Patent Application
20240058031
Surgical robotic systems are currently being used in minimally invasive medical procedures. Some surgical robotic systems include a user console controlling a surgical robotic arm and a surgical instrument having an end effector (e.g., forceps or grasping instrument) coupled to and actuated by the robotic arm.
Port placement in robotic surgery can be time consuming if the surgeon is expecting to follow established setup guidance.
According to one embodiment of the present disclosure, a surgical robotic system is disclosed. The surgical robotic system includes a robotic arm including a surgical instrument coupled thereto, a computer configured to calculate port placement locations based on an image of a patient and a type of procedure to be performed, and a printing device. The printing device is configured to print a template of the port placement locations on a transparent substrate for placement on the patient based on the port placement locations calculated by the computer.
In an aspect, the transparent substrate may be a polyester film.
In an aspect, at least a portion of an underside of the transparent substrate may include an adhesive layer for adhering the transparent substrate to the patient.
In an aspect, the printing device may be configured to print the template of port placement locations on the transparent substrate by engraving the port placement locations through the transparent substrate.
In an aspect, the system may further include a transparent substrate configured to be engraved by the printing device wherein the transparent substrate includes at least one preformed cutout extending through a thickness thereof.
In an aspect, the template of port placement locations printed on the transparent substrate may include port placement locations designated for at least one of a right arm, a left arm, a reserve arm, and a camera arm.
In an aspect, the system may further include an imaging device configured to capture an image of the patient.
In an aspect, the system may further include a projector configured to project a projection of the template of port placement locations on the patient.
In an aspect, the projector may be adjustable to resize or move the projection of the template of port placement locations on the patient.
According to another embodiment of the present disclosure, a method for mapping port placement locations is disclosed. The method includes calculating port placement locations based on an image of a patient and a type of procedure to be performed and printing a template of the port placement locations on a transparent substrate for placement on the patient based on the port placement locations calculated by the computer.
In an aspect, the method may further include capturing the image of the patient with an imaging device.
In an aspect, printing the template of the port placement locations on the transparent substrate may include engraving the port placement locations through the transparent substrate.
In an aspect, printing the template of the port placement locations on the transparent substrate may include printing the template of the port placement locations on a polyester film.
In an aspect, printing the template of the port placement locations on the transparent substrate may include printing the template of the port placement locations on a transparent film having an adhesive disposed on an underside thereof.
In an aspect, printing the template of the port placement locations on the transparent substrate may include printing port placement locations designated for at least one of a right arm, a left arm, a reserve arm, and a camera arm.
In an aspect, the method may further include projecting an image of the template of the port placement locations on the patient using a projector.
According to another aspect of the present disclosure, a surgical accessory for aiding in access port placement includes a transparent substrate formed from a polyester film, an adhesive layer an adhesive layer disposed on a tissue contacting surface of the transparent substrate, and at least one marking designating access port insertion disposed on the transparent substrate.
In an aspect, the at least one marking is calculated based on an image of a patient.
In an aspect, the at least one marking is printed on the transparent substrate based on the image.
Various embodiments of the present disclosure are described herein with reference to the drawings wherein:
Embodiments of the presently disclosed surgical robotic system 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. As used herein the term “proximal” refers to the portion of the surgical robotic system and/or the surgical instrument coupled thereto that is closer to a base of a robot, while the term “distal” refers to the portion that is farther from the base of the robot.
As will be described in detail below, the present disclosure is directed to a surgical robotic system, which includes a user console, a control tower, and one or more mobile carts having a surgical robotic arm coupled to a setup arm. The user console receives user input through one or more interface devices, which are interpreted by the control tower as movement commands for moving the surgical robotic arm. The surgical robotic arm includes a controller, which is configured to process the movement command and to generate a torque command for activating one or more actuators of the robotic arm, which would, in turn, move the robotic arm in response to the movement command.
This disclosure describes a surgical robotic system that includes a printing device for printing a port placement template that may be adhered to the patient and used to map port placement locations on the patient. Port placement in robotic surgery can be time consuming if the surgeon is expecting to follow established setup guidance. In order to allow for more uniform placement, a method of transferring port placement measurements and locations to a transparent sheet, via a combination of laser engraving or laser printing, and then sterilizing is disclosed. The sheet can then be placed over the patient and using anatomical reference points port placement can be marked out through the holes in the transparency.
