Patent Grant
10729494
The present disclosure relates generally to the field of robotic surgery. In particular, the present disclosure relates to, although not exclusively, robotically controlled surgical instruments. More particularly, the present disclosure relates to, although not exclusively, robotically controlled electrosurgical instruments having robotically controlled articulation features for robotically articulating the surgical instrument.
Many surgical procedures require cutting or ligating blood vessels or other internal tissue. Many surgical procedures are performed using minimally invasive techniques where a hand-held instrument is used by the surgeon to perform the cutting or ligating.
Electrosurgical medical instruments generally include an end effector having an electrical contact, a radio frequency (RF) generation circuit for generating an RF drive signal and to provide the RF drive signal to the at least one electrical contact where the RF generation circuit also includes a resonant circuit. The RF circuit includes circuitry to generate a cyclically varying signal, such as a square wave signal, from a direct current (DC) energy source and the resonant circuit is configured to receive the cyclically varying signal from the switching circuitry. The DC energy source is generally provided by one or more batteries that can be mounted in a housing portion of the instrument, for example.
A variety of surgical instruments include a tissue cutting element and one or more elements that transmit RF energy to tissue (e.g., to coagulate or seal the tissue). An example of such a device is the ENSEAL® Tissue Sealing Device by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio. Further examples of such devices and related concepts are disclosed in U.S. Pat. No. 6,500,176 entitled ELECTROSURGICAL SYSTEMS AND TECHNIQUES FOR SEALING TISSUE, issued Dec. 31, 2002, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,112,201 entitled ELECTROSURGICAL INSTRUMENT AND METHOD OF USE, issued Sep. 26, 2006, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,125,409, entitled ELECTROSURGICAL WORKING END FOR CONTROLLED ENERGY DELIVERY, issued Oct. 24, 2006, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,169,146 entitled ELECTROSURGICAL PROBE AND METHOD OF USE, issued Jan. 30, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,186,253, entitled ELECTROSURGICAL JAW STRUCTURE FOR CONTROLLED ENERGY DELIVERY, issued Mar. 6, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,189,233, entitled ELECTROSURGICAL INSTRUMENT, issued Mar. 13, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,220,951, entitled SURGICAL SEALING SURFACES AND METHODS OF USE, issued May 22, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,309,849, entitled POLYMER COMPOSITIONS EXHIBITING A PTC PROPERTY AND METHODS OF FABRICATION, issued Dec. 18, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,311,709, entitled ELECTROSURGICAL INSTRUMENT AND METHOD OF USE, issued Dec. 25, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,354,440, entitled ELECTROSURGICAL INSTRUMENT AND METHOD OF USE, issued Apr. 8, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,381,209, entitled ELECTROSURGICAL INSTRUMENT, issued Jun. 3, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 8,939,974, entitled SURGICAL INSTRUMENT COMPRISING FIRST AND SECOND DRIVE SYSTEMS ACTUATABLE BY A COMMON TRIGGER MECHANISM, issued Jan. 27, 2015, the disclosure of which is incorporated by reference herein; and U.S. patent application Ser. No. 13/151,481, entitled MOTOR DRIVEN ELECTROSURGICAL DEVICE WITH MECHANICAL AND ELECTRICAL FEEDBACK, filed Jun. 2, 2011, which issued on Oct. 20, 2015 as U.S. Pat. No. 9,161,803, the disclosure of which is incorporated by reference herein.
In addition, a variety of surgical instruments include a shaft having an articulation section, providing enhanced positioning capabilities for an end effector that is located distal to the articulation section of the shaft. Examples of such devices include various models of the ENDOPATH® endocutters by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio. Further examples of such devices and related concepts are disclosed in U.S. Pat. No. 7,380,696, entitled ARTICULATING SURGICAL STAPLING INSTRUMENT INCORPORATING A TWO-PIECE E-BEAM FIRING MECHANISM, issued Jun. 3, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,404,508, entitled SURGICAL STAPLING AND CUTTING DEVICE, issued Jul. 29, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,455,208, entitled SURGICAL INSTRUMENT WITH ARTICULATING SHAFT WITH RIGID FIRING BAR SUPPORTS, issued Nov. 25, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,506,790, entitled SURGICAL INSTRUMENT INCORPORATING AN ELECTRICALLY ACTUATED ARTICULATION MECHANISM, issued Mar. 24, 2009, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,549,564, entitled SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATING END EFFECTOR, issued Jun. 23, 2009, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,559,450, entitled SURGICAL INSTRUMENT INCORPORATING A FLUID TRANSFER CONTROLLED ARTICULATION MECHANISM, issued Jul. 14, 2009, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,654,431, entitled SURGICAL INSTRUMENT WITH GUIDED LATERALLY MOVING ARTICULATION MEMBER, issued Feb. 2, 2010, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,780,054, entitled SURGICAL INSTRUMENT WITH LATERALLY MOVED SHAFT ACTUATOR COUPLED TO PIVOTING ARTICULATION JOINT, issued Aug. 24, 2010, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,784,662, entitled SURGICAL INSTRUMENT WITH ARTICULATING SHAFT WITH SINGLE PIVOT CLOSURE AND DOUBLE PIVOT FRAME GROUND, issued Aug. 31, 2010, the disclosure of which is incorporated by reference herein; and U.S. Pat. No. 7,798,386, entitled SURGICAL INSTRUMENT ARTICULATION JOINT COVER, issued Sep. 21, 2010, the disclosure of which is incorporated by reference herein.
In one embodiment, a robotically controlled surgical tool is provided. The surgical tool comprises a tool mounting portion comprising a tool mounting housing, a tool mounting plate, and a coupler to couple a shaft assembly comprising an articulation section to the tool mounting portion. An articulation mechanism is configured to receive a proximal end of the shaft assembly to articulate the articulation section of the shaft assembly. The articulation mechanism comprises a cam mechanism operative to articulate the articulation section of the shaft assembly. An interface mechanically and electrically couples the tool mounting portion to a manipulator.
Before explaining various embodiments of robotically controlled surgical instruments in detail, it should be noted that the illustrative embodiments are not limited in application or use to the details of construction and arrangement of parts illustrated in the accompanying drawings and description. It will be appreciated that the illustrative embodiments may be implemented or incorporated in other embodiments, variations and modifications, and may be practiced or carried out in various ways. Further, unless otherwise indicated, the terms and expressions employed herein have been chosen for the purpose of describing the illustrative embodiments for the convenience of the reader and are not for the purpose of limitation thereof.
Further, it is understood that any one or more of the following-described embodiments, expressions of embodiments, and/or examples, can be combined with any one or more of the other following-described embodiments, expressions of embodiments, and/or examples.
The present disclosure provides various embodiments of robotic surgery apparatuses, systems, and methods. In particular, the present disclosure provides various embodiments of robotically controlled surgical instruments. More particularly, the present disclosure provides various embodiments of robotically controlled electrosurgical and/or ultrasonic instruments comprising robotically controlled articulation features for robotically articulating the surgical instrument.
For clarity of disclosure, the terms “proximal” and “distal” are defined herein relative to a robotic surgical tool comprising a proximal housing having an interface which mechanically and electrically couples the surgical tool to a robotic manipulator and a distal surgical end effector. The term “proximal” refers the position of an element closer to the housing and the term “distal” refers to the position of an element closer to the surgical end effector and further away from the housing.
Many robotic surgical procedures require cutting or ligating blood vessels or other vascular tissue. With minimally invasive robotic surgery, surgical operations are performed through a small incision in the patient's body. As a result of the limited space, often difficulties arise in controlling bleeding when clamping and/or tying-off transected blood vessels. By utilizing electrosurgical forceps, a robotic surgical tool can cauterize, coagulate/desiccate, and/or simply reduce or slow bleeding by robotically controlling the electrosurgical energy applied through jaw members of the robotically controlled electrosurgical forceps, otherwise referred to as clamp arms.
