US20030135204A1 - Robotically controlled medical instrument with a flexible section - Google Patents
Robotically controlled medical instrument with a flexible section Download PDFInfo
- Publication number
- US20030135204A1 US20030135204A1 US10/299,588 US29958802A US2003135204A1 US 20030135204 A1 US20030135204 A1 US 20030135204A1 US 29958802 A US29958802 A US 29958802A US 2003135204 A1 US2003135204 A1 US 2003135204A1
- Authority
- US
- United States
- Prior art keywords
- tool
- section
- medical instrument
- cables
- bending section
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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- A—HUMAN NECESSITIES
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Definitions
- the present invention implements an instrument and methods of using the instrument for performing telerobotic surgical procedures on a patient.
- the instrument includes a bending section that is bendable with at least one degree-of-freedom.
- An instrument may have a bending section with a unibody construction that is bendable with at least one degree-of-freedom.
- a tool can be supported at the distal end of the bending section and can be used to perform a medical procedure on a subject such as a human patient.
- bending is by flexure of the unibody rather than by movement of parts relative to each other.
- the instrument can have two or more bending sections with unibody constructions. The two or more bending sections can be spaced apart or positioned adjacent to each other.
- the bending section has a unibody bellows construction with alternating peaks and valleys positioned between proximal and distal ends of the bending section.
- the unibody construction may have a series of spaced ribs positioned along the length of the bending section between the proximal and distal ends of the bending section.
- the bending section includes a set of opposed ridges that extend along the length of the bending section. The individual ridges are positioned in a respective slot defined by adjacent ribs.
- the bending section includes a first set and a second set of ridges extending along the length of the bending section. The individual ridges of the first set of ridges are positioned in every other slot defined between adjacent ribs, and the individual ridges of the second set of ridges are positioned in respective slots unoccupied by the first set of ridges.
- the first set of ridges can be positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section. Having the two sets of ridges positioned in the described manner makes the bending section torsionally stiff. However, the bending section remains flexible and bendable with two degrees-of-freedom.
- the surgical instrument can include one or more of the following features.
- the instrument can include a first pair of cables and, optionally, a second pair of cables extending along the length of the bending section. To operate the instrument, tension is applied to at least one of the first pair of cables to bend the bending section with one degree-of-freedom, and to at least one of the second pair of cables to bend the bending section with a second degree-of-freedom.
- the tool is able to move with two additional degrees-of-freedom.
- the tool can include a first jaw and a second jaw, connected to the first jaw at a pivot joint, so that the first jaw moves with one of the two additional degrees-of-freedom and the second jaw moves with the other of the two additional degrees-of-freedom.
- the instrument includes two additional pairs of cables extending along the length of the bending section and coupled to the first jaw and second jaws, respectively.
- tension is applied to at least one of the first pair of additional cables to operate the first jaw, and to at least one of the second pair of additional cables to operate the second jaw.
- the additional pairs of cables can be positioned near the longitudinal axis of the bending section, and can be contained in a sleeve positioned along the longitudinal axis of the bending section so that the additional pairs of cables are able to slide along the sleeve relative to the bending section.
- the tool includes a first jaw and a second jaw, connected to the first jaw at a pivot joint such that the first and second jaws open and close, and an actuation element extending along the length of the bending section and coupled to the first and second jaws to operate the first and second jaws.
- the actuation element can be a single cable coupled to the first and second jaws with a pair of linkages. The cable is pulled to close the jaws and pushed to open the jaws.
- the single cable can be positioned near the longitudinal axis of the bending section, and can be contained in a sleeve positioned along the longitudinal axis of the bending section so that the single cable is able to slide back and forth along the sleeve.
- the operation of the instrument may be controlled with a controller coupled with an input device operated by a user such as the surgeon.
- a controller coupled with an input device operated by a user such as the surgeon.
- the surgeon can instruct the controller to direct a driver to manipulate the bending section and the tool in a desired manner.
- a robotically controlled medical instrument system includes an elongated shaft having proximal and distal ends, a tool supported from the distal end of the elongated shaft and useable in performing a medical procedure on a subject, at least one controllably bendable section of the shaft, and an electrical controller for receiving a command from an input device, and for, in turn, controlling the bendable section to provide at least one degree-of-freedom at the bendable section.
- the system may include an actuation element extending with the instrument shaft and operable to control actuation of said tool.
- the actuation element may be positioned at least one of a substantially center axis and substantially center plane of the controllably bendable section so as to de-couple motion at the controllable bendable section from tool actuation.
- the distal end of the elongated shaft and the tool may have respective removably engaging portions that are readily engagable for positioning the tool at the distal end of the elongated shaft in operative position relative to the elongated shaft, and readily disengagable for removal of the tool from the distal end of the elongated shaft.
- the tool may be removably coupled with the distal end of the elongated support shaft.
- a flexible surgical instrument in another embodiment, includes a controllably flexible elongated section having a distal end for positioning at an anatomical site of interest of a subject, and at least one cable attached at or near the distal end of the section.
- the cable extends from its point of attachment exteriorly of the section through an aperture in the section at a position spaced a selected distance along the length of the section away from the distal end.
- a proximal end of the cable extends from the aperture through the shaft and is tensionable to controllably bend the flexible section.
- a bending section with a unibody construction is typically made with fewer parts than bending sections made with multiple linkages joined together, for example, with pins. Hence, the unibody construction is less expensive and easier to fabricate. Furthermore, with a unibody construction, there are less parts to retain together during a medical procedure, which reduces the potential of breakage of the bending section, and therefore minimizes parts of the bending section and medical instrument falling apart within the subject's body.
- FIG. 1 is a perspective view illustrating a telerobotic system with which the concepts of the present invention may be practiced
- FIG. 2 is a schematic diagram illustrating the degrees-of-freedom associated with the slave station of FIG. 1;
- FIG. 3 is a plan view of the instrument insert of the present invention including the stem section and tool;
- FIG. 4 is a cross-sectional view as taken along line 4 - 4 of FIG. 3 and illustrating further details of the stem section;
- FIG. 5 is a perspective view of another embodiment of the tool of the present invention employing a flexible wrist section adjacent the tool;
- FIG. 6 is an exploded perspective view of the embodiment of FIG. 5;
- FIG. 7 is a cross-sectional view of the embodiment of FIG. 5 and as taken along line 7 - 7 of FIG. 6;
- FIG. 8 is a longitudinal cross-sectional view of the embodiment illustrated in FIGS. 5 - 7 and showing further details at the wrist flexure;
- FIG. 9 is a longitudinal cross-sectional view similar to that shown in FIG. 8 but for still another embodiment of the present invention using a single actuation element;
- FIG. 10 is an enlarged fragmentary view of further details of the actuation element at the center of the wrist section
- FIG. 11 is a cross-sectional view through the actuation element of FIG. 10 as taken along line 11 - 11 ;
- FIG. 12 is a cross-sectional view through still another embodiment of the actuation element
- FIG. 13 is still a further cross-sectional view of a further embodiment of the actuation element
- FIG. 14 is a perspective view of yet another embodiment of the present invention employing a slotted flexible wrist section and a detachable and preferably disposable tool;
- FIG. 15 is a cross-sectional view through the embodiment of FIG. 14 as taken along line 15 - 15 of FIG. 14;
- FIG. 15A is a fragmentary cross-sectional view of an alternate embodiment of the flexible section
- FIG. 16 is an exploded perspective view of the embodiment of FIG. 14 showing the detached tool in cross-section;
- FIG. 17 is a further perspective view of the embodiment of FIG. 14;
- FIGS. 18 - 20 illustrate sequential cross-sectional views showing the mating of the tool with the distal end of the instrument
- FIG. 21 is a schematic diagram illustrating principles of the present invention in a catheter or flexible instrument using multiple controllable bendable sections along the instrument;
- FIG. 22 is a schematic diagram of an embodiment of an instrument with both elbow and wrist pivot joints, as well as a disposable tool;
- FIG. 23 is a schematic diagram of an embodiment of an instrument with just a wrist pivot joint, as well as a disposable tool
- FIG. 24 is a diagram showing further details of a wrist joint useable with a disposable tool
- FIG. 25 is a partially cut-away schematic view of another joint construction
- FIG. 26 is a perspective view of a another embodiment of a tool
- FIG. 27 is an exploded perspective view of the tool of FIG. 26 illustrating separate components thereof;
- FIG. 27A is an exploded fragmentary view of one form of resilient member used in the embodiment of FIG. 27;
- FIG. 27B is an exploded fragmentary view of another form of resilient member used in the embodiment of FIG. 27;
- FIG. 28 is a side elevation view of the tool depicted in FIGS. 26 and 27;
- FIG. 29 is an enlarged partial top plan view as seen along line 29 - 29 of FIG. 28 and illustrating further details of the tool;
- FIG. 30 is a cross-sectional view as taken along line 30 - 30 of FIG. 29 showing the tool of the present invention with the jaws in a partially open position;
- FIG. 31 is a cross-sectional view like that illustrated in FIG. 30 but with the jaws in a fully closed position;
- FIG. 32 is a somewhat schematic cross-sectional view of the first embodiment of the tool with the resilient pad partially compressed in grasping a small diameter item such as a thread or suture;
- FIG. 33 is a somewhat schematic cross-sectional view of the first embodiment of the tool with the resilient pad essentially fully compressed in grasping a larger diameter item such as a needle;
- FIG. 34 is a perspective view of a second embodiment of the invention employing a flexure gap in one of the jaws;
- FIG. 35 is an exploded perspective view of the tool of this second embodiment of the invention.
- FIG. 36 is a plan view of the tool of FIGS. 34 and 35;
- FIG. 37 is a cross-sectional view taken along line 37 - 37 of FIG. 36 with the jaws having a slight gap at their closed position;
- FIG. 38 is a cross-sectional view like that illustrated in FIG. 37 but with the jaws grasping a needle or the like, and with the flexure gap in a substantially closed position;
- FIG. 39 is a cross-sectional view similar to that depicted in FIGS. 37 and 38, and of yet another embodiment of the invention illustrating the tool in a partially open position;
- FIG. 40 is a cross-sectional view the same as that depicted in the embodiment of FIG. 39 but with the jaws in a more closed position;
- FIG. 41 is a perspective view of an embodiment of a flexible or bendable shaft segment just proximal to the tool
- FIG. 42 is a cross-sectional view of the embodiment of FIG. 41 as taken along line 17 - 17 of FIG. 16, and with the jaws in a substantially open position;
- FIG. 43 is an enlarged partial cross-sectional view similar to that shown in FIG. 42 but with the jaws in a closed position;
- FIG. 44 is an exploded perspective view showing the components including the flexible or bendable segment of FIG. 41;
- FIG. 45 is a side elevation view of the flexible or bendable section itself
- FIG. 46 is a cross-sectional view through the flexible or bendable section as taken along line 46 - 46 of FIG. 45;
- FIG. 47 is a cross-sectional view through the flexible or bendable section as taken along line 47 - 47 of FIG. 45;
- FIG. 48A is a perspective view of an alternate embodiment of the tool and flexible section
- FIG. 48B is an exploded perspective view of the tool and flexible section illustrated in FIG. 48A;
- FIG. 48C is a fragmentary perspective view showing a portion of the flexible section shown in FIG. 48B.
- FIG. 48D is a plan view of the flexible section illustrated in FIGS. 48 A- 48 C.
- FIG. 49 illustrates a flexible instrument being used in a stomach of a subject in accordance with the invention.
- FIG. 50A is a schematic of a flexible instrument with a pull-type cable to operate the end of the instrument in accordance with the invention.
- FIG. 50B is cross-sectional view of a bendable section of the flexible instrument of FIG. 50A in accordance with the invention.
- FIG. 1 illustrates a surgical instrument system 10 that includes a master station M at which a surgeon 2 manipulates an input device, and a slave station S including a surgical instrument illustrated generally at 14 .
- the input device is illustrated at 3 being manipulated by the hand or hands of the surgeon.
- the surgeon is illustrated as seated in a comfortable chair 4 , and the forearms of the surgeon are typically resting upon armrests 5 .
- FIG. 1 illustrates a master assembly 7 associated with the master station M and a slave assembly 8 , also referred to as a drive unit, associated with the slave station S.
- Assemblies 7 and 8 are interconnected by cabling 6 with a controller 9 , which typically has associated with it one or more displays and a keyboard.
- the drive unit 8 is located remotely from the operative site and is preferably positioned a distance away from the sterile field.
- the drive unit 8 is controlled by a computer system that is part of the controller 9 .
- the master station M may also be referred to as a user interface vis-à-vis the controller 9 .
- the computer translates the commands issued at the user interface into an electronically driven motion in the drive unit 8 , and the surgical instrument, which is tethered to the drive unit through the cabling connections, produces the desired replicated motion. That is, the controller 9 couples the master station M and the slave station S and is operated in accordance with a computer algorithm, to be described in further detail below.
- the controller 9 receives a command from the input device 3 and controls the movement of the surgical instrument 14 so as to replicate the input manipulation.
- FIG. 1 also shows a patient P, upon whom the surgical procedure is performed, lying on an operating table T.
- the surgical instrument 14 includes two separate instruments one on either side of an endoscope 13 .
- the endoscope 13 includes a camera to remotely view the operation site.
- the camera may be mounted on the distal end of the instrument insert, or may be positioned away from the site to provide an additional perspective on the surgical operation.
- FIG. 1 three separate incisions are shown in the patient P, two side incisions for accommodating the surgical instruments and a central incision that accommodates the viewing endoscope. A drape covering the patient is also shown with a single opening.
- the surgical instrument 14 also includes a surgical adaptor or guide 15 and an instrument insert or member 16 .
- the surgical adaptor 15 is basically a passive mechanical device, driven by the attached cable array. Although the surgical adaptor 15 can be easily seen in FIG. 1, the instrument member 16 (FIG. 3) is not clearly illustrated as it extends through the adaptor 15 .
- the instrument insert 16 carries at its distal end a tool 18 , described in greater detail below.
- FIG. 1 there is illustrated cabling 12 coupling the instrument 14 to the drive unit 8 .
- the cabling 12 is preferably detachable from the drive unit 8 .
- the surgical adaptor 15 may be of relatively simple construction. It may thus be designed for particular surgical applications such as abdominal, cardiac, spinal, arthroscopic, sinus, neural, etc.
- the instrument insert 16 couples to the adaptor 15 , and essentially provides a means for exchanging the instrument tools.
- the tools may include, for example, forceps, scissors, needle drivers, electrocautery etc.
- a surgeon can manipulate the input device 3 at a surgeon's interface 11 , to effect a desired motion of the tool 18 within the patient.
- the movement of the handle or hand assembly at input device 3 is interpreted by the controller 9 to control the movement of the tool 18 .
- the surgical instrument 14 is preferably mounted on a rigid post 19 that is affixed to but removable from the surgical table T. This mounting arrangement permits the instrument to remain fixed relative to the patient even if the table is repositioned. In accordance with the present invention the concepts can be practiced even with a single surgical instrument, although, in FIG. 1 there are illustrated two such instruments.
- the surgical instruments 14 are connected to the respective drive units 8 with cablings that include two mechanical cable-in-conduit bundles 21 and 22 .
- These cable bundles 21 and 22 may terminate at two connection modules, which removably attach to the drive unit 8 .
- connection modules 23 and 24 can be found in the earlier co-pending application No. PCT/US00/12553, the entire contents of which are incorporated herein by reference.
- two cable bundles are described here, it is to be understood that more or fewer cable bundles can be used.
- the drive unit 8 is preferably located outside the sterile field, it may be draped with a sterile barrier so that it can be operated within the sterile field.
- the tool 18 of the surgical instrument 14 is inserted into the patient through an incision or opening, and the instrument 14 is then mounted to the rigid post 19 using a mounting bracket 25 .
- the cable bundles 21 and 22 are then extended away from the operative area to the drive unit 8 , and the connection modules of the cable bundles are engaged into the drive unit 8 .
- Instrument inserts 16 (FIG. 3) may then be passed through the surgical adaptor 15 , and coupled laterally with the surgical adaptor 15 through an adaptor coupler, as described below in further detail.
- the instrument 14 is controlled by the input device 3 , which is manipulated by the surgeon. Movement of the hand assembly produces proportional movement of the instrument 14 through the coordinating action of the controller 9 . It is typical for the movement of a single hand control to control movement of a single instrument.
- FIG. 1 shows a second input device that is used to control an additional instrument. Accordingly, in FIG. 1 two input devices associated with the two instruments are illustrated.
- the surgeon's interface 11 is in electrical communication with the controller 9 primarily by way of the cabling 6 through the master assembly 7 .
- Cabling 6 also couples the controller 9 to the actuation or drive unit 8 .
- the actuation or drive unit 8 is in mechanical communication with the instrument 14 .
- the mechanical communication with the instrument allows the electromechanical components to be removed from the operative region, and preferably from the sterile field.
- the surgical instrument 14 provides a number of independent motions, or degrees-of-freedom, to the tool 18 . These degrees-of-freedom are provided by both the surgical adaptor 15 and the instrument insert 16 .
- FIG. 2 Shown in FIG. 2 is a schematic representation of the joint movements associated with the slave station S.
- the first joint movement J 1 represents a pivoting motion of the instrument about the pivot pin 225 at axis 225 A.
- the movement relating to joint J 2 which is a transitional movement of the carriage 226 on the rails 224 to move the carriage as well as the instrument 14 , supported therefrom, in the direction indicated by the arrow 227 in FIG. 2 towards and away from the operative site, OS.
- the cabling in the bundle 21 controls both the J 1 and J 21 movements.
- the distal end of the guide tube 17 extends to the operation site OS.
- the operation site may be defined as the general area in close proximity to where movement of the tool occurs, usually in the viewing area of the endoscope and away from the incision.
- FIG. 2 also depicts the rotary motion of both the adaptor tube 17 and the instrument stem. These are illustrated in FIG. 2 as respective motions or joints J 3 (adaptor tube rotation) and J 4 (instrument stem rotation). Motion J 5 indicates a wrist pivot or, alternatively, a wrist flexure. Finally, motions J 6 and J 7 represent the end jaw motions of the tool 18 .
- joints J 4 -J 7 allows the instrument insert 16 to be actuated with four degrees-of-freedom.
- the insert 16 and adaptor 15 provide the surgical instrument 14 with seven degrees-of-freedom.
- four degrees-of-freedom are described here for the instrument insert 16 , it is to be understood that greater or fewer numbers of degrees-of-freedom are possible with different instrument inserts. For example an energized insert with only one gripper may be useful for electro-surgery applications, while an insert with an additional linear motion may provide stapling capability.
- FIG. 2 shows the incision point along the dashed line 485 , and a cannula 487 that in some surgical procedures is used in combination with a trocar to pierce the skin at the incision.
- the guide tube 17 is inserted through the flexible cannula 487 so that the tool is at the operative site OS.
- the cannula typically has a port at which a gas such as carbon dioxide enters for insufflating the patient.
- the cannula also is usually provided with a switch or button that can be actuated to desufflate.
- the cannula is used primarily for guiding the instrument, but may include a valve mechanism for preventing escape of gas from the body.
- FIG. 3 is a plan view showing an instrument insert including the tool 18 , and elongated sections including a rigid section 302 and a flexible section 303 , with the tool 18 mounted at the end of the flexible stem section 303 .
- the coupler 300 includes one or more wheels that laterally engage wheels of the coupler associated with the surgical adaptor.
- the coupler 300 also includes an axial wheel 306 that also engages a wheel on the adaptor.
- the axial engagement wheel 306 is fixed to the rigid stem 302 , and is used to rotate the tool axially at the distal end of the flexible stem section 303 .
- FIG. 3 illustrates the base coupler 300 of the instrument insert 16 with wheels 330 , 332 , and 334 that have half-moon construction for engagement with mating like wheels of the adaptor. These wheels are meant to mate with the corresponding wheels of the adaptor. Also illustrated in FIG. 3 are capstans or idler pulleys 340 , 342 , and 344 associated with wheels 330 , 332 , and 334 , respectively.
- Each wheel of the coupler has two cables that are affixed to the wheel and wrapped about opposite sides at its base.
- the lower cable rides over one of the idler pulleys or capstans, which routes the cables toward the center of the instrument stem 302 .
- the cables are kept near the center of the instrument stem, since the closer the cables are to the central axis of the stem, the less disturbance the cables experience as the stem section moves (rotates).
- the cables may then be routed individually through plastic tubes that may be affixed, respectively, to the proximal end of the rigid stem 302 and the distal end of the flexible stem section 303 .
- the cables may each be enclosed in separate plastic tubes or sheathes only in the flexible section of the instrument stem (see, e.g., bundle 284 in FIG. 4).
- the tubes assist in maintaining constant length pathways for the cables as they move longitudinally within the instrument stem.
- the coupler 300 there are six cables that connect to each of the wheels. Two cables connect to each wheel and one of these cables extends about the associated idler pulley or capstan. These are illustrated in FIG. 3 as idler pulleys 340 , 342 and 344 . Thus, six separate cables extend through the rigid stem 302 and down through the flexible stem section 303 to the area of the tool.
- Associated with the wheels 330 , 332 , and 334 are six cables that extend through the sections 302 and 303 , as illustrated in FIG. 4.
- One set of these cables controls the pivoting, such as the pivoting movement about pin 620 .
- the other cables control the operation at the gripping jaws.
- one pair of cables may control the movement of the lower jaw 652
- another cable pair may control the operation of the upper jaw 650 .
- FIG. 4 there is shown the rigid section 302 and the flexible section 303 of the instrument insert 16 .
- a series of six cables, illustrated at arrow 280 in FIG. 4 extend through these sections and may be considered as separated into three sets for controlling the tool 18 , to provide the motions indicated in FIG. 2 as J 5 -J 7 .
- the cabling is supported near to the center axis of the rigid and flexible sections. Note that “de-coupling” simply means that any one controlled action associated with the tool, when performed, does not interfere with other controlled actions that may not be selected at the time that the one controlled action is taking place.
- the cables On the rigid section side of the block 282 the cables may be unsupported as shown or they could be held within a plastic sleeve either individually and/or as a group. Because the cables are maintained in tension and the rigid section is not meant to bend or flex, the cables can be held in position by being supported, as a group, at the center of block 282 .
- each individual cable is preferably held within a cable sleeve, such as illustrated in FIGS. 6 and 8, to be described later in further detail.
- the cables contained in the sleeves 292 are twisted, for example, 180 degrees over say 8 inches.
- spacers 286 may be spaced along the flexible section 303 to hold the bundle 284 at the center of the section 303 .
- the individual cable sleeves also define a substantially fixed length pathway for each cable so that even though the instrument may move or rotate, the cable lengths should stay the same within the flexible stem section.
- the sleeves may be held in fixed position at their ends such as at block 282 at one end and at the tool 18 at the other end.
- the outer flexible tube 288 may be a pliable plastic preferably having a fluted or bellows-like configuration, as illustrated.
- the limited twisting of the cable bundle prevents the formation of kinks or loops in individual cables that might occur if the cables were straight and parallel through the flexible section.
- This twisting also provides the de-coupling between motions, so that actuation of one of the degrees-of-freedom (J 5 -J 7 ) does not cause a responding action at another degree-of-freedom (J 5 -J 7 ).
- the twisting essentially occurs between the block 282 and the location where the bundle enters the wrist joint (for example, the entry to base 600 ).
- the 180 degree twisting of the bundle ensures that the cable sheathes are neither stretched nor compressed, even as the bendable section is bent or rotated.
- the construction of one form of tool is illustrated in FIGS. 3 and 4.
- the tool 18 includes the base 600 , link 601 , upper grip or jaw 650 and lower grip or jaw 652 .
- the base 600 is affixed to the flexible stem section 303 .
- this flexible section may be constructed of a ribbed plastic. This flexible section allows the instrument to readily bend through the curved actuator tube 17 .
- the link 601 is rotatably connected to the base 600 about an axis 620 A represented by pivot pin 620 .
- the upper and lower jaws 650 and 652 are rotatably connected to the link about axis 605 , where axis 605 is essentially perpendicular to the wrist axis at pin 620 .
- Another pivot pin defines axis 605 .
- the cabling may travel through the instrument insert stem (section 303 ) and through a hole in the base 600 , wrapping around a curved surface on link 601 , and then attaches on link 601 .
- Tension on one set of cables rotates the link 601 , and tension on other cables operates the upper and lower grips 650 and 652 , about axis pin 605 .
- the cabling is provided in pairs to provide an opposing action operation, including opposite routing paths, on the opposite sides of the instrument insert.
- the set of cables that control the jaws travels through the stem 302 , 303 and though holes in the base 600 . These cables then pass between two fixed posts 621 that constrain the cables so that they pass substantially through an axis 620 A, which defines the rotational motion of the link 601 .
- This construction allows free rotation of the link 601 with essentially no length changes in the cables that actuate the jaws. In other words, these cables, which actuate the grips 650 and 652 , are effectively decoupled from the motion of link 601 .
- These cables pass over rounded sections and terminate on grips (or jaws) 650 and 652 , respectively. Tension on one pair of cables rotate grips 650 and 652 counter-clockwise about axis 605 .
- Another set of cables provides the clockwise motion to grips or jaws 650 and 652 , respectively.
- the ends of the cables can be secured at the jaws 650 and 652 with the use of an adhesive such as epoxy glue, or the cables could be crimped or pinned to the jaw.
- the instrument 16 slides through the guide tube 17 of adaptor 15 , and laterally engages the adaptor coupler 230 pivotally mounted to the base piece 234 .
- the base piece 234 is rotationally mounted to the guide tube 17 , and is affixed to the linear slider or carriage 226 .
- the carriage 226 is pivotally mounted at the pivot 225 about the axis 225 A.
- FIGS. 2 - 4 The embodiment of the invention illustrated in FIGS. 2 - 4 employs a fixed wrist pivot.
- An alternate construction is shown in FIGS. 5 - 8 in which there is provided, in place of a wrist pivot, a controllable flexing or bending section.
- FIGS. 5 - 8 similar reference characters are used for many of the parts as they correspond to elements found in FIGS. 2 - 4 .
- the construction in FIG. 5 may be employed with a stem section such as illustrated in FIGS. 3 and 4 with a curved guide tube.
- the tool 18 includes an upper grip or jaw 650 and a lower grip or jaw 652 , supported from a link 601 .
- Each of the jaws 650 , 652 as well as the link 601 may be constructed of metal, or alternatively, the link 601 may be constructed of a hard plastic.
- the link 601 is engaged with the end of the flexible stem section 303 .
- FIG. 4 shows the ribbed or fluted plastic construction of the flexible stem section 303 .
- the section 303 may be smooth, at least at its distal end, as shown at 304 in FIG. 5.
- both sections 302 and 303 can be rigid depending upon the particular application.
- FIG. 5 shows only the end of the stem section 303 (at 304 ), terminating in bending or flexing section 660 .
- Section 660 may be integrally formed with the rest of section 303 .
- This section 660 is controllably bendable or flexible usually from a remote location such as in accordance with the telerobotic system 10 of FIG. 1.
- the stem section 303 is preferably constructed so as to be flexible and may have either fluted or smooth outer surfaces.
- flexibility and bending is enhanced by a bellows configuration 662 having saw-tooth shape of peaks and valleys as shown in FIG. 8.
- the distal end of the bending section 660 terminates with an opening 666 for receiving the end 668 of the link 601 .
- the bellows configuration may be made of a single piece of material. Alternatively, the bellows configuration 662 may be made of segments connected together, for example, by welds. In any case, the bellows configuration 662 is a unibody construction.
- the bending or flexing section 660 is constructed to have orthogonal bending movements to provide both pitch and yaw movement of the tool. This is accomplished by using four cables separated at 90° intervals. These four cables include the cables 606 , 607 , 616 , and 617 . The operation of cables 606 and 607 provides flexing in one degree-of-freedom while an added degree-of-freedom (orthogonal to the just mentioned one degree-of-freedom) is provided by operation of cables 616 and 617 . As illustrated in FIG.
- each of the cables 606 , 607 , 616 , and 617 terminate in a respective ball end 606 A, 607 A, 616 A, and 617 A, tensioned against an end wall 615 .
- These same cables also are supported by and extend through retainer block 621 . Within section 304 these cables also run near the outer wall as shown to the left in FIG. 8 where cables 616 and 617 are illustrated.
- the cables 608 , 609 , 610 , and 611 extend through the flexible stem section 303 and also through the retainer block 621 , flexing section 660 , and the wall 615 . These cables extend to the respective jaws ( 650 , 652 ) to control the operation thereof in a manner similar to that described previously in connection with FIGS. 2 - 4 .
- the tool actuation cables extend through the center of the bellows and are supported and retained between block 621 and wall 615 by the center sheath 290 .
- the center sheath 290 may be constructed of a soft plastic material, and has an inner diameter sufficient to receive the bundle of cables, and an outer diameter that fits with little clearance against the inner diameter of the bellows 662 .
- the sheath 290 extends between the block 621 and the wall 615 and is dimensioned to hold the cables, as a bundle, at the center axis of the bellows section. Keeping the bundle near the center axis provides proper de-coupling between the various degrees-of-freedom.
- each of the cables is contained in its own cable sleeve 292 .
- These sleeves are sufficiently stiff to maintain constant cable lengths within the flexible or bendable section.
- these sleeves are shown extending between retainer block 621 and wall 615 .
- the cables are shown extending from the sleeve when the cables reach the end tool.
- FIG. 8 also illustrates the aforementioned twisting of the cables that assists in providing the decoupling action between the tool operation and the controlled flexing or bending.
- the cables are twisted about 180 degrees between the block 621 and wall 615 .
- the bellows section itself, may have a length of about one to three inches. Also, more than one bellows section may be used to provide controlled bending at more than one location. In that case separate control cabling is used for each section (see, e.g., FIG. 21 described later).
- the limited twisting of the cable bundle prevents the formation of kinks or loops in individual cables that might occur if the cables were left straight and parallel to one another.
- This twisting also de-couples certain degrees of motions, so that actuation of one of the degrees-of-freedom does not cause a responding action at another degree-of-freedom.
- the twisting occurs between the block 621 and the location where the bundle enters the wrist joint, i.e. the entry to base 601 .
- the individual cable sleeves also define a substantially fixed length pathway for each cable so that even though the instrument may move or rotate the cable lengths stay the same within the section 660 .
- the cross-sectional view of FIG. 8 gives details of the cabling in bending section 660 .
- the sheath 290 extends essentially between block 621 and wall 615 and houses the twisted cables/sleeves.
- the individual sleeves 292 can be considered as terminating at respective ends in blocks 621 and 631 .
- Each of the sleeves may be glued or secured in any other appropriate manner in its supporting end block. This prevents the sleeves from moving axially as the cables are activated.
- the sleeves are preferably constructed of a plastic that is flexible and yet has sufficient rigidity so they do not kink when the cables are activated.
- the sleeves also define fixed length pathways that do not compress or elongate as the cables are operated.
- the 180 degrees twist in the cables/sleeves occurs essentially between blocks 621 and 631 .
- This “twisting” of the center cables/sleeves allows the section 660 to be controllably bent, while preventing or minimizing any transfer of motion to the tool operating cables.
- this arrangement also prevents cross-coupling from the tool operation to the bending control, so that the tool operation alone does not cause any undesired bending of the section 660 .
- FIGS. 9 - 13 there is shown another embodiment that includes bellows which can be bent of flexed in a controllable manner, for example, through a user interface like that shown in FIG. 1. Similar reference characters are used in FIG. 9 as those used in describing the embodiment of FIG. 5. Unlike the embodiment shown in FIG. 5, the embodiment of FIG. 9 provides a single cable (or rod) actuation that simplifies the instrument construction, particularly at the tool end of the instrument. The single actuation is possible because the flexible section has two degrees-of-freedom to provide both pitch and yaw.
- the tool 18 includes an upper grip or jaw 650 and a lower grip or jaw 652 , supported from a housing 670 .
- Each of the jaws 650 , 652 , as well as the housing 670 may be constructed of metal, or alternatively, the housing 670 may be constructed of a hard plastic.
- the housing 670 is engaged to the flexible stem section 303 with the bellows 662 .
- the flexible stem section 303 can be a ribbed or fluted plastic construction like that shown in FIG. 4, or alternatively, the section 303 may be smooth as shown at 304 in FIG. 9.
- the jaws are operated from a single push/pull cable 672 that extends through the instrument stem and through the bellows 662 of the flexible or bendable section 660 .
- the cable is centered in the various sections as depicted in FIG. 9 so that when the bendable section is activated, no movement is transferred to the tool actuation cable.
- the bellows section 662 expands on one side and compresses on the other side, leaving the center portion unchanged in length, and thus not effecting the cable action.
- the jaws themselves are supported by a link bar arrangement shown at 675 that is appropriately secured at the distal end of the cable 672 . In the position shown in FIG. 9 the jaws are open, but by pulling on the cable away from the jaws the proximal end the link bar 675 pivots and closes the jaws 650 , 652 .
- FIG. 9 shows only the end portion of the stem section 303 , i.e., the portion at 304 , terminating in bending or flexing section 660 .
- This section 660 is bent or flexed in a controllable manner usually from a remote location as depicted FIG. 1.
- the stem section 303 is preferably constructed to be flexible and may have either fluted or smooth outer surfaces.
- flexibility and bending is enhanced by means of constructing this section with a bellows configuration 66 having peaks and valleys in a saw-tooth shape arrangement as illustrated in the cross-sectional view of FIG. 9.
- the distal end of the bending section 660 has an opening for receiving the end of the housing 670 .
- a wall 615 is positioned at the distal end of the bellows 662 .
- the bending or flexing section 660 can be bent to provide both pitch and yaw degrees of motion to the tool. This is accomplished by using four cables 606 , 607 , 616 , and 617 that are separated at 90° intervals. The operation of cables 606 and 607 provides flexing in one degree-of-freedom while another degree-of-freedom is provided by the operation of cables 616 and 617 . As illustrated in FIG. 9, these cables extend through the bellows about half way between each peak and valley of the respective bellows, and thus are parallel and near the outer periphery of the flexible section 660 .
- Each of the cables 606 , 607 , 616 , and 617 terminates in a respective ball end 606 A, 607 A, 616 A, and 617 A, tensioned against the end wall 615 .
- These cables also are supported by and extend through retainer block 621 . Within section 304 these cables also run near the inner surface of the outer wall of the section 304 , as shown to the left in FIG. 9 where cables 616 and 617 are illustrated.
- the single actuation cable 672 provides all the action that is required to operate the tool, which simplifies the construction of the instrument and makes it easier to keep the single cable centered in the instrument.