With reference to
The surgical instrument 50 is configured for use during minimally invasive surgical procedures. In embodiments, the surgical instrument 50 may be configured for open surgical procedures. In embodiments, the surgical instrument 50 may be an endoscope, such as an endoscopic camera 51, configured to provide a video feed for the user. In further embodiments, the surgical instrument 50 may be an electrosurgical forceps configured to seal tissue by compressing tissue between jaw members and applying electrosurgical current thereto. In yet further embodiments, the surgical instrument 50 may be a surgical stapler including a pair of jaws configured to grasp and clamp tissue while deploying a plurality of tissue fasteners, e.g., staples, and cutting stapled tissue. In aspect, the surgical instrument 50 may be a surgical port configured to be inserted through the patient's skin to enable insertion of another surgical instrument through the port into the surgical site.
One of the robotic arms 40 may include the endoscopic camera 51 configured to capture video of the surgical site. The endoscopic camera 51 may be a stereoscopic endoscope configured to capture two side-by-side (i.e., left and right) images of the surgical site to produce a video stream of the surgical scene. The endoscopic camera 51 is coupled to a video processing device 56, which may be disposed within the control tower 20. The video processing device 56 may be any computing device as described below configured to receive the video feed from the endoscopic camera 51 and output the processed video stream.
The user console 30 includes a first display 32, which displays a video feed of the surgical site provided by camera 51 of the surgical instrument 50 disposed on the robotic arm 40, and a second display 34, which displays a user interface for controlling the surgical robotic system 10. The first and second displays 32 and 34 are touchscreens allowing for displaying various graphical user inputs.
The user console 30 also includes a plurality of user interface devices, such as foot pedals 36 and a pair of handle controllers 38a and 38b which are used by a user to remotely control robotic arms 40. The user console further includes an armrest 33 used to support clinician's arms while operating the handle controllers 38a and 38b.
The control tower 20 includes a display 23, which may be a touchscreen, and outputs on the graphical user interfaces (GUIs). The control tower 20 also acts as an interface between the user console 30 and one or more robotic arms 40. In particular, the control tower 20 is configured to control the robotic arms 40, such as to move the robotic arms 40 and the corresponding surgical instrument 50, based on a set of programmable instructions and/or input commands from the user console 30, in such a way that robotic arms 40 and the surgical instrument 50 execute a desired movement sequence in response to input from the foot pedals 36 and the handle controllers 38a and 38b.
Each of the control tower 20, the user console 30, and the robotic arm 40 includes a respective computer 21, 31, 41. The computers 21, 31, 41 are interconnected to each other using any suitable communication network based on wired or wireless communication protocols. The term “network,” whether plural or singular, as used herein, denotes a data network, including, but not limited to, the Internet, Intranet, a wide area network, or a local area network, and without limitation as to the full scope of the definition of communication networks as encompassed by the present disclosure. Suitable protocols include, but are not limited to, transmission control protocol/internet protocol (TCP/IP), datagram protocol/internet protocol (UDP/IP), and/or datagram congestion control protocol (DCCP). Wireless communication may be achieved via one or more wireless configurations, e.g., radio frequency, optical, Wi-Fi, Bluetooth (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs), ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-1203 standard for wireless personal area networks (WPANs)).
The computers 21, 31, 41 may include any suitable processor (not shown) operably connected to a memory (not shown), which may include one or more of volatile, non-volatile, magnetic, optical, or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically-erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory. The processor may be any suitable processor (e.g., control circuit) adapted to perform the operations, calculations, and/or set of instructions described in the present disclosure including, but not limited to, a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), a microprocessor, and combinations thereof. Those skilled in the art will appreciate that the processor may be substituted for by using any logic processor (e.g., control circuit) adapted to execute algorithms, calculations, and/or set of instructions described herein.
With reference to
The setup arm 61 includes a first link 62a, a second link 62b, and a third link 62c, which provide for lateral maneuverability of the robotic arm 40. The links 62a, 62b, 62c are interconnected at joints 63a and 63b, each of which may include an actuator (not shown) for rotating the links 62b and 62b relative to each other and the link 62c. In particular, the links 62a, 62b, 62c are movable in their corresponding lateral planes that are parallel to each other, thereby allowing for extension of the robotic arm 40 relative to the patient (e.g., surgical table). In embodiments, the robotic arm 40 may be coupled to the surgical table (not shown). The setup arm 61 includes controls 65 for adjusting movement of the links 62a, 62b, 62c as well as the lift 67. In embodiments, the setup arm 61 may include any type and/or number of joints.