Over the years a variety of minimally invasive robotic (or “telesurgical”) systems have been developed to increase surgical dexterity as well as to permit a surgeon to operate on a patient in an intuitive manner. Robotic surgical systems can be used with many different types of surgical instruments including, for example, ultrasonic instruments and/or electrosurgical instruments, as described herein. Example robotic systems include those manufactured by Intuitive Surgical, Inc., of Sunnyvale, Calif., U.S.A. Such systems, as well as robotic systems from other manufacturers, are disclosed in the following U.S. Patents which are each herein incorporated by reference in their respective entirety: U.S. Pat. No. 5,792,135, entitled ARTICULATED SURGICAL INSTRUMENT FOR PERFORMING MINIMALLY INVASIVE SURGERY WITH ENHANCED DEXTERITY AND SENSITIVITY, U.S. Pat. No. 6,231,565, entitled ROBOTIC ARM DLUS FOR PERFORMING SURGICAL TASKS, U.S. Pat. No. 6,783,524, entitled ROBOTIC SURGICAL TOOL WITH ULTRASOUND CAUTERIZING AND CUTTING INSTRUMENT, U.S. Pat. No. 6,364,888, entitled ALIGNMENT OF MASTER AND SLAVE IN A MINIMALLY INVASIVE SURGICAL APPARATUS, U.S. Pat. No. 7,524,320, entitled MECHANICAL ACTUATOR INTERFACE SYSTEM FOR ROBOTIC SURGICAL TOOLS, U.S. Pat. No. 7,691,098, entitled PLATFORM LINK WRIST MECHANISM, U.S. Pat. No. 7,806,891, entitled REPOSITIONING AND REORIENTATION OF MASTER/SLAVE RELATIONSHIP IN MINIMALLY INVASIVE TELESURGERY, and U.S. Pat. No. 7,824,401, entitled SURGICAL TOOL WITH WRISTED MONOPOLAR ELECTROSURGICAL END EFFECTORS. Many of such systems, however, have in the past been unable to generate the magnitude of forces required to effectively cut and fasten tissue.
Additional surgical instruments that may be used in the robotic system 200 are described in the following commonly assigned U.S. Patent Applications: (1) U.S. Patent Application Publication No. 2013/0012957 filed Feb. 9, 2012, published Jan. 10, 2013, and issued on Sep. 30, 2014 as U.S. Pat. No. 8,844,789, entitled AUTOMATED END EFFECTOR COMPONENT RELOADING SYSTEM FOR USE WITH A ROBOTIC SYSTEM; (2) U.S. Patent Application Publication No. 2012/0199630 filed Feb. 9, 2012, published Aug. 9, 2012, and issued on Sep. 2, 2014 as U.S. Pat. No. 8,820,605, entitled ROBOTICALLY-CONTROLLED SURGICAL INSTRUMENT WITH FORCE-FEEDBACK CAPABILITIES; (3) U.S. Patent Application Publication No. 2012/0132450 filed Feb. 9, 2012, published May 31, 2012, and issued on Dec. 31, 2014 as U.S. Pat. No. 8,616,431, entitled SHIFTABLE DRIVE INTERFACE FOR ROBOTICALLY-CONTROLLED SURGICAL TOOL; (4) U.S. Patent Application Publication No. 2012/0199633 filed Feb. 9, 2012, published Aug. 9, 2012, and issued on Nov. 5, 2013 as U.S. Pat. No. 8,573,461, entitled SURGICAL STAPLING INSTRUMENTS WITH CAM-DRIVEN STAPLE DEPLOYMENT ARRANGEMENTS; (5) U.S. Patent Application Publication No. 2012/0199631, filed Feb. 9, 2012, published Aug. 9, 2012, and issued on Dec. 10, 2013 as U.S. Pat. No. 8,602,288, entitled ROBOTICALLY-CONTROLLED MOTORIZED SURGICAL END EFFECTOR SYSTEM WITH ROTARY ACTUATED CLOSURE SYSTEMS HAVING VARIABLE ACTUATION SPEEDS; (6) U.S. Patent Application Publication No. 2012/0199632, filed Feb. 9, 2012, published Aug. 9, 2012, and issued on Apr. 5, 2016 as U.S. Pat. No. 9,301,759, entitled ROBOTICALLY-CONTROLLED SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR; (7) U.S. Patent Application Publication No. 2012/0203247, filed Feb. 9, 2012, published Aug. 9, 2012, and issued on Jul. 22, 2014 as U.S. Pat. No. 8,783,541, entitled ROBOTICALLY-CONTROLLED SURGICAL END EFFECTOR SYSTEM; (8) U.S. Patent Application Publication No. 2012/0211546, filed Feb. 9, 2012, published Aug. 23, 2012, and issued on Jul. 9, 2013 as U.S. Pat. No. 8,479,969, entitled DRIVE INTERFACE FOR OPERATIVELY COUPLING A MANIPULATABLE SURGICAL TOOL TO A ROBOT; (9) U.S. Patent Application Publication No. 2012/0138660, filed Feb. 9, 2012, published Jun. 7, 2012, and issued on Aug. 12, 2014 as U.S. Pat. No. 8,800,838, entitled ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS; and (10) U.S. Patent Application Publication No. 2012/0205421, filed Feb. 9, 2012, published Aug. 16, 2012, and issued on Nov. 5, 2013 as U.S. Pat. No. 8,573,465, entitled ROBOTICALLY-CONTROLLED SURGICAL END EFFECTOR SYSTEM WITH ROTARY ACTUATED CLOSURE SYSTEMS; the disclosure of each of these applications is herein incorporated by reference in its entirety.
In various embodiments, the tool mounting portion 614 comprises a tool mounting housing 626 and a tool mounting plate 618 that operatively supports a plurality of rotatable body portions, driven discs or elements 620 (four are shown in
In one embodiment, the surgical tool 600 provides bipolar RF energy, articulation of the elongate shaft for better access to vessels and tissue, vessel sealing, low thermal spreading, and uniform compression for improved hemostasis, among other features. As described in more detail with reference to
For clarity of disclosure, in
The surgical tool 600 will now be described with reference to
In one embodiment, the tool mounting portion 614 of the surgical tool 600 comprises a shaft assembly 608 articulation mechanism, a shaft assembly 608 rotation mechanism, a clamp jaw 602 open/close mechanism, and a knife actuation mechanism. In one embodiment, the rotatable bodies 621 (e.g., rotatable spools) are coupled to the driven elements 620. The rotatable bodies 621 may be formed integrally with the driven elements 620. In some embodiments, the rotatable bodies 621 may be formed separately from the driven elements 620 provided that the rotatable bodies 621 and the driven elements 620 are fixedly coupled such that driving the driven elements 620 causes rotation of the rotatable bodies 621. Each of the rotatable bodies 621 is coupled to a gear train or gear mechanism to provide shaft articulation and rotation and clamp jaw open/close and knife actuation.
In one embodiment, the tool mounting portion 614 of the surgical tool 600 comprises a shaft assembly 608 articulation mechanism. In the illustrated embodiment, for example, the surgical tool 600 comprises a rack and pinion gearing mechanism to provide shaft articulation functionality. In one embodiment, the rack and pinion gearing mechanism comprises a first pinion gear 636 coupled to a rotatable body 621 such that rotation of the corresponding driven element 620 causes the first pinion gear 636 to rotate. A bearing 660 (
In one embodiment, the tool mounting portion 614 of the surgical tool 600 comprises a shaft assembly 608 rotation mechanism. In the illustrated embodiment, for example, the surgical tool 600 comprises a first spiral worm gear 644 coupled to a rotatable body 621 and a second spiral worm gear 646 coupled to the shaft assembly 608. A bearing 660 (
In one embodiment, the tool mounting portion 614 of the surgical tool 600 comprises a clamp jaw 602 open/close mechanism and a knife actuation mechanism. In the illustrated embodiment, for example, the surgical tool 600 comprises a rack and pinion gearing mechanism to provide the clamp jaw 602 open/close and knife actuation functionality. In the illustrated embodiment, a first gear 640 is coupled to a rotatable body 621 such that rotation of the corresponding driven element 620 causes the first gear 640 to rotate in a first direction. A second gear 642 is free to rotate about a post 656 formed in the tool mounting plate 618. The first gear 640 is meshed to the second gear 642 such that the second gear 642 rotates in a direction that is opposite of the first gear 640. In one embodiment, the gear mechanism comprising the first and second gears 640, 642 is configured to control the opening and closing the top jaw 804 of the clamp jaw 602 and movement of an “I-beam” shaped cutting element through the slot 628 formed in the clamp jaw 602. In one embodiment, the second gear 642 is a pinion gear meshed to a rack gear 649, which moves in a liner direction. The rack gear 649 is coupled to a close/open block 648, which is coupled to a distal portion of the shaft assembly 608. As the rack gear 649 moves in a distal direction, the “I-beam” shaped cutting element advances and closes the top jaw 604 portion of the clamp jaw 602. As the rack gear 649 moves in a proximal direction, the “I-beam” shaped cutting element retracts to enable the top jaw 604 portion of the clamp jaw 602 to open. A description of one embodiment of an “I-beam” shaped cutting element is provided in the '247 Application, which is herein incorporated by reference.