- a supporting sleeve 680 that receives the cable 672 with a snug fit.
- the sleeve 680 (FIG. 10) is preferably constructed of a polyethylene plastic such as PEEK which has the flexibility to flex with bending at the section 660 , but at the same time is sufficiently rigid to properly retain and hold the supported cable 672 to enable the cable to readily slide within the supporting sleeve 680 when performing its function.
- Sleeve 680 defines a fixed length for the cable and does not allow any expansion or compression of the cable or sleeve.
- the sleeve 680 may extend from the wall 615 back through the retainer block 621 and into the flexible section of the instrument, as shown in FIG. 9. Alternatively, the sleeve 680 may extend only through the section 660 and terminate at block 621 .
- a helical spring 682 having an outer diameter to allow it to fit snugly within the inner diameter of the bellows 662 .
- a helical spring 682 having an outer diameter to allow it to fit snugly within the inner diameter of the bellows 662 .
- Opposite ends of the helical spring 682 are located between the block 621 and wall 615 .
- FIG. 10 shows the spring shape and the relationship of the helical spring to the sleeve 680 and the actuation cable 672 . In FIG. 10, the coils of the spring are shown spaced apart, but they can be more closely spaced then shown or completely closed.
- the spring 682 may be free-floating about the sleeve 680 , and is preferably not engaged in any passage in the end supports, such as the passage in block 621 .
- the sleeve 680 receives the cable 672 and is fixed in position relative to block 621 and wall 615 . Passages are provided in block 621 and wall 615 , and a glue or other securing arrangement is preferably used to hold the sleeve fixed at the block 621 and wall 615 .
- the spring 682 is also used as a filler or spacer between the sleeve 680 and the bellows 662 inner surface.
- the spring provides a fixed position spacer since it is typically a metal, and thus will maintain the centering of the sleeve/cable, and yet is also flexible enough to bend when the section 660 is bent in a controlled manner.
- the sleeve itself is preferably made of plastic such as PEEK which has sufficient strength to receive and guide the cable, yet is flexible enough so that it will not kink or distort, and thus keeps the cable in a proper state for activation, and defines a fixed length for the cable.
- the cable length at the center axis of section 660 does not change when the section 660 is bent. That is, the bellows shortens on one side and expands on the other side while keeping the center axis length unchanged. In this way when bending occurs at section 660 there is no transfer of motion to the cable 672 which could undesirably move the jaws. Hence, the bending motion is de-coupled from the tool operation motion, and vice versa.
- FIG. 11 is a cross-sectional view taken along line 11 - 11 of FIG. 10 showing the centered cable 672 , plastic sleeve 680 , and the helical spring 682 .
- FIG. 12 is a similar cross-sectional view but for an alternate embodiment using only the center cable 672 and the sleeve 680 .
- the sleeve 680 is larger in outer diameter in comparison to the sleeve shown in FIG. 11 so that there is a proper and close fit between the sleeve and the inside of the bellows.
- FIG. 13 is a cross-sectional view through another embodiment of the cable support.
- This embodiment also has the center cable 672 contained within the sleeve 680 , but in place of the spring 682 there is instead used a spacer 681 made of, for example, plastic, to keep the sleeve and cable centered in the bellows.
- the spacer 681 may be constructed of a softer plastic than the sleeve 680 , or may be made of a plastic foam material.
- FIG. 9 One of the benefits of the embodiment of FIG. 9 is that only a single cable is necessary to activate the tool. Recall that the pitch and yaw of the tool is controlled at the flexible wrist section 660 shown in FIG. 9. This arrangement lends itself to making the tool disposable or at the very least detachable from the instrument body so that it can be replaced with a substitute tool.
- a detachable embodiment of the present invention is illustrated in FIG. 14 and the companion views are shown in FIGS. 15 - 20 . Besides being detachable this arrangement also makes it possible to provide at least a resposable and preferably a disposable instrument tip or tool.
- FIG. 14 a disposable tip is illustrated in conjunction with a flexible shaft or tube having a remotely controllable bending or flexing section 700 .
- the medical instrument may include an elongated shaft, such as shaft section 710 shown in FIGS. 14 and 15, having proximal and distal ends, and a tool, such as graspers 702 and 704 , supported from the distal end of the elongated shaft and useable in performing a medical procedure on a subject.
- the distal end of the elongated shaft and the tool have respective removably engaging portions that are readily engagable for positioning the tool at the distal end of the elongated shaft, and readily disengagable for removal of the tool from the distal end of the elongated shaft.
- the tool may be detachable to facilitae substituting another tool, or the tool may be constructed to be readily disposable.
- the removably engaging portions may be snap-fitted together, or, as illustrated here, may be provided by a screw interlock between the distal end of the instrument shaft and the base or housing of the tool. Also, other forms of detachable engaging portions are considered as falling within the scope of the present invention.
- the detachable or disposable tool is used with a flexible controllably bendable section.
- the disposable tool can be used with a wrist pivot or even a pair of successive wrist pivots that are orthogonal to one another for providing pitch and yaw movement at the tool.
- the disposable tool in this version is also preferably actuated by a single actuation element, cable or the like.
- the tool in a manner similar to that shown in FIG. 9, the tool is actuated by a single tendon or cable 736 that extends through the flexible section 700 .
- the bending or flexing section 700 is constructed to have orthogonal bending movements by pulling on four cables 706 , 707 , 716 , and 717 separated at about 90° intervals, and by using a center support 726 with ribs 712 extending from the center support 726 and defining slots 714 between adjacent ribs, as depicted in FIG. 15.
- the ribs 712 extend from a center support 726 that has extending therethrough a passage for receiving the cable 736 positioned within a sheath 730 .
- the ribs 712 also provide a guide structure to the four cables 706 , 707 , 716 , and 717 .
- the bending section 700 is a unibody construction that extends from the end of tube section 710 , which itself may be flexible, and it may be smooth as shown, or may be fluted as illustrated in FIG. 4.
- This version enables the bending section to be bent in orthogonal directions by the use of the four cables 706 , 707 , 716 , and 717 .
- the operation of cables 706 and 707 provides flexing in one degree-of-freedom while another orthogonal degree-of-freedom is provided by the operation of cables 716 and 717 .
- Each of the cables 706 , 707 , 716 , and 717 has at their terminating ends respective balls 706 A, 707 A, 716 A, and 717 A that may be held in corresponding recesses in a distal end wall 719 of the flexible section 700 .
- a bellows arrangement such as shown in FIGS. 5 or 9 can be used.
- the structure shown in FIGS. 14 - 17 preferably includes a plastic stiffener sheath or sleeve 730 that surrounds the cable 736 , and that fits closely within the passage of the center support wall 726 .
- the sleeve 730 is preferably constructed of a polyethylene plastic such as PEEK which has enough flexibility to flex with the bending section section 700 , but at the same time is sufficiently rigid to properly retain, center and hold the supported cable to allow the cable 736 to readily slide within the supporting sleeve 730 in performing its function.
- the sleeve 730 may extend from the distal end of the flex section 700 , back through the passage in the wall 726 , and into the shaft section 710 of the instrument, as shown in FIG. 15.
- FIG. 15A there is shown an alternate embodiment for the bending section 700 in which the sleeve 730 is eliminated.
- the passage in the wall 726 is dimensioned to directly and snugly receive the cable 736 with a close tolerance fit but having sufficient clearance to allow the cable to readily slide in the instrument.
- the grippers 702 and 704 are supported for opening and closing by the use of a pivot pin 735 that extends along axis 735 A in a housing 740 .
- a pivot pin 735 that extends along axis 735 A in a housing 740 .
- the pin 735 may be supported at its ends on opposite sides of housing 740 .
- the tool also includes a pivot linkage 742 that intercouples the grippers with the actuation cable 736 such that as the linkage is moved in the axial direction by the cable 736 to open or close the jaws (or grippers).
- a pivot linkage 742 that intercouples the grippers with the actuation cable 736 such that as the linkage is moved in the axial direction by the cable 736 to open or close the jaws (or grippers).
- FIG. 15 the linkage and tool are shown in solid outline in the closed position, which corresponds to a “pulling” of the cable in a direction away from the tool.
- FIG. 15 also shows, in dotted outline, the linkage and grippers in an open position, which corresponds to a “pushing” of the cable in a direction toward the tool.
- the grippers themselves are prevented from any axial movement by the support at pin 735 , so when the linkage is operated from the cable 736 the resulting action is either opening or closing of the grippers, depending upon the direction of longitudinal translation of the actuating cable 736 .
- removably engaging portions which in the illustrated embodiment are formed by mating threaded portions. Further, these mating portions are provided both with respect to the actuation element (cable) as well as the stationary components of the tool and tube.
- the tool housing has a threaded portion 746 with female threads
- the distal end of the flexible section 700 as shown in FIG. 16, has a threaded portion 748 with male threads.
- the end of the actuation cable 736 is terminated at block 750 , passing through a center passage in the threaded portion 748 .
- the block 750 interacting with arms 751 , allows longitudinal sliding of the cable 736 , but prevents rotation thereof so that the tool can be screwed onto the shaft without rotating the actuation cable.
- the block 750 supports a male threaded shaft 753 that is adapted to mate with the tool.
- the threaded portion at 753 may have twice the threads per length as the threaded portion 748 .
- the block 750 interacts with the arms as the tool is fully engaged to compensate for differences in thread pitch between the engaging members
- FIG. 17 shows the end of this linkage supporting a female threaded piece 760 .
- the female piece 760 is threaded onto the male threaded shaft 753 in the direction indicated by the rotational direction arrow 770 .
- FIGS. 18 - 20 there is shown the sequence of steps to attach the instrument tip to the shaft of the instrument. These views are somewhat schematic and are for the purpose of merely illustrating the steps taken in attaching the tool to the instrument shaft.
- FIG. 18 the tool is first illustrated with its housing 740 about to engage at threaded female piece 760 with the corresponding threaded male shaft 753 .
- the threads of pieces 760 and shaft 753 are finer that the threaded portions 748 and 746 .
- the threaded piece 760 and shaft 753 are designed such that only about four turns are necessary to fully seat these members together.
- the sections 746 and 748 have courser threads so that it takes, say, only about two turns to engage the two sections together.
- FIG. 19 illustrates the positions of the various components after two turns have occurred between threaded shaft 753 and threaded piece 760 , and the other outer mating threaded sections are to engage.
- the threaded portions 746 and 748 engage and after two more turns of the tool, the tool is fully engaged with the shaft, as illustrated in FIG. 20.
- the detents are also engaged so that the tool is, in essence, locked to the instrument shaft and ready for use.
- the block 750 is free to move inward away from the tool.
- FIG. 21 there is shown an embodiment having a detachable and disposable tool, and particularly adapted for application to a flexible instrument including a catheter.
- the tool is operated remotely in a telerobotic manner from a user device such as shown in FIG. 1.
- the use of multiple controllably bendable segments as shown in FIG. 21 is particularly advantageous in a flexible instrument to assist in guidance thereof such as, for example, in vessels or arteries.
- FIG. 21 shows primarily the distal end of a flexible instrument with the more proximal portions of the instrument being supported and driven in a manner similar to that illustrated in FIGS. 1 and 2.
- the flexible instrument 800 has two bending sections 810 and 815 spaced along the instrument shaft that are remotely actuable. In other configurations, these sections 810 and 815 can be formed directly in series, and more than two controllable segments can be used.
- a tool 820 is positioned at the distal end of the instrument, and is preferably constructed to be disposable and may be substantially the same as the tool illustrated in FIGS. 14 - 17 including the interengaging portions for detachability of both the tool body and the tool actuation element. As shown in FIG. 21, a cable 825 is used as the actuation element. Also illustrated in FIG. 21 are instrument transition segments 830 and 835 , which may be similarly constructed as the flexible section 303 shown in FIG. 4. Alternatively, one or both of these sections 830 , 835 may be rigid.
- the actuation elements (cables) that are not used to operate a particular section run preferably through the center of the respective section to provide the proper de-coupling between the various degrees of movement.
- the center cable bundle 840 through the section 810 includes the cables to operate section 815 and the tool 820 .
- each section 810 , 815 is controlled with both pitch and yaw movements, then four cables are used to actuate each section.
- the actuation of each section is similar to the actuation of the embodiments shown earlier in FIGS. 5 and 9.
- the aforementioned “twisting” concept is also preferably used in each of these sections 810 , 815 where multiple cables are running through them, particularly in section 810 where five cables extend along the center of the section (four for actuation of the section 815 and one for tool actuation) similar to that shown in FIG. 8.
- FIG. 21 shows two of these cables terminating at 812 and used to operate and move the section 810 with one degree of freedom.
- Two other cables (displaced about 90 degrees) also terminate at the same general area and are used to operate the bending section 810 with the other degree-of-freedom.
- section 835 four cables at 836 branch outwardly and terminate at the end of section 815 at 837 to control the flexing of section 815 .
- section 815 there is thus only the single tool actuation cable 825 contained in a sheath extending through the center of the section.
- FIG. 21 shows only two of the cables 836 for controlling one of the degrees-of-freedom of movement of the section 815 , there are two other cables (displaced about 90 degrees) that also terminate at the same location for the other degree-of-freedom of control of section 815 .
- FIG. 8 can be made for the operation of the bending movement of the sections with the use of the cables.
- FIG. 21 may be used for any number of different surgical procedures. Flexible instruments of this general type are shown in co-pending applications that have been incorporated herein by reference in their entirety. Although FIG. 21 shows four cables that are used to actuate a respective bending section, more or fewer cables can be used in each section. For example, if only one degree-of-freedom is desired in section 810 then only two actuating cables are employed to control bending in only one plane. The instrument may also be controlled for rotation to provide another degree-of-freedom.
- FIGS. 14 - 17 the tool is readily disposable. By providing a bendable section that can control both pitch and yaw movement of the tool, the tool itself becomes actuable with a single cable or rod.
- FIGS. 22 and 23 disclose in a schematic manner this same disposability feature as applies to an instrument, whether flexible or rigid, that employs a wrist pivot or wrist and elbow pivot.
- FIG. 22 is a schematic diagram of the instrument illustrating both elbow and wrist pivot joints, as well as the disposable tool.
- FIG. 23 shows just a wrist pivot joint with a disposable tool. More specific details of portions of the diagrams can be found in earlier embodiments described herein.
- FIGS. 22 and 23 like reference characters are used to identify like parts.
- an instrument 900 that includes both an elbow joint 905 and a wrist joint 910 . These joints allow for orthogonal motions of the various segments about respective axes 905 A and 910 A. Both of these joints are driven by cabling in a manner as described earlier, such as in the pivot arrangement shown in FIGS. 3 and 4. This cabling preferably runs through the center of the instrument as previously described.
- the instrument 900 also includes an end tool 920 driven from a cable or rod 925 . This tool construction and its actuation element may be the same as described in FIGS. 14 - 17 , and would include separate interengagable/disengagable portions as previously described.
- FIG. 23 there is shown an instrument 930 that includes only a single wrist joint 910 , along with the tool 920 actuated by means of the actuation element 925 .
- tool 920 is preferably readily detachable in the manner shown in FIGS. 14 - 17 and is thus readily disposable.
- the instrument may be controllably rotated as indicated by the arrow 927 in FIG. 23.
- FIG. 24 illustrates a wrist or other joint that may be used for the joints shown FIGS. 22 and 23.
- FIG. 24 shows a ball joint 950 with intercoupling sections 951 and 952 .
- An actuation cable 954 is also illustrated extending through sections 951 and 952 as well as through the middle of the joint 950 .
- the joint 950 may be of a conventional type using mating outer pieces at 956 that enable the sections 951 and 952 to have relative rotation therebetween.
- a sheath 958 that encloses the cable 954 , and that is preferably fixed in position at the top and bottom of the joint.
- the sheath is flexible and yet sufficiently durable so as to define a fixed length for the cable to extend through, even as the joint is actuated to rotate or pivot.
- Appropriate cabling may be provided for control of the joint 950 .
- This type of joint is particularly advantageous in that the center of the joint is open and does not interfere at all with the passing of the actuation cable 954 and sheath 958 through the joint 950 . Again, by maintaining the cable at the center of the joint, as illustrated, even as the joint is actuated there is no adverse effect on the actuation cable. In other words as the joint rotates it does not change the length of the cable 954 , and thus these separate actions are de-coupled from each other.
- FIG. 25 shows a ball joint 960 intercoupling sections 961 and 962 .
- An actuation cable 964 is also illustrated extending through sections 961 and 962 as well as through the middle of the joint 960 .
- the joint 960 may be a conventional joint using mating outer pieces at 966 that enable the sections 961 and 962 to have relative rotation therebetween.
- a sheath that encloses the cable 964 and that may be preferably fixed in position at the top and bottom of the joint.
- Appropriate cabling may be provided for control of the joint 960 .
- a funnel like surface illustrated at 970 that directs the cable to an output orifice 972 where the cable is coupled into the section 962 .
- This funnel surface 970 holds the cable such that as the sections experience relative rotation while the length of the cable within the joint is maintained at a fairly fixed length.
- FIGS. 26 - 33 Other embodiments of the tool 18 are within the scope of the invention, such as that illustrated in FIGS. 26 - 33 .
- a set of jaws is illustrated in the figures, but it is understood that other types of tool constructions may also be used with the concepts of the present invention.
- the instrument shaft may be a rigid shaft, a flexible shaft, or combinations thereof.
- the tool 18 includes four basic members including the base 1020 , link 1021 , upper grip or jaw 1022 and lower grip or jaw 1023 .
- the base 1020 is affixed to the instrument shaft 1010 .
- the instrument shaft 1010 may be rigid or flexible depending upon the particular use. If the shaft 1010 is flexible it may be constructed, for example, of a ribbed plastic material. A flexible shaft or section thereof would, in particular, be used in conjunction with a curved guide tube so that the instrument readily bends through the curved adaptor guide tube.
- link 1021 is rotatably connected to the base 1020 about wrist pivot axis 1025 with a wrist pivot pin at 1026 .
- the upper and lower jaws 1022 and 1023 are rotatably connected to the link 1021 about axis 1028 with a pivot pin 1030 , where axis 1028 is essentially perpendicular to axis 1025 .
- the jaws may also be referred to as grippers or graspers.
- Cable 1036 - 1041 actuate the wrist, namely the link 1021 , as well as the end effector or tool 18 .
- Cable 1036 extends through the instrument shaft and through a hole in the base 1020 , wraps around curved surface 1032 on link 1021 , and then attaches on link 1021 at 1034 .
- Tension on cable 1036 rotates the link 1021 , as well as the upper and lower jaws 1022 and 1023 , about axis 1025 .
- Cable 1037 provides the opposing action to cable 1036 , and goes through the same routing pathway, but on the opposite side of the instrument shaft. Cable 1037 is also attached to link 1021 generally at 1034 .
- Cables 1038 and 1040 also travel through the instrument shaft 1030 and though holes in the base 1020 .
- the cables 1038 and 1040 then pass between two fixed posts 1035 . These posts constrain the cables to pass substantially through the axis 1025 about which the link 1021 rotates.
- This construction allows the link 1021 to rotate freely with minimal length changes in cables 1038 - 1041 .
- the cables 1038 - 1041 which actuate the jaws 1022 and 1023 , are essentially decoupled from the motion of link 1021 .
- Cables 1038 and 1040 pass over rounded sections and terminate on jaws 1022 and 1023 , respectively.
- the application of tension on cables 1038 and 1040 rotate jaws 1022 and 1023 counter-clockwise about axis 1028 .
- cables 1039 and 1041 pass through the same routing pathway as cables 1038 and 1040 , but on the opposite side of the instrument. These cables 1039 and 1041 provide the clockwise motion to grips or jaws 1022 and 1023 , respectively. The ends of cables 1038 - 1041 maybe secured at 1033 of the jaws 1022 and 1023 .
- the tool 18 includes a rotation piece 1045 , a linkage 1046 and slotted linkage 1048 .
- the rotation piece 1045 has a centrally disposed hole 1045 A that is adapted to receive the pivot pin 1030 .
- the pivot pin 1030 also passes through holes 1023 A in one jaw member and holes 1022 A in the other jaw member.
- the pin 1030 is secured in respective holes in the arms 1029 of the link 1021 in a well-known manner to rotatably support the jaw members from the link 1021 .
- the rotation piece 1045 also carries an actuation pin 1050 extending in the same direction as the pivot pin 1030 , and parallel thereto.
- the actuation pin 1050 extends into curved J-shaped slots 1052 in respective jaw flanges 1054 of jaw 1023 .
- the actuation pin 1050 is also received by the linkage 1048 through the end hole 1048 A, and the linkage is supported between the spaced flanges 1054 of the jaw 1023 .
- At the slotted end of the linkage 1048 there is a set of holes 1048 B that receive the pin 1056 .
- the linkage 1048 also pivotally attaches with the linkage 1046 by virtue of the pin 1056 passing through the holes 1046 B and 1048 B.
- the pin 1056 is also positioned in the slots 1052 of the flanges 1054 , and thus moves along the slots to different positions, two of which are illustrated in FIGS. 30 and 31. When the jaws are fully closed, the pin 1056 is at the very top of the slot 1052 as illustrated in FIG. 31.
- FIG. 30 shows the pin 1056 in a lower position which occurs when the jaws are partially opened.
- the pin 1050 likewise is in different positions in the slot 52 depending upon the position of the jaws.
- the linkage 1046 is also supported at its other end at hole 1046 A by the pin 1058 .
- the pin 1058 also passes through a set of holes 1022 B in the base of the jaw 1022 .
- the linkage 1046 fits in a slot at the base of the jaw 1022 , and the pin 1058 passes through both the base of the jaw 1022 as well as the linkage 1046 .
- the pin 1058 also preferably has a compliant member such as a set of resilient members disposed about at least a portion thereof, as illustrated in FIGS. 30 and 31, at 1060 , in an uncompressed position.
- FIG. 31 shows the resilient cups 1060 uncompressed, while FIG.
- FIG. 32 shows the resilient cups partially compressed when the jaws are grasping a small diameter member such as a suture S.
- FIG. 33 shows the cups 1060 essentially fully compressed, when the jaws are grasping a larger diameter member such as a needle N.
- the cups 1060 may fit about the pin 1058 , and be disposed in the base of the jaw 1022 .
- the holes 1022 B that receive the cups 1060 are of somewhat elongated shape, such as illustrated in FIGS. 27A, 27B, 30 , and 31 .
- the jaws 1022 and 1023 apply a smaller but sufficient force to hold a smaller diameter item, such as the suture S than when holding a larger item such as a needle N.
- This force is primarily a function of the resiliency of the cups 1060 .
- the tool is constructed so that when the jaws are holding an item the size of a needle N the cups 1060 are essentially fully compressed, and a maximum grasping force is applied to the needle N. This is particularly desirable for important surgery techniques for the securing and controlling of the needle.
- the pin 1056 When the jaws 1022 and 1023 first make contact with an item positioned between them, the pin 1056 is in a contact position A′ (FIG. 33) for a larger item such as the needle N, or further up the slot 1052 at a position A (FIG. 32) for a smaller item such as the suture S. When a sufficient force is applied to the item with the jaws, the pin 1056 moves to a locked position B (FIGS. 32 and 33), regardless of the size of the item being grasped.
- FIGS. 27A and 27B Other embodiments of the resilient members are shown in the fragmentary exploded views of FIGS. 27A and 27B.
- the embodiment of FIG. 27A uses a pair of cups 1060 A, while the embodiment of FIG. 27B uses only a single cup.
- the same reference characters are used as in FIG. 27 to identify like components.
- the cups 1060 A are positioned within respective holes 1022 B. They may be positioned with the use of an adhesive.
- the cups 1060 A are thus be located at opposite ends of the pin 1058 . When the jaws are in the closed position, these cups 1060 A are compressed as the pin 1058 rides downwardly in the somewhat elongated hole or slot 1022 B.
- FIG. 27A uses a pair of cups 1060 A
- FIG. 27B uses only a single cup.
- the same reference characters are used as in FIG. 27 to identify like components.
- the cups 1060 A are positioned within respective holes 1022 B. They may be positioned with the use of an adhesive.
- the single cup 1060 B is of somewhat larger shape than the cups 1060 A and is located between the spaced walls of the base 1022 C.
- the link 1046 is positioned between these walls, as is the cup 1060 B.
- the cup 1060 B may also be secured in position by an adhesive.
- the cup 1060 B is engaged by the end of the link 1046 .
- the pin 1058 also rides within the elongated slots 1022 B and when the jaws are moved to a closed position the end of link 1046 bears against the cup 1060 B.
- the actuation cables for the end effector include the cables 1038 - 1041 .
- One set of cables actuates the rotation piece 1045
- the other set of cables actuates the jaw 1023 .
- the other jaw 1022 is actuated through the coupling provided from the rotation piece 1045 to the jaw 1022 , including pin 1050 and the associated linkages 1046 and 1048 controlled via pins riding in slots 1052 .
- These linkages provide direct drive from the rotation piece 1045 to the base of the jaw 1022 , to control the pivoting motion of that jaw, controlled usually from a remote location.
- FIGS. 34 - 38 Another embodiment of the tool 18 is illustrated in FIGS. 34 - 38 , where FIG. 34 is a perspective view of the tool while FIG. 35 is an exploded perspective view showing the separate components of the tool.
- FIG. 34 is a perspective view of the tool while FIG. 35 is an exploded perspective view showing the separate components of the tool.
- the same reference characters are used to designate similar components.
- the tool 18 shown in FIGS. 34 - 38 includes four basic members including a base 1020 , a link 1021 attached to the base, an upper grip or jaw 1022 , and a lower grip or jaw 1023 .
- the base is affixed to an instrument shaft in a manner similar to that depicted in FIG. 26.
- the instrument shaft may be rigid or flexible depending upon the particular use.
- the link 1021 may be rotatably connected to the base about a wrist axis such as the axis 1025 of the just previously described embodiment.
- the upper and lower jaws 1022 and 1023 are rotatably connected to the link 1021 about axis 1028 with a pin 1030 that is substantially perpendicular to axis 1025 .
- Cable 1036 - 1041 actuate the wrist, namely the link 1021 , as well as the end effector or tool 18 .
- Cable 1036 extends through the instrument shaft and through a hole in the base, wraps around curved surface 1032 on link 1021 , and then attaches on link 1021 at 1034 (FIG. 35).
- Tension on cable 1036 rotates the link 1021 , and the upper and lower jaws 1022 and 1023 , about the wrist axis.
- Cable 1037 provides the opposing action to cable 1036 , and goes through the same routing pathway, but on the opposite side of the instrument shaft. Cable 1037 is also attached to link 1021 generally at 1034 .
- Cables 1038 and 1040 also travel through the instrument shaft and though holes in the base.
- the cables 1038 and 1040 then pass between two fixed posts that are similar to the posts 1035 in FIG. 26. These posts constrain the cables so that they pass substantially through the wrist axis about which the link 1021 rotates.
- This construction allows the link 1021 to freely rotate with minimal length changes in cables 1038 - 1041 .
- the cables 1038 - 1041 which actuate the jaws 1022 and 1023 , are decoupled from the motion of link 1021 .
- Cables 1038 and 1040 pass over rounded sections and terminate on jaws 1022 and 1023 , respectively.
- the application of tension on cables 1038 and 1040 rotate jaws 1022 and 1023 counter-clockwise about axis 1028 .
- cables 1039 and 1041 pass through the same routing pathway as cables 1038 and 1040 , but on the opposite side of the instrument. These cables 1039 and 1041 provide the clockwise motion to jaws 1022 and 1023 , respectively. The ends of cables 1038 - 1041 are secured at 1033 of the jaws 1022 and 1023 .
- the tool 18 includes the rotation piece 1045 , along with linkage pair 1066 and straight linkage 1068 .
- the rotation piece 1045 has a central hole 1045 A that receives the pivot pin 1030 .
- the pivot pin 1030 also passes through holes 1023 A in one jaw member and hole 1022 A in the other jaw member.
- the pin 1030 is secured to respective holes in the arms 1029 of the link 1021 to rotatably support the jaw members from the link 1021 .
- the rotation piece 1045 also carries an actuation pin 1050 extending in the same direction as the pivot pin 1030 , and parallel thereto.
- the actuation pin 1050 extends into curved slots 1052 in respective jaw flanges 1054 of jaw 1023 , as shown in FIGS. 35, 37, and 38 .
- the actuation pin 1050 is also received through an end hole 1068 A of the linkage 1068 , and the linkage is supported between the spaced flanges 1054 of the jaw 1023 .
- a hole 1068 B that receives the pin 1076 .
- the linkage 1068 also pivotally attaches with the linkage pair 1066 by virtue of the pin 1076 passing through the holes 1066 B and 1068 B.
- the pin 1076 is also positioned in the slots 1052 of the flanges 1054 , and thus moves along the slots to different positions, two of which are illustrated in FIGS. 37 and 38. When the jaws are in a substantially closed position, the pin 1076 is at the top of the slot 1052 as illustrated in FIG. 37. When the jaws are in other positions, the pin 1050 will reside in different positions in the slot 1052 .
- the linkages 1066 are also supported at its other ends at holes 1066 A the pin 1078 .
- the pin 1078 also passes through a hole 1022 B in the base of the jaw 1022 .
- the base has a support wall 1022 D in which the hole 1022 B is located.
- the linkage pair 1066 fits on opposite sides of the wall 1022 D, and the pin 1078 passes through both the base of the jaw 1022 as well as the linkage pair 1066 .
- the actuation cables for the end effector or tool include the cables 1038 - 1041 .
- One set of cables actuates the rotation piece 1045
- the other set of cables actuates the jaw 1023 .
- the other jaw 1022 is actuated through the coupling provided from the rotation piece 1045 to the jaw 1022 , including pin 1050 and the associated linkages 1046 and 1048 riding in slots 1052 .
- These linkages provide direct drive from the rotation piece 1045 to the base of the jaw 1022 , to control the pivoting motion of that jaw, typically from a remote location.
- control of the grasping force on an item is provided primarily by means of a slot or gap in one of the jaws.
- This is illustrated in FIGS. 34 - 38 by the gap 1031 located near the base 1022 C in the jaw 1022 .
- FIGS. 35, 37, and 38 show in particular the shape and depth of the gap 1031 .
- the gap 1031 is located above a hinge 1044 where the jaw can deflect when grasping and holding an item, regardless of its size, and with a firm grasping force.
- the gap 1031 may be terminated in a tubular passage 1031 A to enhance the hinging effect of the hinge 1044 .
- the hinge 1044 acts as a compliance member similar to the resilient members 1060 described with reference to FIGS. 27 - 33 .
- FIGS. 37 and 38 the jaws 1022 , 1023 are shown in a substantially closed position in FIG. 37 grasping a suture S. In that position it is noted that both of the pins 1050 and 1076 are substantially at their top transition locations.
- FIG. 38 illustrates the jaws 1022 , 1023 grasping an item such as a needle N that causes the jaw 1022 to flex and consequently the gap 31 to close up. This flexure enables the application of a varied grasping force at the tip of the jaws. When the links are at the end of their travel, the jaw 1022 flexes when the jaws 1022 , 1023 grasp an item. The amount of flexure depends on the diameter of the item being grasped.
- the jaws 1022 flexes to a lesser extent when a smaller diameter item such as a suture S is being grasped then when a larger item such as a needle N is being held. That is, to grasp a smaller item, the gap 1031 closes to a lesser extent, while the jaws still apply a sufficient holding force to the item.
- This force is primarily a function of the resiliency at the gap, as defined primarily by the flexure capability at the hinge 1044 .
- the larger the diameter of the item being held the larger the corresponding holding force.
- the tool is constructed so that, for an item the size of a needle, as shown in FIG.
- the gap 1031 is fully closed with the sides of the top of the gap touching, with a maximum grasping force being applied to the needle N.
- This is particularly desirable for the securing and controlling of the needle in important surgery techniques.
- the pin 1076 is at a contact position A′ (FIG. 38) when the jaws first make contact with a larger item such as the needle N, or further up the slot 1052 at a contact position A (FIG. 37) when the jaws contact a smaller item such as the suture S. Regardless of the size of the item, the pin moves to a locked position B (FIGS. 37 and 38) when the sufficient force is applied to lock the jaws onto the item.
- FIGS. 39 and 40 Reference is now made to another embodiment of the invention illustrated in FIGS. 39 and 40.
- This embodiment has a structure very similar to that described in detail in FIGS. 26 - 33 .
- the resilient cup 1060 there is provided a modified jaw slot configuration.
- the slots 1052 in jaw 1023 have a curved segment 1052 A, and a straight segment 1052 B.
- the J-slots 1052 also have a contiguous end slot 1052 C that extends back toward the tip of the jaw tip.
- the overall slot configuration is C-shaped.
- the jaws are in a substantially open position with a gap G 1 as noted when the jaw members 1022 , 1023 are locked onto and the needle N, with the pin 1056 located at a locked position B.
- the pin 1056 Before the jaws make contact with the needle N, the pin 1056 may be out of the end slot 1052 C, and the pins 1050 and 1056 are located at different positions along the slots 1052 depending upon the degree of openness of the jaws.
- the pin 1056 is at a contact position A′.
- the jaws are in a substantially closed position with a small gap G 2 as the jaws grasp a smaller item such as a suture S.
- the pin 1056 now moves further into the end slots 1052 C to the locked position B, as the jaws apply a grasping force to an item to lock the suture between the jaws.
- the pin 1056 is located at the contact position A further up the slot 1052 than the contact position A′ of FIG. 39.
- the pin 1056 moves to a greater or lesser extent into the slots 1052 C.
- the pins 1050 and 1056 are in the position illustrated in FIG. 39 with there being a maximum grasping force applied to the item by virtue of the links 1046 and 1048 being positioned at 90 degrees relative to each other.
- the pins rotate slightly further clockwise with the pin 1056 moving into the slot 1052 C as illustrated in FIG. 40.
- the jaw and linkages move together as a rigid body while closing against the suture.
- the slots 1052 C like the resilient member 1060 (FIGS. 27 - 33 ) and the hinge 1044 (FIGS. 37 and 38), are accommodating mechanisms that allow a closing force to be applied to grasped items of different sizes as the force is applied to the grasped item as the jaws close to a position at which the jaws remain open.
- the medical instrument includes a jaw or work members controlled by a drive mechanism that is used to open and close the jaws or work members for applying an increased force to an item grasped between the jaws or work members.