The third link 62c may include a rotatable base 64 having two degrees of freedom. In particular, the rotatable base 64 includes a first actuator 64a and a second actuator 64b. The first actuator 64a is rotatable about a first stationary arm axis which is perpendicular to a plane defined by the third link 62c and the second actuator 64b is rotatable about a second stationary arm axis which is transverse to the first stationary arm axis. The first and second actuators 64a and 64b allow for full three-dimensional orientation of the robotic arm 40.
The actuator 48b of the joint 44b is coupled to the joint 44c via the belt 45a, and the joint 44c is in turn coupled to the joint 46b via the belt 45b. Joint 44c may include a transfer case coupling the belts 45a and 45b, such that the actuator 48b is configured to rotate each of the links 42b, 42c and a holder 46 relative to each other. More specifically, links 42b, 42c, and the holder 46 are passively coupled to the actuator 48b which enforces rotation about a pivot point “P” which lies at an intersection of the first axis defined by the link 42a and the second axis defined by the holder 46. In other words, the pivot point “P” is a remote center of motion (RCM) for the robotic arm 40. Thus, the actuator 48b controls the angle θ between the first and second axes allowing for orientation of the surgical instrument 50. Due to the interlinking of the links 42a, 42b, 42c, and the holder 46 via the belts 45a and 45b, the angles between the links 42a, 42b, 42c, and the holder 46 are also adjusted in order to achieve the desired angle θ. In embodiments, some or all of the joints 44a, 44b, 44c may include an actuator to obviate the need for mechanical linkages.
The joints 44a and 44b include an actuator 48a and 48b configured to drive the joints 44a, 44b, 44c relative to each other through a series of belts 45a and 45b or other mechanical linkages such as a drive rod, a cable, or a lever and the like. In particular, the actuator 48a is configured to rotate the robotic arm 40 about a longitudinal axis defined by the link 42a.
With reference to
The robotic arm 40 also includes a plurality of manual override buttons 53 (
With reference to
The computer 41 includes a plurality of controllers, namely, a main cart controller 41a, a setup arm controller 41b, a robotic arm controller 41c, and an instrument drive unit (IDU) controller 41d. The main cart controller 41a receives and processes joint commands from the controller 21a of the computer 21 and communicates them to the setup arm controller 41b, the robotic arm controller 41c, and the IDU controller 41d. The main cart controller 41a also manages instrument exchanges and the overall state of the mobile cart 60, the robotic arm 40, and the IDU 52. The main cart controller 41a also communicates actual joint angles back to the controller 21a.
Each of joints 63a and 63b and the rotatable base 64 of the setup arm 61 are passive joints (i.e., no actuators are present therein) allowing for manual adjustment thereof by a user. The joints 63a and 63b and the rotatable base 64 include brakes that are disengaged by the user to configure the setup arm 61. The setup arm controller 41b monitors slippage of each of joints 63a and 63b and the rotatable base 64 of the setup arm 61, when brakes are engaged or may be freely moved by the operator when brakes are disengaged, but do not impact controls of other joints. The robotic arm controller 41c controls each joint 44a and 44b of the robotic arm 40 and calculates desired motor torques required for gravity compensation, friction compensation, and closed loop position control of the robotic arm 40. The robotic arm controller 41c calculates a movement command based on the calculated torque. The calculated motor commands are then communicated to one or more of the actuators 48a and 48b in the robotic arm 40. The actual joint positions are then transmitted by the actuators 48a and 48b back to the robotic arm controller 41c.
The IDU controller 41d receives desired joint angles for the surgical instrument 50, such as wrist and jaw angles, and computes desired currents for the motors in the IDU 52. The IDU controller 41d calculates actual angles based on the motor positions and transmits the actual angles back to the main cart controller 41a.
