Patent Application
20230363879
The present disclosure relates to surgical implants including indicia. More specifically, the present disclosure relates to various types of surgical implants, including surgical mesh, sutures, tacks, clips, etc., which include fiducial demarcation for use in robotic surgical systems.
Surgical mesh is commonly used to reinforce muscular walls when a weak area is detected and/or when a tissue herniation is observed. It can be ergonomically challenging, especially during inguinal and incisional procedures, to deploy and properly position mesh to tissue. Depending on the type of surgical procedure, location in the body, and surgeon preference, mesh may be secured to tissue using any combination of sutures, tacks, clips, staples, etc.
In addition to the challenge of properly positioning the mesh on tissue, it can also be a challenge to secure the mesh to tissue because of difficult access to the mesh, and the duration of the securing process, for instance. Suturing, for example, can be a time-consuming process, which may lead to surgical fatigue.
Suturing, applying tacks, and applying clips are now being accomplished by or with the assistance of robotic surgery. Accordingly, it may be helpful to include fiducial demarcation on the implant to be used as a reference frame to help guide a robotic system during the positioning and/or securing of mesh, for example.
The present disclosure relates to a surgical system including a surgical implant and a detecting device. The surgical implant includes indicia that is non-visible to a human eye. The detecting device is configured to detect the indicia on the surgical implant.
In disclosed embodiments, the indicia is made from indocyanine green.
It is further disclosed that the surgical implant includes secondary indicia that is visible to a human eye.
In aspects, the surgical implant is a surgical mesh, and the surgical system includes a suture or a surgical tack configured to secure the surgical mesh to tissue. It is disclosed that the suture or surgical tack includes indicia that is non-visible to a human eye. In embodiments, the indicia on the suture or surgical tack is made from indocyanine green.
In disclosed embodiments, the surgical implant is a surgical mesh, and the surgical system includes a surgical robot in communication with the detecting device and configured to secure the surgical mesh to tissue using suture or a surgical tack. It is disclosed that the suture or surgical tack includes indicia that is non-visible to a human eye.
It is also disclosed that the indicia is configured to be reflected by ultraviolet light.
The present disclosure also relates to a surgical implant including a first indicia, and a second indicia. The first indicia is made from a cyanine dye that is invisible to a human eye.
In disclosed embodiments, the second indicia is made from the cyanine dye that is invisible to a human eye.
It is also disclosed that the cyanine dye is indocyanine green.
In embodiments, the second indicia is visible to a human eye.
In aspects, the first indicia includes one of a linear pattern or a circular pattern.
It is disclosed that the cyanine dye is configured to be detected by a detecting device.
Further details and aspects of exemplary embodiments of the present disclosure are described in more detail below with reference to the appended figures.
Embodiments of the present disclosure are described herein with reference to the accompanying drawings, wherein:
Embodiments of the presently disclosed surgical implant are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. Non-limiting examples of surgical devices according to the present disclosure include manual, robotic, mechanical and/or electromechanical surgical tack appliers (e.g., tackers), clip appliers, surgical forceps, and the like.
Referring initial to
Surgical robots are used to perform or assist with various surgical procedures to reduce the operating time, to reduce the possibility of surgeon fatigue, and to standardize such procedures. The surgical mesh 100, 200 of the present disclosure includes examples of fiducial demarcation or indicia that can be detected by surgical robots.
More particularly, the surgical mesh 100, 200 includes fiducial markers or indicia 120 (e.g., on the fibers of the mesh) that are configured to reflect non-visible (to the human eye) wavelengths of light.
Referring now to
The non-visible wavelengths of light reflected by the indicia 120 can be achieved by using a cyanine dye, e.g., Indocyanine Green (ICG). ICG is a fluorescent dye and is typically naturally eliminated from a patient's body in a relatively short amount of time (e.g., under one hour). Depending on the amount of solvent used and its concentration, the absorption and fluorescence spectrum of ICG is in the near-infrared region. ICG typically emits fluorescence between about 750 nanometers (nm) and about 950 nm. When ICG is used in medical applications (e.g., in blood plasma), its maximum absorption is about 800 nm. In the present disclosure, a surgical robot including a laser having a wavelength of about 780 nm can be used to detect the fluorescence of ICG on the indicia 120. The laser can be fine-tuned to filter out scattered light of the excitation beam, for instance.
Referring back to
With continued reference to
In
While the surgical mesh 100, 200, the suture 300 and/or the tacks 400 may include fiducial markers or other indicia that is visible to the human eye, the inclusion of indicia 120, 320, 420 that is not visible to the human eye may be especially helpful during procedures that are at least partially performed by the surgical robot 134. Further, the surgical mesh 100, 200, the suture 300 and/or the tacks 400 may include both types of indicia: indicia that is visible to the human eye, and indicia 120, 320, 420 that is not visible to the human eye. More particularly, the inclusion of indicia visible to the human eye may assist a surgeon or operator in selecting the appropriate type of mesh, suture and/or tacks to be used for the surgical procedure. However, since the surgical mesh 100, 200, suture 300 and tacks 400 are quite small, it can be challenging to have both sets of indicia (including the indicia 120, 320, 420 that is configured to be detected by the surgical robot 134, and the indicia that is configured to be visible to the human eye) visible to the human eye without interfering with the user's ability properly decipher a particular indicia.
Surgical robots 134 and surgical meshes 100, 200 such as those described herein are configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.
The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).
The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.
Referring to
Each of the robot arms 2002, 2003 may include a plurality of members, which are connected through joints, and an attaching device 2009, 2011, to which may be attached, for example, a surgical tool “ST” supporting an end effector 2100, in accordance with any one of several embodiments disclosed herein, as will be described in greater detail below.
Robot arms 2002, 2003 may be driven by electric drives (not shown) that are connected to control device 1004. Control device 2004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that robot arms 2002, 2003, their attaching devices 2009, 2011 and thus the surgical tool (including end effector 2100) execute a desired movement according to a movement defined by means of manual input devices 2007, 2008. Control device 2004 may also be set up in such a way that it regulates the movement of robot arms 2002, 2003 and/or of the drives.
Medical work station 2000 may be configured for use on a patient 2013 lying on a patient table 2012 to be treated in a minimally invasive manner by means of end effector 2100. Medical work station 2000 may also include more than two robot arms 2002, 2003, the additional robot arms likewise being connected to control device 2004 and being telemanipulatable by means of operating console 1005. A medical instrument or surgical tool (including an end effector 2100) may also be attached to the additional robot arm. Medical work station 2000 may include a database 2014, in particular coupled to with control device 2004, in which are stored, for example, pre-operative data from patient/living being 2013 and/or anatomical atlases.
Reference is made herein to U.S. Pat. No. 8,828,023 to Neff et al., entitled “Medical Workstation,” the entire content of which is incorporated herein by reference, for a more detailed discussion of the construction and operation of an exemplary robotic surgical system.
Any of the components described herein may be fabricated from either metals, plastics, resins, composites or the like taking into consideration strength, durability, wearability, weight, resistance to corrosion, ease of manufacturing, cost of manufacturing, and the like.
It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variances. The embodiments described with reference to the attached drawing figures are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2021/063974 | 12/17/2021 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 63131852 | Dec 2020 | US |