In various embodiments, the tool mounting portion 714 comprises a tool mounting housing 726 and a tool mounting plate 718 that operatively supports a plurality of rotatable body portions, driven discs or elements 720 (four are shown in
In one embodiment, the surgical tool 700 provides bipolar RF energy, articulation of the elongate shaft for better access to vessels and tissue, vessel sealing, low thermal spreading, and uniform compression for improved hemostasis, among other features. As described in more detail with reference to
For clarity of disclosure, in
The surgical tool 700 will now be described with reference to
In one embodiment, the tool mounting portion 714 of the surgical tool 700 comprises a shaft assembly 708 articulation mechanism, a shaft assembly 708 rotation mechanism, a clamp jaw 702 open/close mechanism, and a knife actuation mechanism. In one embodiment, the rotatable bodies 721 (e.g., rotatable spools) are coupled to the driven elements 720. The rotatable bodies 721 may be formed integrally with the driven elements 720. In some embodiments, the rotatable bodies 721 may be formed separately from the driven elements 720 provided that the rotatable bodies 721 and the driven elements 720 are fixedly coupled such that driving the driven elements 720 causes rotation of the rotatable bodies 721. Each of the rotatable bodies 721 is coupled to a gear train or gear mechanism to provide shaft articulation and rotation and clamp jaw open/close and knife actuation.
In one embodiment, the tool mounting portion 714 of the surgical tool 700 comprises a shaft assembly 708 articulation mechanism. In the illustrated embodiment, for example, the surgical tool 700 comprises a rack and pinion mechanism to provide shaft articulation functionality. In one embodiment, the rack and pinion gearing mechanism comprises a first pinion gear 736 coupled to a rotatable body 721 such that rotation of the corresponding driven element 720 causes the first pinion gear 736 to rotate. A bearing 760 (
In one embodiment, the tool mounting portion 714 of the surgical tool 700 comprises a shaft assembly 708 rotation mechanism. In the illustrated embodiment, for example, the surgical tool 700 comprises a first spiral worm gear 766 coupled to a second spiral worm gear 764, which is coupled to a third spiral worm gear 744. Such an arrangement is provided for various reasons including maintaining compatibility with existing robotic systems 200 and/or where space may be limited. The first spiral worm gear 766 is coupled to a rotatable body 721. The third spiral worm gear 744 is meshed with a fourth spiral worm gear 746 coupled to the shaft assembly 708. A bearing 760 (
In one embodiment, the tool mounting portion 714 of the surgical tool 700 comprises a clamp jaw 702 open/close mechanism and a knife actuation mechanism. In the illustrated embodiment, for example, the surgical tool 700 comprises a rack and pinion gearing mechanism to provide the clamp jaw 702 open/close and knife actuation functionality. In one embodiment, a third pinion gear 740 is coupled to a rotatable body 721 such that rotation of the corresponding driven element 720 causes the third pinion gear 740 to rotate in a first direction. The third pinion gear 740 is meshed to a rack gear 749, which moves in a linear direction. The rack gear 749 is coupled to a close/open block 748, which is coupled to a distal portion of the shaft assembly 708. In one embodiment, the gear mechanism comprising the pinion gear 740 is configured to control the opening and closing of the clamp jaw 702 and movement of an “I-beam” shaped cutting element through the slot 728 formed in the clamp jaw 702. As the rack gear 749 moves in a distal direction, the “I-beam” shaped cutting element advances and closes the top jaw 704 portion of the clamp jaw 702. As the rack gear 749 moves in a proximal direction, the “I-beam” shaped cutting element retracts and enables the top jaw 704 portion of the clamp jaw 702 to open. A description of one embodiment of an “I-beam” shaped cutting element is provided in the '247 Application.
In various embodiments, the tool mounting portion 814 comprises a tool mounting housing 826 and a tool mounting plate 818 that operatively supports a plurality of rotatable body portions, driven discs or elements 820 (four are shown in
In one embodiment, the surgical tool 800 provides bipolar RF energy, articulation of the elongate shaft for better access to vessels and tissue, vessel sealing, low thermal spreading, and uniform compression for improved hemostasis, among other features. As described in more detail with reference to
For clarity of disclosure, in
The surgical tool 800 will now be described with reference to
In one embodiment, the tool mounting portion 814 of the surgical tool 800 comprises a shaft assembly 808 articulation mechanism, a shaft assembly 808 rotation mechanism, a clamp jaw 802 open/close mechanism, and a knife actuation mechanism. In one embodiment, the rotatable bodies 821 (e.g., rotatable spools) are coupled to the driven elements 820. The rotatable bodies 821 may be formed integrally with the driven elements 820. In some embodiments, the rotatable bodies 821 may be formed separately from the driven elements 820 provided that the rotatable bodies 821 and the driven elements 820 are fixedly coupled such that driving the driven elements 820 causes rotation of the rotatable bodies 821. Each of the rotatable bodies 821 is coupled to a gear train or gear mechanism to provide shaft articulation and rotation and clamp jaw open/close and knife actuation.
In one embodiment, the tool mounting portion 814 of the surgical tool 800 comprises a shaft assembly 808 articulation mechanism. In the illustrated embodiment, for example, the surgical tool 800 comprises a rack and pinion gearing mechanism to provide shaft articulation functionality. In one embodiment, the rack and pinion gearing mechanism comprises a first pinion gear 836 coupled to a rotatable body 821 such that rotation of the corresponding driven element 820 causes the first pinion gear 836 to rotate. The first pinion gear 836 is meshed to a first rack gear 850 to convert the rotational motion of the first pinion gear 836 into linear motion of the first rack gear 850 to control the articulation of the articulation section 812 of the shaft assembly 808 in a left direction 858L. The first rack gear 850 is attached to a first articulation band 851 such that linear motion of the first rack gear 850 in a distal direction causes the articulation section 812 of the shaft assembly 808 to articulate in the left direction 858L. A second pinion gear 838 is coupled to another rotatable body 821 such that rotation of the corresponding driven element 820 causes the second pinion gear 838 to rotate. The second pinion gear 838 is meshed to a second rack gear 852 to convert the rotational motion of the second pinion gear 838 into linear motion of the second rack gear 852 to control the articulation of the articulation section 812 of the shaft assembly 808 in a right direction 858R. The second rack gear 852 is attached to a second articulation band 853 such that linear motion of the second rack gear 852 in a distal direction causes the articulation section 812 of the shaft assembly 808 to articulate in the right direction 858R.
In one embodiment, the tool mounting portion 814 of the surgical tool 800 comprises a shaft assembly 808 rotation mechanism. In the illustrated embodiment, for example, the surgical tool 800 comprises a first gear 844 coupled to a rotatable body 821, a fixed post 868 comprising first and second openings 870, first and second rotatable pins 874 coupled to the shaft assembly, and a cable 872 (or rope). The cable is wrapped around the rotatable body 821. One end of the cable 872 is located through a top opening 870 of the fixed post 868 and fixedly coupled to a top rotatable pin 874. Another end of the cable 872 is located through a bottom opening 870 of the fixed post 868 and fixedly coupled to a bottom rotating pin 874. Such an arrangement is provided for various reasons including maintaining compatibility with existing robotic systems 200 and/or where space may be limited. Accordingly, rotation of the rotatable body 821 causes the rotation of the shaft assembly 808, to control the rotation of the shaft assembly 808 in a CW and a CCW direction based on the rotational direction of the rotatable body 821. Accordingly, rotation of the rotatable body 821 about a first axis is converted to rotation of the shaft assembly 808 about a second axis, which is orthogonal to the first axis. As shown in
In one embodiment, the tool mounting portion 814 of the surgical tool 800 comprises a clamp jaw 802 open/close mechanism and a knife actuation mechanism. In the illustrated embodiment, for example, the surgical tool 800 comprises a rack and pinion mechanism to provide the clamp jaw 802 open/close and knife actuation functionality. In one embodiment, a third pinion gear 840. The third pinion gear 840 is coupled to a rotatable body 821 such that rotation of the corresponding driven element 820 causes the third pinion gear 840 to rotate in a first direction. The third pinion gear 840 is meshed to a rack gear 849, which moves in a linear direction. The rack gear 849 is coupled to a close/open block 848, which is coupled to a distal portion of the shaft assembly 808. In one embodiment, the gear mechanism comprising the pinion gear 840 is configured to control the opening and closing of the top jaw 804 portion of the clamp jaw 802 and movement of an “I-beam” shaped cutting element through the slot 828 formed in the clamp jaw 802. As the rack gear 849 moves in a distal direction, the “I-beam” shaped cutting element advances and closes the top jaw 804 portion of the clamp jaw 802. As the rack gear 849 moves in a proximal direction, the “I-beam” shaped cutting element retracts and enables the top jaw 804 portion of the clamp jaw 802 to open. A description of one embodiment of an “I-beam” shaped cutting element is provided in the '247 Application.