- the accommodating mechanisms described above such as the slots 1052 C (FIGS. 39 and 40), the resilient member 1060 (FIGS. 27 - 33 ), and the hinge 1044 (FIGS. 37 and 38, each have the characteristic of providing a maximum grasping force at what may be considered a maximum grasping position. This corresponds to the positions illustrated, and discussed previously, in FIGS. 33, 38, and 39 .
- the instrument is constructed so that this maximum position corresponds to a predetermined size or diameter items that is to be grasped, usually a needle in this case.
- a predetermined size or diameter items that is to be grasped usually a needle in this case.
- the grasping force is progressively less.
- the force is less because the compliant member is compressed less.
- the linkage does not go to the top of the J-slot and thus the applied force is also less in that case, as the linkages are not yet to a maximum force 90 degree position.
- the accommodating mechanism allows the jaws or work members to be closed beyond this maximum grasping position in order to grasp items of various sizes, particularly smaller size items. Again, this is illustrated by way of example in FIG. 32 where the jaws go past their maximum grasping position, closing to a closer position therebetween, in grasping the suture S. In FIG. 37 this is illustrated by the jaws closing to grasp the suture S with less force being imposed by the flexure at the jaw 1022 . This is also illustrated in FIGS. 39 and 40. In FIG. 39 the jaws are at their maximum grasping position. In FIG. 40 the jaws are closed beyond this maximum grasping position to grasp the smaller size suture S.
- the accommodating mechanism in this case may be considered as including the slot segment 1052 C that enables further rotation of the linkages to the position illustrated in FIG. 40.
- FIGS. 41 - 47 Another embodiment of a flexible or bending segment with a unibody construction which can be used with any suitable end effector like the tools 18 described above, whether used with a rigid shaft body or a flexible shaft body or combinations thereof.
- one of the benefits of the embodiment shown in FIGS. 41 - 47 is that only a single cable 1136 needs to be coupled to the tool 18 to actuate it.
- the pitch and yaw of the tool 18 is controlled at the flexible section 1100 shown in FIG. 41.
- This arrangement also lends itself to making the tool disposable or at the very least detachable from the instrument body to facilitate substituting another tool.
- a tool can be constructed that is readily detachable from the instrument.
- the bendable section 1100 is depicted near the tool, the bendable section can be located at other locations further away from the tool. Since the tool 18 of the embodiment shown in FIGS. 41 - 47 requires only a single actuation cable, it is simpler to operate than the wrist/tool combination shown in FIGS. 26 and 27. Recall, in the wrist arrangement, a pivot axis does not accommodate single cable actuation. Thus, with the wrist unit one has to use a far more complex cabling scheme, such as, by way of example, the cabling arrangement illustrated in U.S. Pat. Nos. 6,312,435 and 6,206,903. Furthermore, the single cable actuation provides a more simplified design that readily lends itself to a variety of tool constructions.
- the instrument In order for the various degrees of motions to be decoupled from each other, and for the proper overall functioning of the distal end of the instrument, the instrument has certain preferred characteristics, particularly at the flexible or bendable section of the instrument shaft. These characteristics are listed below but are not in any particular order of significance. Embodiments can employ at least one of these characteristics. Furthermore, although these characteristics are listed with reference to the embodiment described in FIGS. 41 - 44 , one or more of the characteristics can apply as well to any of the other embodiments described earlier.
- a first characteristic is that the actuation element for the tool be centered in the flexible or bendable section. In this way, during any bending operation the center of the flexible or bendable section tends to maintain the same length, even though opposed outer surfaces of the section may, respectively, expand and contract. This, in essence, means that the bending action is not erroneously transferred to the actuation element for the tool, hence, de-coupling the bending operation from the tool actuation, and vice versa.
- a second characteristic is that the flexible or bendable section of the instrument shaft be readily flexible without the application of undue force.
- This bendable section in a preferred embodiment, is to have orthogonal bending characteristics, hence providing two degrees of freedom (DOF) to the distal tool, for example, yaw and pitch.
- DOF degrees of freedom
- a substantial portion of the flexible or bendable section is located as near to the center neutral axis 1111 of the section as physically possible. This is achieved by the spaced rib construction including the ribs 1112 shown in the drawings.
- the slots 1114 defined by these ribs 1112 provide void areas, leaving more material near the center neutral axis, as depicted in FIG. 45. Reference has been made to a neutral axis 1111 of the bendable section 1 100 . In actuality there is for a particular bend direction a neutral plane that during a bend is maintained at a fixed length.
- a third characteristic relates to the torsional nature of the flexible or bendable section.
- the bendable section is torsionally stiff, then upon controlled rotation of the instrument shaft, there is no an undesired twisting action imparted on the shaft particularly at the flexible or bendable section 1100 .
- a substantial portion of the material forming the flexible or bendable section is located at the periphery of the flexible or bendable section. This may be achieved by having portions of the section extend to an outer surface.
- this is accomplished by providing radial ridges, such as the ridges 1120 shown in the drawings. Furthermore, these ridges are alternated between horizontal and vertical positions to, at the same time, to provide the orthogonal bending or flexing.
- a fourth characteristic is that the flexible or bendable section of the instrument shaft is constructed so that there is little or no end-to-end compression.
- the flexible or bendable section maintains a relatively constant length regardless of the motion actuations that occur in the multiple degrees of freedom movement of the instrument.
- a stiff member is provided to maintain the ends of the flexible or bendable section at a fixed spacing. This may be achieved by providing the stiff member as a centrally located stiff sleeve that receives and supports the sliding motion of the actuation element for operation of the distal tool.
- This stiff member is preferably fixed at its opposite ends to the bendable section to maintain the fixed length of the section, thereby preventing end-to-end compression. At least part of this member may include the sleeve 1182 depicted in FIG. 43.
- the medical instrument may include an elongated shaft, such as shaft section 1110 shown in FIGS. 41 and 42, having proximal and distal ends; and the tool 18 with jaws 102 and 104 , supported from the distal end of the elongated shaft and useable in performing a medical procedure on a subject.
- the tool 18 is actuated preferably by a single tendon or cable 1136 that extends through the flexible section 1100 .
- the bending or flexing section 1100 is constructed to bend in orthogonal directions with the use of four cables separated at about 90° intervals and by using a center support with ribs and slots about the entire periphery of the bending section 1100 , as depicted in FIGS. 42 - 44 .
- This orthogonal bending may also be referred to as bi-axial bending, meaning bending in separate axes.
- the ribs 1112 define corresponding slots 1114 , and also define at each of their centers a center support passage 1118 that has the cable 1136 extending through it, as well as other cable support members described in further detail later.
- the bending section 1100 extends from the end of tube section 1110 , which itself may be flexible, may be smooth as shown, or may be fluted, and may have other controllable bending sections disposed along its length.
- cables 1106 , 1107 , 1116 and 1117 To bend the bending section 1100 in orthogonal directions, use is made of the four cables 1106 , 1107 , 1116 and 1117 .
- the operation of cables 1106 and 1107 provides flexing in one degree-of-freedom while an added orthogonal degree-of-freedom is provided by operation of cables 1116 and 1117 .
- Each of the cables 1106 , 1107 , 1116 , and 1117 have at their terminating ends respective balls 1 106 A, 1 107 A, 1116 A, and 1117 A that may be held in corresponding recesses in a distal end wall 1119 (FIG. 45) of the flexible section 1100 .
- the bending section 1100 includes a series of spaced ribs 1112 positioned, in parallel, with the plane of each rib extending orthogonal to the neutral axis 1111 of the section 1100 .
- an end rib connects to the shaft section 1110 , while at the distal end there is provided the distal end wall 1119 that supports the ends of the cables.
- Each of the ribs 1112 are held in spaced relationship by means of the alternating ridges 1120 . As depicted in FIG. 43 these ridges are identified as horizontal ridges 11 20 A, alternating with vertical ridges 1120 B. This structure provides support at the center passage for the actuating cable 1136 , while also providing torsional strength to prevent undesired twisting at the shaft section 1100 .
- the jaws 1102 and 1104 are supported for opening and closing by means of a pivot pin 1135 that extends along a pivot axis. These grippers may be supported in link 1140 , and the pin 1135 may be supported at its ends in opposite sides of link 1140 .
- the tool also includes a pivot linkage 1142 that intercouples between the grippers and the actuation cable 1136 .
- the pivot linkage 1142 includes linkages 1142 A and 1142 B. At one end, each of the linkages 1142 A and 1142 B connects to respective jaws 1104 and 1102 . At the other end, the linkages 1142 A and 1142 B are pivotally supported at end 1137 of cable 1136 . Opposed pins extend from end 1137 for engagement with the linkages 1142 A and 1142 B.
- the jaws 1102 and 1104 are shown having recesses 1102 A and 1104 A for accommodating the respective linkages 1142 B and 1142 A.
- FIG. 42 the jaws 1102 and 1104 are shown in their open position with the linkages 1142 A and 1142 B shown in a forward pivoted configuration.
- FIG. 43 illustrates the jaws 1102 and 1104 in a closed position with the linkages 1142 A and 1142 B shown in an in-line configuration.
- FIG. 43 shows the linkage and grippers in a closed position.
- the structure shown in FIGS. 41 - 47 preferably also includes a plastic cable sheath 1180 , a plastic stiffener sheath or sleeve 1182 that surrounds the cable 1136 and the sheath 1180 , and that fits closely in the center passage 1118 , and an outer silicon spacer 1184 .
- the sleeve 1182 is preferably constructed of a polyethylene plastic such as PEEK which has flexibility to allow the sleeve 1182 to bend with the section 1100 , but at the same time is sufficiently stiff (particularly end-to-end) to properly retain, center and hold the supported cable to enable the cable to readily slide within the sheath 1180 and the supporting sleeve 1182 , in performing its function.
- the sleeve 1182 is illustrated extending from the distal end of the bendable section 1100 , back through the passage, to the more proximal end of the bendable section 1100 .
- FIGS. 42 and 43 also show the use of an adhesive, at 1186 , such an epoxy adhesive for anchoring opposite ends of the sheath 1180 and the sleeve 1182 to opposite ends of the bendable section 1100 .
- an adhesive such an epoxy adhesive for anchoring opposite ends of the sheath 1180 and the sleeve 1182 to opposite ends of the bendable section 1100 .
- FIG. 45 Other features of the bending section are shown in FIG. 45 in a side elevation view, while FIGS. 46 and 47 illustrate cross-sectional views, with one through one of the ridges 1120 A and the other through one of the ridges 1120 B.
- the respective ridges 1120 A and 1120 B are arranged at about 90 degrees to each other.
- the section 1100 is easily bendable while being torsionally stiff, and has other improved characteristics as well. Details of these characteristics are best described with reference to FIGS. 45 - 47 by considering a particular cross-section such as the cross-section in FIG. 45 taken along line 46 - 46 . In viewing FIG. 45 it is clear that, at that location and with the orientation of the section 1100 as shown, there is a substantial void created by the slot 1114 , so that the majority of the section material is located at the center of the section. This is consistent with the desired bendability at that location, since, in general, a structure becomes more bendable as its diameter deceases. The void area mentioned is also illustrated in the cross-sectional view of FIG. 46 at 1115 .
- the section 1100 is constructed so that there is preferably a relatively large center passage 1118 , leaving more material toward the outer periphery, which is desired for providing enhanced torsional stiffness. Note that this material is the material of the ridge itself. Thus, for torsional stiffness it is desired to have a void near the middle and more material located away from the middle.
- the rib and ridge arrangement shown in the drawings thus provides in a single structure a bendable section that provides two degrees of freedom (biaxial motion) that is also torsionally stiff.
- the bending characteristics enable the transfer of two degrees of freedom to the tool, rather than just one degree of freedom as with a conventional wrist joint.
- the torsional stiffness enables direct rotational transfer to the tool through the bendable section and without any twisting at the bendable section.
- the first characteristic relates to the centering of the actuation element. This is carried out primarily with the use of the center passage and the associated sheath 1180 , sleeve 1182 , and the spacer 1184 .
- the second characteristic relates to the ease of bending. This is accomplished primarily with the ribbed construction with void peripheral areas.
- the third characteristic relates to the torsion stiffness that is accomplished primarily by the alternating ridges.
- the fourth characteristic relates to the end-to-end compression.
- the center passage is provided with the stiff sleeve 1182 , and the opposite ends of the sheath 1180 and sleeve 1182 fixed in place, and the section 1100 has a ridged construction.
- FIGS. 41 - 47 disclose one version of an end effector employing jaws 1102 and 1104 , in combination with, linkage 1142 .
- other tool constructions are also contemplated as falling within the scope of the present invention including ones that provide a mechanical advantage at the tip of the jaws or other work elements.
- FIGS. 48 A- 48 D there is illustrated yet another embodiment of a flexible section 1660 with a unibody construction.
- the tool 18 attached to the distal end of the flexible section 1660 includes an upper grip or jaw 1602 and a lower grip or jaw 603 , supported from a link 1601 .
- Each of the jaws 1602 , 1603 , as well as the link 1601 may be constructed of metal, or alternatively, the link 1601 may be constructed of a hard plastic.
- the link 1601 is engaged with the distal end of the flexible stem section 1302 .
- FIG. 48C shows the distal end of the stem section 1302 , terminating in a bending or flexing section 1660 .
- the flexible section 1660 flexing and bending is enhanced by the arrangement of diametrically-disposed slots 1662 that define ribs 1664 between the slots.
- the flexible section 1660 also has a longitudinally extending wall 1665 , through which cabling extends, particularly for the operation of the tool jaws.
- the wall 1665 can also be thought of as opposed ridges that extend outward from the center of the flexible section 1660 .
- the very distal end of the bending section 1660 terminates with an opening 1666 for receiving the end 1668 of the link 1601 .
- the cabling 1608 - 1611 is preferably at the center of the flex section at wall 1665 to effectively decouple flex or bending motions from tool motions.
- FIGS. 48 A- 48 D also show cables 1606 and 1607 which couple through the bending section 1660 and terminate at ball ends 1606 A and 1607 A, respectively, and urge against the end of the bendable section in opening 1666 .
- FIG. 48D illustrates the cable 1607 having been pulled in the direction of arrow 1670 so as to flex the section 1660 as depicted in the figure. Pulling on the other cable 1606 causes a bending in the opposite direction.
- FIG. 48B has a separate link 1601 .
- this link 1601 may be fabricated integrally with, and as part of, the bending section 1660 .
- the link 1601 would then be constructed of a relatively hard plastic rather than the metal link as illustrated in FIG. 48B and would be integral with section 1660 .
- the tool may include a variety of articulated tools such as: jaws, scissors, graspers, needle holders, micro dissectors, staple appliers, tackers, suction irrigation tools and clip appliers.
- the tool may include a non-articulated tool such as: a cutting blade, probe, irrigator, catheter or suction orifice.
- the bending section itself may be non-actuated. As such, even when the bending movements of the bending section are not controlled by a surgeon, the one or more degrees-of-freedom of movement of the bending section allows it to conform to orifices or lumens within the patient's body as the section is advanced through the body.
- bendable sections such as in FIGS. 5, 14, 21 , or 41 . These may be used, as illustrated herein, in conjunction with instrument systems as described in, for example, FIG. 1 where the instrument is inserted laparoscopically. Alternatively, these concepts may also be used in flexible instrument systems more like that described in FIG. 21 wherein the bendable sections can be located at various positions along the instrument shaft or body. In this case the bendable section or sections may be used both for guidance toward an operative site, such as for guidance through an anatomic lumen or vessel, or for operation or manipulation at an operative site.
- the bendable section located close to but just proximal of the distal end effector or tool.
- This bendable section positioning provides for proper manipulation of the tool at the operative site.
- the bendable section preferably has a length in a range on the order of 3 ⁇ 4 inch to 4 inches.
- the distance between the tool pivot point and the distal end of the bendable section is preferably equal to or less than the length of the bendable section.
- FIG. 49 an example of a flexible instrument 2000 is shown in use in a stomach 2002 of a patient.
- the instrument 2000 includes an elongated portion 2004 , which itself is flexible, and an articulated bendable section 2006 .
- Any embodiments of the tool 18 described can be mounted at the terminal end of the bendable section 2006 .
- the bendable section 2006 can be any one of the different embodiments described earlier such as those shown in FIGS. 5, 14, 21 , or 41 .
- the flexible instrument 2000 is inserted through a body lumen such as the esophagus 2008 , and the tool 18 is directed to the operative site 2009 .
- the instrument 2000 can lean against some element of the anatomy such as a wall 2010 of the stomach to brace the instrument during the medical procedure, while the bendable section 2006 and the tool 18 are articulated as described above.
- a flexible instrument 2100 may include a bendable section 2102 that can be operated with one or more pull cables 2104 to manipulate the tip 2106 of the bendable section.
- the tip 2106 may be provided with an embodiment of the tool 18 described above that is positioned at the operative site to perform a medical procedure.
- At least one cable 2104 is attached at or near the tip 2106 of the bendable section 2102 , and extends from its point of attachment through an aperture 2108 at a position spaced a selected distance along the length of the bendable section 2102 away from the distal end.
- the remainder of the cable 2109 extends from the aperture 2108 through a shaft 2110 of the instrument 2100 and is coupled, for example, to a drive unit 8 , like that described earlier, that applies a tension to the cable 2104 to controllably bend the bendable section 2102 .
- the bendable section 2102 may have a circular cross section, or in some embodiments, the bendable section is provided with one or more grooves or valleys 2112 (FIG. 50B) along its length. As such, while the instrument 2100 is inserted into the patient, the cables 2104 lie along the grooves 2112 , which prevents the cables 2104 from inadvertently catching any body element. As appropriate tension is applied to a particular cable, it effectively “pops” out of the groove 2112 as the tip of the bendable section 2102 is pulled towards the aperture 2108 .
- the bendable section 2102 is provided with a center tube 2114 through which the actuation element for the tool 18 extends.
Abstract
A robotically controlled medical instrument includes a bending section with a unibody construction, a tool supported at a distal end of the bending section and used to perform a medical procedure on a subject such as a human patient, and an electronic controller that controls the bending section to provide at least one degree-of-freedom of movement.
Description
- Various types of instruments are used to perform surgical procedures on living subjects such as human patients. Typically, in the past, the surgeon held the instrument and inserted it into the patient to an internal surgical site. The surgeon then manually manipulated the instrument to perform the operation at the site. These instruments have been used to perform a number of surgical procedures including holding a needle to suture a region of the surgical site, cutting tissue, and grasping tissue and blood vessels.
- Recently, some have proposed using telerobotic surgical systems to perform certain surgical procedures. With these systems, the surgeon sits at a master station remotely located from the patient and surgical instrument, and controls the movements of the surgical instrument with an input device. In some systems, the surgeon manipulates the input device with one or both hands, and the instrument replicates the hand and finger movements of the surgeon. Because these replicated movements can be quite complex, the surgical instrument is controlled to move with multiple degrees-of-freedom.
- The present invention implements an instrument and methods of using the instrument for performing telerobotic surgical procedures on a patient. The instrument includes a bending section that is bendable with at least one degree-of-freedom.
- An instrument may have a bending section with a unibody construction that is bendable with at least one degree-of-freedom. A tool can be supported at the distal end of the bending section and can be used to perform a medical procedure on a subject such as a human patient. With a unibody construction, bending is by flexure of the unibody rather than by movement of parts relative to each other. The instrument can have two or more bending sections with unibody constructions. The two or more bending sections can be spaced apart or positioned adjacent to each other.
- In one embodiment, the bending section has a unibody bellows construction with alternating peaks and valleys positioned between proximal and distal ends of the bending section.
- The unibody construction may have a series of spaced ribs positioned along the length of the bending section between the proximal and distal ends of the bending section. In certain embodiments, the bending section includes a set of opposed ridges that extend along the length of the bending section. The individual ridges are positioned in a respective slot defined by adjacent ribs. In other embodiments, the bending section includes a first set and a second set of ridges extending along the length of the bending section. The individual ridges of the first set of ridges are positioned in every other slot defined between adjacent ribs, and the individual ridges of the second set of ridges are positioned in respective slots unoccupied by the first set of ridges. The first set of ridges can be positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section. Having the two sets of ridges positioned in the described manner makes the bending section torsionally stiff. However, the bending section remains flexible and bendable with two degrees-of-freedom.
- Some embodiments of the surgical instrument can include one or more of the following features. The instrument can include a first pair of cables and, optionally, a second pair of cables extending along the length of the bending section. To operate the instrument, tension is applied to at least one of the first pair of cables to bend the bending section with one degree-of-freedom, and to at least one of the second pair of cables to bend the bending section with a second degree-of-freedom.
- In some embodiments, the tool is able to move with two additional degrees-of-freedom. The tool can include a first jaw and a second jaw, connected to the first jaw at a pivot joint, so that the first jaw moves with one of the two additional degrees-of-freedom and the second jaw moves with the other of the two additional degrees-of-freedom.
- In certain embodiments, the instrument includes two additional pairs of cables extending along the length of the bending section and coupled to the first jaw and second jaws, respectively. During the surgical procedure, tension is applied to at least one of the first pair of additional cables to operate the first jaw, and to at least one of the second pair of additional cables to operate the second jaw. The additional pairs of cables can be positioned near the longitudinal axis of the bending section, and can be contained in a sleeve positioned along the longitudinal axis of the bending section so that the additional pairs of cables are able to slide along the sleeve relative to the bending section.
- In some embodiments, the tool includes a first jaw and a second jaw, connected to the first jaw at a pivot joint such that the first and second jaws open and close, and an actuation element extending along the length of the bending section and coupled to the first and second jaws to operate the first and second jaws. The actuation element can be a single cable coupled to the first and second jaws with a pair of linkages. The cable is pulled to close the jaws and pushed to open the jaws. The single cable can be positioned near the longitudinal axis of the bending section, and can be contained in a sleeve positioned along the longitudinal axis of the bending section so that the single cable is able to slide back and forth along the sleeve.
- The operation of the instrument may be controlled with a controller coupled with an input device operated by a user such as the surgeon. In particular, the surgeon can instruct the controller to direct a driver to manipulate the bending section and the tool in a desired manner.
- In some embodiments, a robotically controlled medical instrument system includes an elongated shaft having proximal and distal ends, a tool supported from the distal end of the elongated shaft and useable in performing a medical procedure on a subject, at least one controllably bendable section of the shaft, and an electrical controller for receiving a command from an input device, and for, in turn, controlling the bendable section to provide at least one degree-of-freedom at the bendable section.
- The system may include an actuation element extending with the instrument shaft and operable to control actuation of said tool. The actuation element may be positioned at least one of a substantially center axis and substantially center plane of the controllably bendable section so as to de-couple motion at the controllable bendable section from tool actuation.
- The distal end of the elongated shaft and the tool may have respective removably engaging portions that are readily engagable for positioning the tool at the distal end of the elongated shaft in operative position relative to the elongated shaft, and readily disengagable for removal of the tool from the distal end of the elongated shaft. The tool may be removably coupled with the distal end of the elongated support shaft.
- In another embodiment, a flexible surgical instrument includes a controllably flexible elongated section having a distal end for positioning at an anatomical site of interest of a subject, and at least one cable attached at or near the distal end of the section. The cable extends from its point of attachment exteriorly of the section through an aperture in the section at a position spaced a selected distance along the length of the section away from the distal end. A proximal end of the cable extends from the aperture through the shaft and is tensionable to controllably bend the flexible section.
- Some embodiments may have one or more of the following advantages. A bending section with a unibody construction is typically made with fewer parts than bending sections made with multiple linkages joined together, for example, with pins. Hence, the unibody construction is less expensive and easier to fabricate. Furthermore, with a unibody construction, there are less parts to retain together during a medical procedure, which reduces the potential of breakage of the bending section, and therefore minimizes parts of the bending section and medical instrument falling apart within the subject's body.
- The foregoing and other objects, features and advantages of the invention will be apparent from the following more particular description of preferred embodiments of the invention, as illustrated in the accompanying drawings in which like reference characters refer to the same parts throughout the different views. The drawings are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the invention.
- FIG. 1 is a perspective view illustrating a telerobotic system with which the concepts of the present invention may be practiced;
- FIG. 2 is a schematic diagram illustrating the degrees-of-freedom associated with the slave station of FIG. 1;
- FIG. 3 is a plan view of the instrument insert of the present invention including the stem section and tool;
- FIG. 4 is a cross-sectional view as taken along line4-4 of FIG. 3 and illustrating further details of the stem section;
- FIG. 5 is a perspective view of another embodiment of the tool of the present invention employing a flexible wrist section adjacent the tool;
- FIG. 6 is an exploded perspective view of the embodiment of FIG. 5;
- FIG. 7 is a cross-sectional view of the embodiment of FIG. 5 and as taken along line7-7 of FIG. 6;
- FIG. 8 is a longitudinal cross-sectional view of the embodiment illustrated in FIGS.5-7 and showing further details at the wrist flexure;
- FIG. 9 is a longitudinal cross-sectional view similar to that shown in FIG. 8 but for still another embodiment of the present invention using a single actuation element;
- FIG. 10 is an enlarged fragmentary view of further details of the actuation element at the center of the wrist section;
- FIG. 11 is a cross-sectional view through the actuation element of FIG. 10 as taken along line11-11;
- FIG. 12 is a cross-sectional view through still another embodiment of the actuation element;
- FIG. 13 is still a further cross-sectional view of a further embodiment of the actuation element;
- FIG. 14 is a perspective view of yet another embodiment of the present invention employing a slotted flexible wrist section and a detachable and preferably disposable tool;
- FIG. 15 is a cross-sectional view through the embodiment of FIG. 14 as taken along line15-15 of FIG. 14;
- FIG. 15A is a fragmentary cross-sectional view of an alternate embodiment of the flexible section;
- FIG. 16 is an exploded perspective view of the embodiment of FIG. 14 showing the detached tool in cross-section;
- FIG. 17 is a further perspective view of the embodiment of FIG. 14;
- FIGS.18-20 illustrate sequential cross-sectional views showing the mating of the tool with the distal end of the instrument;
- FIG. 21 is a schematic diagram illustrating principles of the present invention in a catheter or flexible instrument using multiple controllable bendable sections along the instrument;
- FIG. 22 is a schematic diagram of an embodiment of an instrument with both elbow and wrist pivot joints, as well as a disposable tool;
- FIG. 23 is a schematic diagram of an embodiment of an instrument with just a wrist pivot joint, as well as a disposable tool;
- FIG. 24 is a diagram showing further details of a wrist joint useable with a disposable tool;
- FIG. 25 is a partially cut-away schematic view of another joint construction;
- FIG. 26 is a perspective view of a another embodiment of a tool;
- FIG. 27 is an exploded perspective view of the tool of FIG. 26 illustrating separate components thereof;
- FIG. 27A is an exploded fragmentary view of one form of resilient member used in the embodiment of FIG. 27;
- FIG. 27B is an exploded fragmentary view of another form of resilient member used in the embodiment of FIG. 27;
- FIG. 28 is a side elevation view of the tool depicted in FIGS. 26 and 27;
- FIG. 29 is an enlarged partial top plan view as seen along line29-29 of FIG. 28 and illustrating further details of the tool;
- FIG. 30 is a cross-sectional view as taken along line30-30 of FIG. 29 showing the tool of the present invention with the jaws in a partially open position;
- FIG. 31 is a cross-sectional view like that illustrated in FIG. 30 but with the jaws in a fully closed position;
- FIG. 32 is a somewhat schematic cross-sectional view of the first embodiment of the tool with the resilient pad partially compressed in grasping a small diameter item such as a thread or suture;
- FIG. 33 is a somewhat schematic cross-sectional view of the first embodiment of the tool with the resilient pad essentially fully compressed in grasping a larger diameter item such as a needle;
- FIG. 34 is a perspective view of a second embodiment of the invention employing a flexure gap in one of the jaws;
- FIG. 35 is an exploded perspective view of the tool of this second embodiment of the invention;
- FIG. 36 is a plan view of the tool of FIGS. 34 and 35;
- FIG. 37 is a cross-sectional view taken along line37-37 of FIG. 36 with the jaws having a slight gap at their closed position;
- FIG. 38 is a cross-sectional view like that illustrated in FIG. 37 but with the jaws grasping a needle or the like, and with the flexure gap in a substantially closed position;
- FIG. 39 is a cross-sectional view similar to that depicted in FIGS. 37 and 38, and of yet another embodiment of the invention illustrating the tool in a partially open position;
- FIG. 40 is a cross-sectional view the same as that depicted in the embodiment of FIG. 39 but with the jaws in a more closed position;
- FIG. 41 is a perspective view of an embodiment of a flexible or bendable shaft segment just proximal to the tool;
- FIG. 42 is a cross-sectional view of the embodiment of FIG. 41 as taken along line17-17 of FIG. 16, and with the jaws in a substantially open position;
- FIG. 43 is an enlarged partial cross-sectional view similar to that shown in FIG. 42 but with the jaws in a closed position;
- FIG. 44 is an exploded perspective view showing the components including the flexible or bendable segment of FIG. 41;
- FIG. 45 is a side elevation view of the flexible or bendable section itself;
- FIG. 46 is a cross-sectional view through the flexible or bendable section as taken along line46-46 of FIG. 45;
- FIG. 47 is a cross-sectional view through the flexible or bendable section as taken along line47-47 of FIG. 45;
- FIG. 48A is a perspective view of an alternate embodiment of the tool and flexible section;
- FIG. 48B is an exploded perspective view of the tool and flexible section illustrated in FIG. 48A;
- FIG. 48C is a fragmentary perspective view showing a portion of the flexible section shown in FIG. 48B; and
- FIG. 48D is a plan view of the flexible section illustrated in FIGS.48A-48C.
- FIG. 49 illustrates a flexible instrument being used in a stomach of a subject in accordance with the invention.
- FIG. 50A is a schematic of a flexible instrument with a pull-type cable to operate the end of the instrument in accordance with the invention.
- FIG. 50B is cross-sectional view of a bendable section of the flexible instrument of FIG. 50A in accordance with the invention.
- A description of preferred embodiments of the invention follows.
- The surgical robotic system of the present invention, as illustrated in the accompanying drawings, although preferably used to perform minimally invasive surgery, can also be used to perform other procedures as well, such as open or endoscopic surgical procedures. FIG. 1 illustrates a
surgical instrument system 10 that includes a master station M at which asurgeon 2 manipulates an input device, and a slave station S including a surgical instrument illustrated generally at 14. In FIG. 1 the input device is illustrated at 3 being manipulated by the hand or hands of the surgeon. The surgeon is illustrated as seated in acomfortable chair 4, and the forearms of the surgeon are typically resting uponarmrests 5. - FIG. 1 illustrates a
master assembly 7 associated with the master station M and aslave assembly 8, also referred to as a drive unit, associated with the slavestation S. Assemblies controller 9, which typically has associated with it one or more displays and a keyboard. - As shown in FIG. 1, the
drive unit 8 is located remotely from the operative site and is preferably positioned a distance away from the sterile field. Thedrive unit 8 is controlled by a computer system that is part of thecontroller 9. The master station M may also be referred to as a user interface vis-à-vis thecontroller 9. The computer translates the commands issued at the user interface into an electronically driven motion in thedrive unit 8, and the surgical instrument, which is tethered to the drive unit through the cabling connections, produces the desired replicated motion. That is, thecontroller 9 couples the master station M and the slave station S and is operated in accordance with a computer algorithm, to be described in further detail below. Thecontroller 9 receives a command from theinput device 3 and controls the movement of thesurgical instrument 14 so as to replicate the input manipulation. FIG. 1 also shows a patient P, upon whom the surgical procedure is performed, lying on an operating table T. - In the embodiment illustrated in FIG. 1, the
surgical instrument 14 includes two separate instruments one on either side of anendoscope 13. Theendoscope 13 includes a camera to remotely view the operation site. The camera may be mounted on the distal end of the instrument insert, or may be positioned away from the site to provide an additional perspective on the surgical operation. In certain situations, it may be desirable to provide the endoscope through an opening other than the one used by thesurgical instrument 14. In this regard, in FIG. 1 three separate incisions are shown in the patient P, two side incisions for accommodating the surgical instruments and a central incision that accommodates the viewing endoscope. A drape covering the patient is also shown with a single opening. - The
surgical instrument 14 also includes a surgical adaptor or guide 15 and an instrument insert ormember 16. Thesurgical adaptor 15 is basically a passive mechanical device, driven by the attached cable array. Although thesurgical adaptor 15 can be easily seen in FIG. 1, the instrument member 16 (FIG. 3) is not clearly illustrated as it extends through theadaptor 15. The instrument insert 16 carries at its distal end atool 18, described in greater detail below. - Although reference is made herein to a “surgical instrument,” it is contemplated that the principles of this invention also apply to other medical instruments, not necessarily for surgery, and including, but not limited to, such other implements as catheters, as well as diagnostic and therapeutic instruments and implements.
