 122 may display that joystick 192 may tilt the operating room lights, and that trigger 54 is not functional.
  • the user may decouple a remote instrument from controls 72, and recouple the controls to the tool physically connected to handle 152, i.e., to tool 166.
  • the decoupling and recoupling corresponding to transferring from the remote mode of operation to the local mode of operation, and vice versa, is typically implemented using trigger 54 and/or using selector 80.
  • the decoupling and recoupling may be implemented using any other method for toggling between two states known in the art.
  • the scope of the present invention includes medical tools, such as a grasper, a clincher, a biopsy retriever and/or a laparoscope, one of the tools being locally operated in the locked mode of relay based tool control system 10, and one or more other of the tools being remotely operated in the unlocked mode of the system.
  • medical tools such as a grasper, a clincher, a biopsy retriever and/or a laparoscope, one of the tools being locally operated in the locked mode of relay based tool control system 10, and one or more other of the tools being remotely operated in the unlocked mode of the system.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Robotics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un appareil médical comprenant un outil médical local (12) et un outil médical distant (14) situé à distance de l'outil médical local. L'appareil comprend un joint verrouillable (50) raccordé physiquement à l'outil médical local qui peut être actionné dans un état verrouillé ou dans un état déverrouillé. Une poignée (52) est physiquement raccordée au joint verrouillable de sorte que dans l'état verrouillé du joint, les mouvements de la poignée soient directement transférés à des mouvements correspondants de l'outil médical local. L'appareil comprend des capteurs (70) qui sont conçus, dans l'état déverrouillé du joint, pour mesurer les mouvements de la poignée par rapport au joint verrouillable. L'appareil comprend également un dispositif de commande (20), lequel, dans l'état déverrouillé du joint, reçoit des indications concernant les mouvements de la poignée par rapport au joint verrouillable et qui est conçu pour appliquer les indications pour générer des mouvements correspondants pour l'outil médical distant.
PCT/US2014/033903 2013-04-21 2014-04-13 Commande d'outil reposant sur un relais WO2014176052A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US201361814278P 2013-04-21 2013-04-21
US61/814,278 2013-04-21
US13/933,144 2013-07-02
US13/933,144 US9271797B2 (en) 2013-07-02 2013-07-02 Robotic surgery

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US11759271B2 (en) 2017-04-28 2023-09-19 Stryker Corporation System and method for indicating mapping of console-based surgical systems

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