In various embodiments, the tool mounting portion 914 comprises a tool mounting housing 926 and a tool mounting plate 918 that operatively supports a plurality of rotatable body portions, driven discs or elements 920, and a fixed disc or element 990 (three driven and one fixed are shown in
In one embodiment, the surgical tool 900 provides bipolar RF energy, articulation of the elongate shaft for better access to vessels and tissue, vessel sealing, low thermal spreading, and uniform compression for improved hemostasis, among other features. As described in more detail with reference to
For clarity of disclosure, in
The surgical tool 900 will now be described with reference to
In one embodiment, the tool mounting portion 914 of the surgical tool 900 comprises a shaft assembly 908 articulation mechanism, a shaft assembly 908 rotation mechanism, a clamp jaw 902 open/close mechanism, and a knife actuation mechanism. In one embodiment, the rotatable bodies 921 (e.g., rotatable spools) are coupled to the driven elements 920. The rotatable bodies 921 may be formed integrally with the driven elements 920. In some embodiments, the rotatable bodies 921 may be formed separately from the driven elements 920 provided that the rotatable bodies 921 and the driven elements 920 are fixedly coupled such that driving the driven elements 920 causes rotation of the rotatable bodies 921. In one embodiment, some of the rotatable bodies 921 are coupled to a double cam mechanism to provide shaft articulation and other rotatable bodies may be coupled to a gear train or gear mechanism to provided shaft rotation and clamp jaw open/close and knife actuation.
In one embodiment, the tool mounting portion 914 of the surgical tool 900 comprises a shaft assembly 908 articulation mechanism. In the illustrated embodiment, for example, the surgical tool 900 comprises a double cam mechanism 984 to provide the shaft articulation functionality. In one embodiment, the double cam mechanism 984 comprises first and second cam portions 984A, 984B. First and second follower arms 986, 988 are pivotally coupled to corresponding pivot spools 982. As the rotatable body 921 coupled to the double cam mechanism 984 rotates, the first cam portion 984A acts on the first follower arm 986 and the second cam portion 984B acts on the second follower arm 988. As the cam mechanism 984 rotates the follower arms 986, 988 pivot about the pivot spools 982. The first follower arm 986 is attached to the first articulation band 951 and the second follower arm 988 is attached to the second articulation band 953. As the top cam portion 984A acts of the first follower arm 986, the shaft assembly 908 articulates in a left direction 958L. As the bottom cam portion 984B acts of the second follower arm 988, the shaft assembly 908 articulates in a right direction 958R. The first and second follower arms 986, 988 (or levers) are mounted on the shaft within the tool mounting portion 914 and are connected to the articulating bands (wires) coming from the distal end of the shaft assembly 908. Two separate bushings 983, 985 are mounted beneath the respective first and second follower arms 986, 988 to allow the rotation of the shaft without affecting the articulating positions of the first and second follower arms 986, 988. For articulation motion, these bushings reciprocate with the first and second follower arms 986, 988 without affecting the rotary position of the jaw 902.
The operation of the left and right articulation of the shaft assembly 908 using the double cam mechanism 984 is further illustrated in
As shown in more detail in
In one embodiment, the tool mounting portion 914 of the surgical tool 900 comprises a clamp jaw 902 open/close mechanism and a knife actuation mechanism. In the illustrated embodiment, for example, the surgical tool 900 comprises a rack and pinion gearing mechanism to provide the clamp jaw 902 open/close and knife actuation functionality. In embodiment, the rack and pinion gearing mechanism comprises a rotatable body 921 coupled to a pinion gear 997 that is meshed to a rack gear 995. The pinion gear 997 is coupled to a rotatable body 921 such that rotation of the corresponding driven element 920 causes the pinion gear 997 to rotate in a first direction. The pinion gear 997 is meshed to the rack gear 995, which moves in a linear direction. The rack gear 995 is coupled to a close/open block 999, which is coupled to a distal portion of the shaft assembly 908. In one embodiment, the rack and pinion gear mechanism comprising the pinion gear 997 is configured to control the opening and closing of the top jaw 904 portion of the clamp jaw 902 and movement of an “I-beam” shaped cutting element through the slot 928 formed in the clamp jaw 902. As the rack gear 995 moves in a distal direction, the “I-beam” shaped cutting element advances and closes the top jaw 904 portion of the clamp jaw 902. As the rack gear 995 moves in a proximal direction, the “I-beam” shaped cutting element retracts and enables the top jaw 904 portion of the clamp jaw 902 to open. A description of one embodiment of an “I-beam” shaped cutting element is provided in the '247 Application.
With reference now to
In various embodiments, the surgical tools 600, 700, 800, 900 may be operated with external power and energy sources. In other embodiments, surgical tools 1000, 1100 as shown in
Accordingly,
In one embodiment, the tool mounting portion 1014 of the surgical tool 1000 comprises a shaft assembly articulation mechanism, a shaft assembly rotation mechanism, a clamp jaw open/close mechanism, and a knife actuation mechanism. In one embodiment, the rotatable bodies 721 (e.g., rotatable spools) are coupled to the driven elements. The rotatable bodies 1021 may be formed integrally with the driven elements. In some embodiments, the rotatable bodies 1021 may be formed separately from the driven elements provided that the rotatable bodies 1021 and the driven elements are fixedly coupled such that driving the driven elements causes rotation of the rotatable bodies 1021. Each of the rotatable bodies 1021 is coupled to a gear train or gear mechanism to provide shaft articulation and rotation and clamp jaw open/close and knife actuation.
In one embodiment, the tool mounting portion 1014 of the surgical tool 1000 comprises a shaft assembly articulation mechanism. In the illustrated embodiment, for example, the surgical tool 1000 comprises a rack and pinion mechanism to provide shaft articulation functionality. In one embodiment, the rack and pinion gearing mechanism comprises a first pinion gear 1036 coupled to a rotatable body 1021 such that rotation of the corresponding driven element causes the first pinion gear 1036 to rotate. The first pinion gear 1036 is meshed to a first rack gear 1050 to convert the rotational motion of the first pinion gear 1036 into linear motion of the first rack gear 1050 to control the articulation of the articulation section of the shaft assembly in a left direction. The first rack gear 1050 is attached to a first articulation band such that linear motion of the first rack gear 1050 in a distal direction causes the articulation section of the shaft assembly to articulate in the left direction. A second pinion gear 1038 is coupled to another rotatable body 1021 such that rotation of the corresponding driven element 1020 causes the second pinion gear 1038 to rotate. The second pinion gear 1038 is meshed to a second rack gear 1052 to convert the rotational motion of the second pinion gear 1038 into linear motion of the second rack gear 1052 to control the articulation of the articulation section of the shaft assembly in a right direction. The second rack gear 1052 is attached to a second articulation band such that linear motion of the second rack gear 1052 in a distal direction causes the articulation section of the shaft assembly to articulate in the right direction.
In one embodiment, the tool mounting portion 1014 of the surgical tool 1000 comprises a shaft assembly rotation mechanism. In the illustrated embodiment, for example, the surgical tool 1000 comprises a first spiral worm gear 1066 coupled to a second spiral worm gear 1064, which is coupled to a third spiral worm gear 1044. Such an arrangement is provided for various reasons including maintaining compatibility with existing robotic systems 200 and/or where space may be limited. The first spiral worm gear 1066 is coupled to a rotatable body 1021. The third spiral worm gear 1044 is meshed with a fourth spiral worm gear 1046 coupled to the shaft assembly. The third spiral worm gear 1066 is meshed to the fourth spiral worm gear 1046, which is coupled to the shaft assembly, to control the rotation of the shaft assembly in a CW and a CCW direction based on the rotational direction of the spiral worm gears 1044, 1046. Accordingly, rotation of the third spiral worm gear 1044 about a first axis is converted to rotation of the fourth spiral worm gear 1046 about a second axis, which is orthogonal to the first axis.