- In FIG. 1 there is illustrated
cabling 12 coupling theinstrument 14 to thedrive unit 8. Thecabling 12 is preferably detachable from thedrive unit 8. Furthermore, thesurgical adaptor 15 may be of relatively simple construction. It may thus be designed for particular surgical applications such as abdominal, cardiac, spinal, arthroscopic, sinus, neural, etc. As indicated previously, the instrument insert 16 couples to theadaptor 15, and essentially provides a means for exchanging the instrument tools. The tools may include, for example, forceps, scissors, needle drivers, electrocautery etc. - During use, a surgeon can manipulate the
input device 3 at a surgeon'sinterface 11, to effect a desired motion of thetool 18 within the patient. The movement of the handle or hand assembly atinput device 3 is interpreted by thecontroller 9 to control the movement of thetool 18. - The
surgical instrument 14 is preferably mounted on arigid post 19 that is affixed to but removable from the surgical table T. This mounting arrangement permits the instrument to remain fixed relative to the patient even if the table is repositioned. In accordance with the present invention the concepts can be practiced even with a single surgical instrument, although, in FIG. 1 there are illustrated two such instruments. - The
surgical instruments 14 are connected to therespective drive units 8 with cablings that include two mechanical cable-in-conduit bundles 21 and 22. These cable bundles 21 and 22 may terminate at two connection modules, which removably attach to thedrive unit 8. For further details of the connection modules 23 and 24 can be found in the earlier co-pending application No. PCT/US00/12553, the entire contents of which are incorporated herein by reference. Although two cable bundles are described here, it is to be understood that more or fewer cable bundles can be used. Furthermore, although thedrive unit 8 is preferably located outside the sterile field, it may be draped with a sterile barrier so that it can be operated within the sterile field. - In the preferred technique to set up the system, the
tool 18 of thesurgical instrument 14 is inserted into the patient through an incision or opening, and theinstrument 14 is then mounted to therigid post 19 using a mountingbracket 25. The cable bundles 21 and 22 are then extended away from the operative area to thedrive unit 8, and the connection modules of the cable bundles are engaged into thedrive unit 8. Instrument inserts 16 (FIG. 3) may then be passed through thesurgical adaptor 15, and coupled laterally with thesurgical adaptor 15 through an adaptor coupler, as described below in further detail. - As just mentioned, the
instrument 14 is controlled by theinput device 3, which is manipulated by the surgeon. Movement of the hand assembly produces proportional movement of theinstrument 14 through the coordinating action of thecontroller 9. It is typical for the movement of a single hand control to control movement of a single instrument. However, FIG. 1 shows a second input device that is used to control an additional instrument. Accordingly, in FIG. 1 two input devices associated with the two instruments are illustrated. - The surgeon's
interface 11 is in electrical communication with thecontroller 9 primarily by way of thecabling 6 through themaster assembly 7.Cabling 6 also couples thecontroller 9 to the actuation or driveunit 8. While thecabling 6 transmits electrical signals, the actuation or driveunit 8 is in mechanical communication with theinstrument 14. The mechanical communication with the instrument allows the electromechanical components to be removed from the operative region, and preferably from the sterile field. Thesurgical instrument 14 provides a number of independent motions, or degrees-of-freedom, to thetool 18. These degrees-of-freedom are provided by both thesurgical adaptor 15 and theinstrument insert 16. - Shown in FIG. 2 is a schematic representation of the joint movements associated with the slave station S. The first joint movement J1 represents a pivoting motion of the instrument about the
pivot pin 225 ataxis 225A. Also illustrated is the movement relating to joint J2 which is a transitional movement of thecarriage 226 on therails 224 to move the carriage as well as theinstrument 14, supported therefrom, in the direction indicated by thearrow 227 in FIG. 2 towards and away from the operative site, OS. The cabling in thebundle 21 controls both the J1 and J21 movements. It is further noted that the distal end of theguide tube 17 extends to the operation site OS. The operation site may be defined as the general area in close proximity to where movement of the tool occurs, usually in the viewing area of the endoscope and away from the incision. - FIG. 2 also depicts the rotary motion of both the
adaptor tube 17 and the instrument stem. These are illustrated in FIG. 2 as respective motions or joints J3 (adaptor tube rotation) and J4 (instrument stem rotation). Motion J5 indicates a wrist pivot or, alternatively, a wrist flexure. Finally, motions J6 and J7 represent the end jaw motions of thetool 18. - The combination of joints J4-J7 allows the
instrument insert 16 to be actuated with four degrees-of-freedom. When coupled to thesurgical adaptor 15, theinsert 16 andadaptor 15 provide thesurgical instrument 14 with seven degrees-of-freedom. Although four degrees-of-freedom are described here for theinstrument insert 16, it is to be understood that greater or fewer numbers of degrees-of-freedom are possible with different instrument inserts. For example an energized insert with only one gripper may be useful for electro-surgery applications, while an insert with an additional linear motion may provide stapling capability. - With regard to the incision point, FIG. 2 shows the incision point along the dashed
line 485, and acannula 487 that in some surgical procedures is used in combination with a trocar to pierce the skin at the incision. Theguide tube 17 is inserted through theflexible cannula 487 so that the tool is at the operative site OS. The cannula typically has a port at which a gas such as carbon dioxide enters for insufflating the patient. The cannula also is usually provided with a switch or button that can be actuated to desufflate. The cannula is used primarily for guiding the instrument, but may include a valve mechanism for preventing escape of gas from the body. - FIG. 3 is a plan view showing an instrument insert including the
tool 18, and elongated sections including arigid section 302 and aflexible section 303, with thetool 18 mounted at the end of theflexible stem section 303. Thecoupler 300 includes one or more wheels that laterally engage wheels of the coupler associated with the surgical adaptor. Thecoupler 300 also includes anaxial wheel 306 that also engages a wheel on the adaptor. Theaxial engagement wheel 306 is fixed to therigid stem 302, and is used to rotate the tool axially at the distal end of theflexible stem section 303. - FIG. 3 illustrates the
base coupler 300 of theinstrument insert 16 withwheels idler pulleys wheels - Each wheel of the coupler has two cables that are affixed to the wheel and wrapped about opposite sides at its base. The lower cable rides over one of the idler pulleys or capstans, which routes the cables toward the center of the
instrument stem 302. The cables are kept near the center of the instrument stem, since the closer the cables are to the central axis of the stem, the less disturbance the cables experience as the stem section moves (rotates). The cables may then be routed individually through plastic tubes that may be affixed, respectively, to the proximal end of therigid stem 302 and the distal end of theflexible stem section 303. Alternatively, the cables may each be enclosed in separate plastic tubes or sheathes only in the flexible section of the instrument stem (see, e.g.,bundle 284 in FIG. 4). The tubes assist in maintaining constant length pathways for the cables as they move longitudinally within the instrument stem. - As for the
coupler 300, there are six cables that connect to each of the wheels. Two cables connect to each wheel and one of these cables extends about the associated idler pulley or capstan. These are illustrated in FIG. 3 asidler pulleys rigid stem 302 and down through theflexible stem section 303 to the area of the tool. - Associated with the
wheels sections pin 620. The other cables control the operation at the gripping jaws. For example, one pair of cables may control the movement of thelower jaw 652, while another cable pair may control the operation of theupper jaw 650. - In FIG. 4 there is shown the
rigid section 302 and theflexible section 303 of theinstrument insert 16. A series of six cables, illustrated atarrow 280 in FIG. 4 extend through these sections and may be considered as separated into three sets for controlling thetool 18, to provide the motions indicated in FIG. 2 as J5-J7. To de-couple wrist control from jaw control, the cabling is supported near to the center axis of the rigid and flexible sections. Note that “de-coupling” simply means that any one controlled action associated with the tool, when performed, does not interfere with other controlled actions that may not be selected at the time that the one controlled action is taking place. This may be controlled to some extent by using aretainer block 282 within these sections between thesections block 282 the cables may be unsupported as shown or they could be held within a plastic sleeve either individually and/or as a group. Because the cables are maintained in tension and the rigid section is not meant to bend or flex, the cables can be held in position by being supported, as a group, at the center ofblock 282. - From the other side of
block 282 the cables extend through in abundle 284. Also, each individual cable is preferably held within a cable sleeve, such as illustrated in FIGS. 6 and 8, to be described later in further detail. Also, as shown in FIG. 8 the cables contained in thesleeves 292 are twisted, for example, 180 degrees over say 8 inches. As also shown in FIG. 4,spacers 286 may be spaced along theflexible section 303 to hold thebundle 284 at the center of thesection 303. The individual cable sleeves also define a substantially fixed length pathway for each cable so that even though the instrument may move or rotate, the cable lengths should stay the same within the flexible stem section. The sleeves may be held in fixed position at their ends such as atblock 282 at one end and at thetool 18 at the other end. The outerflexible tube 288 may be a pliable plastic preferably having a fluted or bellows-like configuration, as illustrated. - The limited twisting of the cable bundle prevents the formation of kinks or loops in individual cables that might occur if the cables were straight and parallel through the flexible section. This twisting also provides the de-coupling between motions, so that actuation of one of the degrees-of-freedom (J5-J7) does not cause a responding action at another degree-of-freedom (J5-J7). The twisting essentially occurs between the
block 282 and the location where the bundle enters the wrist joint (for example, the entry to base 600). The 180 degree twisting of the bundle ensures that the cable sheathes are neither stretched nor compressed, even as the bendable section is bent or rotated. - The construction of one form of tool is illustrated in FIGS. 3 and 4. The
tool 18 includes thebase 600, link 601, upper grip orjaw 650 and lower grip orjaw 652. Thebase 600 is affixed to theflexible stem section 303. As illustrated in the drawings, this flexible section may be constructed of a ribbed plastic. This flexible section allows the instrument to readily bend through thecurved actuator tube 17. - The
link 601 is rotatably connected to the base 600 about anaxis 620A represented bypivot pin 620. The upper andlower jaws axis 605, whereaxis 605 is essentially perpendicular to the wrist axis atpin 620. Another pivot pin definesaxis 605. - Six cables actuate the separate members600-603 of the tool. The cabling may travel through the instrument insert stem (section 303) and through a hole in the
base 600, wrapping around a curved surface onlink 601, and then attaches onlink 601. Tension on one set of cables rotates thelink 601, and tension on other cables operates the upper andlower grips axis pin 605. The cabling is provided in pairs to provide an opposing action operation, including opposite routing paths, on the opposite sides of the instrument insert. - The set of cables that control the jaws travels through the
stem base 600. These cables then pass between twofixed posts 621 that constrain the cables so that they pass substantially through anaxis 620A, which defines the rotational motion of thelink 601. This construction allows free rotation of thelink 601 with essentially no length changes in the cables that actuate the jaws. In other words, these cables, which actuate thegrips link 601. These cables pass over rounded sections and terminate on grips (or jaws) 650 and 652, respectively. Tension on one pair of cables rotategrips axis 605. Another set of cables provides the clockwise motion to grips orjaws jaws - The
instrument 16 slides through theguide tube 17 ofadaptor 15, and laterally engages theadaptor coupler 230 pivotally mounted to thebase piece 234. Thebase piece 234 is rotationally mounted to theguide tube 17, and is affixed to the linear slider orcarriage 226. Thecarriage 226, in turn, is pivotally mounted at thepivot 225 about theaxis 225A. - The embodiment of the invention illustrated in FIGS.2-4 employs a fixed wrist pivot. An alternate construction is shown in FIGS. 5-8 in which there is provided, in place of a wrist pivot, a controllable flexing or bending section. In FIGS. 5-8, similar reference characters are used for many of the parts as they correspond to elements found in FIGS. 2-4. The construction in FIG. 5 may be employed with a stem section such as illustrated in FIGS. 3 and 4 with a curved guide tube.
- In the embodiment illustrated in FIGS.5-8, the
tool 18 includes an upper grip orjaw 650 and a lower grip orjaw 652, supported from alink 601. Each of thejaws link 601, may be constructed of metal, or alternatively, thelink 601 may be constructed of a hard plastic. Thelink 601 is engaged with the end of theflexible stem section 303. In this regard reference may also be made to FIG. 4 that shows the ribbed or fluted plastic construction of theflexible stem section 303. Alternatively, thesection 303 may be smooth, at least at its distal end, as shown at 304 in FIG. 5. In still another embodiment bothsections - FIG. 5 shows only the end of the stem section303 (at 304), terminating in bending or flexing
section 660.Section 660 may be integrally formed with the rest ofsection 303. Thissection 660 is controllably bendable or flexible usually from a remote location such as in accordance with thetelerobotic system 10 of FIG. 1. Thestem section 303 is preferably constructed so as to be flexible and may have either fluted or smooth outer surfaces. Also, at theflexible section 660, flexibility and bending is enhanced by abellows configuration 662 having saw-tooth shape of peaks and valleys as shown in FIG. 8. The distal end of thebending section 660 terminates with anopening 666 for receiving theend 668 of thelink 601. The bellows configuration may be made of a single piece of material. Alternatively, thebellows configuration 662 may be made of segments connected together, for example, by welds. In any case, thebellows configuration 662 is a unibody construction. - In the embodiment shown in FIGS.5-8, the bending or flexing
section 660 is constructed to have orthogonal bending movements to provide both pitch and yaw movement of the tool. This is accomplished by using four cables separated at 90° intervals. These four cables include thecables cables cables flexible section 660. Each of thecables end wall 615. These same cables also are supported by and extend throughretainer block 621. Withinsection 304 these cables also run near the outer wall as shown to the left in FIG. 8 wherecables - As for the operation of the tool, the
cables flexible stem section 303 and also through theretainer block 621, flexingsection 660, and thewall 615. These cables extend to the respective jaws (650, 652) to control the operation thereof in a manner similar to that described previously in connection with FIGS. 2-4. - As is apparent from FIGS.6-8, within the
bellows 662, the tool actuation cables extend through the center of the bellows and are supported and retained betweenblock 621 andwall 615 by thecenter sheath 290. Thecenter sheath 290 may be constructed of a soft plastic material, and has an inner diameter sufficient to receive the bundle of cables, and an outer diameter that fits with little clearance against the inner diameter of thebellows 662. Thesheath 290 extends between theblock 621 and thewall 615 and is dimensioned to hold the cables, as a bundle, at the center axis of the bellows section. Keeping the bundle near the center axis provides proper de-coupling between the various degrees-of-freedom. - Also, within the
bellows 662 each of the cables is contained in itsown cable sleeve 292. These sleeves are sufficiently stiff to maintain constant cable lengths within the flexible or bendable section. In FIG. 8 these sleeves are shown extending betweenretainer block 621 andwall 615. As shown in the right most portion of FIG. 8, the cables are shown extending from the sleeve when the cables reach the end tool. FIG. 8 also illustrates the aforementioned twisting of the cables that assists in providing the decoupling action between the tool operation and the controlled flexing or bending. The cables are twisted about 180 degrees between theblock 621 andwall 615. The bellows section itself, may have a length of about one to three inches. Also, more than one bellows section may be used to provide controlled bending at more than one location. In that case separate control cabling is used for each section (see, e.g., FIG. 21 described later). - As with the earlier described embodiment, the limited twisting of the cable bundle prevents the formation of kinks or loops in individual cables that might occur if the cables were left straight and parallel to one another. This twisting also de-couples certain degrees of motions, so that actuation of one of the degrees-of-freedom does not cause a responding action at another degree-of-freedom. The twisting occurs between the
block 621 and the location where the bundle enters the wrist joint, i.e. the entry tobase 601. By twisting the cables through 180 degrees, the placement of all the cables is displaced from one end of the bundle to the other by 180 degrees. The individual cable sleeves also define a substantially fixed length pathway for each cable so that even though the instrument may move or rotate the cable lengths stay the same within thesection 660. - The cross-sectional view of FIG. 8 gives details of the cabling in bending
section 660. Thesheath 290 extends essentially betweenblock 621 andwall 615 and houses the twisted cables/sleeves. Theindividual sleeves 292 can be considered as terminating at respective ends inblocks - The 180 degrees twist in the cables/sleeves occurs essentially between
blocks section 660 to be controllably bent, while preventing or minimizing any transfer of motion to the tool operating cables. Similarly, this arrangement also prevents cross-coupling from the tool operation to the bending control, so that the tool operation alone does not cause any undesired bending of thesection 660. - Referring now to FIGS.9-13 there is shown another embodiment that includes bellows which can be bent of flexed in a controllable manner, for example, through a user interface like that shown in FIG. 1. Similar reference characters are used in FIG. 9 as those used in describing the embodiment of FIG. 5. Unlike the embodiment shown in FIG. 5, the embodiment of FIG. 9 provides a single cable (or rod) actuation that simplifies the instrument construction, particularly at the tool end of the instrument. The single actuation is possible because the flexible section has two degrees-of-freedom to provide both pitch and yaw.
- In the embodiment illustrated in FIGS.9-13, the
tool 18 includes an upper grip orjaw 650 and a lower grip orjaw 652, supported from ahousing 670. Each of thejaws housing 670, may be constructed of metal, or alternatively, thehousing 670 may be constructed of a hard plastic. Thehousing 670 is engaged to theflexible stem section 303 with thebellows 662. Theflexible stem section 303 can be a ribbed or fluted plastic construction like that shown in FIG. 4, or alternatively, thesection 303 may be smooth as shown at 304 in FIG. 9. - In FIG. 9 the jaws are operated from a single push/
pull cable 672 that extends through the instrument stem and through thebellows 662 of the flexible orbendable section 660. The cable is centered in the various sections as depicted in FIG. 9 so that when the bendable section is activated, no movement is transferred to the tool actuation cable. In essence, thebellows section 662 expands on one side and compresses on the other side, leaving the center portion unchanged in length, and thus not effecting the cable action. The jaws themselves are supported by a link bar arrangement shown at 675 that is appropriately secured at the distal end of thecable 672. In the position shown in FIG. 9 the jaws are open, but by pulling on the cable away from the jaws the proximal end thelink bar 675 pivots and closes thejaws - FIG. 9 shows only the end portion of the
stem section 303, i.e., the portion at 304, terminating in bending or flexingsection 660. Thissection 660 is bent or flexed in a controllable manner usually from a remote location as depicted FIG. 1. Thestem section 303 is preferably constructed to be flexible and may have either fluted or smooth outer surfaces. Also, at the bending or flexingsection 660, flexibility and bending is enhanced by means of constructing this section with a bellows configuration 66 having peaks and valleys in a saw-tooth shape arrangement as illustrated in the cross-sectional view of FIG. 9. The distal end of thebending section 660 has an opening for receiving the end of thehousing 670. Awall 615 is positioned at the distal end of thebellows 662. - In the embodiment shown in FIG. 9, the bending or flexing
section 660 can be bent to provide both pitch and yaw degrees of motion to the tool. This is accomplished by using fourcables cables cables flexible section 660. Each of thecables end wall 615. These cables also are supported by and extend throughretainer block 621. Withinsection 304 these cables also run near the inner surface of the outer wall of thesection 304, as shown to the left in FIG. 9 wherecables - As mentioned previously, the
single actuation cable 672 provides all the action that is required to operate the tool, which simplifies the construction of the instrument and makes it easier to keep the single cable centered in the instrument. To accomplish this, there is provided a supportingsleeve 680 that receives thecable 672 with a snug fit. The sleeve 680 (FIG. 10) is preferably constructed of a polyethylene plastic such as PEEK which has the flexibility to flex with bending at thesection 660, but at the same time is sufficiently rigid to properly retain and hold the supportedcable 672 to enable the cable to readily slide within the supportingsleeve 680 when performing its function.Sleeve 680 defines a fixed length for the cable and does not allow any expansion or compression of the cable or sleeve. Thesleeve 680 may extend from thewall 615 back through theretainer block 621 and into the flexible section of the instrument, as shown in FIG. 9. Alternatively, thesleeve 680 may extend only through thesection 660 and terminate atblock 621. - In addition to the
sleeve 680, there is provided, about thesleeve 680, ahelical spring 682 having an outer diameter to allow it to fit snugly within the inner diameter of thebellows 662. Note that there is a relatively close fit between thecable 672,sleeve 680, andhelical spring 682 within thebellows 662. Opposite ends of thehelical spring 682 are located between theblock 621 andwall 615. FIG. 10 shows the spring shape and the relationship of the helical spring to thesleeve 680 and theactuation cable 672. In FIG. 10, the coils of the spring are shown spaced apart, but they can be more closely spaced then shown or completely closed. - The
spring 682 may be free-floating about thesleeve 680, and is preferably not engaged in any passage in the end supports, such as the passage inblock 621. Thesleeve 680, on the other hand receives thecable 672 and is fixed in position relative to block 621 andwall 615. Passages are provided inblock 621 andwall 615, and a glue or other securing arrangement is preferably used to hold the sleeve fixed at theblock 621 andwall 615. Thespring 682 is also used as a filler or spacer between thesleeve 680 and thebellows 662 inner surface. The spring provides a fixed position spacer since it is typically a metal, and thus will maintain the centering of the sleeve/cable, and yet is also flexible enough to bend when thesection 660 is bent in a controlled manner. The sleeve itself is preferably made of plastic such as PEEK which has sufficient strength to receive and guide the cable, yet is flexible enough so that it will not kink or distort, and thus keeps the cable in a proper state for activation, and defines a fixed length for the cable. - By maintaining the
sleeve 680 fixed in position at theblock 621 andwall 615, the cable length at the center axis ofsection 660 does not change when thesection 660 is bent. That is, the bellows shortens on one side and expands on the other side while keeping the center axis length unchanged. In this way when bending occurs atsection 660 there is no transfer of motion to thecable 672 which could undesirably move the jaws. Hence, the bending motion is de-coupled from the tool operation motion, and vice versa. - FIG. 11 is a cross-sectional view taken along line11-11 of FIG. 10 showing the
centered cable 672,plastic sleeve 680, and thehelical spring 682. FIG. 12 is a similar cross-sectional view but for an alternate embodiment using only thecenter cable 672 and thesleeve 680. In FIG. 12 thesleeve 680 is larger in outer diameter in comparison to the sleeve shown in FIG. 11 so that there is a proper and close fit between the sleeve and the inside of the bellows. - FIG. 13 is a cross-sectional view through another embodiment of the cable support. This embodiment also has the
center cable 672 contained within thesleeve 680, but in place of thespring 682 there is instead used aspacer 681 made of, for example, plastic, to keep the sleeve and cable centered in the bellows. Thespacer 681 may be constructed of a softer plastic than thesleeve 680, or may be made of a plastic foam material. - One of the benefits of the embodiment of FIG. 9 is that only a single cable is necessary to activate the tool. Recall that the pitch and yaw of the tool is controlled at the
flexible wrist section 660 shown in FIG. 9. This arrangement lends itself to making the tool disposable or at the very least detachable from the instrument body so that it can be replaced with a substitute tool. A detachable embodiment of the present invention is illustrated in FIG. 14 and the companion views are shown in FIGS. 15-20. Besides being detachable this arrangement also makes it possible to provide at least a resposable and preferably a disposable instrument tip or tool. - In FIG. 14 a disposable tip is illustrated in conjunction with a flexible shaft or tube having a remotely controllable bending or flexing
section 700. The medical instrument may include an elongated shaft, such asshaft section 710 shown in FIGS. 14 and 15, having proximal and distal ends, and a tool, such asgraspers - As shown in FIG. 14, the detachable or disposable tool is used with a flexible controllably bendable section. In another version the disposable tool can be used with a wrist pivot or even a pair of successive wrist pivots that are orthogonal to one another for providing pitch and yaw movement at the tool. The disposable tool in this version is also preferably actuated by a single actuation element, cable or the like.
- In FIGS. 14 and 15, in a manner similar to that shown in FIG. 9, the tool is actuated by a single tendon or
cable 736 that extends through theflexible section 700. To provide the pitch and yaw action at the tool, the bending or flexingsection 700 is constructed to have orthogonal bending movements by pulling on fourcables center support 726 withribs 712 extending from thecenter support 726 and definingslots 714 between adjacent ribs, as depicted in FIG. 15. Theribs 712 extend from acenter support 726 that has extending therethrough a passage for receiving thecable 736 positioned within asheath 730. Theribs 712 also provide a guide structure to the fourcables bending section 700 is a unibody construction that extends from the end oftube section 710, which itself may be flexible, and it may be smooth as shown, or may be fluted as illustrated in FIG. 4. - This version enables the bending section to be bent in orthogonal directions by the use of the four
cables cables cables cables respective balls distal end wall 719 of theflexible section 700. Note that in place of the slotted bendingsection 700, a bellows arrangement such as shown in FIGS. 5 or 9 can be used. - The structure shown in FIGS.14-17 preferably includes a plastic stiffener sheath or
sleeve 730 that surrounds thecable 736, and that fits closely within the passage of thecenter support wall 726. Thesleeve 730 is preferably constructed of a polyethylene plastic such as PEEK which has enough flexibility to flex with thebending section section 700, but at the same time is sufficiently rigid to properly retain, center and hold the supported cable to allow thecable 736 to readily slide within the supportingsleeve 730 in performing its function. Thesleeve 730 may extend from the distal end of theflex section 700, back through the passage in thewall 726, and into theshaft section 710 of the instrument, as shown in FIG. 15. - Referring to FIG. 15A there is shown an alternate embodiment for the
bending section 700 in which thesleeve 730 is eliminated. In this case, the passage in thewall 726 is dimensioned to directly and snugly receive thecable 736 with a close tolerance fit but having sufficient clearance to allow the cable to readily slide in the instrument. - The
grippers pivot pin 735 that extends alongaxis 735A in ahousing 740. Referring to FIG. 16 there is shown in partial cross-section thehousing 740,pin 735, andgrippers pin 735 may be supported at its ends on opposite sides ofhousing 740. The tool also includes apivot linkage 742 that intercouples the grippers with theactuation cable 736 such that as the linkage is moved in the axial direction by thecable 736 to open or close the jaws (or grippers). In FIG. 15 the linkage and tool are shown in solid outline in the closed position, which corresponds to a “pulling” of the cable in a direction away from the tool. FIG. 15 also shows, in dotted outline, the linkage and grippers in an open position, which corresponds to a “pushing” of the cable in a direction toward the tool. The grippers themselves are prevented from any axial movement by the support atpin 735, so when the linkage is operated from thecable 736 the resulting action is either opening or closing of the grippers, depending upon the direction of longitudinal translation of theactuating cable 736. - For the tool shown in FIGS.14-17 to be detachable there is provided removably engaging portions, which in the illustrated embodiment are formed by mating threaded portions. Further, these mating portions are provided both with respect to the actuation element (cable) as well as the stationary components of the tool and tube. Thus, the tool housing has a threaded
portion 746 with female threads, and the distal end of theflexible section 700, as shown in FIG. 16, has a threadedportion 748 with male threads. The end of theactuation cable 736, as shown in FIGS. 16 and 17, is terminated atblock 750, passing through a center passage in the threadedportion 748. Theblock 750, interacting witharms 751, allows longitudinal sliding of thecable 736, but prevents rotation thereof so that the tool can be screwed onto the shaft without rotating the actuation cable. Theblock 750 supports a male threadedshaft 753 that is adapted to mate with the tool. The threaded portion at 753 may have twice the threads per length as the threadedportion 748. Also, theblock 750 interacts with the arms as the tool is fully engaged to compensate for differences in thread pitch between the engaging members - As previously indicated, the tool grippers are operated with the
linkage 742. FIG. 17 shows the end of this linkage supporting a female threadedpiece 760. To engage the tool with the instrument shaft, thefemale piece 760 is threaded onto the male threadedshaft 753 in the direction indicated by the rotational direction arrow 770. - Referring to FIGS.18-20, there is shown the sequence of steps to attach the instrument tip to the shaft of the instrument. These views are somewhat schematic and are for the purpose of merely illustrating the steps taken in attaching the tool to the instrument shaft.
- In FIG. 18 the tool is first illustrated with its
housing 740 about to engage at threadedfemale piece 760 with the corresponding threadedmale shaft 753. It is noted that the threads ofpieces 760 andshaft 753 are finer that the threadedportions piece 760 andshaft 753 are designed such that only about four turns are necessary to fully seat these members together. On the other hand thesections tab 780 ofhousing 740, and recess 782 associated with theflexible section 700. - FIG. 19 illustrates the positions of the various components after two turns have occurred between threaded
shaft 753 and threadedpiece 760, and the other outer mating threaded sections are to engage. Next the threadedportions block 750 is free to move inward away from the tool. - Referring now to FIG. 21, there is shown an embodiment having a detachable and disposable tool, and particularly adapted for application to a flexible instrument including a catheter. Features of the earlier described embodiments may be used with the embodiment of FIG. 21. Again, although not necessary, in a preferred embodiment the tool is operated remotely in a telerobotic manner from a user device such as shown in FIG. 1. The use of multiple controllably bendable segments as shown in FIG. 21 is particularly advantageous in a flexible instrument to assist in guidance thereof such as, for example, in vessels or arteries.
- FIG. 21 shows primarily the distal end of a flexible instrument with the more proximal portions of the instrument being supported and driven in a manner similar to that illustrated in FIGS. 1 and 2. Rather than having only one bending or flexing section as described above, the
flexible instrument 800 has two bendingsections sections - A
tool 820 is positioned at the distal end of the instrument, and is preferably constructed to be disposable and may be substantially the same as the tool illustrated in FIGS. 14-17 including the interengaging portions for detachability of both the tool body and the tool actuation element. As shown in FIG. 21, acable 825 is used as the actuation element. Also illustrated in FIG. 21 areinstrument transition segments flexible section 303 shown in FIG. 4. Alternatively, one or both of thesesections - In each of the instrument sections shown in FIG. 21 the actuation elements (cables) that are not used to operate a particular section run preferably through the center of the respective section to provide the proper de-coupling between the various degrees of movement. Thus, the
center cable bundle 840 through thesection 810 includes the cables to operatesection 815 and thetool 820. - If the two
controllable sections sections section 810 where five cables extend along the center of the section (four for actuation of thesection 815 and one for tool actuation) similar to that shown in FIG. 8. - Thus, nine cables extend through
section 830, five in thecenter bundle 840 and four extending through and about the periphery ofsection 810 to provide the controlled bending ofsection 810. FIG. 21 shows two of these cables terminating at 812 and used to operate and move thesection 810 with one degree of freedom. Two other cables (displaced about 90 degrees) also terminate at the same general area and are used to operate thebending section 810 with the other degree-of-freedom. - Next, in
section 835 four cables at 836 branch outwardly and terminate at the end ofsection 815 at 837 to control the flexing ofsection 815. Insection 815 there is thus only the singletool actuation cable 825 contained in a sheath extending through the center of the section. Although FIG. 21 shows only two of thecables 836 for controlling one of the degrees-of-freedom of movement of thesection 815, there are two other cables (displaced about 90 degrees) that also terminate at the same location for the other degree-of-freedom of control ofsection 815. Again, reference to FIG. 8 can be made for the operation of the bending movement of the sections with the use of the cables. - The instrument shown in FIG. 21 may be used for any number of different surgical procedures. Flexible instruments of this general type are shown in co-pending applications that have been incorporated herein by reference in their entirety. Although FIG. 21 shows four cables that are used to actuate a respective bending section, more or fewer cables can be used in each section. For example, if only one degree-of-freedom is desired in
section 810 then only two actuating cables are employed to control bending in only one plane. The instrument may also be controlled for rotation to provide another degree-of-freedom. - In the embodiment of the invention shown in FIGS.14-17, the tool is readily disposable. By providing a bendable section that can control both pitch and yaw movement of the tool, the tool itself becomes actuable with a single cable or rod. Now, FIGS. 22 and 23 disclose in a schematic manner this same disposability feature as applies to an instrument, whether flexible or rigid, that employs a wrist pivot or wrist and elbow pivot.
- FIG. 22 is a schematic diagram of the instrument illustrating both elbow and wrist pivot joints, as well as the disposable tool. FIG. 23 shows just a wrist pivot joint with a disposable tool. More specific details of portions of the diagrams can be found in earlier embodiments described herein.