The robotic arm 40 is controlled in response to a pose of the handle controller controlling the robotic arm 40, e.g., the handle controller 38a, which is transformed into a desired pose of the robotic arm 40 through a hand eye transform function executed by the controller 21a. The hand eye function, as well as other functions described herein, is/are embodied in software executable by the controller 21a or any other suitable controller described herein. The pose of one of the handle controllers 38a may be embodied as a coordinate position and roll-pitch-yaw (RPY) orientation relative to a coordinate reference frame, which is fixed to the user console 30. The desired pose of the instrument 50 is relative to a fixed frame on the robotic arm 40. The pose of the handle controller 38a is then scaled by a scaling function executed by the controller 21a. In embodiments, the coordinate position may be scaled down and the orientation may be scaled up by the scaling function. In addition, the controller 21a may also execute a clutching function, which disengages the handle controller 38a from the robotic arm 40. In particular, the controller 21a stops transmitting movement commands from the handle controller 38a to the robotic arm 40 if certain movement limits or other thresholds are exceeded and in essence acts like a virtual clutch mechanism, e.g., limits mechanical input from effecting mechanical output.
The desired pose of the robotic arm 40 is based on the pose of the handle controller 38a and is then passed by an inverse kinematics function executed by the controller 21a. The inverse kinematics function calculates angles for the joints 44a, 44b, 44c of the robotic arm 40 that achieve the scaled and adjusted pose input by the handle controller 38a. The calculated angles are then passed to the robotic arm controller 41c, which includes a joint axis controller having a proportional-derivative (PD) controller, the friction estimator module, the gravity compensator module, and a two-sided saturation block, which is configured to limit the commanded torque of the motors of the joints 44a, 44b, 44c.
With continued reference to
In an aspect, the transparent substrate 70 may be a polyester film and may include an adhesive layer 75 on an underside of the transparent substrate 70 for adhering the transparent substrate 70 to the patient. The adhesive layer 75 may cover an entire underside (i.e., patient contacting surface) of the transparent substrate 70 or only one or more portions thereof, e.g., along the perimeter, around placement locations 72, etc. Additionally, the transparent substrate 70 may include dimensional markings. As illustrated best in
As described above, the printing device 80 is configured to print the template of port placement locations 72 on the transparent substrate 70, for example by engraving the port placement locations 72 through the transparent substrate 70. The template of port placement locations 72 printed on the transparent substrate 70 may include port placement locations designated for the robotic arms 40, e.g., at least one of a right arm, a left arm, a reserve arm, and/or a camera arm, depending on the procedure being performed.
In an aspect, the camera 90 captures an image of the patient and the algorithm utilizes the image captured by the camera 90 to calculate the port placement locations. In addition to printing the template for port placement locations 72 on the transparent substrate 70, the surgical system 10 may also include a projector 95 that projects an image of the port placement locations 72 on the patient. The projector 95 may be adjustable to resize or move the projected image relative to the patient.
Method 500 begins at step 501 where an image of the patient is captured, for example, by a camera 90. In step 503, the system 10 receives data corresponding to the procedure type and/or the patient. Such data may be manually input by a clinician in step 503, for example. In step 505, the system 10 calculates port placement locations based on the image captured in step 501 and the data received in step 503.
In step 507, the printing device 80 prints a template of port placement locations 72 on a transparent substrate 70. Step 507 may include engraving the port placement locations through the transparent substrate 70. Additionally, or alternatively, step 507 may include printing port placement locations designated for the robotic arms 40, e.g., at least one of a right arm, a left arm, a reserve arm, and a camera arm.
In step 509, the transparent substrate 70 is placed on the patient's skin. In an aspect, a user may adhere the transparent substrate 70 to the patient's skin for example, before or after optionally adjusting the position of the transparent substrate 70 to the patient's skin in step 511. Another optional step of method 500 is step 513, where an image of the template of port placement locations 72 is projected onto the patient's skin via the projector 95. Once the image is projected onto the patient's skin, the projector 95 may be adjusted at step 515 so as to resize or move the template of port placement locations 72 relative to the patient's skin.
It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as exemplifications of various embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended thereto.
This application claims the benefit of the filing date of provisional U.S. Patent Application No. 63/398,246 filed on Aug. 16, 2022. The entire disclosure of the foregoing application is incorporated by reference herein.
| Number | Date | Country | |
|---|---|---|---|
| 63398246 | Aug 2022 | US |