In one embodiment, the tool mounting portion 1014 of the surgical tool 1000 comprises a clamp jaw open/close mechanism and a knife actuation mechanism. In the illustrated embodiment, for example, the surgical tool 1000 comprises a rack and pinion gearing mechanism to provide the clamp jaw open/close and knife actuation functionality. In one embodiment, a third pinion gear 1040 is coupled to a rotatable body 1021 such that rotation of the corresponding driven element causes the third pinion gear 1040 to rotate in a first direction. The third pinion gear 1040 is meshed to a rack gear 1049, which moves in a linear direction. The rack gear 1049 is coupled to a close/open block 1048, which is coupled to a distal portion of the shaft assembly. In one embodiment, the gear mechanism comprising the pinion gear 1040 is configured to control the opening and closing of the clamp jaw and movement of an “I-beam” shaped cutting element through the slot formed in the clamp jaw. As the rack gear 1049 moves in a distal direction, the “I-beam” shaped cutting element advances and closes the top jaw portion of the clamp jaw. As the rack gear 1049 moves in a proximal direction, the “I-beam” shaped cutting element retracts and enables the top jaw portion of the clamp jaw to open. A description of one embodiment of an “I-beam” shaped cutting element is provided in the '247 Application.
In one embodiment, the tool mounting portion 1014 of the surgical tool 1100 comprises a shaft assembly articulation mechanism. In the illustrated embodiment, for example, the surgical tool 1100 comprises a double cam mechanism 1184 to provide the shaft articulation functionality. In one embodiment, the double cam mechanism 1184 comprises a first cam portion 1184A and a second cam portion (not shown). First and second follower arms 1186, 1188 are pivotally coupled to corresponding pivot spools 1182. As the rotatable body 1121 coupled to the double cam mechanism 1184 rotates, the first cam portion 1184A acts on the first follower arm 1186 and the second cam portion acts on the second follower arm 1188. As the cam mechanism 1184 rotates the follower arms 1186, 1188 pivot about the pivot spools 1182. The first follower arm 1186 is attached to the first articulation band 1151 and the second follower arm 1188 is attached to the second articulation band 1153. As the top cam portion 1184A acts of the first follower arm 1186, the shaft assembly articulates in a left direction 1158L. As the bottom cam portion acts of the second follower arm 1188, the shaft assembly articulates in a right direction 1158R.
As shown in more detail in
In one embodiment, the tool mounting portion 1114 of the surgical tool 1100 comprises a clamp jaw open/close mechanism and a knife actuation mechanism. In the illustrated embodiment, for example, the surgical tool 1100 comprises a rack and pinion gearing mechanism to provide the clamp jaw open/close and knife actuation functionality. In embodiment, the rack and pinion gearing mechanism comprises a rotatable body 1121 coupled to a pinion gear 1197 that is meshed to a rack gear 1195. The pinion gear 1197 is coupled to a rotatable body 1121 such that rotation of the corresponding driven element 1120 causes the pinion gear 1197 to rotate in a first direction. The pinion gear 1197 is meshed to the rack gear 1195, which moves in a linear direction. The rack gear 1195 is coupled to a close/open block 1199, which is coupled to a distal portion of the shaft assembly. In one embodiment, the rack and pinion gear mechanism comprising the pinion gear 1197 is configured to control the opening and closing of the top jaw portion of the clamp jaw and movement of an “I-beam” shaped cutting element through the slot 1128 formed in the clamp jaw. As the rack gear 1195 moves in a distal direction, the “I-beam” shaped cutting element advances and closes the top jaw portion of the clamp jaw. As the rack gear 1195 moves in a proximal direction, the “I-beam” shaped cutting element retracts and enables the top jaw portion of the clamp jaw to open. A description of one embodiment of an “I-beam” shaped cutting element is provided in the '247 Application.
A limit switch 1180 is provided to indicate the position of the cutter element in the end effector. An on/off switch 1194 is provided to controls the electrical state of the surgical tool 1100. The limit switch 1180 is compressed and provides an indication to a controller that the top jaw 1104 of the clamp jaw is closed and the cutter element is “out” in a distal position. The limit switch is free and provides an indication to a controller that the top jaw of the clamp jaw is open and the cutter element is in a proximal position.
Although the modified surgical tools 1000, 1100 shown in
The description now turns
In various embodiments, efficiency of the power supply and RF drive and control circuitry sections also may minimize the size of the batteries 1004, 1006, 1104, 1106 shown in
Radio frequency drive amplifier topologies may vary according to various embodiments. In one embodiment, for example, a series resonant approach may be employed where the operating frequency is varied to change the output voltage to force the surgical tool to operate according to a pre-programmed load curve. In a series resonant approach, the impedance of a series resonant network is at a minimum at the resonant frequency, because the reactance of the capacitive and inductive elements cancel, leaving a small real resistance. The voltage maximum for a series resonant circuit also occurs at the resonant frequency (and also depends upon the circuit Q). Accordingly, to produce a high voltage on the output, the series resonant circuit should operate closer to the resonant frequency, which increases the current draw from the DC supply (e.g., battery 1300) to feed the RF amplifier section with the required current. Although the series resonant approach may be referred to as a resonant mode boost converter, in reality, the design is rarely operated at the resonant frequency, because that is the point of maximum voltage. The benefit of a resonant mode topology is that if it is operated very close to the resonant frequency, the switching field effect transistors (FETs) can be switched “ON” or “OFF” at either a voltage or current zero crossing, which dissipates the least amount of power in the switching FETs as is possible.
Another feature of the RF drive and control circuitry section according to one embodiment, provides a relatively high turns ratio transformer which steps up the output voltage to about 85 VRMS from the nominal battery 1300 voltage of about 11.1V. This provides a more compact implementation because only one transformer and one other inductor are required. In such a circuit, high currents are necessary on the transformer primary to create the desired output voltage or current. Such device, however, cannot be operated at the resonant frequency because allowances are made to take into account for the battery voltage dropping as it is expended. Accordingly, some headroom is provided to maintain the output voltage at the required level. A more detailed description of a series resonant approach is provided in commonly assigned international PCT Patent Application No. PCT/GB2011/000778, entitled MEDICAL DEVICE, filed May 20, 2011, the disclosure of which is incorporated herein by reference in its entirety.
According to another embodiment, an RF instrument topology comprising a novel and unique architecture is provided for a handheld battery powered RF based generator for the electrosurgical surgical tool. Accordingly, in one embodiment, the present disclosure provides an RF instrument topology with an architecture configured such that each power section of the device operate at maximum efficiency regardless of the load resistance presented by the tissue or what voltage, current, or power level is commanded by the controller. In one embodiment, this may be implemented by employing the most efficient modalities of energy transformation presently known and by minimizing the component size to provide a small and light weight electronics package to fit within the housing, for example.
In one embodiment, the RF power electronics section of the electronics system 400 may be partitioned as a boost mode converter, synchronous buck converter, and a parallel resonant amplifier. According to one embodiment, a resonant mode boost converter section of the surgical tool may be employed to convert the DC battery 1300 voltage to a higher DC voltage for use by the synchronous mode buck converter. One aspect to consider for achieving a predetermined efficiency of the resonant mode boost converter section is ratio between input and output voltages of the boost converter. In one embodiment, although a 10:1 ratio is achievable, the cost is that for any appreciable power on the secondary the input currents to the boost mode transformer become quite heavy, in the range of about 15-25 A, depending on the load. In another embodiment a transformer turns ratio of about 5:1 is provided. It will be appreciated that transformer ratios in the range of about 5:1 to about 10:1 also may be implemented, without limitation. In a 5:1 transformer turns ratio, the design tradeoff is managing the Q of the parallel resonant output against the boost ratio. The resonant output network performs two functions. First, it filters the square, digital pulses from the Class D output amplifier and removes all but the fundamental frequency sine wave from the output. Second, it provides a passive voltage gain due to the Q of the filter network. In other words, current from the amplifier is turned into output voltage, at a gain determined by the circuit's unloaded Q and the load resistance, which affects the Q of the circuit.
Another aspect to consider for achieving a predetermined efficiency in the resonant mode boost converter section is to utilize a full bridge switcher topology, which allows half the turns ratio for the boost transformer for the same input voltage. The tradeoff is that this approach may require additional FET transistors, e.g., an additional two FETs are required over a half bridge approach, for example. Presently available switchmode FETs, however, are relatively small, and while the gate drive power is not negligible, it provides a reasonable design tradeoff.