- In FIGS. 22 and 23 like reference characters are used to identify like parts. In FIG. 22 there is provided an
instrument 900 that includes both an elbow joint 905 and awrist joint 910. These joints allow for orthogonal motions of the various segments aboutrespective axes instrument 900 also includes anend tool 920 driven from a cable orrod 925. This tool construction and its actuation element may be the same as described in FIGS. 14-17, and would include separate interengagable/disengagable portions as previously described. - In FIG. 23 there is shown an
instrument 930 that includes only asingle wrist joint 910, along with thetool 920 actuated by means of theactuation element 925. Againtool 920 is preferably readily detachable in the manner shown in FIGS. 14-17 and is thus readily disposable. To provide another degree-of-freedom the instrument may be controllably rotated as indicated by thearrow 927 in FIG. 23. - FIG. 24 illustrates a wrist or other joint that may be used for the joints shown FIGS. 22 and 23. FIG. 24 shows a ball joint950 with
intercoupling sections actuation cable 954 is also illustrated extending throughsections sections sheath 958 that encloses thecable 954, and that is preferably fixed in position at the top and bottom of the joint. The sheath is flexible and yet sufficiently durable so as to define a fixed length for the cable to extend through, even as the joint is actuated to rotate or pivot. - Appropriate cabling may be provided for control of the joint950. This type of joint is particularly advantageous in that the center of the joint is open and does not interfere at all with the passing of the
actuation cable 954 andsheath 958 through the joint 950. Again, by maintaining the cable at the center of the joint, as illustrated, even as the joint is actuated there is no adverse effect on the actuation cable. In other words as the joint rotates it does not change the length of thecable 954, and thus these separate actions are de-coupled from each other. - Referring now to FIG. 25, a further description of a wrist or other joint is illustrated that may be used for the joints shown in FIGS. 22 and 23. FIG. 25 shows a ball joint960
intercoupling sections actuation cable 964 is also illustrated extending throughsections sections cable 964 and that may be preferably fixed in position at the top and bottom of the joint. - Appropriate cabling may be provided for control of the joint960. In this particular joint rather than being completely open as in FIG. 24 there is provided a funnel like surface illustrated at 970 that directs the cable to an
output orifice 972 where the cable is coupled into thesection 962. Thisfunnel surface 970 holds the cable such that as the sections experience relative rotation while the length of the cable within the joint is maintained at a fairly fixed length. - Other embodiments of the
tool 18 are within the scope of the invention, such as that illustrated in FIGS. 26-33. A set of jaws is illustrated in the figures, but it is understood that other types of tool constructions may also be used with the concepts of the present invention. Also, the instrument shaft may be a rigid shaft, a flexible shaft, or combinations thereof. - The
tool 18 includes four basic members including thebase 1020,link 1021, upper grip orjaw 1022 and lower grip orjaw 1023. Thebase 1020 is affixed to theinstrument shaft 1010. Theinstrument shaft 1010 may be rigid or flexible depending upon the particular use. If theshaft 1010 is flexible it may be constructed, for example, of a ribbed plastic material. A flexible shaft or section thereof would, in particular, be used in conjunction with a curved guide tube so that the instrument readily bends through the curved adaptor guide tube. - In the embodiment of FIGS.26-33,
link 1021 is rotatably connected to thebase 1020 aboutwrist pivot axis 1025 with a wrist pivot pin at 1026. The upper andlower jaws link 1021 aboutaxis 1028 with apivot pin 1030, whereaxis 1028 is essentially perpendicular toaxis 1025. The jaws may also be referred to as grippers or graspers. - Six cables1036-1041 actuate the wrist, namely the
link 1021, as well as the end effector ortool 18.Cable 1036 extends through the instrument shaft and through a hole in thebase 1020, wraps aroundcurved surface 1032 onlink 1021, and then attaches onlink 1021 at 1034. Tension oncable 1036 rotates thelink 1021, as well as the upper andlower jaws axis 1025.Cable 1037 provides the opposing action tocable 1036, and goes through the same routing pathway, but on the opposite side of the instrument shaft.Cable 1037 is also attached to link 1021 generally at 1034. -
Cables instrument shaft 1030 and though holes in thebase 1020. Thecables fixed posts 1035. These posts constrain the cables to pass substantially through theaxis 1025 about which thelink 1021 rotates. This construction allows thelink 1021 to rotate freely with minimal length changes in cables 1038-1041. In other words, the cables 1038-1041, which actuate thejaws link 1021.Cables jaws cables jaws axis 1028. - Finally, as shown in FIG. 27, the
cables cables cables jaws jaws - In addition to the
jaws tool 18 includes arotation piece 1045, alinkage 1046 and slottedlinkage 1048. Therotation piece 1045 has a centrallydisposed hole 1045A that is adapted to receive thepivot pin 1030. Thepivot pin 1030 also passes throughholes 1023A in one jaw member and holes 1022A in the other jaw member. Thepin 1030 is secured in respective holes in thearms 1029 of thelink 1021 in a well-known manner to rotatably support the jaw members from thelink 1021. Therotation piece 1045 also carries anactuation pin 1050 extending in the same direction as thepivot pin 1030, and parallel thereto. Theactuation pin 1050 extends into curved J-shapedslots 1052 inrespective jaw flanges 1054 ofjaw 1023. - The
actuation pin 1050 is also received by thelinkage 1048 through theend hole 1048A, and the linkage is supported between the spacedflanges 1054 of thejaw 1023. At the slotted end of thelinkage 1048 there is a set ofholes 1048B that receive thepin 1056. Thelinkage 1048 also pivotally attaches with thelinkage 1046 by virtue of thepin 1056 passing through theholes pin 1056 is also positioned in theslots 1052 of theflanges 1054, and thus moves along the slots to different positions, two of which are illustrated in FIGS. 30 and 31. When the jaws are fully closed, thepin 1056 is at the very top of theslot 1052 as illustrated in FIG. 31. FIG. 30 shows thepin 1056 in a lower position which occurs when the jaws are partially opened. Thepin 1050 likewise is in different positions in the slot 52 depending upon the position of the jaws. - The
linkage 1046 is also supported at its other end athole 1046A by thepin 1058. Thepin 1058 also passes through a set ofholes 1022B in the base of thejaw 1022. Thelinkage 1046 fits in a slot at the base of thejaw 1022, and thepin 1058 passes through both the base of thejaw 1022 as well as thelinkage 1046. Thepin 1058 also preferably has a compliant member such as a set of resilient members disposed about at least a portion thereof, as illustrated in FIGS. 30 and 31, at 1060, in an uncompressed position. FIG. 31 shows theresilient cups 1060 uncompressed, while FIG. 32 shows the resilient cups partially compressed when the jaws are grasping a small diameter member such as a suture S. FIG. 33 shows thecups 1060 essentially fully compressed, when the jaws are grasping a larger diameter member such as a needle N. Thecups 1060 may fit about thepin 1058, and be disposed in the base of thejaw 1022. Theholes 1022B that receive thecups 1060 are of somewhat elongated shape, such as illustrated in FIGS. 27A, 27B, 30, and 31. - With further reference to FIGS. 32 and 33, the
jaws cups 1060. Thus, the larger the diameter of the item being held, the larger the corresponding holding force. The tool is constructed so that when the jaws are holding an item the size of a needle N thecups 1060 are essentially fully compressed, and a maximum grasping force is applied to the needle N. This is particularly desirable for important surgery techniques for the securing and controlling of the needle. When thejaws pin 1056 is in a contact position A′ (FIG. 33) for a larger item such as the needle N, or further up theslot 1052 at a position A (FIG. 32) for a smaller item such as the suture S. When a sufficient force is applied to the item with the jaws, thepin 1056 moves to a locked position B (FIGS. 32 and 33), regardless of the size of the item being grasped. - Other embodiments of the resilient members are shown in the fragmentary exploded views of FIGS. 27A and 27B. The embodiment of FIG. 27A uses a pair of
cups 1060A, while the embodiment of FIG. 27B uses only a single cup. In FIGS. 27A and 27B the same reference characters are used as in FIG. 27 to identify like components. In the embodiment of FIG. 27A thecups 1060A are positioned withinrespective holes 1022B. They may be positioned with the use of an adhesive. Thecups 1060A are thus be located at opposite ends of thepin 1058. When the jaws are in the closed position, thesecups 1060A are compressed as thepin 1058 rides downwardly in the somewhat elongated hole orslot 1022B. In the embodiment of FIG. 27B thesingle cup 1060B is of somewhat larger shape than thecups 1060A and is located between the spaced walls of thebase 1022C. Thelink 1046 is positioned between these walls, as is thecup 1060B. Thecup 1060B may also be secured in position by an adhesive. Thecup 1060B is engaged by the end of thelink 1046. In this embodiment thepin 1058 also rides within theelongated slots 1022B and when the jaws are moved to a closed position the end oflink 1046 bears against thecup 1060B. In still another embodiment one may use all three cups to provide additional resiliency. - The actuation cables for the end effector include the cables1038-1041. One set of cables actuates the
rotation piece 1045, while the other set of cables actuates thejaw 1023. Theother jaw 1022 is actuated through the coupling provided from therotation piece 1045 to thejaw 1022, includingpin 1050 and the associatedlinkages slots 1052. These linkages provide direct drive from therotation piece 1045 to the base of thejaw 1022, to control the pivoting motion of that jaw, controlled usually from a remote location. - Another embodiment of the
tool 18 is illustrated in FIGS. 34-38, where FIG. 34 is a perspective view of the tool while FIG. 35 is an exploded perspective view showing the separate components of the tool. In this embodiment the same reference characters are used to designate similar components. - The
tool 18 shown in FIGS. 34-38 includes four basic members including abase 1020, alink 1021 attached to the base, an upper grip orjaw 1022, and a lower grip orjaw 1023. The base is affixed to an instrument shaft in a manner similar to that depicted in FIG. 26. As before, the instrument shaft may be rigid or flexible depending upon the particular use. - In the embodiment shown in FIGS.34-38, the
link 1021 may be rotatably connected to the base about a wrist axis such as theaxis 1025 of the just previously described embodiment. The upper andlower jaws link 1021 aboutaxis 1028 with apin 1030 that is substantially perpendicular toaxis 1025. - Six cables1036-1041 actuate the wrist, namely the
link 1021, as well as the end effector ortool 18.Cable 1036 extends through the instrument shaft and through a hole in the base, wraps aroundcurved surface 1032 onlink 1021, and then attaches onlink 1021 at 1034 (FIG. 35). Tension oncable 1036 rotates thelink 1021, and the upper andlower jaws Cable 1037 provides the opposing action tocable 1036, and goes through the same routing pathway, but on the opposite side of the instrument shaft.Cable 1037 is also attached to link 1021 generally at 1034. -
Cables cables posts 1035 in FIG. 26. These posts constrain the cables so that they pass substantially through the wrist axis about which thelink 1021 rotates. This construction allows thelink 1021 to freely rotate with minimal length changes in cables 1038-1041. Hence, the cables 1038-1041, which actuate thejaws link 1021.Cables jaws cables jaws axis 1028. - Finally, as shown in FIG. 35, the
cables cables cables jaws jaws - In addition to the
jaws tool 18 includes therotation piece 1045, along withlinkage pair 1066 andstraight linkage 1068. Therotation piece 1045 has acentral hole 1045A that receives thepivot pin 1030. Thepivot pin 1030 also passes throughholes 1023A in one jaw member andhole 1022A in the other jaw member. Thepin 1030 is secured to respective holes in thearms 1029 of thelink 1021 to rotatably support the jaw members from thelink 1021. Therotation piece 1045 also carries anactuation pin 1050 extending in the same direction as thepivot pin 1030, and parallel thereto. Theactuation pin 1050 extends intocurved slots 1052 inrespective jaw flanges 1054 ofjaw 1023, as shown in FIGS. 35, 37, and 38. - The
actuation pin 1050 is also received through anend hole 1068A of thelinkage 1068, and the linkage is supported between the spacedflanges 1054 of thejaw 1023. At the other end of thelinkage 1068 there is ahole 1068B that receives thepin 1076. Thelinkage 1068 also pivotally attaches with thelinkage pair 1066 by virtue of thepin 1076 passing through theholes pin 1076 is also positioned in theslots 1052 of theflanges 1054, and thus moves along the slots to different positions, two of which are illustrated in FIGS. 37 and 38. When the jaws are in a substantially closed position, thepin 1076 is at the top of theslot 1052 as illustrated in FIG. 37. When the jaws are in other positions, thepin 1050 will reside in different positions in theslot 1052. - The
linkages 1066 are also supported at its other ends atholes 1066A thepin 1078. Thepin 1078 also passes through ahole 1022B in the base of thejaw 1022. At that point the base has asupport wall 1022D in which thehole 1022B is located. Thelinkage pair 1066 fits on opposite sides of thewall 1022D, and thepin 1078 passes through both the base of thejaw 1022 as well as thelinkage pair 1066. - The actuation cables for the end effector or tool include the cables1038-1041. One set of cables actuates the
rotation piece 1045, while the other set of cables actuates thejaw 1023. Theother jaw 1022 is actuated through the coupling provided from therotation piece 1045 to thejaw 1022, includingpin 1050 and the associatedlinkages slots 1052. These linkages provide direct drive from therotation piece 1045 to the base of thejaw 1022, to control the pivoting motion of that jaw, typically from a remote location. - In the embodiment shown in FIGS.35-38, control of the grasping force on an item is provided primarily by means of a slot or gap in one of the jaws. This is illustrated in FIGS. 34-38 by the
gap 1031 located near thebase 1022C in thejaw 1022. FIGS. 35, 37, and 38 show in particular the shape and depth of thegap 1031. Thegap 1031 is located above ahinge 1044 where the jaw can deflect when grasping and holding an item, regardless of its size, and with a firm grasping force. Thegap 1031 may be terminated in atubular passage 1031 A to enhance the hinging effect of thehinge 1044. Hence thehinge 1044 acts as a compliance member similar to theresilient members 1060 described with reference to FIGS. 27-33. - Referring now in particular to FIGS. 37 and 38, the
jaws pins jaws jaw 1022 to flex and consequently the gap 31 to close up. This flexure enables the application of a varied grasping force at the tip of the jaws. When the links are at the end of their travel, thejaw 1022 flexes when thejaws jaws 1022 flexes to a lesser extent when a smaller diameter item such as a suture S is being grasped then when a larger item such as a needle N is being held. That is, to grasp a smaller item, thegap 1031 closes to a lesser extent, while the jaws still apply a sufficient holding force to the item. This force is primarily a function of the resiliency at the gap, as defined primarily by the flexure capability at thehinge 1044. The larger the diameter of the item being held, the larger the corresponding holding force. The tool is constructed so that, for an item the size of a needle, as shown in FIG. 38, thegap 1031 is fully closed with the sides of the top of the gap touching, with a maximum grasping force being applied to the needle N. This is particularly desirable for the securing and controlling of the needle in important surgery techniques. Here again, thepin 1076 is at a contact position A′ (FIG. 38) when the jaws first make contact with a larger item such as the needle N, or further up theslot 1052 at a contact position A (FIG. 37) when the jaws contact a smaller item such as the suture S. Regardless of the size of the item, the pin moves to a locked position B (FIGS. 37 and 38) when the sufficient force is applied to lock the jaws onto the item. - In connection with both of the embodiments described in respective FIG. 26-33, and FIGS. 34-38, there has been described a “locked” position B of the pins or jaws. This locked position corresponds to a position wherein the linkages are disposed at right angles to each other. In other words, for example, in FIG. 31 in that locked position the
linkages linkages - Reference is now made to another embodiment of the invention illustrated in FIGS. 39 and 40. This embodiment has a structure very similar to that described in detail in FIGS.26-33. However, in place of the
resilient cup 1060 there is provided a modified jaw slot configuration. As indicated previously theslots 1052 injaw 1023 have acurved segment 1052A, and astraight segment 1052B. In this embodiment the J-slots 1052 also have acontiguous end slot 1052C that extends back toward the tip of the jaw tip. Hence, the overall slot configuration is C-shaped. In FIG. 39 the jaws are in a substantially open position with a gap G1 as noted when thejaw members pin 1056 located at a locked position B. Before the jaws make contact with the needle N, thepin 1056 may be out of theend slot 1052C, and thepins slots 1052 depending upon the degree of openness of the jaws. When the jaws contact the needle N, thepin 1056 is at a contact position A′. In FIG. 40 the jaws are in a substantially closed position with a small gap G2 as the jaws grasp a smaller item such as a suture S. In this position thepin 1056 now moves further into theend slots 1052C to the locked position B, as the jaws apply a grasping force to an item to lock the suture between the jaws. When contact is first made between the jaws and the suture, thepin 1056 is located at the contact position A further up theslot 1052 than the contact position A′ of FIG. 39. Thus, depending upon the size thereof, thepin 1056 moves to a greater or lesser extent into theslots 1052C. - To hold a large diameter item such as a needle, the
pins links pin 1056 moving into theslot 1052C as illustrated in FIG. 40. When thepin 1056 moves into theslot 1052C, the jaw and linkages move together as a rigid body while closing against the suture. - In sum the
slots 1052C, like the resilient member 1060 (FIGS. 27-33) and the hinge 1044 (FIGS. 37 and 38), are accommodating mechanisms that allow a closing force to be applied to grasped items of different sizes as the force is applied to the grasped item as the jaws close to a position at which the jaws remain open. - The accommodating mechanisms described above like the
slots 1052C (FIGS. 39 and 40), the resilient member 1060 (FIGS. 27-33), and the hinge 1044 (FIGS. 37 and 38, can be implemented in other types of grasping mechanisms as well, such as those described in U.S. application Ser. No. 09/827,643, filed Apr. 6, 2001, and U.S. application Ser. No. 10/014,143, filed Nov. 16, 2001, the entire contents of which are incorporated herein by reference. - In each of the aforementioned embodiments described herein the medical instrument includes a jaw or work members controlled by a drive mechanism that is used to open and close the jaws or work members for applying an increased force to an item grasped between the jaws or work members. The accommodating mechanisms described above such as the
slots 1052C (FIGS. 39 and 40), the resilient member 1060 (FIGS. 27-33), and the hinge 1044 (FIGS. 37 and 38, each have the characteristic of providing a maximum grasping force at what may be considered a maximum grasping position. This corresponds to the positions illustrated, and discussed previously, in FIGS. 33, 38, and 39. In each of the embodiments the instrument is constructed so that this maximum position corresponds to a predetermined size or diameter items that is to be grasped, usually a needle in this case. For item smaller or larger than this size the grasping force is progressively less. In the instance of the embodiment of FIGS. 26-33, for smaller items such as the suture S, the force is less because the compliant member is compressed less. For the case of an item larger than the needle N, the linkage does not go to the top of the J-slot and thus the applied force is also less in that case, as the linkages are not yet to a maximum force 90 degree position. - In all three of the described embodiments the accommodating mechanism allows the jaws or work members to be closed beyond this maximum grasping position in order to grasp items of various sizes, particularly smaller size items. Again, this is illustrated by way of example in FIG. 32 where the jaws go past their maximum grasping position, closing to a closer position therebetween, in grasping the suture S. In FIG. 37 this is illustrated by the jaws closing to grasp the suture S with less force being imposed by the flexure at the
jaw 1022. This is also illustrated in FIGS. 39 and 40. In FIG. 39 the jaws are at their maximum grasping position. In FIG. 40 the jaws are closed beyond this maximum grasping position to grasp the smaller size suture S. The accommodating mechanism in this case may be considered as including theslot segment 1052C that enables further rotation of the linkages to the position illustrated in FIG. 40. - Other embodiments of the flexible or bending segment are within the scope of the invention. For example, there is shown in FIGS.41-47 another embodiment of a flexible or bending segment with a unibody construction which can be used with any suitable end effector like the
tools 18 described above, whether used with a rigid shaft body or a flexible shaft body or combinations thereof. As with some of the embodiments described earlier, one of the benefits of the embodiment shown in FIGS. 41-47 is that only asingle cable 1136 needs to be coupled to thetool 18 to actuate it. The pitch and yaw of thetool 18 is controlled at theflexible section 1100 shown in FIG. 41. This arrangement also lends itself to making the tool disposable or at the very least detachable from the instrument body to facilitate substituting another tool. Here again, because of the simplified construction at the tip of the instrument, a tool can be constructed that is readily detachable from the instrument. - Although the
bendable section 1100 is depicted near the tool, the bendable section can be located at other locations further away from the tool. Since thetool 18 of the embodiment shown in FIGS. 41-47 requires only a single actuation cable, it is simpler to operate than the wrist/tool combination shown in FIGS. 26 and 27. Recall, in the wrist arrangement, a pivot axis does not accommodate single cable actuation. Thus, with the wrist unit one has to use a far more complex cabling scheme, such as, by way of example, the cabling arrangement illustrated in U.S. Pat. Nos. 6,312,435 and 6,206,903. Furthermore, the single cable actuation provides a more simplified design that readily lends itself to a variety of tool constructions. - In order for the various degrees of motions to be decoupled from each other, and for the proper overall functioning of the distal end of the instrument, the instrument has certain preferred characteristics, particularly at the flexible or bendable section of the instrument shaft. These characteristics are listed below but are not in any particular order of significance. Embodiments can employ at least one of these characteristics. Furthermore, although these characteristics are listed with reference to the embodiment described in FIGS.41-44, one or more of the characteristics can apply as well to any of the other embodiments described earlier.
- A first characteristic is that the actuation element for the tool be centered in the flexible or bendable section. In this way, during any bending operation the center of the flexible or bendable section tends to maintain the same length, even though opposed outer surfaces of the section may, respectively, expand and contract. This, in essence, means that the bending action is not erroneously transferred to the actuation element for the tool, hence, de-coupling the bending operation from the tool actuation, and vice versa.
- A second characteristic is that the flexible or bendable section of the instrument shaft be readily flexible without the application of undue force. This bendable section, in a preferred embodiment, is to have orthogonal bending characteristics, hence providing two degrees of freedom (DOF) to the distal tool, for example, yaw and pitch. To accomplish this, at a particular bend location, a substantial portion of the flexible or bendable section is located as near to the center
neutral axis 1111 of the section as physically possible. This is achieved by the spaced rib construction including theribs 1112 shown in the drawings. Theslots 1114 defined by theseribs 1112 provide void areas, leaving more material near the center neutral axis, as depicted in FIG. 45. Reference has been made to aneutral axis 1111 of thebendable section 1 100. In actuality there is for a particular bend direction a neutral plane that during a bend is maintained at a fixed length. - A third characteristic relates to the torsional nature of the flexible or bendable section. The more stiff the section is torsionally (twisting moment) the less likely there will be an undesired twisting of the bendable section that accompanies controlled rotation thereof. In other words, if the bendable section is torsionally stiff, then upon controlled rotation of the instrument shaft, there is no an undesired twisting action imparted on the shaft particularly at the flexible or
bendable section 1100. To accomplish this, at a particular bend location, a substantial portion of the material forming the flexible or bendable section is located at the periphery of the flexible or bendable section. This may be achieved by having portions of the section extend to an outer surface. In the embodiment described here this is accomplished by providing radial ridges, such as theridges 1120 shown in the drawings. Furthermore, these ridges are alternated between horizontal and vertical positions to, at the same time, to provide the orthogonal bending or flexing. - A fourth characteristic is that the flexible or bendable section of the instrument shaft is constructed so that there is little or no end-to-end compression. In other words, the flexible or bendable section maintains a relatively constant length regardless of the motion actuations that occur in the multiple degrees of freedom movement of the instrument. To accomplish this, a stiff member is provided to maintain the ends of the flexible or bendable section at a fixed spacing. This may be achieved by providing the stiff member as a centrally located stiff sleeve that receives and supports the sliding motion of the actuation element for operation of the distal tool. This stiff member is preferably fixed at its opposite ends to the bendable section to maintain the fixed length of the section, thereby preventing end-to-end compression. At least part of this member may include the
sleeve 1182 depicted in FIG. 43. - Referring again to FIG. 41 there is disclosed one embodiment of the
tool 18, used in conjunction with a flexible shaft or tube having a remotely controllable bending orflexing section 1100. The medical instrument may include an elongated shaft, such asshaft section 1110 shown in FIGS. 41 and 42, having proximal and distal ends; and thetool 18 with jaws 102 and 104, supported from the distal end of the elongated shaft and useable in performing a medical procedure on a subject. In FIGS. 42 and 43 thetool 18 is actuated preferably by a single tendon orcable 1136 that extends through theflexible section 1100. In order to provide the pitch and yaw action at the tool, the bending orflexing section 1100 is constructed to bend in orthogonal directions with the use of four cables separated at about 90° intervals and by using a center support with ribs and slots about the entire periphery of thebending section 1100, as depicted in FIGS. 42-44. This orthogonal bending may also be referred to as bi-axial bending, meaning bending in separate axes. Theribs 1112 define correspondingslots 1114, and also define at each of their centers acenter support passage 1118 that has thecable 1136 extending through it, as well as other cable support members described in further detail later. Thebending section 1100 extends from the end oftube section 1110, which itself may be flexible, may be smooth as shown, or may be fluted, and may have other controllable bending sections disposed along its length. - To bend the
bending section 1100 in orthogonal directions, use is made of the fourcables cables cables cables respective balls 1 106A, 1 107A, 1116A, and 1117A that may be held in corresponding recesses in a distal end wall 1119 (FIG. 45) of theflexible section 1100. - The
bending section 1100, as indicated previously, includes a series of spacedribs 1112 positioned, in parallel, with the plane of each rib extending orthogonal to theneutral axis 1111 of thesection 1100. At the proximal end of the bendable section, an end rib connects to theshaft section 1110, while at the distal end there is provided thedistal end wall 1119 that supports the ends of the cables. Each of theribs 1112 are held in spaced relationship by means of the alternatingridges 1120. As depicted in FIG. 43 these ridges are identified ashorizontal ridges 11 20A, alternating withvertical ridges 1120B. This structure provides support at the center passage for theactuating cable 1136, while also providing torsional strength to prevent undesired twisting at theshaft section 1100. - The
jaws pivot pin 1135 that extends along a pivot axis. These grippers may be supported inlink 1140, and thepin 1135 may be supported at its ends in opposite sides oflink 1140. The tool also includes apivot linkage 1142 that intercouples between the grippers and theactuation cable 1136. Thepivot linkage 1142 includeslinkages linkages respective jaws linkages end 1137 ofcable 1136. Opposed pins extend fromend 1137 for engagement with thelinkages jaws recesses respective linkages - In FIG. 42 the
jaws linkages jaws linkages linkage 1142 is moved in an axial direction by thecable 1136, this action opens and closes the jaws or grippers. This corresponds to a “pushing” of the cable in a direction toward the tool. FIG. 43, on the other hand, shows the linkage and grippers in a closed position. This corresponds to a “pulling” of the cable in a direction away from the tool with thespecific linkages pin 1135, so when the linkage is operated from thecable 1136 the resulting action is either opening or closing of the grippers, depending upon the direction of forward-to-back translation of theactuating cable 1136. - The structure shown in FIGS.41-47 preferably also includes a
plastic cable sheath 1180, a plastic stiffener sheath orsleeve 1182 that surrounds thecable 1136 and thesheath 1180, and that fits closely in thecenter passage 1118, and anouter silicon spacer 1184. Thesleeve 1182 is preferably constructed of a polyethylene plastic such as PEEK which has flexibility to allow thesleeve 1182 to bend with thesection 1100, but at the same time is sufficiently stiff (particularly end-to-end) to properly retain, center and hold the supported cable to enable the cable to readily slide within thesheath 1180 and the supportingsleeve 1182, in performing its function. In FIG. 42 thesleeve 1182 is illustrated extending from the distal end of thebendable section 1100, back through the passage, to the more proximal end of thebendable section 1100. - Reference has been made previously to the
single actuation cable 1136 that provides all the action that is required to operate the tool. This greatly simplifies the construction and makes it easier to keep the single cable centered in the instrument. As indicated previously this centering feature maintains the same length of the actuation element, even though opposed outer surfaces of the section itself may, respectively, expand and contract during bending. This, in essence, means that the bending action is not erroneously transferred to the actuation element, hence, the bending operation is de-coupled from tool actuation, and vice versa. - FIGS. 42 and 43 also show the use of an adhesive, at1186, such an epoxy adhesive for anchoring opposite ends of the
sheath 1180 and thesleeve 1182 to opposite ends of thebendable section 1100. By maintaining thesheath 1180 andsleeve 1182 fixed in position at their ends, when thesection 1100 is controlled to bend, the cable length at the center or neutral axis ofsection 1100 does not change. Furthermore, at the ribbed bendable section, on one side the section shortens and on the other side it expands while keeping the center or neutral axis length unchanged. In this way when bending occurs atsection 1100 there is no transfer of motion to thecable 1136 which could undesirably move the jaws. The bending motion is thus de-coupled from the tool operation motion, and vice versa. - Other features of the bending section are shown in FIG. 45 in a side elevation view, while FIGS. 46 and 47 illustrate cross-sectional views, with one through one of the
ridges 1120A and the other through one of theridges 1120B. Therespective ridges - As described earlier, the
section 1100 is easily bendable while being torsionally stiff, and has other improved characteristics as well. Details of these characteristics are best described with reference to FIGS. 45-47 by considering a particular cross-section such as the cross-section in FIG. 45 taken along line 46-46. In viewing FIG. 45 it is clear that, at that location and with the orientation of thesection 1100 as shown, there is a substantial void created by theslot 1114, so that the majority of the section material is located at the center of the section. This is consistent with the desired bendability at that location, since, in general, a structure becomes more bendable as its diameter deceases. The void area mentioned is also illustrated in the cross-sectional view of FIG. 46 at 1115. - To understand how the
bending section 1100 can be torsionally stiff while also being bendable, reference is also made to the same location at the line 46-46, but with the section rotated through 90 degrees. This is the same as looking at the cross-sectional view depicted in FIG. 47. In other words, one is thus considering the location through theridge 1120A. Thesection 1100 is constructed so that there is preferably a relativelylarge center passage 1118, leaving more material toward the outer periphery, which is desired for providing enhanced torsional stiffness. Note that this material is the material of the ridge itself. Thus, for torsional stiffness it is desired to have a void near the middle and more material located away from the middle. - The rib and ridge arrangement shown in the drawings thus provides in a single structure a bendable section that provides two degrees of freedom (biaxial motion) that is also torsionally stiff. The bending characteristics enable the transfer of two degrees of freedom to the tool, rather than just one degree of freedom as with a conventional wrist joint. The torsional stiffness enables direct rotational transfer to the tool through the bendable section and without any twisting at the bendable section.
- Mention has been made previously of the four characteristics of the bendable section described herein. The first characteristic relates to the centering of the actuation element. This is carried out primarily with the use of the center passage and the associated
sheath 1180,sleeve 1182, and thespacer 1184. The second characteristic relates to the ease of bending. This is accomplished primarily with the ribbed construction with void peripheral areas. The third characteristic relates to the torsion stiffness that is accomplished primarily by the alternating ridges. Lastly, the fourth characteristic relates to the end-to-end compression. To prevent the bendable section from compressing from end-to-end during an operation, particularly during tool actuation, to facilitate proper tool operation, the center passage is provided with thestiff sleeve 1182, and the opposite ends of thesheath 1180 andsleeve 1182 fixed in place, and thesection 1100 has a ridged construction. - It is noted that FIGS.41-47 disclose one version of an end
effector employing jaws linkage 1142. However, other tool constructions are also contemplated as falling within the scope of the present invention including ones that provide a mechanical advantage at the tip of the jaws or other work elements. - Also, in various embodiments described herein only a single cable is used for tool actuation. (See, for example, FIGS. 9, 15, and42.) In these embodiments it is preferable to provide at least the opposite ends of the actuation cables with enhanced stiffness, particularly where the cable is unsupported. For example, in FIG. 42 this might be in the distal section of
cable 1136 exiting fromwall 1119 to the jaws of the tool. This stiffness can be provided by treating the ends of the cable with a harder metal coating, or by other means that will provide a stiffer end section. - Turning now to FIGS.48A-48D, there is illustrated yet another embodiment of a
flexible section 1660 with a unibody construction. Thetool 18 attached to the distal end of theflexible section 1660 includes an upper grip orjaw 1602 and a lower grip or jaw 603, supported from alink 1601. Each of thejaws link 1601, may be constructed of metal, or alternatively, thelink 1601 may be constructed of a hard plastic. Thelink 1601 is engaged with the distal end of theflexible stem section 1302. FIG. 48C shows the distal end of thestem section 1302, terminating in a bending orflexing section 1660. Also, at theflexible section 1660, flexing and bending is enhanced by the arrangement of diametrically-disposedslots 1662 that defineribs 1664 between the slots. Theflexible section 1660 also has alongitudinally extending wall 1665, through which cabling extends, particularly for the operation of the tool jaws. Thewall 1665 can also be thought of as opposed ridges that extend outward from the center of theflexible section 1660. The very distal end of thebending section 1660 terminates with anopening 1666 for receiving theend 1668 of thelink 1601. The cabling 1608-1611 is preferably at the center of the flex section atwall 1665 to effectively decouple flex or bending motions from tool motions. - To operate the tool, reference is made to the
cables wall 1665 as illustrated in FIG. 48C. The cables extend to therespective jaws cables bending section 1660 and terminate at ball ends 1606A and 1607A, respectively, and urge against the end of the bendable section inopening 1666. When these cables are pulled individually, they can cause a bending of the wrist at the bending orflexing section 1660. FIG. 48D illustrates thecable 1607 having been pulled in the direction ofarrow 1670 so as to flex thesection 1660 as depicted in the figure. Pulling on theother cable 1606 causes a bending in the opposite direction. - By virtue of the
slots 1662 forming theribs 1664, there is provided a structure that bends quite easily, while the wall oropposed ridges 1665 provide some torsional rigidity to theflexing section 1660. Thewall 1665 bends by compressing at the slots in the manner illustrated in FIG. 48D. This construction eliminates the need for a wrist pin or hinge. - The embodiment illustrated in FIG. 48B has a
separate link 1601. However, in an alternate embodiment, thislink 1601 may be fabricated integrally with, and as part of, thebending section 1660. For this purpose thelink 1601 would then be constructed of a relatively hard plastic rather than the metal link as illustrated in FIG. 48B and would be integral withsection 1660. - Mention has also been made of various forms of tools that can be used. The tool may include a variety of articulated tools such as: jaws, scissors, graspers, needle holders, micro dissectors, staple appliers, tackers, suction irrigation tools and clip appliers. In addition, the tool may include a non-articulated tool such as: a cutting blade, probe, irrigator, catheter or suction orifice. Moreover, the bending section itself may be non-actuated. As such, even when the bending movements of the bending section are not controlled by a surgeon, the one or more degrees-of-freedom of movement of the bending section allows it to conform to orifices or lumens within the patient's body as the section is advanced through the body.
- There have been described herein a number of different embodiments of bendable sections such as in FIGS. 5, 14,21, or 41. These may be used, as illustrated herein, in conjunction with instrument systems as described in, for example, FIG. 1 where the instrument is inserted laparoscopically. Alternatively, these concepts may also be used in flexible instrument systems more like that described in FIG. 21 wherein the bendable sections can be located at various positions along the instrument shaft or body. In this case the bendable section or sections may be used both for guidance toward an operative site, such as for guidance through an anatomic lumen or vessel, or for operation or manipulation at an operative site. In the more rigid system where the instrument is meant to enter the body, for example, through an incision, such as laparoscopically, then it is preferred to have the bendable section located close to but just proximal of the distal end effector or tool. This bendable section positioning provides for proper manipulation of the tool at the operative site. In this case the bendable section preferably has a length in a range on the order of ¾ inch to 4 inches. Also, the distance between the tool pivot point and the distal end of the bendable section is preferably equal to or less than the length of the bendable section.
- Referring to FIG. 49, an example of a
flexible instrument 2000 is shown in use in astomach 2002 of a patient. Theinstrument 2000 includes anelongated portion 2004, which itself is flexible, and an articulatedbendable section 2006. Any embodiments of thetool 18 described can be mounted at the terminal end of thebendable section 2006. Thebendable section 2006 can be any one of the different embodiments described earlier such as those shown in FIGS. 5, 14, 21, or 41. In operation, theflexible instrument 2000 is inserted through a body lumen such as theesophagus 2008, and thetool 18 is directed to theoperative site 2009. As shown, theinstrument 2000 can lean against some element of the anatomy such as awall 2010 of the stomach to brace the instrument during the medical procedure, while thebendable section 2006 and thetool 18 are articulated as described above. - In certain implementations, as shown in FIG. 50A, a
flexible instrument 2100 may include abendable section 2102 that can be operated with one ormore pull cables 2104 to manipulate thetip 2106 of the bendable section. Thetip 2106 may be provided with an embodiment of thetool 18 described above that is positioned at the operative site to perform a medical procedure. At least onecable 2104 is attached at or near thetip 2106 of thebendable section 2102, and extends from its point of attachment through anaperture 2108 at a position spaced a selected distance along the length of thebendable section 2102 away from the distal end. The remainder of thecable 2109 extends from theaperture 2108 through ashaft 2110 of theinstrument 2100 and is coupled, for example, to adrive unit 8, like that described earlier, that applies a tension to thecable 2104 to controllably bend thebendable section 2102. - The
bendable section 2102 may have a circular cross section, or in some embodiments, the bendable section is provided with one or more grooves or valleys 2112 (FIG. 50B) along its length. As such, while theinstrument 2100 is inserted into the patient, thecables 2104 lie along thegrooves 2112, which prevents thecables 2104 from inadvertently catching any body element. As appropriate tension is applied to a particular cable, it effectively “pops” out of thegroove 2112 as the tip of thebendable section 2102 is pulled towards theaperture 2108. For certain embodiments of thetool 18, thebendable section 2102 is provided with acenter tube 2114 through which the actuation element for thetool 18 extends. - While this invention has been particularly shown and described with references to preferred embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the invention encompassed by the appended claims. For example, mention has been made of the bi-axial bending of the bendable section of the instrument. However, the principles of the present invention may also apply to a bendable section that has only one degree-of-freedom, in which case the bendable section would only be controlled by one set of control cables rather than the two sets described earlier.
- This invention can be implemented and combined with other applications, systems, and apparatuses, for example, those discussed in greater detail in U.S. Provisional Application No. 60/332,287, filed Nov. 21, 2001, the entire contents of which are incorporated herein by reference, as well as those discussed in greater detail in each of the following documents, all of which are incorporated herein by reference in their entirety:
- U.S. Pat. Nos. 6,197,017 and 6,432,112, PCT application Serial No. PCT/US00/12553 filed May 9, 2000, and U.S. application Ser. Nos. 09/827,643 filed Apr. 6, 2001, 10/034,871 filed Dec. 21, 2001, 10/270,741 file Oct. 11, 2002, 10/270,743 filed Oct. 11, 2002, 10/270,740 filed Oct. 11, 2002, 10/077,233 filed Feb. 15, 2002, and 10/097,923 filed Mar. 15, 2002.