Yet another aspect to consider for achieving a predetermined efficiency in the resonant mode boost converter section and operating the boost converter at maximum efficiency, is to always run the circuit at the resonant frequency so that the FETs are always switching at either a voltage or current minima, whichever is selected by the designer (ZCS vs. ZVS switching), for example. This can include monitoring the resonant frequency of the converter as the load changes, and making adjustments to the switching frequency of the boost converter to allow ZVS or ZCS (Zero Voltage Switching/Zero Current Switching) to occur for minimum power dissipation.
Yet another aspect to consider for achieving a predetermined efficiency in the resonant mode boost converter section is to utilize a synchronous rectifier circuit instead of a conventional full-wave diode rectifier block. Synchronous rectification employs FETs as diodes because the on-resistance of the FET is so much lower than that of even a Schottky power diode optimized for low forward voltage drop under high current conditions. A synchronous rectifier requires gate drive for the FETs and the logic to control them, but offers significant power savings over a traditional full bridge rectifier.
In accordance with various embodiments, the predetermined efficiency of a resonant mode boost converter is approximately 98-99% input to output, for example. Any suitable predetermined efficiency may be selected based on the particular implementation. Accordingly, the embodiments described herein are limited in this context.
According to one embodiment, a synchronous buck converter section of the surgical tool may be employed to reduce the DC voltage fed to the RF amplifier section to the predetermined level to maintain the commanded output power, voltage or current as dictated by the load curve, with as little loss as is possible. The buck converter is essentially an LC lowpass filter fed by a low impedance switch, along with a regulation circuit to control the switch to maintain the commanded output voltage. The operating voltage is dropped to the predetermined level commanded by the main controller, which is running the control system code to force the system to follow the assigned load curve as a function of sensed tissue resistance. In accordance with various embodiments, the predetermined efficiency of a synchronous buck regulator is approximately 99%, for example. Any suitable predetermined efficiency may be selected based on the particular implementation. Accordingly, the embodiments described herein are limited in this context.
According to one embodiment, a resonant mode RF amplifier section comprising a parallel resonant network on the RF amplifier section output is provided. In one embodiment, a predetermined efficiency may be achieved by a providing a parallel resonant network on the RF amplifier section output. The RF amplifier section may be driven at the resonant frequency of the output network which accomplished three things. First, the high Q network allows some passive voltage gain on the output, reducing the boost required from the boost regulator in order to produce high voltage output levels. Second, the square pulses produced by the RF amplifier section are filtered and only the fundamental frequency is allowed to pass to the output. Third, a full-bridge amplifier is switched at the resonant frequency of the output filter, which is to say at either the voltage zero crossings or the current zero crossings in order to dissipate minimum power. Accordingly, a predetermined efficiency of the RF amplifier section is approximately 98%. Gate drive losses may limit the efficiency to this figure or slightly lower. Any suitable predetermined efficiency may be selected based on the particular implementation. Accordingly, the embodiments described herein are limited in this context.
In view of the RF instrument topology and architecture described above, an overall system efficiency of approximately 0.99*0.99*0.98, which is approximately 96%, m ay be achieved. Accordingly, to deliver approximately 45 W, approximately 1.8 W would be dissipated by the electronics exclusive of the power required to run the main and housekeeping microprocessors, and the support circuits such as the ADC and analog amplifiers and filters. To deliver approximately 135 W, approximately 5.4 W would be dissipated. This is the amount of power that would be required to implement a large jaw class generator in a hand held electrosurgical medical instrument. Overall system efficiency would likely only be a weak function of load resistance, instead of a relatively strong one as it may be the case in some conventional instruments.
In various other embodiments of the electrosurgical surgical tool, a series resonant topology may be employed to achieve certain predetermined efficiency increase by employing a full bridge amplifier for the primary circuit and isolate the full bridge amplifier from ground to get more voltage on the primary. This provides a larger primary inductance and lower flux density due to the larger number of turns on the primary.
As shown in
As shown in
In one embodiment, the transformer 1815 may be implemented with a Core Diameter (mm), Wire Diameter (mm), and Gap between secondary windings in accordance with the following specifications:
Core Diameter, D (mm)
D=19.9×10−3
Wire diameter, W (mm) for 22 AWG wire
W=7.366×10<4
Gap between secondary windings, in gap=0.125
G=gap/25.4
In this embodiment, the amount of electrical power supplied to the forceps is controlled by varying the frequency of the switching signals used to switch the FETs 1803. This works because the resonant circuit 810 acts as a frequency dependent (loss less) attenuator. The closer the drive signal is to the resonant frequency of the resonant circuit 1810, the less the drive signal is attenuated. Similarly, as the frequency of the drive signal is moved away from the resonant frequency of the circuit 1810, the more the drive signal is attenuated and so the power supplied to the load reduces. In this embodiment, the frequency of the switching signals generated by the FET gate drive circuitry 1805 is controlled by a controller 1841 based on a desired power to be delivered to the load 1819 and measurements of the load voltage (VL) and of the load current (IL) obtained by conventional voltage sensing circuitry 1843 and current sensing circuitry 1845. The way that the controller 841 operates will be described in more detail below.
In one embodiment, the voltage sensing circuitry 1843 and the current sensing circuitry 1845 may be implemented with high bandwidth, high speed rail-to-rail amplifiers (e.g., LMH6643 by National Semiconductor). Such amplifiers, however, consume a relatively high current when they are operational. Accordingly, a power save circuit may be provided to reduce the supply voltage of the amplifiers when they are not being used in the voltage sensing circuitry 1843 and the current sensing circuitry 1845. In one-embodiment, a step-down regulator (e.g., LT3502 by Linear Technologies) may be employed by the power save circuit to reduce the supply voltage of the rail-to-rail amplifiers and thus extend the life of the battery 1300.
The frequency control module 1855 uses the values obtained from the calculation module 1853 and the power set point (Pset) obtained from the medical device control module 1857 and predefined system limits (to be explained below), to determine whether or not to increase or decrease the applied frequency. The result of this decision is then passed to a square wave generation module 1863 which, in this embodiment, increments or decrements the frequency of a square wave signal that it generates by 1 kHz, depending on the received decision. As those skilled in the art will appreciate, in an alternative embodiment, the frequency control module 1855 may determine not only whether to increase or decrease the frequency, but also the amount of frequency change required. In this case, the square wave generation module 1863 would generate the corresponding square wave signal with the desired frequency shift. In this embodiment, the square wave signal generated by the square wave generation module 1863 is output to the FET gate drive circuitry 1805, which amplifies the signal and then applies it to the FET 1803-1. The FET gate drive circuitry 1805 also inverts the signal applied to the FET 1803-1 and applies the inverted signal to the FET 1803-2.
The samples obtained by the synchronous sampling circuitry 1851 are then passed to the power, Vrms and Irms calculation module 1853 which can determine the magnitude and phase of the measured signal from just one “I” sample and one “Q” sample of the load current and load voltage. However, in this embodiment, to achieve some averaging, the calculation module 1853 averages consecutive “I” samples to provide an average “I” value and consecutive “Q” samples to provide an average “0” value; and then uses the average I and Q values to determine the magnitude and phase of the measured signal (in a conventional manner). As those skilled in the art will appreciate, with a drive frequency of about 400 kHz and sampling once per period means that the synchronous sampling circuit 1851 will have a sampling rate of 400 kHz and the calculation module 1853 will produce a voltage measure and a current measure every 0.01 ms. The operation of the synchronous sampling circuit 1851 offers an improvement over existing products, where measurements can not be made at the same rate and where only magnitude information is available (the phase information being lost).