Claims (107)
1. A robotically controlled medical instrument comprising:
a bending section having a unibody construction, and being bendable with at least one degree-of-freedom;
a tool supported at a distal end of the bending section for performing a medical procedure on a subject; and
an electronic controller that controls the bending section to provide the at least one degree-of-freedom of movement.
2. The medical instrument of claim 1 further comprising a first pair of cables extending along the length of the bending section, tension being applied to at least one of the first pair of cables to operate the bending section with one degree-of-freedom.
3. The medical instrument of claim 2 further comprising a second pair of cables extending along the length of the bending section, tension being applied to at least one of the second pair of cables to operate the bending section with a second degree-of-freedom.
4. The medical instrument of claim 3 wherein the amount of tension being applied to the respective cables is controlled with the controller coupled with an input device operated by a user.
5. The medical instrument of claim 2 wherein the tool is movable with at least two additional degrees-of-freedom.
6. The medical instrument of claim 5 wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint, the first jaw being movable with one of the two additional degrees-of-freedom and the second jaw being movable with the other of the two additional degrees-of-freedom.
7. The medical instrument of claim 6 comprising a second pair of cables and a third pair of cables extending along the length of the bending section and coupled to the first jaw and second jaws, respectively, tension being applied to at least one of the second pair of cables to operate the first jaw, and to at least one of the third pair of cables to operate the second jaw.
8. The medical instrument of claim 7 wherein the second and third pair of cables are positioned near the longitudinal axis of the bending section.
9. The medical instrument of claim 8 wherein the second and third pair of cables are contained in a sleeve positioned along the longitudinal axis of the bending section, the second and third pair of cables being able to slide along the sleeve.
10. The medical instrument of claim 7 wherein the amount of tension being applied to the respective cables of the second and third pair of cables is controlled with the controller coupled with an input device operated by a user.
11. The medical instrument of claim 2 wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close.
12. The medical instrument of claim 11 further comprising an actuation element extending along the length of the bending section and coupled to the first and second jaws to operate the first and second jaws.
13. The medical instrument of claim 12 wherein the actuation element is a single cable, the single cable being coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the single cable and being opened by pushing on the single cable.
14. The medical instrument of claim 13 wherein the single cable is positioned near the longitudinal axis of the bending section.
15. The medical instrument of claim 14 wherein the single cable is contained in a sleeve positioned along the longitudinal axis of the bending section, the single cable being able to slide back and forth along the sleeve.
16. The medical instrument of claim 15 further comprising a helical spring positioned about the sleeve along the length of the bending section to keep the sleeve and single cable near the longitudinal axis of the bending section.
17. The medical instrument of claim 13 wherein the amount of pushing and pulling on the single cable is controlled with the controller coupled with an input device operated by a user.
18. The medical instrument of claim 1 wherein the bending section has a bellows construction with alternating peaks and valleys positioned between proximal and distal ends of the bending section.
19. The medical instrument of claim 1 wherein the bending section has a series of spaced ribs positioned along the length of the bending section between proximal and distal ends of the bending section.
20. The medial instrument of claim 19 wherein the bending section includes a set of opposed ridges extending along the length of the bending section, the individual ridges of the set of ridges being positioned in a respective slot defined by adjacent ribs.
21. The medical instrument of claim 19 wherein the bending section includes a first set of ridges extending along the length of the bending section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges.
22. The medical instrument of claim 21 wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section.
23. The medical instrument of claim 1 further comprising a second bending section with a unibody construction, and being bendable with at least one degree-of-freedom.
24. A robotically controlled medical instrument comprising:
a bending section being bendable with two degrees-of-freedom and having a unibody construction with a series of spaced ribs, the ribs being positioned along the length of the bending between proximal and distal ends of the bending section, the bending section including a first set of ridges extending along the length of the bending section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges;
a first pair of cables and a second pair of cables extending along the length of the bending section, tension being applied to at least one of the first pair of cables to operate the bending section with one degree-of-freedom, and to at least one of the second pair cables to operate the bending section with a second degree-of-freedom;
a tool supported at the distal end of the bending section for performing a medical procedure on a subject; and
an electronic controller that controls the bending section to provide the at least one degree-of-freedom of movement.
25. The medical instrument of claim 24 wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close.
26. The medical instrument of claim 25 further comprising an actuation element extending along the length of the bending section and coupled to the first and second jaws to operate the first and second jaws.
27. The medical instrument of claim 26 wherein the actuation element is a single cable, the single cable being coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the single cable and being opened by pushing on the single cable.
28. The medical instrument of claim 27 wherein the single cable is contained in a sleeve positioned along the longitudinal axis of the bending section, the single cable being able to slide back and forth along the sleeve.
29. The medical instrument of claim 24 wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section.
30. A method of remotely controlling a medical instrument comprising:
controlling the bending movements of a bending section with a unibody construction having at least one degree-of-freedom with an electronic controller; and
performing a medical procedure on a subject with a tool supported at a distal end of the bending section.
31. The method of claim 30 wherein the controlling includes applying a tension to at least one of a first pair of cables extending along the length of the bending section to operate the bending section with one degree-of-freedom.
32. The method of claim 31 wherein controlling includes applying a tension to at least one of a second pair cables extending along the length of the bending section to operate the bending section with a second degree-of-freedom.
33. The method of claim 32 wherein the controlling includes controlling with the controller coupled with an input device operated by a user.
34. The method of claim 31 wherein the performing includes applying a tension to at least one of a second pair of cables extending along the length of bending section and coupled to a first jaw of the tool, and applying a tension to at least one of third pair of cables extending along the length of bending section and coupled to a second jaw of the tool.
35. The method of claim 34 wherein the applying includes applying a respective tension to the cables with the controller coupled with an input device operated by a user.
36. The method of claim 31 wherein the performing includes pushing and pulling an actuation element extending along the length of the bending section and coupled to a first jaw and a second jaw connected to the first jaw at a pivot joint, the pushing and pulling causing the jaws to open and close, respectively.
37. The method of claim 36 wherein the pushing and pulling are controlled by the controller coupled with an input device operated by a user.
38. The method of claim 30 further comprising controlling a second bending section with a unibody construction having at least one degree-of-freedom.
39. A method of remotely controlling a medical instrument comprising:
controlling the bending movements of a bending section with two degrees-of-freedom, the bending section having a unibody construction with a series of spaced ribs, the ribs being positioned along the length of the bending section between proximal and distal ends of the bending section, the bending section including a first set of ridges extending along the length of the bending section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges; and
performing a medical procedure on a subject with a tool supported at a distal end of the bending section.
40. The method of claim 39 wherein the controlling includes applying a tension to at least one of a first pair of cables extending along the length of the bending section to operate the bending section with one degree-of-freedom, and applying a tension to at least one of a second pair cables extending along the length of the bending section to operate the bending section with a second degree-of-freedom.
41. The method of claim 39 wherein the performing includes pushing and pulling an actuation element extending along the length of the bending section and coupled to a first jaw and a second jaw connected to the first jaw at a pivot joint, the pushing and pulling causing the jaws to open and close, respectively.
42. The method of claim 39 wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section.
43. A robotically controlled medical instrument comprising:
a means for supporting a tool;
a means for bending the means for supporting with at least one degree-of-freedom with an electronic controller; and
a means for operating the tool to perform a medical procedure on a subject.
44. A robotically controlled medical instrument system comprising:
an elongated shaft having proximal and distal ends;
a tool supported from the distal end of said elongated shaft and useable in performing a medical procedure on a subject;
at least one controllably bendable section of said shaft; and
an electrical controller for receiving a command from an input device, and for, in turn, controlling said bendable section to provide at least one degree-of-freedom at said bendable section.
45. The instrument system of claim 44 further including a mechanically drivable mechanism at the proximal end of said elongated shaft.
46. The instrument system of claim 2 wherein said mechanically drivable mechanism has at least one coupling tendon extending via said elongated shaft for operating said tool.
47. The instrument system of claim 44 including mechanical cabling comprised of at least one cable for operating said tool and at least another cable for controlling said bendable section.
48. The instrument system of claim 44 wherein said input device is controlled by a medical practitioner that issues commands for also controlling at least one degree-of-freedom of said tool.
49. The instrument system of claim 44 including a drive unit intercoupled with said elongated shaft for controlling the bending action at said bendable section and, via a mechanically drivable portion, actuation of said distally placed tool.
50. The instrument system of claim 44 wherein the bendable section preferably has a length in a range on the order of ¾ inch to 4 inches.
51. The instrument system of claim 44 wherein the distance between the too] pivot point and the distal end of the bendable section is preferably equal to or less than the length of the bendable section.
52. The instrument system of claim 44 further comprising an actuation element extending with said instrument shaft and operable to control actuation of said tool.
53. The instrument system of claim 52 wherein said actuation element is positioned at at least one of a substantially center axis and substantially center plane of said controllably bendable section so as to de-couple motion at said controllable bendable section from tool actuation.
54. A method of remotely controlling an instrument, comprising:
providing an instrument shaft of the instrument that has supported at its distal end a tool that is usable in performing a medical procedure or application;
providing a controllably bendable section along said instrument shaft;
inserting the shaft into a patient's body so as to dispose the tool at an internal operative site; and
controlling, from a remote location, an input device that effects bending of the controllably bendable section to thereby effect positioning of the tool at the operative site.
55. A method as set forth in claim 54 wherein the step of controlling also includes controlling, from the input device, the operation of said tool.
56. A method as set forth in claim 54 wherein said input device is controlled by a medical practitioner that issues commands for also controlling at least one degree-of-freedom of said tool.
57. A method as set forth in claim 54 wherein the step of inserting includes inserting through an incision.
58. A method as set forth in claim 54 wherein the step of inserting includes inserting through a natural body orifice.
59. A method as set forth in claim 54 wherein the step of inserting includes inserting percutaneously.
60. A robotically controlled medical instrument comprising:
an elongated shaft having proximal and distal ends;
a tool supported from the distal end of said elongated shaft and useable in performing a medical procedure on a subject;
at least one controllably bendable section of said shaft disposed proximally of said tool; and
an actuation element extending with said instrument shaft and operable to control actuation of said tool;
said actuation element positioned at at least one of a substantially center axis and substantially center plane of said controllably bendable section so as to de-couple motion at said controllable bendable section from tool actuation.
61. The medical instrument of claim 60 further comprising a first pair of cables extending along a length of the bendable section, tension being applied to at least one of the first pair of cables to operate the bendable section with one degree-of-freedom.
62. The medical instrument of claim 61 further comprising a second pair of cables extending along the length of the bendable section, tension being applied to at least one of the second pair of cables to operate the bendable section with a second degree-of-freedom.
63. The medical instrument of claim 60 further including an electrical controller coupled with an input device operated by a user for remote control of at least said tool.
64. The medical instrument of claim 60 wherein the tool is movable with at least two additional degrees-of-freedom.
65. The medical instrument of claim 64 wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint, the first jaw being movable with one of the two additional degrees-of-freedom and the second jaw being movable with the other of the two additional degrees-of-freedom.
66. The medical instrument of claim 65 comprising a second pair of cables and a third pair of cables extending along the length of the bendable section and coupled to the first jaw and second jaws, respectively, tension being applied to at least one of the second pair of cables to operate the first jaw, and to at least one of the third pair of cables to operate the second jaw.
67. The medical instrument of claim 66 wherein the second and third pair of cables are positioned near the longitudinal axis of the bendable section.
68. The medical instrument of claim 67 wherein the second and third pair of cables are contained in a sleeve positioned along the longitudinal axis of the bendable section, the second and third pair of cables being able to slide along the sleeve.
69. The medical instrument of claim 66 wherein the amount of tension being applied to the respective cables of the second and third pair of cables is controlled with a controller coupled with an input device operated by a user.
70. The medical instrument of claim 60 wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close.
71. The medical instrument of claim 70 wherein the actuation element extends along the length of the bendable section and couples to the first and second jaws to operate the first and second jaws.
72. The medical instrument of claim 71 wherein the actuation element is a single cable, the single cable being coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the single cable and being opened by pushing on the single cable.
73. The medical instrument of claim 72 wherein the single cable is positioned near the longitudinal axis of the bendable section.
74. The medical instrument of claim 73 wherein the single cable is contained in a sleeve positioned along the longitudinal axis of the bendable section, the single cable being able to slide back and forth along the sleeve.
75. The medical instrument of claim 74 further comprising a helical spring positioned about the sleeve along the length of the bendable section to keep the sleeve and single cable near the longitudinal axis of the bendable section.
76. The medical instrument of claim 72 wherein the amount of pushing and pulling on the single cable is controlled with a controller coupled with an input device operated by a user.
77. The medical instrument of claim 60 wherein the bendable section has a bellows construction with alternating peaks and valleys positioned between proximal and distal ends of the bendable section.
78. The medical instrument of claim 60 wherein the bendable section has a series of spaced ribs positioned along the length of the bendable section between proximal and distal ends of the bendable section.
79. The medial instrument of claim 78 wherein the bendable section includes a set of opposed ridges extending along the length of the bendable section, the individual ridges of the set of ridges being positioned in a respective slot defined by adjacent ribs.
80. The medical instrument of claim 78 wherein the bendable section includes a first set of ridges extending along the length of the bendable section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges.
81. The medical instrument of claim 80 wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bendable section.
82. The medical instrument of claim 60 further comprising a second bendable section with a unibody construction, and being bendable with at least one degree-of-freedom.
83. A method of operating a medical instrument comprising:
controlling the bending movements of a bending section with a unibody construction having at least one degree-of-freedom; and
performing a medical procedure on a subject with a tool supported at a distal end of the bending section;
said step of controlling including controlling the one degree-of-freedom, from a remote location via an electrical controller with an input device that effects bending of the controllably bendable section to thereby effect positioning of the tool at the operative site.
84. The method of claim 83 wherein the controlling includes applying a tension to at least one of a first pair of cables extending along the length of the bending section to operate the bending section with one degree-of-freedom.
85. The method of claim 84 wherein controlling includes applying a tension to at least one of a second pair cables extending along the length of the bending section to operate the bending section with a second degree-of-freedom.
86. The method of claim 83 further including controlling actuation of the tool by means of at least one actuation element.
87. The method of claim 86 wherein said actuation element is positioned at at least one of a substantially center axis and substantially center plane of said controllably bendable section so as to de-couple motion at said controllable bendable section from tool actuation.
88. The method of claim 83 further comprising controlling a second bendable section with a unibody construction having at least one degree-of-freedom.
89. A robotically controlled medical instrument comprising:
a means for supporting a tool;
a means of bending the means for supporting with at least one degree-of-freedom;
a means for operating the tool to perform a medical procedure on a subject;
an actuation means operable to control actuation of said tool;
said actuation means positioned at least one of a substantially center axis and substantially center plane of said means for bending so as to de-couple motion at said means for bending from tool actuation.
90. A robotically controlled medical instrument comprising:
an elongated shaft having proximal and distal ends;
a tool supported from the distal end of said elongated shaft and useable in performing a medical procedure on a subject;
the distal end of said elongated shaft and the tool having respective removably engaging portions that are readily engagable for positioning the tool at the distal end of said elongated shaft in operative position relative to said elongated shaft, and readily disengagable for removal of said tool from the distal end of said elongated shaft.
91. The medical instrument of claim 90 further including a mechanically drivable mechanism at the proximal end of said elongated shaft.
92. The medical instrument of claim 91 wherein said mechanically drivable mechanism, elongated shaft, and tool comprise a single piece disposable unit.
93. The medical instrument of claim 91 wherein said mechanically drivable mechanism has at least one coupling tendon extending via said elongated shaft for operating said tool.
94. The medical instrument of claim 93 wherein said tool is controlled remotely from an electrical controller.
95. The medical instrument of claim 94 wherein said electrical controller couples from a user interface controlled by an operator to remotely and telerobotically control said tool.
96. The medical instrument of claim 90 wherein said tool is disposable.
97. The medical instrument of claim 90 wherein said tool is readily disengagable to allow the substitution of a different tool at the distal end of said elongated shaft.
98. The medical instrument of claim 90 wherein said elongated shaft has a segment thereof that is controllably bendable.
99. The medical instrument of claim 90 wherein said engaging portions include mating threaded portions.
100. The medical instrument of claim 90 including at least one actuation element extending via said elongated shaft and for control of said tool.
101. The medical instrument of claim 100 wherein said actuation element and said tool have removably engaging sections that are readily engagable to provide mechanical drive from the actuation element to the tool, and readily disengagable for removal of said tool from said actuation element.
102. The medical instrument of claim 100 wherein said actuation element includes a tendon that is sufficiently rigid to enable linear translation relative to said tool for actuation and deactuation of said tool.
103. A robotically controlled medical instrument comprising:
an elongated support shaft having proximal and distal ends; and
a tool supported from the distal end of said elongated support shaft and controllable in performing a medical procedure on a subject;
said tool being removably coupled with the distal end of said elongated support shaft.
104. The medical instrument of claim 103 wherein said disposable tool is readily attachable to and detachable from said elongated support shaft.
105. The medical instrument of claim 103 further including a mechanically drivable mechanism disposed at the proximal end of the elongated support shaft and having extending therefrom at least one control tendon coupling to said tool for operation thereof.
106. The medical instrument of claim 103 wherein said tool is actuated remotely via a computer from a user interface device.
107. A flexible surgical instrument comprising a controllably flexible elongated section having a distal end for positioning at an anatomical site of interest of a subject, and at least one cable attached at or near the distal end of the section, the cable extending from its point of attachment exteriorly of the section through an aperture in the section at a position spaced a selected distance along the length of the section away from the distal end, a proximal end of the cable extending from the aperture through the shaft and being tensionable to controllably bend the flexible section.
Priority Applications (6)
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US10/976,066 US7608083B2 (en) | 2001-02-15 | 2004-10-28 | Robotically controlled medical instrument with a flexible section |
US12/023,981 US7744608B2 (en) | 2001-02-15 | 2008-01-31 | Robotically controlled medical instrument |
US12/024,013 US7819884B2 (en) | 2001-02-15 | 2008-01-31 | Robotically controlled medical instrument |
US12/024,039 US7854738B2 (en) | 2001-02-15 | 2008-01-31 | Robotically controlled medical instrument |
US12/960,861 US20110144656A1 (en) | 2001-02-15 | 2010-12-06 | Robotically controlled medical instrument |
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US10/011,449 US20020087048A1 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/008,457 US6949106B2 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
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US10/008,871 US6843793B2 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
US10/013,046 US20020138082A1 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
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US10/023,024 US20020095175A1 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/010,150 US7214230B2 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/014,143 US20020120252A1 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
US10/012,586 US7371210B2 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/011,371 US7090683B2 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
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US38253202P | 2002-05-22 | 2002-05-22 | |
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US10/011,371 Continuation-In-Part US7090683B2 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/011,449 Continuation-In-Part US20020087048A1 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/012,845 Continuation-In-Part US7169141B2 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
US10/013,046 Continuation-In-Part US20020138082A1 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
US10/008,871 Continuation-In-Part US6843793B2 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
US10/010,150 Continuation-In-Part US7214230B2 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/014,143 Continuation-In-Part US20020120252A1 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
US10/008,457 Continuation-In-Part US6949106B2 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
US10/023,024 Continuation-In-Part US20020095175A1 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/012,586 Continuation-In-Part US7371210B2 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/022,038 Continuation-In-Part US20020087148A1 (en) | 1998-02-24 | 2001-11-16 | Flexible instrument |
US10/011,450 Continuation-In-Part US20020128662A1 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
US10/008,964 Continuation-In-Part US20020128661A1 (en) | 1998-02-24 | 2001-11-16 | Surgical instrument |
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US10/976,066 Expired - Fee Related US7608083B2 (en) | 2001-02-15 | 2004-10-28 | Robotically controlled medical instrument with a flexible section |
US12/024,013 Expired - Fee Related US7819884B2 (en) | 2001-02-15 | 2008-01-31 | Robotically controlled medical instrument |
US12/023,981 Expired - Lifetime US7744608B2 (en) | 2001-02-15 | 2008-01-31 | Robotically controlled medical instrument |
US12/024,039 Expired - Fee Related US7854738B2 (en) | 2001-02-15 | 2008-01-31 | Robotically controlled medical instrument |
US12/960,861 Abandoned US20110144656A1 (en) | 2001-02-15 | 2010-12-06 | Robotically controlled medical instrument |
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US12/023,981 Expired - Lifetime US7744608B2 (en) | 2001-02-15 | 2008-01-31 | Robotically controlled medical instrument |
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US12/960,861 Abandoned US20110144656A1 (en) | 2001-02-15 | 2010-12-06 | Robotically controlled medical instrument |
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Cited By (304)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040193146A1 (en) * | 2001-02-15 | 2004-09-30 | Endo Via Medical, Inc. | Robotically controlled surgical instruments |
US20050096694A1 (en) * | 2003-10-30 | 2005-05-05 | Woojin Lee | Surgical instrument |
US20050222554A1 (en) * | 2004-03-05 | 2005-10-06 | Wallace Daniel T | Robotic catheter system |
US20050251112A1 (en) * | 2003-05-23 | 2005-11-10 | Danitz David J | Articulating mechanism for remote manipulation of a surgical or diagnostic tool |
US20050273085A1 (en) * | 2004-06-07 | 2005-12-08 | Novare Surgical Systems, Inc. | Articulating mechanism with flex-hinged links |
US20050273084A1 (en) * | 2004-06-07 | 2005-12-08 | Novare Surgical Systems, Inc. | Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools |
US20060020287A1 (en) * | 2003-10-30 | 2006-01-26 | Woojin Lee | Surgical instrument |
US20060084945A1 (en) * | 2004-03-05 | 2006-04-20 | Hansen Medical, Inc. | Instrument driver for robotic catheter system |
US20060095022A1 (en) * | 2004-03-05 | 2006-05-04 | Moll Frederic H | Methods using a robotic catheter system |
US20060111210A1 (en) * | 2004-11-23 | 2006-05-25 | Novare Surgical Systems, Inc. | Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools |
US20060111616A1 (en) * | 2004-11-24 | 2006-05-25 | Novare Surgical Systems, Inc. | Articulating mechanism components and system for easy assembly and disassembly |
US20060111615A1 (en) * | 2004-11-23 | 2006-05-25 | Novare Surgical Systems, Inc. | Articulating sheath for flexible instruments |
US20060111692A1 (en) * | 2004-07-19 | 2006-05-25 | Hlavka Edwin J | Robotically controlled intravascular tissue injection system |
US20060195071A1 (en) * | 2000-07-20 | 2006-08-31 | Doyle Mark C | Hand-actuated articulating surgical tool |
US20060201130A1 (en) * | 2005-01-31 | 2006-09-14 | Danitz David J | Articulating mechanisms with joint assembly and manual handle for remote manipulation of instruments and tools |
EP1709910A1 (en) * | 2004-01-27 | 2006-10-11 | Olympus Corporation | Surgical treatment appliance |
US20070010801A1 (en) * | 2005-06-22 | 2007-01-11 | Anna Chen | Medical device control system |
US20070043338A1 (en) * | 2004-03-05 | 2007-02-22 | Hansen Medical, Inc | Robotic catheter system and methods |
US20070066986A1 (en) * | 2003-06-11 | 2007-03-22 | Intuitive Surgical Inc. | Surgical instrument with a universal wrist |
US20070250113A1 (en) * | 2003-05-23 | 2007-10-25 | Hegeman David E | Tool with articulation lock |
US20070276430A1 (en) * | 2006-05-23 | 2007-11-29 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20070287993A1 (en) * | 2006-06-13 | 2007-12-13 | Hinman Cameron D | Tool with rotation lock |
US20080021278A1 (en) * | 2006-07-24 | 2008-01-24 | Leonard Robert F | Surgical device with removable end effector |
US20080046000A1 (en) * | 2006-08-16 | 2008-02-21 | Woojin Lee | Surgical instrument |
US7338513B2 (en) | 2003-10-30 | 2008-03-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20080119872A1 (en) * | 1998-02-24 | 2008-05-22 | Hansen Medical, Inc. | Surgical instrument |
US20080255608A1 (en) * | 2007-04-16 | 2008-10-16 | Hinman Cameron D | Tool with end effector force limiter |
US20080255588A1 (en) * | 2007-04-16 | 2008-10-16 | Hinman Cameron D | Tool with multi-state ratcheted end effector |
US20080255421A1 (en) * | 2007-04-16 | 2008-10-16 | David Elias Hegeman | Articulating tool with improved tension member system |
US20080262492A1 (en) * | 2007-04-11 | 2008-10-23 | Cambridge Endoscopic Devices, Inc. | Surgical Instrument |
US20080269727A1 (en) * | 2005-07-20 | 2008-10-30 | Cambridge Endoscopic Devices, Inc. | Surgical instrument guide device |
US20080285909A1 (en) * | 2007-04-20 | 2008-11-20 | Hansen Medical, Inc. | Optical fiber shape sensing systems |
US20080294191A1 (en) * | 2007-05-22 | 2008-11-27 | Woojin Lee | Surgical instrument |
US20090048611A1 (en) * | 1992-05-27 | 2009-02-19 | International Business Machines Corporation | System and method for augmentation of endoscopic surgery |
US20090054734A1 (en) * | 2007-08-23 | 2009-02-26 | Tyco Healthcare Group Lp | Endoscopic surgical devices |
US20090069842A1 (en) * | 2007-09-11 | 2009-03-12 | Woojin Lee | Surgical instrument |
US20090138025A1 (en) * | 2007-05-04 | 2009-05-28 | Hansen Medical, Inc. | Apparatus systems and methods for forming a working platform of a robotic instrument system by manipulation of components having controllably rigidity |
US20090171147A1 (en) * | 2007-12-31 | 2009-07-02 | Woojin Lee | Surgical instrument |
US20090171159A1 (en) * | 2005-12-20 | 2009-07-02 | Orthodynamix Llc | Method and Devices for Minimally Invasive Arthroscopic Procedures |
US20090259248A1 (en) * | 2006-06-14 | 2009-10-15 | Hans Ganter | Surgical gripping forceps |
US7615067B2 (en) | 2006-06-05 | 2009-11-10 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20090299344A1 (en) * | 2005-07-20 | 2009-12-03 | Woojin Lee | Surgical instrument guide device |
EP2130504A1 (en) * | 2007-03-29 | 2009-12-09 | Olympus Medical Systems Corporation | Articulated bending mechanism and articulated medical device with articulated bending mechanism |
US20090320637A1 (en) * | 2008-06-27 | 2009-12-31 | Allegiance Corporation | Flexible wrist-type element and methods of manufacture and use thereof |
US7648519B2 (en) | 2006-09-13 | 2010-01-19 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20100023050A1 (en) * | 2006-08-30 | 2010-01-28 | Josef Reinauer | Surgical gripping forceps |
US20100030018A1 (en) * | 2008-08-04 | 2010-02-04 | Richard Fortier | Articulating surgical device |
US20100041945A1 (en) * | 2008-08-18 | 2010-02-18 | Isbell Jr Lewis | Instrument with articulation lock |
US7713190B2 (en) | 1998-02-24 | 2010-05-11 | Hansen Medical, Inc. | Flexible instrument |
US20100125285A1 (en) * | 2008-11-20 | 2010-05-20 | Hansen Medical, Inc. | Automated alignment |
EP2200516A2 (en) * | 2007-10-17 | 2010-06-30 | National Cancer Center | Small caliber laparoscope surgical apparatus |
US20100241136A1 (en) * | 2006-12-05 | 2010-09-23 | Mark Doyle | Instrument positioning/holding devices |
US20100249497A1 (en) * | 2009-03-30 | 2010-09-30 | Peine William J | Surgical instrument |
US20100262180A1 (en) * | 2003-05-23 | 2010-10-14 | Danitz David J | Articulating mechanisms with bifurcating control |
US20100286670A1 (en) * | 2004-06-16 | 2010-11-11 | Mark Doyle | Surgical tool kit |
US20100308195A1 (en) * | 2005-05-03 | 2010-12-09 | Hansen Medical, Inc. | Support assembly for robotic catheter system |
WO2011025886A1 (en) * | 2009-08-26 | 2011-03-03 | Carefusion 2200, Inc. | Mechanisms for positioning and/or holding surgical instruments and performing other functions, and methods of manufacture and use thereof |
US20110106078A1 (en) * | 2009-10-30 | 2011-05-05 | Tyco Healthcare Group Lp | Coaxial Drive |