In one embodiment, the RF amplifier and drive circuitry for the electrosurgical surgical tool employs a resonant mode step-up switching regulator, running at the desired RF electrosurgical frequency to produce the required tissue effect. The waveform illustrated in
The main processor 1902 controls various functions of the overall surgical tool. In one embodiment, the main processor receives voltage sense (V Sense) and current sense (I Sense) signals measured at the load (represented by the load resistance Rload 1819 in
Examples of frequency agile algorithms that may be employed to operate the present surgical instrument 100 are described in the following commonly-owned U.S. Patent Applications, each of which is incorporated herein by reference in its entirety: (1) U.S. Patent Application Publication No. 2011/0082486 filed Oct. 1, 2010, published Apr. 7, 2011, and issued on Jul. 28, 2015 as U.S. Pat. No. 9,089,360, entitled DEVICES AND TECHNIQUES FOR CUTTING AND COAGULATING TISSUE; (2) U.S. Patent Application Publication No. 2011/0087216, filed Oct. 1, 2010, published Apr. 14, 2011, and issued on Feb. 17, 2015 as U.S. Pat. No. 8,956,349, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES; (3) U.S. Patent Application Publication No. 2011/0087212, filed Oct. 1, 2010, published Apr. 14, 2011, and issued on Mar. 24, 2015 as U.S. Pat. No. 8,986,302, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES; (4) U.S. Patent Application Publication No. 2011/0087213 filed Oct. 1, 2010, published Apr. 14, 2011, and issued on Feb. 10, 2015 as U.S. Pat. No. 8,951,248, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES; (5) U.S. Patent Application Publication No. 2011/0087215 filed Oct. 1, 2010, published Apr. 14, 2011, and issued on Jun. 9, 2015 as U.S. Pat. No. 9,050,093, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES; (6) U.S. Patent Application Publication No. 2011/0087214 filed Oct. 1, 2010, published Apr. 14, 2011, and issued on May 26, 2015 as U.S. Pat. No. 9,039,695, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES; (7) U.S. Patent Application Publication No. 2011/0087217 filed Oct. 1, 2010, published Apr. 14, 2011, and issued on Jun. 23, 2015 as U.S. Pat. No. 9,060,776, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES; and U.S. Pat. No. 8,058,771 filed Jul. 15, 2009, issued Nov. 15, 2011, entitled ULTRASONIC DEVICE FOR CUTTING AND COAGULATING WITH STEPPED OUTPUT; the disclosure of each is herein incorporated by reference in its entirety.
In one embodiment, the main processor 1902 also detects the limit switch end of stroke position (Lmt Sw Sense). The limit switch is activated when the knife reaches the end of stroke limit. The signal generated by the limit switch Lmt Sw Sense is provided to the main processor 1902 to indicate the end-of-stroke condition of the knife.
In one embodiment, the main processor 1902 also senses an actuation signal (Reed Sw Sense) associated with a magnetically operated element located on the electronics system, limit switch, or other switch or input device. When initialization is detected by the main processor 1902, an algorithm is executed to control the operation of the surgical tool. One embodiment of such an algorithm is described in more detail hereinbelow. Further, on initial power up, when a magnetically operated element connects the battery 1300 supply to the electronics system, a low resistance load is applied to the terminals of the battery 1300 to check the internal resistance of the battery 1300. This enables the main processor 1902 to determine the charge state of the battery 1300 or in other words, determines the ability of the battery 1300 to deliver power to the electronics system. In one embodiment, the main processor 1902 may simply determine the absolute value of the difference between the unloaded and loaded battery 1300. If the main processor 1902 determines that the battery 1300 does not have enough capacity to deliver a suitable amount of power, the main processor 1902 disables the surgical tool and outputs a Discharge Battery signal, as discussed in more detail hereinbelow, to controllably discharge the battery 1300 such that it cannot be reused and is classified as an out-of-the box failure.
In one embodiment, as part of the algorithm, the main processor 1902 enables one or more visual feedback elements 1181. As shown in
In one embodiment, the main processor 1902 provides certain output signals. For example, one output signal is provided to the circuitry to discharge the battery 1300 (Discharge Battery). This is explained in more detail with reference to
In one embodiment, the main processor 1902 can verify the output voltage (V) and current (I) sensing function by an artificial injection of voltage and current into the load. The main processor 1902 then reads back the voltage and current from the load and determines whether the surgical tool can operate or fail in safe mode. In one embodiment, the test voltage and current are applied to the dummy load via an electronically controlled switch. For example, the electronic switch may comprise a two-pole relay. The main processor 1902 verifies the output sensing function once per hour when it is inactive and once prior to every firing. It will be appreciated that these periods may vary based on the particular implementation. To verify the output sensing function, the main processor 1902 outputs inject test voltage (Inject Test V) and inject test current (Inject test I) signals to the output sensing test circuit described in connection with
The main processor 1902 is also coupled to a memory 1908 and the nonvolatile memory 1402. The computer program instructions executed by the main processor 1902 are stored in the nonvolatile memory 1402 (e.g., EEPROM, FLASH memory, and the like). The memory 1908, which may be random access memory (RAM) may be used for storing instructions during execution, measured data, variables, among others. The memory 1908 is volatile and its contents are erased when the battery 1300 is discharged below a predetermine voltage level. The nonvolatile memory 1402 is nonvolatile and its contents are not erased when the battery 1300 is discharged below a predetermined level. In one embodiment, it may be desirable to erase the contents of the nonvolatile memory 1402 to prevent its reuse, for example, when the surgical tool has already been utilized in a procedure, the surgical tool is determined to be an out-of-the box failure, or when the surgical tool otherwise fails. In each of these circumstances, the main processor 1902 initiates a battery 1300 discharge operation. In such circumstances, program instructions in the nonvolatile memory 1402 for erasing nonvolatile memory are transferred to the memory 1908 where program execution resumes. The instructions executed from the memory 1908 then erase the contents of the nonvolatile memory 1402.
The safety processor 1904 is coupled to the main processor 1902 and monitors the operation of the main processor 1902. If the safety processor 1904 determines a malfunction of the main processor 1902, the safety processor 1904 can disable the operation of the main processor 1902 and shuts down the surgical tool in a safe mode.
The controller 1906 is coupled to both the main processor 1902 and the safety processor 1904. In one embodiment, the controller 1906 also monitors the operation of the main processor 1902 and if the main processor 1902 loses control, the controller 1906 enables the safety processor to shut down the RF amplifier section in a safe manner. In one embodiment the controller 1906 may be implemented as complex programmable logic device (CPLD), without limitation.
To preserve or extend the life of the battery 1300, the main processor 1902, the safety processor 1904, and/or the controller 1906 may be powered down (e.g., place din sleep mode) when they are not in use. This enables the digital processing system 1900 to conserve energy to preserve or extend the life of the battery 1300.
In various embodiments, the main processor 1902, the safety processor 1904, or the controller 906 may comprise several separate functional elements, such as modules and/or blocks. Although certain modules and/or blocks may be described by way of example, it can be appreciated that a greater or lesser number of modules and/or blocks may be used and still fall within the scope of the embodiments. Further, although various embodiments may be described in terms of modules and/or blocks to facilitate description, such modules and/or blocks may be implemented by one or more than one hardware component, e.g., processor, Complex Programmable Logic Device (CPLD), Digital Signal Processor (DSP), Programmable Logic Devices (PLD), Application Specific Integrated Circuit (ASIC), circuits, registers and/or software components, e.g., programs, subroutines, logic and/or combinations of hardware and software components.
In one embodiment, the digital processing system 1900 may comprise one or more embedded applications implemented as firmware, software, hardware, or any combination thereof. The digital processing system 1900 may comprise various executable modules such as software, programs, data, drivers, application program interfaces (APIs), and so forth. The firmware may be stored in the nonvolatile memory 1402 (NVM), such as in bit-masked read-only memory (ROM) or flash memory. In various implementations, storing the firmware in ROM may preserve flash memory. The NVM may comprise other types of memory including, for example, programmable ROM (PROM), erasable programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM), or battery backed random-access memory 1908 (RAM) such as dynamic RAM (DRAM), Double-Data-Rate DRAM (DDRAM), and/or synchronous DRAM (SDRAM).
To verify the output sensing function, the main processor 1902 disables the operation of the RF amplifier section 11112 by disabling the driver circuit 11116. Once the RF amplifier section 11112 is disabled, the main processor 1902 outputs a first inject test current (Inject Test I) signal and a second inject test voltage (Inject Test V) signal to the output sensing test circuit 11100. As a result a first test current 11102 is injected into resistors that turn ON transistor T111106, which turns ON transistor T211108 to generate I Out Sense 1 current through the transistor T211108. The current I Out Sense 1 flows out of the current sense terminal 11120 and is detected by the main processor 1902 as the I Sense signal. A second test current 11104 is applied through the input section of a solid state relay 11110 (SSR). This causes a current I Out Sense 2 to flow through the dummy load 11114. The current I Out Sense 2 flows out of the current sense terminal 11122 and is detected by the main processor 1902 as the V Sense signal. The dummy load 11114 comprises a first voltage divider network comprised of resistors R1-R4 and a second voltage divider network comprised of R5-R8. As previously described, the main processor 1902 reads the sensed voltage and current signals V Sense and I Sense to determine the operation of the voltage (V) and current (I) sensing function of the surgical tool.
In one embodiment, the magnetically actuated element 1606, which works in conjunction with a magnet. As shown in
Certain sections of the hardware circuits may be shut down or placed in sleep mode to conserve energy and thus extend the life of the battery 1300. In particular, amplifier circuits associated with the injection of the test current and test voltage and sensing the output sense currents may be placed in sleep mode or periodically shut down to conserve energy.
The various embodiments of the surgical tools 600, 700, 800, 900, 1000, 1100 discussed herein comprise motorized spools or rotatable bodies that are generally operated by power supplied by the robotic system 200 (
The various embodiments of the surgical tools 600, 700, 800, 900, 1000, 1100 discussed above may comprise shaft assemblies 608, 708, 808, 908, 1008, 1108 and tool mounting portions 614, 714, 814, 914, 1014, 1114 that are disposable. In other embodiments, however, it is contemplated that the surgical tools 600, 700, 800, 900, 1000, 1100 be designed such that the shaft assemblies 608, 708, 808, 908, 1008, 1108 can easily be disassembled and disposed whereas the tool mounting portions 614, 714, 814, 914, 1014, 1114 can be reused after cleaning and re-sterilization.
Some aspects may be described using the expression “coupled” and “connected” along with their derivatives. It should be understood that these terms are not intended as synonyms for each other. For example, some aspects may be described using the term “connected” to indicate that two or more elements are in direct physical or electrical contact with each other. In another example, some aspects may be described using the term “coupled” to indicate that two or more elements are in direct physical or electrical contact. The term “coupled,” however, also may mean that two or more elements are not in direct contact with each other, but yet still co-operate or interact with each other.
While the examples herein are described mainly in the context of electrosurgical instruments, it should be understood that the teachings herein may be readily applied to a variety of other types of medical instruments. By way of example only, the teachings herein may be readily applied to tissue graspers, tissue retrieval pouch deploying instruments, surgical staplers, ultrasonic surgical instruments, etc. It should also be understood that the teachings herein may be readily applied to any of the instruments described in any of the references cited herein, such that the teachings herein may be readily combined with the teachings of any of the references cited herein in numerous ways. Other types of instruments into which the teachings herein may be incorporated will be apparent to those of ordinary skill in the art.
It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
Embodiments of devices and components thereof disclosed herein have application in conventional endoscopic and open surgical instrumentation as well as application in robotic-assisted surgery. For instance, those of ordinary skill in the art will recognize that various teaching herein may be readily combined with various teachings of U.S. Pat. No. 6,783,524, entitled ROBOTIC SURGICAL TOOL WITH ULTRASOUND CAUTERIZING AND CUTTING INSTRUMENT, which issued Aug. 31, 2004, the disclosure of which is incorporated herein by reference.
Embodiments of the devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. Embodiments may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, embodiments of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, embodiments of the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
By way of example only, embodiments described herein may be processed before surgery. First, a new or used instrument may be obtained and if necessary cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. The sealed container may keep the instrument sterile until it is opened in a medical facility. A device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.
Having shown and described various embodiments of devices and components thereof, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.
All of the above-mentioned U.S. patents, U.S. patent application publications, U.S. patent applications, foreign patents, foreign patent applications, non-patent publications referred to in this specification and/or listed in any Application Data Sheet, or any other disclosure material are incorporated herein by reference, to the extent not inconsistent herewith. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
One skilled in the art will recognize that the herein described components (e.g., operations), devices, objects, and the discussion accompanying them are used as examples for the sake of conceptual clarity and that various configuration modifications are contemplated. Consequently, as used herein, the specific exemplars set forth and the accompanying discussion are intended to be representative of their more general classes. In general, use of any specific exemplar is intended to be representative of its class, and the non-inclusion of specific components (e.g., operations), devices, and objects should not be taken limiting.
With respect to the use of substantially any plural and/or singular terms herein, those having skill in the art can translate from the plural to the singular and/or from the singular to the plural as is appropriate to the context and/or application. The various singular/plural permutations are not expressly set forth herein for sake of clarity.
The herein described subject matter sometimes illustrates different components contained within, or connected with, different other components. It is to be understood that such depicted architectures are merely exemplary, and that in fact many other architectures may be implemented which achieve the same functionality. In a conceptual sense, any arrangement of components to achieve the same functionality is effectively “associated” such that the desired functionality is achieved. Hence, any two components herein combined to achieve a particular functionality can be seen as “associated with” each other such that the desired functionality is achieved, irrespective of architectures or intermedial components. Likewise, any two components so associated can also be viewed as being “operably connected,” or “operably coupled,” to each other to achieve the desired functionality, and any two components capable of being so associated can also be viewed as being “operably couplable,” to each other to achieve the desired functionality. Specific examples of operably couplable include but are not limited to physically mateable and/or physically interacting components, and/or wirelessly interactable, and/or wirelessly interacting components, and/or logically interacting, and/or logically interactable components.
In some instances, one or more components may be referred to herein as “configured to,” “configurable to,” “operable/operative to,” “adapted/adaptable,” “able to,” “conformable/conformed to,” etc. Those skilled in the art will recognize that “configured to” can generally encompass active-state components and/or inactive-state components and/or standby-state components, unless context requires otherwise.
While particular aspects of the present subject matter described herein have been shown and described, it will be apparent to those skilled in the art that, based upon the teachings herein, changes and modifications may be made without departing from the subject matter described herein and its broader aspects and, therefore, the appended claims are to encompass within their scope all such changes and modifications as are within the true spirit and scope of the subject matter described herein. It will be understood by those within the art that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should typically be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations.
In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, typically means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention analogous to “at least one of A, B, and C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It will be further understood by those within the art that typically a disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms unless context dictates otherwise. For example, the phrase “A or B” will be typically understood to include the possibilities of “A” or “B” or “A and B.”
With respect to the appended claims, those skilled in the art will appreciate that recited operations therein may generally be performed in any order. Also, although various operational flows are presented in a sequence(s), it should be understood that the various operations may be performed in other orders than those which are illustrated, or may be performed concurrently. Examples of such alternate orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplemental, simultaneous, reverse, or other variant orderings, unless context dictates otherwise. Furthermore, terms like “responsive to,” “related to,” or other past-tense adjectives are generally not intended to exclude such variants, unless context dictates otherwise.
Although various embodiments have been described herein, many modifications, variations, substitutions, changes, and equivalents to those embodiments may be implemented and will occur to those skilled in the art. Also, where materials are disclosed for certain components, other materials may be used. It is therefore to be understood that the foregoing description and the appended claims are intended to cover all such modifications and variations as falling within the scope of the disclosed embodiments. The following claims are intended to cover all such modification and variations.
In summary, numerous benefits have been described which result from employing the concepts described herein. The foregoing description of the one or more embodiments has been presented for purposes of illustration and description. It is not intended to be exhaustive or limiting to the precise form disclosed. Modifications or variations are possible in light of the above teachings. The one or more embodiments were chosen and described in order to illustrate principles and practical application to thereby enable one of ordinary skill in the art to utilize the various embodiments and with various modifications as are suited to the particular use contemplated. It is intended that the claims submitted herewith define the overall scope.
While certain features of the aspects have been illustrated as described herein, many modifications, substitutions, changes and equivalents will now occur to those skilled in the art. It is therefore to be understood that the appended claims are intended to cover all such modifications and changes as fall within the true scope of the disclosed embodiments.
This application is a divisional application claiming priority under 35 U.S.C. § 121 to U.S. patent application Ser. No. 14/963,905, entitled ROBOTICALLY CONTROLLED SURGICAL INSTRUMENT, filed Dec. 9, 2015, which issued on Mar. 27, 2018 as U.S. Pat. No. 9,925,003, which is a divisional application claiming priority under 35 U.S.C. § 121 to U.S. patent application Ser. No. 13/760,560, entitled ROBOTICALLY CONTROLLED SURGICAL INSTRUMENT, filed Feb. 6, 2013, which issued on Jan. 12, 2016 as U.S. Pat. No. 9,232,979, which claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No. 61/597,603, entitled ROBOTICALLY CONTROLLED SURGICAL INSTRUMENT, filed Feb. 10, 2012, the entire disclosures of which are hereby incorporated by reference herein.
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