US20110112517A1 (en) * | 2009-11-06 | 2011-05-12 | Peine Willliam J | Surgical instrument |
US7955316B2 (en) | 2001-02-15 | 2011-06-07 | Han Sen Medical, Inc. | Coaxial catheter system |
US7976539B2 (en) | 2004-03-05 | 2011-07-12 | Hansen Medical, Inc. | System and method for denaturing and fixing collagenous tissue |
US20110184459A1 (en) * | 2008-08-04 | 2011-07-28 | Malkowski Jaroslaw T | Articulating Surgical Device |
US20110184232A1 (en) * | 2008-07-31 | 2011-07-28 | Vhairi Maxwell | Endoscopic surgical instrument |
US8005571B2 (en) | 2002-08-13 | 2011-08-23 | Neuroarm Surgical Ltd. | Microsurgical robot system |
US8007511B2 (en) | 2003-06-06 | 2011-08-30 | Hansen Medical, Inc. | Surgical instrument design |
US8021358B2 (en) | 2004-06-16 | 2011-09-20 | Carefusion 2200, Inc. | Surgical tool kit |
US8029531B2 (en) | 2006-07-11 | 2011-10-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20110276084A1 (en) * | 2010-05-07 | 2011-11-10 | Ethicon Endo-Surgery, Inc. | Laparoscopic devices with flexible actuation mechanisms |
US20110277579A1 (en) * | 2010-05-14 | 2011-11-17 | Intuitive Surgical Operations, Inc. | Cable Re-ordering Device |
US20120065467A1 (en) * | 2005-07-01 | 2012-03-15 | Hansen Medical, Inc. | Robotic catheter system and methods |
ES2388867A1 (en) * | 2009-10-27 | 2012-10-19 | Universitat Politècnica De Catalunya | Minimally invasive laparoscopic surgical pliers |
EP2522282A1 (en) * | 2007-05-30 | 2012-11-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting instrument with articulatable end effector |
US8333204B2 (en) | 1999-06-25 | 2012-12-18 | Hansen Medical, Inc. | Apparatus and methods for treating tissue |
US20130023859A1 (en) * | 2011-07-21 | 2013-01-24 | Tyco Healthcare Group Lp | Articulating Links with Middle Link Control System |
EP2613728A2 (en) * | 2010-09-10 | 2013-07-17 | CareFusion 2200 Inc. | Protective sheath |
US20130197540A1 (en) * | 2003-05-21 | 2013-08-01 | The Johns Hopkins University | Devices, systems and methods for minimally invasive surgery of the throat and other portions of mammalian body |
US20130274760A1 (en) * | 2002-03-20 | 2013-10-17 | P Tech, Llc | Robotic fastening system |
EP2666429A1 (en) * | 2011-03-11 | 2013-11-27 | Olympus Corporation | Medical treatment tool and manipulator |
WO2014012780A1 (en) * | 2012-07-17 | 2014-01-23 | Richard Wolf Gmbh | Endoscopic instrument |
US8652031B2 (en) | 2011-12-29 | 2014-02-18 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Remote guidance system for medical devices for use in environments having electromagnetic interference |
US20140358163A1 (en) * | 2011-07-11 | 2014-12-04 | EON Surgical Ltd. | Laparoscopic graspers |
US20150012134A1 (en) * | 2009-03-09 | 2015-01-08 | Intuitive Surgical Operations, Inc. | Adaptable integrated energy control system for electrosurgical tools in robotic surgical systems |
US20150073434A1 (en) * | 2012-04-20 | 2015-03-12 | Vanderbilt University | Dexterous wrists for surgical intervention |
US20150088152A1 (en) * | 2013-09-25 | 2015-03-26 | Terumo Kabushiki Kaisha | Elongated member for medical use |
US20150088160A1 (en) * | 2012-04-27 | 2015-03-26 | Industry-University Cooperation Foundation Hanyang University Erica Campus | Surgical robot for changing position of surgical equipment |
US9033998B1 (en) * | 2010-05-13 | 2015-05-19 | Titan Medical Inc. | Independent roll wrist mechanism |
US20150150633A1 (en) * | 2012-06-07 | 2015-06-04 | Medrobotics Corporation | Articulating surgical instruments and methods of deploying the same |
EP2779919A4 (en) * | 2011-11-16 | 2015-08-26 | Olympus Corp | Medical treatment tool and manipulator including the same |
CN104856760A (en) * | 2015-04-16 | 2015-08-26 | 段友建 | Automatic nursing device for orthopedic inspection |
CN104887326A (en) * | 2009-11-13 | 2015-09-09 | 直观外科手术操作公司 | Method and system for hand presence detection in a minimally invasive surgical system |
US9138166B2 (en) | 2011-07-29 | 2015-09-22 | Hansen Medical, Inc. | Apparatus and methods for fiber integration and registration |
CN104958111A (en) * | 2010-05-14 | 2015-10-07 | 直观外科手术操作公司 | Surgical system sterile drape |
US9161771B2 (en) | 2011-05-13 | 2015-10-20 | Intuitive Surgical Operations Inc. | Medical instrument with snake wrist structure |
US9168050B1 (en) | 2011-03-24 | 2015-10-27 | Cambridge Endoscopic Devices, Inc. | End effector construction |
US20150352715A1 (en) * | 2013-02-27 | 2015-12-10 | Olympus Corporation | Manipulator |
US20150367508A1 (en) * | 2013-03-18 | 2015-12-24 | Olympus Corporation | Manipulator |
US9221179B2 (en) | 2009-07-23 | 2015-12-29 | Intuitive Surgical Operations, Inc. | Articulating mechanism |
US9282993B1 (en) | 2013-03-15 | 2016-03-15 | Southern Methodist University | Steerable extendable devices |
US9301811B2 (en) | 2012-09-17 | 2016-04-05 | Intuitive Surgical Operations, Inc. | Methods and systems for assigning input devices to teleoperated surgical instrument functions |
US9314306B2 (en) | 2010-09-17 | 2016-04-19 | Hansen Medical, Inc. | Systems and methods for manipulating an elongate member |
US9326822B2 (en) | 2013-03-14 | 2016-05-03 | Hansen Medical, Inc. | Active drives for robotic catheter manipulators |
WO2016067436A1 (en) * | 2014-10-30 | 2016-05-06 | オリンパス株式会社 | Medical treatment tool |
US9333001B2 (en) | 2009-10-08 | 2016-05-10 | Ethicon Endo-Surgery, Inc. | Articulable laparoscopic instrument |
US9357984B2 (en) | 2013-04-23 | 2016-06-07 | Covidien Lp | Constant value gap stabilizer for articulating links |
US9358076B2 (en) | 2011-01-20 | 2016-06-07 | Hansen Medical, Inc. | System and method for endoluminal and translumenal therapy |
US9408669B2 (en) | 2013-03-15 | 2016-08-09 | Hansen Medical, Inc. | Active drive mechanism with finite range of motion |
US20160270807A1 (en) * | 2015-03-16 | 2016-09-22 | Ethicon Endo-Surgery, Llc | Surgical Jaw Coupling Methods and Devices |
US9468426B2 (en) | 2010-05-07 | 2016-10-18 | Ethicon Endo-Surgery, Inc. | Compound angle laparoscopic methods and devices |
US20170007224A1 (en) * | 2014-03-31 | 2017-01-12 | Human Extensions Ltd. | Steerable medical device |
US9566201B2 (en) | 2007-02-02 | 2017-02-14 | Hansen Medical, Inc. | Mounting support assembly for suspending a medical instrument driver above an operating table |
CN106572889A (en) * | 2014-08-13 | 2017-04-19 | 柯惠Lp公司 | Robotically controlling mechanical advantage gripping |
WO2017064303A1 (en) | 2015-10-16 | 2017-04-20 | Medical Microinstruments S.R.L. | Surgical tool for robotic surgery and robotic surgical assembly |
WO2017064306A1 (en) | 2015-10-16 | 2017-04-20 | Medical Microinstruments S.R.L. | A surgical tool |
CN106794048A (en) * | 2015-01-06 | 2017-05-31 | 奥林巴斯株式会社 | Operation input unit and medical manipulator system |
US20170258483A1 (en) * | 2007-03-30 | 2017-09-14 | Ethicon Endo-Surgery, Inc. | Detachable End Effectors |
US9763683B2 (en) | 2001-08-28 | 2017-09-19 | Bonutti Skeletal Innovations Llc | Method for performing surgical procedures using optical cutting guides |
US9795394B2 (en) | 2000-01-14 | 2017-10-24 | Bonutti Skeletal Innovations Llc | Method for placing implant using robotic system |
EP3238650A1 (en) * | 2013-06-19 | 2017-11-01 | Titan Medical Inc. | Articulated tool positioner and system employing same |
US20170340316A1 (en) * | 2016-05-25 | 2017-11-30 | Medtronic, Inc. | Interventional medical device retrieval |
EP3130304A4 (en) * | 2014-04-09 | 2017-12-20 | Olympus Corporation | Treatment tool and surgical system |
US20170360462A1 (en) * | 2011-11-29 | 2017-12-21 | Covidien Lp | Coupling mechanisms for surgical instruments |
EP3137009A4 (en) * | 2014-04-28 | 2017-12-27 | Covidien LP | Surgical assemblies for housing force transmitting members |
CN107683120A (en) * | 2015-07-09 | 2018-02-09 | 川崎重工业株式会社 | Operation manipulator |
CN107708597A (en) * | 2015-07-09 | 2018-02-16 | 川崎重工业株式会社 | Operation robot |
CN107708596A (en) * | 2015-07-09 | 2018-02-16 | 川崎重工业株式会社 | Operation manipulator |
US9901402B2 (en) | 2010-09-21 | 2018-02-27 | Intuitive Surgical Operations, Inc. | Method and apparatus for hand gesture control in a minimally invasive surgical system |
WO2018049217A1 (en) | 2016-09-09 | 2018-03-15 | Intuitive Surgical Operations, Inc. | Push-pull surgical instrument end effector actuation using flexible tension member |
US9962168B2 (en) | 2005-12-20 | 2018-05-08 | CroJor, LLC | Method and apparatus for performing minimally invasive arthroscopic procedures |
US10039532B2 (en) | 2015-05-06 | 2018-08-07 | Covidien Lp | Surgical instrument with articulation assembly |
US10046140B2 (en) | 2014-04-21 | 2018-08-14 | Hansen Medical, Inc. | Devices, systems, and methods for controlling active drive systems |
US10058393B2 (en) | 2015-10-21 | 2018-08-28 | P Tech, Llc | Systems and methods for navigation and visualization |
CN108472025A (en) * | 2015-10-05 | 2018-08-31 | 弗莱克斯德克斯公司 | The medical treatment device of more cluster connectors with smooth articulation |
WO2018189722A1 (en) | 2017-04-14 | 2018-10-18 | Medical Microinstruments S.p.A. | Robotic microsurgical assembly |
WO2018189721A1 (en) | 2017-04-14 | 2018-10-18 | Medical Microinstruments S.p.A. | Robotic microsurgical assembly |
US10166061B2 (en) | 2014-03-17 | 2019-01-01 | Intuitive Surgical Operations, Inc. | Teleoperated surgical system equipment with user interface |
EP3476351A1 (en) * | 2017-10-26 | 2019-05-01 | Ethicon LLC | Auto cable tensioning system |
US10300599B2 (en) | 2012-04-20 | 2019-05-28 | Vanderbilt University | Systems and methods for safe compliant insertion and hybrid force/motion telemanipulation of continuum robots |
CN110037758A (en) * | 2019-05-15 | 2019-07-23 | 成都五义医疗器械有限公司 | A kind of installation pedestal and elongated shaft assembly |
US10363103B2 (en) | 2009-04-29 | 2019-07-30 | Auris Health, Inc. | Flexible and steerable elongate instruments with shape control and support elements |
US10390853B2 (en) | 2014-08-13 | 2019-08-27 | Covidien Lp | Robotically controlling mechanical advantage gripping |
US10463439B2 (en) | 2016-08-26 | 2019-11-05 | Auris Health, Inc. | Steerable catheter with shaft load distributions |
US10524867B2 (en) | 2013-03-15 | 2020-01-07 | Auris Health, Inc. | Active drive mechanism for simultaneous rotation and translation |
US10556092B2 (en) | 2013-03-14 | 2020-02-11 | Auris Health, Inc. | Active drives for robotic catheter manipulators |
CN110772334A (en) * | 2019-04-25 | 2020-02-11 | 深圳市精锋医疗科技有限公司 | Surgical instrument |
US10583271B2 (en) | 2012-11-28 | 2020-03-10 | Auris Health, Inc. | Method of anchoring pullwire directly articulatable region in catheter |
US10583270B2 (en) | 2016-03-14 | 2020-03-10 | Covidien Lp | Compound curve navigation catheter |
US10631939B2 (en) | 2012-11-02 | 2020-04-28 | Intuitive Surgical Operations, Inc. | Systems and methods for mapping flux supply paths |
US10667873B2 (en) | 2015-06-23 | 2020-06-02 | Covidien Lp | Surgical end effectors with mechanical advantage |
US10702285B2 (en) | 2005-12-20 | 2020-07-07 | Quantum Medical Innovations, LLC | Method and apparatus for performing minimally invasive arthroscopic procedures |
CN111388083A (en) * | 2020-03-26 | 2020-07-10 | 平阴县中医医院 | Multi-angle operation electric coagulation forceps for stomatology department |
US10753439B2 (en) | 2015-04-03 | 2020-08-25 | The Regents Of The University Of Michigan | Tension management apparatus for cable-driven transmission |
JPWO2019073859A1 (en) * | 2017-10-12 | 2020-11-19 | 日本発條株式会社 | Flexible tubes and flexible structures for medical manipulators |
US10864053B2 (en) | 2016-04-08 | 2020-12-15 | Olympus Corporation | Flexible manipulator |
US10864048B2 (en) | 2012-11-02 | 2020-12-15 | Intuitive Surgical Operations, Inc. | Flux disambiguation for teleoperated surgical systems |
US20210000558A1 (en) * | 2019-07-16 | 2021-01-07 | Transenterix Surgical, Inc. | Dynamic scaling for a robotic surgical system |
US20210030425A1 (en) * | 2019-07-29 | 2021-02-04 | Boston Scientific Scimed, Inc. | Tissue clipping device |
US20210038293A1 (en) * | 2009-10-30 | 2021-02-11 | Covidien Lp | Jaw roll joint |
CN112370008A (en) * | 2016-02-05 | 2021-02-19 | 得克萨斯系统大学董事会 | Surgical device |
US10932691B2 (en) | 2016-01-26 | 2021-03-02 | Auris Health, Inc. | Surgical tools having electromagnetic tracking components |
US10932861B2 (en) | 2016-01-14 | 2021-03-02 | Auris Health, Inc. | Electromagnetic tracking surgical system and method of controlling the same |
US10967504B2 (en) | 2017-09-13 | 2021-04-06 | Vanderbilt University | Continuum robots with multi-scale motion through equilibrium modulation |
US20210137624A1 (en) * | 2019-07-16 | 2021-05-13 | Transenterix Surgical, Inc. | Dynamic scaling of surgical manipulator motion based on surgeon stress parameters |
US11006975B1 (en) | 2013-03-15 | 2021-05-18 | Southern Methodist University | Steerable extendable devices |
US11026755B2 (en) * | 2011-02-15 | 2021-06-08 | Intuitive Surgical Operations, Inc. | Systems and methods for operating an end effector |
US20210178610A1 (en) * | 2018-08-31 | 2021-06-17 | Industry-University Cooperation Foundation Hanyang University Erica Campus | Flexible mechanism |
US11123146B2 (en) | 2019-05-30 | 2021-09-21 | Titan Medical Inc. | Surgical instrument apparatus, actuator, and drive |
US20210339398A1 (en) * | 2019-01-31 | 2021-11-04 | Kawasaki Jukogyo Kabushiki Kaisha | Robot and method of operating the same |
WO2022013469A1 (en) * | 2020-07-14 | 2022-01-20 | Universidad Carlos Iii De Madrid | Link for soft joint and soft joint comprising the link |
US11234783B2 (en) | 2018-12-28 | 2022-02-01 | Titan Medical Inc. | Articulated tool positioner for robotic surgery system |
US11241559B2 (en) | 2016-08-29 | 2022-02-08 | Auris Health, Inc. | Active drive for guidewire manipulation |
US20220071632A1 (en) * | 2018-12-21 | 2022-03-10 | Intuitive Surgical Operations, Inc. | Actuation mechanisms for surgical instruments |
US11304769B2 (en) * | 2006-06-13 | 2022-04-19 | Intuitive Surgical Operations, Inc. | Side looking minimally invasive surgery instrument assembly |
US11324554B2 (en) | 2016-04-08 | 2022-05-10 | Auris Health, Inc. | Floating electromagnetic field generator system and method of controlling the same |
US11376031B2 (en) | 2015-10-20 | 2022-07-05 | Lumendi Ltd. | Medical instruments for performing minimally-invasive procedures |
US11426095B2 (en) * | 2013-03-15 | 2022-08-30 | Auris Health, Inc. | Flexible instrument localization from both remote and elongation sensors |
CN115005993A (en) * | 2022-05-31 | 2022-09-06 | 四川省肿瘤医院 | Bending mechanism and surgical mechanical arm applying same |
US20220287699A1 (en) * | 2014-09-26 | 2022-09-15 | Intuitive Surgical Operations, Inc. | Surgical instrument with flexible shaft and actuation element guide |
US11446081B2 (en) | 2015-10-20 | 2022-09-20 | Lumedi Ltd. | Medical instruments for performing minimally-invasive procedures |
US20220304714A1 (en) * | 2021-03-24 | 2022-09-29 | Ethicon Llc | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US20220304715A1 (en) * | 2021-03-24 | 2022-09-29 | Ethicon Llc | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11504104B2 (en) | 2015-10-20 | 2022-11-22 | Lumendi Ltd. | Medical instruments for performing minimally-invasive procedures |
US11559301B2 (en) * | 2003-06-17 | 2023-01-24 | Covidien Lp | Surgical stapling device |
EP4094705A3 (en) * | 2021-05-28 | 2023-02-22 | Endo Robotics Co., Ltd. | Tendon-sheath driving apparatus, surgical member driving apparatus, and method of operating the same |
US20230107005A1 (en) * | 2021-09-29 | 2023-04-06 | Cilag Gmbh International | Surgical systems with port devices for instrument control |
US11622785B2 (en) | 2006-09-29 | 2023-04-11 | Cilag Gmbh International | Surgical staples having attached drivers and stapling instruments for deploying the same |
US11633183B2 (en) | 2013-04-16 | 2023-04-25 | Cilag International GmbH | Stapling assembly comprising a retraction drive |
US11648006B2 (en) | 2007-06-04 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US11648008B2 (en) | 2006-01-31 | 2023-05-16 | Cilag Gmbh International | Surgical instrument having force feedback capabilities |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
US11653918B2 (en) | 2014-09-05 | 2023-05-23 | Cilag Gmbh International | Local display of tissue parameter stabilization |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11660110B2 (en) | 2006-01-31 | 2023-05-30 | Cilag Gmbh International | Motor-driven surgical cutting and fastening instrument with tactile position feedback |
US11672532B2 (en) | 2017-06-20 | 2023-06-13 | Cilag Gmbh International | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US11672536B2 (en) | 2010-09-30 | 2023-06-13 | Cilag Gmbh International | Layer of material for a surgical end effector |
US11678877B2 (en) | 2014-12-18 | 2023-06-20 | Cilag Gmbh International | Surgical instrument including a flexible support configured to support a flexible firing member |
US11684369B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Method of using multiple RFID chips with a surgical assembly |
US11684361B2 (en) | 2008-09-23 | 2023-06-27 | Cilag Gmbh International | Motor-driven surgical cutting instrument |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11696759B2 (en) | 2017-06-28 | 2023-07-11 | Cilag Gmbh International | Surgical stapling instruments comprising shortened staple cartridge noses |
US11701110B2 (en) | 2013-08-23 | 2023-07-18 | Cilag Gmbh International | Surgical instrument including a drive assembly movable in a non-motorized mode of operation |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11701115B2 (en) | 2016-12-21 | 2023-07-18 | Cilag Gmbh International | Methods of stapling tissue |
US11707273B2 (en) | 2012-06-15 | 2023-07-25 | Cilag Gmbh International | Articulatable surgical instrument comprising a firing drive |
US11712244B2 (en) | 2015-09-30 | 2023-08-01 | Cilag Gmbh International | Implantable layer with spacer fibers |
US11717297B2 (en) | 2014-09-05 | 2023-08-08 | Cilag Gmbh International | Smart cartridge wake up operation and data retention |
US11717294B2 (en) | 2014-04-16 | 2023-08-08 | Cilag Gmbh International | End effector arrangements comprising indicators |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11723662B2 (en) | 2021-05-28 | 2023-08-15 | Cilag Gmbh International | Stapling instrument comprising an articulation control display |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11730477B2 (en) | 2008-10-10 | 2023-08-22 | Cilag Gmbh International | Powered surgical system with manually retractable firing system |
US11730471B2 (en) | 2016-02-09 | 2023-08-22 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11730474B2 (en) | 2005-08-31 | 2023-08-22 | Cilag Gmbh International | Fastener cartridge assembly comprising a movable cartridge and a staple driver arrangement |
US11737754B2 (en) | 2010-09-30 | 2023-08-29 | Cilag Gmbh International | Surgical stapler with floating anvil |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11744588B2 (en) | 2015-02-27 | 2023-09-05 | Cilag Gmbh International | Surgical stapling instrument including a removably attachable battery pack |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11751867B2 (en) | 2017-12-21 | 2023-09-12 | Cilag Gmbh International | Surgical instrument comprising sequenced systems |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11759208B2 (en) | 2015-12-30 | 2023-09-19 | Cilag Gmbh International | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US11771426B2 (en) | 2007-01-10 | 2023-10-03 | Cilag Gmbh International | Surgical instrument with wireless communication |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11779420B2 (en) | 2012-06-28 | 2023-10-10 | Cilag Gmbh International | Robotic surgical attachments having manually-actuated retraction assemblies |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
US11779336B2 (en) | 2016-02-12 | 2023-10-10 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US11786325B2 (en) | 2019-07-02 | 2023-10-17 | Intuitive Surgical Operations, Inc. | Remotely controlling a system using video |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11793513B2 (en) | 2017-06-20 | 2023-10-24 | Cilag Gmbh International | Systems and methods for controlling motor speed according to user input for a surgical instrument |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11793509B2 (en) | 2012-03-28 | 2023-10-24 | Cilag Gmbh International | Staple cartridge including an implantable layer |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US11793512B2 (en) | 2005-08-31 | 2023-10-24 | Cilag Gmbh International | Staple cartridges for forming staples having differing formed staple heights |
US11793394B2 (en) | 2016-12-02 | 2023-10-24 | Vanderbilt University | Steerable endoscope with continuum manipulator |
US11801047B2 (en) | 2008-02-14 | 2023-10-31 | Cilag Gmbh International | Surgical stapling system comprising a control circuit configured to selectively monitor tissue impedance and adjust control of a motor |
US11811253B2 (en) | 2016-04-18 | 2023-11-07 | Cilag Gmbh International | Surgical robotic system with fault state detection configurations based on motor current draw |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11806015B2 (en) | 2018-12-21 | 2023-11-07 | Intuitive Surgical Operations, Inc. | Surgical instruments having mechanisms for identifying and/or deactivating stapler cartridges |
US11806013B2 (en) | 2012-06-28 | 2023-11-07 | Cilag Gmbh International | Firing system arrangements for surgical instruments |
US11812958B2 (en) | 2014-12-18 | 2023-11-14 | Cilag Gmbh International | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US11812954B2 (en) | 2008-09-23 | 2023-11-14 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11839352B2 (en) | 2007-01-11 | 2023-12-12 | Cilag Gmbh International | Surgical stapling device with an end effector |
US11839375B2 (en) | 2005-08-31 | 2023-12-12 | Cilag Gmbh International | Fastener cartridge assembly comprising an anvil and different staple heights |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
US11849946B2 (en) | 2015-09-23 | 2023-12-26 | Cilag Gmbh International | Surgical stapler having downstream current-based motor control |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11849952B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US11850310B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge including an adjunct |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11857187B2 (en) | 2010-09-30 | 2024-01-02 | Cilag Gmbh International | Tissue thickness compensator comprising controlled release and expansion |
US11857188B2 (en) | 2018-12-21 | 2024-01-02 | Intuitive Surgical Operations, Inc. | Articulation assemblies for surgical instruments |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11864762B2 (en) | 2018-02-12 | 2024-01-09 | Intuitive Surgical Operations, Inc. | Surgical instrument with lockout mechanism |
WO2024007472A1 (en) * | 2022-07-04 | 2024-01-11 | 中国科学院自动化研究所 | Feeding system and feeding method for medical instrument having controllable flexible tail end |
US11871939B2 (en) | 2017-06-20 | 2024-01-16 | Cilag Gmbh International | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
US11871923B2 (en) | 2008-09-23 | 2024-01-16 | Cilag Gmbh International | Motorized surgical instrument |
US11871925B2 (en) | 2020-07-28 | 2024-01-16 | Cilag Gmbh International | Surgical instruments with dual spherical articulation joint arrangements |
US11877748B2 (en) | 2006-10-03 | 2024-01-23 | Cilag Gmbh International | Robotically-driven surgical instrument with E-beam driver |
US11883026B2 (en) | 2014-04-16 | 2024-01-30 | Cilag Gmbh International | Fastener cartridge assemblies and staple retainer cover arrangements |
US11883025B2 (en) | 2010-09-30 | 2024-01-30 | Cilag Gmbh International | Tissue thickness compensator comprising a plurality of layers |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11883020B2 (en) | 2006-01-31 | 2024-01-30 | Cilag Gmbh International | Surgical instrument having a feedback system |
US11882987B2 (en) | 2004-07-28 | 2024-01-30 | Cilag Gmbh International | Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
US11883006B2 (en) | 2018-06-04 | 2024-01-30 | Valuebiotech Israel Ltd. | Articulation arm link |
US11890012B2 (en) | 2004-07-28 | 2024-02-06 | Cilag Gmbh International | Staple cartridge comprising cartridge body and attached support |
US11890005B2 (en) | 2017-06-29 | 2024-02-06 | Cilag Gmbh International | Methods for closed loop velocity control for robotic surgical instrument |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
US11896224B2 (en) | 2019-05-31 | 2024-02-13 | Intuitive Surgical Operations, Inc. | Staple cartridge for a surgical instrument |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11896255B2 (en) | 2015-10-05 | 2024-02-13 | Flexdex, Inc. | End-effector jaw closure transmission systems for remote access tools |
US11896222B2 (en) | 2017-12-15 | 2024-02-13 | Cilag Gmbh International | Methods of operating surgical end effectors |
US11903572B2 (en) | 2021-09-14 | 2024-02-20 | Nuvasive, Inc. | Surgical instruments, systems, and methods with optical sensors |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
US11911027B2 (en) | 2010-09-30 | 2024-02-27 | Cilag Gmbh International | Adhesive film laminate |
US11918222B2 (en) | 2014-04-16 | 2024-03-05 | Cilag Gmbh International | Stapling assembly having firing member viewing windows |
US11918210B2 (en) | 2014-10-16 | 2024-03-05 | Cilag Gmbh International | Staple cartridge comprising a cartridge body including a plurality of wells |
US11918208B2 (en) | 2011-05-27 | 2024-03-05 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US11918215B2 (en) | 2016-12-21 | 2024-03-05 | Cilag Gmbh International | Staple cartridge with array of staple pockets |
US11918220B2 (en) | 2012-03-28 | 2024-03-05 | Cilag Gmbh International | Tissue thickness compensator comprising tissue ingrowth features |
US11918212B2 (en) | 2015-03-31 | 2024-03-05 | Cilag Gmbh International | Surgical instrument with selectively disengageable drive systems |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
Families Citing this family (621)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5792135A (en) * | 1996-05-20 | 1998-08-11 | Intuitive Surgical, Inc. | Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity |
US7594912B2 (en) | 2004-09-30 | 2009-09-29 | Intuitive Surgical, Inc. | Offset remote center manipulator for robotic surgery |
US8414505B1 (en) | 2001-02-15 | 2013-04-09 | Hansen Medical, Inc. | Catheter driver system |
US20030135204A1 (en) * | 2001-02-15 | 2003-07-17 | Endo Via Medical, Inc. | Robotically controlled medical instrument with a flexible section |
US8010180B2 (en) | 2002-03-06 | 2011-08-30 | Mako Surgical Corp. | Haptic guidance system and method |
CN1774220A (en) | 2003-02-14 | 2006-05-17 | 德普伊斯派尔公司 | In-situ formed intervertebral fusion device and method |
US7909873B2 (en) * | 2006-12-15 | 2011-03-22 | Soteira, Inc. | Delivery apparatus and methods for vertebrostenting |
US7632265B2 (en) | 2004-05-28 | 2009-12-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Radio frequency ablation servo catheter and method |
US10258285B2 (en) | 2004-05-28 | 2019-04-16 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Robotic surgical system and method for automated creation of ablation lesions |
US7974674B2 (en) | 2004-05-28 | 2011-07-05 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Robotic surgical system and method for surface modeling |
US10863945B2 (en) | 2004-05-28 | 2020-12-15 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Robotic surgical system with contact sensing feature |
US8755864B2 (en) | 2004-05-28 | 2014-06-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Robotic surgical system and method for diagnostic data mapping |
US8528565B2 (en) | 2004-05-28 | 2013-09-10 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Robotic surgical system and method for automated therapy delivery |
US9782130B2 (en) | 2004-05-28 | 2017-10-10 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Robotic surgical system |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US10646292B2 (en) | 2004-09-30 | 2020-05-12 | Intuitive Surgical Operations, Inc. | Electro-mechanical strap stack in robotic arms |
US9261172B2 (en) | 2004-09-30 | 2016-02-16 | Intuitive Surgical Operations, Inc. | Multi-ply strap drive trains for surgical robotic arms |
US9492240B2 (en) * | 2009-06-16 | 2016-11-15 | Intuitive Surgical Operations, Inc. | Virtual measurement tool for minimally invasive surgery |
US8971597B2 (en) * | 2005-05-16 | 2015-03-03 | Intuitive Surgical Operations, Inc. | Efficient vision and kinematic data fusion for robotic surgical instruments and other applications |
US8155910B2 (en) | 2005-05-27 | 2012-04-10 | St. Jude Medical, Atrial Fibrillation Divison, Inc. | Robotically controlled catheter and method of its calibration |
JP2006334695A (en) * | 2005-05-31 | 2006-12-14 | Kyoto Univ | Remote control device |
US8591583B2 (en) | 2005-08-16 | 2013-11-26 | Benvenue Medical, Inc. | Devices for treating the spine |
AU2006279558B2 (en) | 2005-08-16 | 2012-05-17 | Izi Medical Products, Llc | Spinal tissue distraction devices |
US8366773B2 (en) * | 2005-08-16 | 2013-02-05 | Benvenue Medical, Inc. | Apparatus and method for treating bone |
US7673781B2 (en) | 2005-08-31 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with staple driver that supports multiple wire diameter staples |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
WO2007075989A2 (en) * | 2005-12-20 | 2007-07-05 | Orthodynamix Llc | Method and devices for minimally invasive arthroscopic procedures |
EP1983903B1 (en) * | 2006-01-27 | 2014-03-19 | Medtronic, Inc. | Ablation device and system for guiding ablation device into a patient's body |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
US7753904B2 (en) | 2006-01-31 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical instrument with a handle that can articulate with respect to the shaft |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
US8236010B2 (en) | 2006-03-23 | 2012-08-07 | Ethicon Endo-Surgery, Inc. | Surgical fastener and cutter with mimicking end effector |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US7506791B2 (en) | 2006-09-29 | 2009-03-24 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with mechanical mechanism for limiting maximum tissue compression |
US9456877B2 (en) | 2006-12-01 | 2016-10-04 | Boston Scientific Scimed, Inc. | Direct drive instruments and methods of use |
US8105382B2 (en) | 2006-12-07 | 2012-01-31 | Interventional Spine, Inc. | Intervertebral implant |
US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
US7655004B2 (en) | 2007-02-15 | 2010-02-02 | Ethicon Endo-Surgery, Inc. | Electroporation ablation apparatus, system, and method |
CA2678006C (en) | 2007-02-21 | 2014-10-14 | Benvenue Medical, Inc. | Devices for treating the spine |
US20090001130A1 (en) | 2007-03-15 | 2009-01-01 | Hess Christopher J | Surgical procedure using a cutting and stapling instrument having releasable staple-forming pockets |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US8900307B2 (en) | 2007-06-26 | 2014-12-02 | DePuy Synthes Products, LLC | Highly lordosed fusion cage |
US8579897B2 (en) | 2007-11-21 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Bipolar forceps |
ITRM20070476A1 (en) * | 2007-09-14 | 2009-03-15 | Uni Degli Studi Di Roma Rl A S | MOBILE PLATFORM CONTROLLED WITH SELECTIVE SENSING, IN PARTICULAR FOR ENDOSCOPIC SURGICAL DEVICES |
US8289385B2 (en) * | 2009-02-13 | 2012-10-16 | Seektech, Inc. | Push-cable for pipe inspection system |
US20090112059A1 (en) | 2007-10-31 | 2009-04-30 | Nobis Rudolph H | Apparatus and methods for closing a gastrotomy |
JP5128904B2 (en) * | 2007-10-31 | 2013-01-23 | 株式会社東芝 | manipulator |
US8480657B2 (en) | 2007-10-31 | 2013-07-09 | Ethicon Endo-Surgery, Inc. | Detachable distal overtube section and methods for forming a sealable opening in the wall of an organ |
US20100262162A1 (en) * | 2007-12-28 | 2010-10-14 | Terumo Kabushiki Kaisha | Medical manipulator and medical robot system |
EP2471493A1 (en) | 2008-01-17 | 2012-07-04 | Synthes GmbH | An expandable intervertebral implant and associated method of manufacturing the same |
JP5258314B2 (en) * | 2008-02-01 | 2013-08-07 | テルモ株式会社 | Medical manipulator and medical robot system |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US9770245B2 (en) | 2008-02-15 | 2017-09-26 | Ethicon Llc | Layer arrangements for surgical staple cartridges |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US20090240660A1 (en) * | 2008-03-18 | 2009-09-24 | Morgan Christopher B | Integration for intelligence data systems |
CA2720580A1 (en) | 2008-04-05 | 2009-10-08 | Synthes Usa, Llc | Expandable intervertebral implant |
US10405936B2 (en) | 2008-04-11 | 2019-09-10 | The Regents Of The University Of Michigan | Parallel kinematic mechanisms with decoupled rotational motions |
US9869339B2 (en) | 2008-04-11 | 2018-01-16 | Flexdex, Inc. | End-effector jaw closure transmission systems for remote access tools |
CN103961050B (en) * | 2008-04-18 | 2016-09-28 | 福蒂美迪克斯外科医疗器材有限公司 | A kind of instrument for endoscopic applications |
EA023597B1 (en) * | 2008-04-18 | 2016-06-30 | Фортимедикс Сёрджикал Б.В. | Instrument for endoscopic applications |
US9357708B2 (en) * | 2008-05-05 | 2016-06-07 | Energid Technologies Corporation | Flexible robotic manipulation mechanism |
US8771260B2 (en) * | 2008-05-30 | 2014-07-08 | Ethicon Endo-Surgery, Inc. | Actuating and articulating surgical device |
US8679003B2 (en) | 2008-05-30 | 2014-03-25 | Ethicon Endo-Surgery, Inc. | Surgical device and endoscope including same |
US8906035B2 (en) | 2008-06-04 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Endoscopic drop off bag |
US8403926B2 (en) | 2008-06-05 | 2013-03-26 | Ethicon Endo-Surgery, Inc. | Manually articulating devices |
US8361112B2 (en) | 2008-06-27 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical suture arrangement |
US9179832B2 (en) | 2008-06-27 | 2015-11-10 | Intuitive Surgical Operations, Inc. | Medical robotic system with image referenced camera control using partitionable orientational and translational modes |
US8479173B2 (en) * | 2008-07-09 | 2013-07-02 | International Business Machines Corporation | Efficient and self-balancing verification of multi-threaded microprocessors |
US8888792B2 (en) | 2008-07-14 | 2014-11-18 | Ethicon Endo-Surgery, Inc. | Tissue apposition clip application devices and methods |
US9204923B2 (en) | 2008-07-16 | 2015-12-08 | Intuitive Surgical Operations, Inc. | Medical instrument electronically energized using drive cables |
US8409200B2 (en) | 2008-09-03 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical grasping device |
US9679499B2 (en) * | 2008-09-15 | 2017-06-13 | Immersion Medical, Inc. | Systems and methods for sensing hand motion by measuring remote displacement |
US20100114081A1 (en) | 2008-11-05 | 2010-05-06 | Spectranetics | Biasing laser catheter: monorail design |
US8157834B2 (en) | 2008-11-25 | 2012-04-17 | Ethicon Endo-Surgery, Inc. | Rotational coupling device for surgical instrument with flexible actuators |
US20110264136A1 (en) * | 2008-12-12 | 2011-10-27 | Seung Wook Choi | Surgical instrument |
US8702773B2 (en) | 2008-12-17 | 2014-04-22 | The Spectranetics Corporation | Eccentric balloon laser catheter |
US8830224B2 (en) | 2008-12-31 | 2014-09-09 | Intuitive Surgical Operations, Inc. | Efficient 3-D telestration for local robotic proctoring |
US8361066B2 (en) | 2009-01-12 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US20100198248A1 (en) * | 2009-02-02 | 2010-08-05 | Ethicon Endo-Surgery, Inc. | Surgical dissector |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
CN102341048A (en) | 2009-02-06 | 2012-02-01 | 伊西康内外科公司 | Driven surgical stapler improvements |
US8444036B2 (en) | 2009-02-06 | 2013-05-21 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector |
US9526620B2 (en) | 2009-03-30 | 2016-12-27 | DePuy Synthes Products, Inc. | Zero profile spinal fusion cage |
DE202009012796U1 (en) | 2009-05-29 | 2009-11-26 | Aesculap Ag | Surgical instrument |
DE202009012793U1 (en) | 2009-05-29 | 2010-01-28 | Aesculap Ag | Surgical instrument |
US9155592B2 (en) * | 2009-06-16 | 2015-10-13 | Intuitive Surgical Operations, Inc. | Virtual measurement tool for minimally invasive surgery |
US8827134B2 (en) | 2009-06-19 | 2014-09-09 | Covidien Lp | Flexible surgical stapler with motor in the head |
US20110071541A1 (en) | 2009-09-23 | 2011-03-24 | Intuitive Surgical, Inc. | Curved cannula |
US8551115B2 (en) * | 2009-09-23 | 2013-10-08 | Intuitive Surgical Operations, Inc. | Curved cannula instrument |
US8623028B2 (en) | 2009-09-23 | 2014-01-07 | Intuitive Surgical Operations, Inc. | Surgical port feature |
US8465476B2 (en) * | 2009-09-23 | 2013-06-18 | Intuitive Surgical Operations, Inc. | Cannula mounting fixture |
US8888789B2 (en) | 2009-09-23 | 2014-11-18 | Intuitive Surgical Operations, Inc. | Curved cannula surgical system control |
US20110098704A1 (en) | 2009-10-28 | 2011-04-28 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US8608652B2 (en) | 2009-11-05 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Vaginal entry surgical devices, kit, system, and method |
US8521331B2 (en) * | 2009-11-13 | 2013-08-27 | Intuitive Surgical Operations, Inc. | Patient-side surgeon interface for a minimally invasive, teleoperated surgical instrument |
CN102596058B (en) * | 2009-11-13 | 2015-10-21 | 直观外科手术操作公司 | There is the end effector of the close mechanism established again |
CN102596087B (en) * | 2009-11-13 | 2015-07-22 | 直观外科手术操作公司 | Motor interface for parallel drive shafts within an independently rotating member |
US9259275B2 (en) * | 2009-11-13 | 2016-02-16 | Intuitive Surgical Operations, Inc. | Wrist articulation by linked tension members |
CN102596062B (en) * | 2009-11-13 | 2016-08-24 | 直观外科手术操作公司 | Flex socket, robotic manipulator and there is the operating theater instruments of passive flexible shaft |
EP2489323B1 (en) | 2009-11-13 | 2018-05-16 | Intuitive Surgical Operations, Inc. | Surgical tool with a compact wrist |
DE102009056982A1 (en) * | 2009-12-07 | 2011-06-09 | Deutsches Zentrum für Luft- und Raumfahrt e.V. | Surgical manipulation instrument |
US9393129B2 (en) | 2009-12-10 | 2016-07-19 | DePuy Synthes Products, Inc. | Bellows-like expandable interbody fusion cage |
US8496574B2 (en) | 2009-12-17 | 2013-07-30 | Ethicon Endo-Surgery, Inc. | Selectively positionable camera for surgical guide tube assembly |
US8353487B2 (en) | 2009-12-17 | 2013-01-15 | Ethicon Endo-Surgery, Inc. | User interface support devices for endoscopic surgical instruments |
US9028483B2 (en) | 2009-12-18 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US8506564B2 (en) | 2009-12-18 | 2013-08-13 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
CA2786480C (en) | 2010-01-26 | 2018-01-16 | Novolap Medical Ltd. | Articulating medical instrument |
US9005198B2 (en) | 2010-01-29 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US9339341B2 (en) | 2010-02-08 | 2016-05-17 | Intuitive Surgical Operations, Inc. | Direct pull surgical gripper |
US10376331B2 (en) | 2010-02-12 | 2019-08-13 | Intuitive Surgical Operations, Inc. | Sheaths for jointed instruments |
US9089351B2 (en) | 2010-02-12 | 2015-07-28 | Intuitive Surgical Operations, Inc. | Sheath for surgical instrument |
WO2011115311A1 (en) * | 2010-03-15 | 2011-09-22 | 주식회사 아덴 | Surgical tool |
JP4837117B2 (en) * | 2010-04-14 | 2011-12-14 | ファナック株式会社 | Linear arrangement of robot arm |
US9764481B2 (en) * | 2010-06-10 | 2017-09-19 | Carefusion 2200, Inc. | Flexible wrist-type element |
US8979860B2 (en) | 2010-06-24 | 2015-03-17 | DePuy Synthes Products. LLC | Enhanced cage insertion device |
US9592063B2 (en) | 2010-06-24 | 2017-03-14 | DePuy Synthes Products, Inc. | Universal trial for lateral cages |
TW201215379A (en) | 2010-06-29 | 2012-04-16 | Synthes Gmbh | Distractible intervertebral implant |
KR102038654B1 (en) | 2010-07-09 | 2019-10-30 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | A surgical device including an electrosurgical instrument and cover |
CA2806278C (en) * | 2010-07-28 | 2020-08-04 | Medrobotics Corporation | Surgical positioning and support system |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
CA2811450A1 (en) * | 2010-09-14 | 2012-03-22 | The Johns Hopkins University | Robotic system to augment endoscopes |
US9402682B2 (en) | 2010-09-24 | 2016-08-02 | Ethicon Endo-Surgery, Llc | Articulation joint features for articulating surgical device |
JP5707824B2 (en) * | 2010-09-29 | 2015-04-30 | ソニー株式会社 | Control device and control method |
AU2011308701B2 (en) | 2010-09-30 | 2013-11-14 | Ethicon Endo-Surgery, Inc. | Fastener system comprising a retention matrix and an alignment matrix |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US9055941B2 (en) | 2011-09-23 | 2015-06-16 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck |
US9301753B2 (en) | 2010-09-30 | 2016-04-05 | Ethicon Endo-Surgery, Llc | Expandable tissue thickness compensator |
US9220500B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising structure to produce a resilient load |
US9241714B2 (en) | 2011-04-29 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator and method for making the same |
US8777004B2 (en) | 2010-09-30 | 2014-07-15 | Ethicon Endo-Surgery, Inc. | Compressible staple cartridge comprising alignment members |
US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
US9402732B2 (en) | 2010-10-11 | 2016-08-02 | DePuy Synthes Products, Inc. | Expandable interspinous process spacer implant |
US8992421B2 (en) | 2010-10-22 | 2015-03-31 | Medrobotics Corporation | Highly articulated robotic probes and methods of production and use of such probes |
US8951288B2 (en) | 2010-11-09 | 2015-02-10 | Benvenue Medical, Inc. | Devices and methods for treatment of a bone fracture |
US20120190970A1 (en) | 2010-11-10 | 2012-07-26 | Gnanasekar Velusamy | Apparatus and method for stabilizing a needle |
AU2011338931B2 (en) | 2010-11-11 | 2017-02-09 | Medrobotics Corporation | Introduction devices for highly articulated robotic probes and methods of production and use of such probes |
JP2012115471A (en) * | 2010-11-30 | 2012-06-21 | Olympus Corp | Medical treatment instrument, and manipulator |
WO2012074564A1 (en) | 2010-12-02 | 2012-06-07 | Freehand Endoscopic Devices, Inc. | Surgical tool |
US9119655B2 (en) | 2012-08-03 | 2015-09-01 | Stryker Corporation | Surgical manipulator capable of controlling a surgical instrument in multiple modes |
US9921712B2 (en) | 2010-12-29 | 2018-03-20 | Mako Surgical Corp. | System and method for providing substantially stable control of a surgical tool |
US10092291B2 (en) | 2011-01-25 | 2018-10-09 | Ethicon Endo-Surgery, Inc. | Surgical instrument with selectively rigidizable features |
US9314620B2 (en) | 2011-02-28 | 2016-04-19 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9254169B2 (en) | 2011-02-28 | 2016-02-09 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9233241B2 (en) | 2011-02-28 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
CN102210610B (en) * | 2011-03-17 | 2013-06-05 | 北京航空航天大学 | Pushing mechanism for minimally invasive surgical robot |
US9049987B2 (en) | 2011-03-17 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Hand held surgical device for manipulating an internal magnet assembly within a patient |
EP3488802A1 (en) | 2011-04-06 | 2019-05-29 | Medrobotics Corporation | Articulating surgical tools and tool sheaths, and methods of deploying the same |
DE102011001973A1 (en) | 2011-04-12 | 2012-10-18 | Aesculap Ag | control device |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US20140094825A1 (en) * | 2011-06-02 | 2014-04-03 | Medrobotics Corporation | Robotic systems, robotic system user interfaces, human interface devices for controlling robotic systems and methods of controlling robotic systems |
WO2012178018A2 (en) | 2011-06-24 | 2012-12-27 | Benvenue Medical, Inc. | Devices and methods for treating bone tissue |
JP6005950B2 (en) | 2011-08-04 | 2016-10-12 | オリンパス株式会社 | Surgery support apparatus and control method thereof |
JP6081061B2 (en) | 2011-08-04 | 2017-02-15 | オリンパス株式会社 | Surgery support device |
JP5841451B2 (en) | 2011-08-04 | 2016-01-13 | オリンパス株式会社 | Surgical instrument and control method thereof |
JP5953058B2 (en) | 2011-08-04 | 2016-07-13 | オリンパス株式会社 | Surgery support device and method for attaching and detaching the same |
JP6021353B2 (en) | 2011-08-04 | 2016-11-09 | オリンパス株式会社 | Surgery support device |
JP6009840B2 (en) | 2011-08-04 | 2016-10-19 | オリンパス株式会社 | Medical equipment |
JP6000641B2 (en) | 2011-08-04 | 2016-10-05 | オリンパス株式会社 | Manipulator system |
JP6021484B2 (en) | 2011-08-04 | 2016-11-09 | オリンパス株式会社 | Medical manipulator |
EP2740434A4 (en) * | 2011-08-04 | 2015-03-18 | Olympus Corp | Medical manipulator and method for controlling same |
EP2740435B8 (en) | 2011-08-04 | 2018-12-19 | Olympus Corporation | Surgical support apparatus |
WO2013018897A1 (en) * | 2011-08-04 | 2013-02-07 | オリンパス株式会社 | Surgical implement and medical treatment manipulator |
JP5936914B2 (en) | 2011-08-04 | 2016-06-22 | オリンパス株式会社 | Operation input device and manipulator system including the same |
JP5931497B2 (en) | 2011-08-04 | 2016-06-08 | オリンパス株式会社 | Surgery support apparatus and assembly method thereof |
US8945174B2 (en) * | 2011-08-15 | 2015-02-03 | Intuitive Surgical Operations, Inc. | Medical instrument with flexible jaw mechanism |
KR102122822B1 (en) * | 2011-08-15 | 2020-06-15 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | Medical instrument with flexible jaw and/or flexible wrist mechanisms |
US9005196B2 (en) * | 2011-08-16 | 2015-04-14 | Boston Scientific Scimed, Inc. | Medical device handles and related methods of use |
WO2013026012A1 (en) * | 2011-08-18 | 2013-02-21 | President And Fellows Of Harvard College | Hybrid snake robot for minimally invasive intervention |
EP3213697B1 (en) | 2011-09-02 | 2020-03-11 | Stryker Corporation | Surgical instrument including a housing, a cutting accessory that extends from the housing and actuators that establish the position of the cutting accessory relative to the housing |
JP6395605B2 (en) | 2011-09-13 | 2018-09-26 | メドロボティクス コーポレイション | Highly articulated probe having anti-twist link arrangement, formation method thereof, and medical procedure execution method |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
WO2013063674A1 (en) | 2011-11-04 | 2013-05-10 | Titan Medical Inc. | Apparatus and method for controlling an end-effector assembly |
US8911429B2 (en) | 2011-11-04 | 2014-12-16 | The Johns Hopkins University | Steady hand micromanipulation robot |
EP2773277B1 (en) | 2011-11-04 | 2016-03-02 | Titan Medical Inc. | Apparatus for controlling an end-effector assembly |
CN108262741A (en) | 2011-12-21 | 2018-07-10 | 美的洛博迪克斯公司 | The application method of the securing device of probe, the forming method of the device and the device is hinged for the height with chain regulating device |
US9956042B2 (en) | 2012-01-13 | 2018-05-01 | Vanderbilt University | Systems and methods for robot-assisted transurethral exploration and intervention |
EP2809245B1 (en) | 2012-02-02 | 2020-04-29 | Great Belief International Limited | Mechanized multi-instrument surgical system |
US8419720B1 (en) | 2012-02-07 | 2013-04-16 | National Advanced Endoscopy Devices, Incorporated | Flexible laparoscopic device |
US9044230B2 (en) | 2012-02-13 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status |
US8585114B2 (en) * | 2012-02-22 | 2013-11-19 | Carter J. Kovarik | Selectively bendable remote gripping tool |
US9901245B2 (en) | 2012-02-22 | 2018-02-27 | Carter J. Kovarik | Selectively bendable remote gripping tool |
US9592066B2 (en) | 2012-02-22 | 2017-03-14 | Carter J. Kovarik | Selectively bendable remote gripping tool |
US8985659B2 (en) | 2012-02-22 | 2015-03-24 | Carter J. Kovarik | Fish netting tool |
US9832980B2 (en) | 2012-02-22 | 2017-12-05 | Carter J. Kovarik | Selectively bendable remote gripping tool |
US8807615B2 (en) | 2012-02-22 | 2014-08-19 | Carter J. Kovarik | Selectively bendable remote gripping tool |
US8833817B2 (en) | 2012-02-22 | 2014-09-16 | Carter J. Kovarik | Selectively bendable animal waste scooper for sanitary handling of animal droppings |
USD780547S1 (en) | 2013-08-08 | 2017-03-07 | Carter J. Kovarik | Pick up device with flexible shaft portion |
US10226266B2 (en) | 2012-02-22 | 2019-03-12 | Carter J. Kovarik | Selectively bendable remote gripping tool |
US11083475B2 (en) | 2012-02-22 | 2021-08-10 | Carter J. Kovarik | Medical device to remove an obstruction from a body lumen, vessel or organ |
US9095127B2 (en) | 2012-02-22 | 2015-08-04 | Carter J. Kovarik | Selectively bendable remote gripping tool |
US9010320B2 (en) * | 2012-03-12 | 2015-04-21 | Furman Medical Llc | Manually articulated intubation stylet, intubation device and intubation method |
MX353040B (en) | 2012-03-28 | 2017-12-18 | Ethicon Endo Surgery Inc | Retainer assembly including a tissue thickness compensator. |
US9549720B2 (en) | 2012-04-20 | 2017-01-24 | Vanderbilt University | Robotic device for establishing access channel |
US9427255B2 (en) | 2012-05-14 | 2016-08-30 | Ethicon Endo-Surgery, Inc. | Apparatus for introducing a steerable camera assembly into a patient |
US20130345596A1 (en) * | 2012-06-25 | 2013-12-26 | David S. Zimmon | Apparatus and methods for removing and collecting biopsy specimens from biopsy devices with fixation and preparation for histopathological processing or other analysis |
US9408606B2 (en) | 2012-06-28 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Robotically powered surgical device with manually-actuatable reversing system |
US20140005718A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Multi-functional powered surgical device with external dissection features |
US20140005640A1 (en) * | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical end effector jaw and electrode configurations |
BR112014032776B1 (en) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM |
JP6290201B2 (en) | 2012-06-28 | 2018-03-07 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Lockout for empty clip cartridge |
US9282974B2 (en) | 2012-06-28 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Empty clip cartridge lockout |
US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
EP2869779B1 (en) | 2012-07-03 | 2019-02-27 | KUKA Deutschland GmbH | Surgical instrument arrangement |
US9078662B2 (en) | 2012-07-03 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Endoscopic cap electrode and method for using the same |
US9545290B2 (en) | 2012-07-30 | 2017-01-17 | Ethicon Endo-Surgery, Inc. | Needle probe guide |
US10314649B2 (en) | 2012-08-02 | 2019-06-11 | Ethicon Endo-Surgery, Inc. | Flexible expandable electrode and method of intraluminal delivery of pulsed power |
US9572623B2 (en) | 2012-08-02 | 2017-02-21 | Ethicon Endo-Surgery, Inc. | Reusable electrode and disposable sheath |
KR101364053B1 (en) * | 2012-08-03 | 2014-02-19 | 한국과학기술연구원 | Guide Tube for Microsurgical Instruments |
CN112932672A (en) | 2012-08-03 | 2021-06-11 | 史赛克公司 | Systems and methods for robotic surgery |
US9820818B2 (en) | 2012-08-03 | 2017-11-21 | Stryker Corporation | System and method for controlling a surgical manipulator based on implant parameters |
US9226796B2 (en) | 2012-08-03 | 2016-01-05 | Stryker Corporation | Method for detecting a disturbance as an energy applicator of a surgical instrument traverses a cutting path |
WO2014026104A1 (en) | 2012-08-09 | 2014-02-13 | Castro Michael Salvatore | Surgical tool positioning systems |
US9277957B2 (en) | 2012-08-15 | 2016-03-08 | Ethicon Endo-Surgery, Inc. | Electrosurgical devices and methods |
US9463022B2 (en) * | 2012-12-17 | 2016-10-11 | Ethicon Endo-Surgery, Llc | Motor driven rotary input circular stapler with lockable flexible shaft |
US10098527B2 (en) | 2013-02-27 | 2018-10-16 | Ethidcon Endo-Surgery, Inc. | System for performing a minimally invasive surgical procedure |
JP6382235B2 (en) | 2013-03-01 | 2018-08-29 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Articulatable surgical instrument with a conductive path for signal communication |
US9326767B2 (en) | 2013-03-01 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Joystick switch assemblies for surgical instruments |
JP6345707B2 (en) | 2013-03-01 | 2018-06-20 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Surgical instrument with soft stop |
US9522070B2 (en) | 2013-03-07 | 2016-12-20 | Interventional Spine, Inc. | Intervertebral implant |
US9839481B2 (en) * | 2013-03-07 | 2017-12-12 | Intuitive Surgical Operations, Inc. | Hybrid manual and robotic interventional instruments and methods of use |
KR102274277B1 (en) | 2013-03-13 | 2021-07-08 | 스트리커 코포레이션 | System for arranging objects in an operating room in preparation for surgical procedures |
EP2996611B1 (en) | 2013-03-13 | 2019-06-26 | Stryker Corporation | Systems and software for establishing virtual constraint boundaries |
US10058343B2 (en) | 2013-03-14 | 2018-08-28 | Covidien Lp | Systems for performing endoscopic procedures |
US10085783B2 (en) | 2013-03-14 | 2018-10-02 | Izi Medical Products, Llc | Devices and methods for treating bone tissue |
US20140296869A1 (en) | 2013-03-14 | 2014-10-02 | Intuitive Surgical Operations, Inc. | Surgical instrument shaft |
US9687230B2 (en) | 2013-03-14 | 2017-06-27 | Ethicon Llc | Articulatable surgical instrument comprising a firing drive |
US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
EP2967521B1 (en) | 2013-03-15 | 2019-12-25 | SRI International | Electromechanical surgical system |
US9649110B2 (en) | 2013-04-16 | 2017-05-16 | Ethicon Llc | Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output |
KR20140129702A (en) * | 2013-04-30 | 2014-11-07 | 삼성전자주식회사 | Surgical robot system and method for controlling the same |
US9913695B2 (en) | 2013-05-02 | 2018-03-13 | Medrobotics Corporation | Robotic system including a cable interface assembly |
US9517059B2 (en) | 2013-05-20 | 2016-12-13 | Medrobotics Corporation | Articulating surgical instruments and method of deploying the same |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
US10085746B2 (en) | 2013-06-28 | 2018-10-02 | Covidien Lp | Surgical instrument including rotating end effector and rotation-limiting structure |
US9358004B2 (en) | 2013-06-28 | 2016-06-07 | Covidien Lp | Articulating apparatus for endoscopic procedures |
WO2015023888A1 (en) * | 2013-08-15 | 2015-02-19 | Intuitive Surgical Operations, Inc. | Instrument shaft for computer-assisted surgical system |
US10076348B2 (en) | 2013-08-15 | 2018-09-18 | Intuitive Surgical Operations, Inc. | Rotary input for lever actuation |
US10550918B2 (en) | 2013-08-15 | 2020-02-04 | Intuitive Surgical Operations, Inc. | Lever actuated gimbal plate |
EP3033029B1 (en) * | 2013-08-15 | 2020-07-15 | Intuitive Surgical Operations, Inc. | Reusable surgical instrument with single-use tip and integrated tip cover |
MX369362B (en) | 2013-08-23 | 2019-11-06 | Ethicon Endo Surgery Llc | Firing member retraction devices for powered surgical instruments. |
KR102111621B1 (en) | 2013-11-05 | 2020-05-18 | 삼성전자주식회사 | Manipulator |
US9295522B2 (en) | 2013-11-08 | 2016-03-29 | Covidien Lp | Medical device adapter with wrist mechanism |
CN105828738B (en) | 2013-12-20 | 2018-10-09 | 奥林巴斯株式会社 | Flexible manipulator guide member and flexible manipulator |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
US9642620B2 (en) * | 2013-12-23 | 2017-05-09 | Ethicon Endo-Surgery, Llc | Surgical cutting and stapling instruments with articulatable end effectors |
US9681870B2 (en) | 2013-12-23 | 2017-06-20 | Ethicon Llc | Articulatable surgical instruments with separate and distinct closing and firing systems |
US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
US9968354B2 (en) | 2013-12-23 | 2018-05-15 | Ethicon Llc | Surgical staples and methods for making the same |
AU2014374201A1 (en) | 2013-12-30 | 2016-07-07 | Medrobotics Corporation | Articulated robotic probes |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
KR20230056068A (en) * | 2014-02-21 | 2023-04-26 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | Articulatable members having constrained motion, and related devices and methods |
JP6664331B2 (en) | 2014-02-21 | 2020-03-13 | インテュイティブ サージカル オペレーションズ, インコーポレイテッド | Mechanical joints and related systems and methods |
JP6462004B2 (en) | 2014-02-24 | 2019-01-30 | エシコン エルエルシー | Fastening system with launcher lockout |
US20140166725A1 (en) | 2014-02-24 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Staple cartridge including a barbed staple. |
US20150272571A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument utilizing sensor adaptation |
BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US10013049B2 (en) | 2014-03-26 | 2018-07-03 | Ethicon Llc | Power management through sleep options of segmented circuit and wake up control |
US20150272557A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Modular surgical instrument system |
US10285763B2 (en) | 2014-04-02 | 2019-05-14 | Intuitive Surgical Operations, Inc. | Actuation element guide with twisting channels |
CN106456158B (en) | 2014-04-16 | 2019-02-05 | 伊西康内外科有限责任公司 | Fastener cartridge including non-uniform fastener |
US10299792B2 (en) | 2014-04-16 | 2019-05-28 | Ethicon Llc | Fastener cartridge comprising non-uniform fasteners |
US10327764B2 (en) | 2014-09-26 | 2019-06-25 | Ethicon Llc | Method for creating a flexible staple line |
CN103919591B (en) * | 2014-04-24 | 2016-04-13 | 中国科学院深圳先进技术研究院 | A kind of Transnasal endoscopy operation auxiliary robot |
CA3193139A1 (en) | 2014-05-05 | 2015-11-12 | Vicarious Surgical Inc. | Virtual reality surgical device |
JP6284438B2 (en) * | 2014-06-12 | 2018-02-28 | オリンパス株式会社 | manipulator |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
SI3188645T1 (en) * | 2014-09-04 | 2020-08-31 | Memic Innovative Surgery Ltd. | Device and system including mechanical arms |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
MX2017003960A (en) | 2014-09-26 | 2017-12-04 | Ethicon Llc | Surgical stapling buttresses and adjunct materials. |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US10492863B2 (en) | 2014-10-29 | 2019-12-03 | The Spectranetics Corporation | Laser energy delivery devices including laser transmission detection systems and methods |
EP3212103B1 (en) | 2014-10-29 | 2021-12-15 | The Spectranetics Corporation | Laser energy delivery devices including laser transmission detection systems and methods |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US10603135B2 (en) * | 2014-10-30 | 2020-03-31 | Intuitive Surgical Operations, Inc. | System and method for an articulated arm based tool guide |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
CN104434318B (en) * | 2014-12-17 | 2016-05-25 | 上海交通大学 | A kind of operating theater instruments end structure of micro-wound operation robot |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
US9943309B2 (en) | 2014-12-18 | 2018-04-17 | Ethicon Llc | Surgical instruments with articulatable end effectors and movable firing beam support arrangements |
US9844374B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
KR101710256B1 (en) * | 2015-01-19 | 2017-02-24 | 고려대학교 산학협력단 | Robotic joint device using wire and module-type robotic joint system using wire |
CN104546066B (en) * | 2015-01-22 | 2017-02-22 | 中国科学院深圳先进技术研究院 | Passive type nasal endoscopic surgery assisting robot |
JP6664407B2 (en) * | 2015-02-19 | 2020-03-13 | コヴィディエン リミテッド パートナーシップ | Surgical assembly and method of use |
CN106794023A (en) * | 2015-02-26 | 2017-05-31 | 奥林巴斯株式会社 | Medical intervention utensil |
US20160249910A1 (en) | 2015-02-27 | 2016-09-01 | Ethicon Endo-Surgery, Llc | Surgical charging system that charges and/or conditions one or more batteries |
US10180463B2 (en) | 2015-02-27 | 2019-01-15 | Ethicon Llc | Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US10045776B2 (en) | 2015-03-06 | 2018-08-14 | Ethicon Llc | Control techniques and sub-processor contained within modular shaft with select control processing from handle |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
JP2020121162A (en) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーEthicon LLC | Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
US10548504B2 (en) | 2015-03-06 | 2020-02-04 | Ethicon Llc | Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression |
US11426290B2 (en) | 2015-03-06 | 2022-08-30 | DePuy Synthes Products, Inc. | Expandable intervertebral implant, system, kit and method |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
GB201504787D0 (en) * | 2015-03-20 | 2015-05-06 | Cambridge Medical Robotics Ltd | User interface for a robot |
JP6498281B2 (en) * | 2015-04-17 | 2019-04-10 | オリンパス株式会社 | Medical manipulator |
US9486927B1 (en) * | 2015-05-20 | 2016-11-08 | Google Inc. | Robotic gripper with multiple pairs of gripping fingers |
WO2016190049A1 (en) | 2015-05-28 | 2016-12-01 | オリンパス株式会社 | Sheath member, manipulator, and manipulator system |
US10335149B2 (en) | 2015-06-18 | 2019-07-02 | Ethicon Llc | Articulatable surgical instruments with composite firing beam structures with center firing support member for articulation support |
WO2017015167A1 (en) * | 2015-07-17 | 2017-01-26 | Deka Products Limited Partnership | Robotic surgery system, mithod, and appratus |
US10835249B2 (en) | 2015-08-17 | 2020-11-17 | Ethicon Llc | Implantable layers for a surgical instrument |
US10213203B2 (en) | 2015-08-26 | 2019-02-26 | Ethicon Llc | Staple cartridge assembly without a bottom cover |
CN108348233B (en) | 2015-08-26 | 2021-05-07 | 伊西康有限责任公司 | Surgical staple strip for allowing changing staple characteristics and achieving easy cartridge loading |
MX2022006191A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
US10238390B2 (en) | 2015-09-02 | 2019-03-26 | Ethicon Llc | Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
US10238386B2 (en) | 2015-09-23 | 2019-03-26 | Ethicon Llc | Surgical stapler having motor control based on an electrical parameter related to a motor current |
US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-based motor control |
US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US10478188B2 (en) | 2015-09-30 | 2019-11-19 | Ethicon Llc | Implantable layer comprising a constricted configuration |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US9814451B2 (en) | 2015-10-02 | 2017-11-14 | Flexdex, Inc. | Handle mechanism providing unlimited roll |
CN105286999B (en) * | 2015-10-15 | 2017-09-29 | 天津大学 | Minimally Invasive Surgery apparatus with end rotation function |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
JP6944939B2 (en) | 2015-12-31 | 2021-10-06 | ストライカー・コーポレイション | Systems and methods for performing surgery on a patient's target site as defined by a virtual object |
BR122022007763B1 (en) | 2016-02-05 | 2023-03-14 | Board Of Regents Of The University Of Texas System | METHOD FOR THE PREPARATION OF AN IONIC ELECTROACTIVE POLYMER ACTUATOR OF A TUBULAR MEDICAL DEVICE |
US10588625B2 (en) | 2016-02-09 | 2020-03-17 | Ethicon Llc | Articulatable surgical instruments with off-axis firing beam arrangements |
JP6911054B2 (en) | 2016-02-09 | 2021-07-28 | エシコン エルエルシーEthicon LLC | Surgical instruments with asymmetric joint composition |
US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10463438B2 (en) | 2016-03-09 | 2019-11-05 | Memic Innovative Surgery Ltd. | Modular device comprising mechanical arms |
US11064997B2 (en) | 2016-04-01 | 2021-07-20 | Cilag Gmbh International | Surgical stapling instrument |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
KR102429815B1 (en) | 2016-04-14 | 2022-08-08 | 트랜스엔테릭스 서지컬, 인크. | Electromechanical Surgical System Including Linear Driven Instrument Rolls |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
US10433840B2 (en) | 2016-04-18 | 2019-10-08 | Ethicon Llc | Surgical instrument comprising a replaceable cartridge jaw |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
JP6957532B2 (en) | 2016-06-24 | 2021-11-02 | エシコン エルエルシーEthicon LLC | Staple cartridges including wire staples and punched staples |
US10675024B2 (en) | 2016-06-24 | 2020-06-09 | Ethicon Llc | Staple cartridge comprising overdriven staples |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
USD822206S1 (en) | 2016-06-24 | 2018-07-03 | Ethicon Llc | Surgical fastener |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
CN109688981A (en) | 2016-06-28 | 2019-04-26 | Eit 新兴移植技术股份有限公司 | Distensible, adjustable angle intervertebral cage |
JP7023877B2 (en) | 2016-06-28 | 2022-02-22 | イーアイティー・エマージング・インプラント・テクノロジーズ・ゲーエムベーハー | Expandable and angle-adjustable range-of-motion intervertebral cage |
CN109069206B (en) | 2016-06-30 | 2021-08-17 | 直观外科手术操作公司 | System and method for fault reaction mechanism for medical robotic system |
KR102400881B1 (en) | 2016-07-14 | 2022-05-24 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | multi-cable medical device |
US11007024B2 (en) | 2016-07-14 | 2021-05-18 | Intuitive Surgical Operations, Inc. | Geared grip actuation for medical instruments |
US20190231451A1 (en) | 2016-07-14 | 2019-08-01 | Intuitive Surgical Operations, Inc. | Geared roll drive for medical instrument |
US11432836B2 (en) | 2016-09-14 | 2022-09-06 | Intuitive Surgical Operations, Inc. | Joint assemblies with cross-axis flexural pivots |
US11039835B2 (en) * | 2016-09-15 | 2021-06-22 | Intuitive Surgical Operations, Inc. | Medical device drive system |
WO2018052810A1 (en) | 2016-09-15 | 2018-03-22 | Intuitive Surgical Operations, Inc. | Medical device drive system |
US10751117B2 (en) | 2016-09-23 | 2020-08-25 | Ethicon Llc | Electrosurgical instrument with fluid diverter |
US10743859B2 (en) | 2016-10-21 | 2020-08-18 | Covidien Lp | Surgical end effectors |
US10617409B2 (en) | 2016-10-21 | 2020-04-14 | Covidien Lp | Surgical end effectors |
US11298123B2 (en) | 2016-10-21 | 2022-04-12 | Covidien Lp | Surgical end effectors |
US11241290B2 (en) | 2016-11-21 | 2022-02-08 | Intuitive Surgical Operations, Inc. | Cable length conserving medical instrument |
US10888433B2 (en) | 2016-12-14 | 2021-01-12 | DePuy Synthes Products, Inc. | Intervertebral implant inserter and related methods |
US11202682B2 (en) | 2016-12-16 | 2021-12-21 | Mako Surgical Corp. | Techniques for modifying tool operation in a surgical robotic system based on comparing actual and commanded states of the tool relative to a surgical site |
AU2017379816B2 (en) | 2016-12-20 | 2020-02-20 | Verb Surgical Inc. | Sterile adapter control system and communication interface for use in a robotic surgical system |
US10588631B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical instruments with positive jaw opening features |
JP6983893B2 (en) | 2016-12-21 | 2021-12-17 | エシコン エルエルシーEthicon LLC | Lockout configuration for surgical end effectors and replaceable tool assemblies |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
US20180168615A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument |
US20180168598A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Staple forming pocket arrangements comprising zoned forming surface grooves |
US10980536B2 (en) | 2016-12-21 | 2021-04-20 | Ethicon Llc | No-cartridge and spent cartridge lockout arrangements for surgical staplers |
US20180168647A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments having end effectors with positive opening features |
US10588632B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical end effectors and firing members thereof |
US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
US10835246B2 (en) | 2016-12-21 | 2020-11-17 | Ethicon Llc | Staple cartridges and arrangements of staples and staple cavities therein |
US11419606B2 (en) | 2016-12-21 | 2022-08-23 | Cilag Gmbh International | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
JP2020501779A (en) | 2016-12-21 | 2020-01-23 | エシコン エルエルシーEthicon LLC | Surgical stapling system |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
US10524789B2 (en) | 2016-12-21 | 2020-01-07 | Ethicon Llc | Laterally actuatable articulation lock arrangements for locking an end effector of a surgical instrument in an articulated configuration |
US10675025B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Shaft assembly comprising separately actuatable and retractable systems |
US10485543B2 (en) | 2016-12-21 | 2019-11-26 | Ethicon Llc | Anvil having a knife slot width |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US20180168608A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical instrument system comprising an end effector lockout and a firing assembly lockout |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US10888322B2 (en) | 2016-12-21 | 2021-01-12 | Ethicon Llc | Surgical instrument comprising a cutting member |
US10888309B2 (en) | 2017-01-31 | 2021-01-12 | Covidien Lp | Surgical fastener devices with geometric tubes |
EP3579736A4 (en) | 2017-02-09 | 2020-12-23 | Vicarious Surgical Inc. | Virtual reality surgical tools system |
US10357321B2 (en) | 2017-02-24 | 2019-07-23 | Intuitive Surgical Operations, Inc. | Splayed cable guide for a medical instrument |
US10973592B2 (en) | 2017-03-09 | 2021-04-13 | Memie Innovative Surgery Ltd. | Control console for surgical device with mechanical arms |
US11779410B2 (en) | 2017-03-09 | 2023-10-10 | Momentis Surgical Ltd | Control console including an input arm for control of a surgical mechanical arm |
US10806898B2 (en) | 2017-03-30 | 2020-10-20 | University Of Hawaii | Steerable surgical devices with shape memory alloy wires |
US11497546B2 (en) | 2017-03-31 | 2022-11-15 | Cilag Gmbh International | Area ratios of patterned coatings on RF electrodes to reduce sticking |
US11278366B2 (en) | 2017-04-27 | 2022-03-22 | Canon U.S.A., Inc. | Method for controlling a flexible manipulator |
US10398563B2 (en) | 2017-05-08 | 2019-09-03 | Medos International Sarl | Expandable cage |
WO2018229889A1 (en) * | 2017-06-14 | 2018-12-20 | オリンパス株式会社 | Manipulator |
US11344424B2 (en) | 2017-06-14 | 2022-05-31 | Medos International Sarl | Expandable intervertebral implant and related methods |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
US11071554B2 (en) | 2017-06-20 | 2021-07-27 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
US10980537B2 (en) | 2017-06-20 | 2021-04-20 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations |
US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US10813639B2 (en) | 2017-06-20 | 2020-10-27 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
US10327767B2 (en) | 2017-06-20 | 2019-06-25 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
US11382638B2 (en) | 2017-06-20 | 2022-07-12 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
US10390841B2 (en) | 2017-06-20 | 2019-08-27 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US11141154B2 (en) | 2017-06-27 | 2021-10-12 | Cilag Gmbh International | Surgical end effectors and anvils |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US20190000461A1 (en) | 2017-06-28 | 2019-01-03 | Ethicon Llc | Surgical cutting and fastening devices with pivotable anvil with a tissue locating arrangement in close proximity to an anvil pivot axis |
USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
EP4070740A1 (en) | 2017-06-28 | 2022-10-12 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
US10898183B2 (en) | 2017-06-29 | 2021-01-26 | Ethicon Llc | Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
US10940016B2 (en) | 2017-07-05 | 2021-03-09 | Medos International Sarl | Expandable intervertebral fusion cage |
US11007641B2 (en) | 2017-07-17 | 2021-05-18 | Canon U.S.A., Inc. | Continuum robot control methods and apparatus |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
CN109381261B (en) * | 2017-08-14 | 2022-10-28 | 新加坡国立大学 | Surgical operation arm and surgical operation robot |
EP3681368A4 (en) | 2017-09-14 | 2021-06-23 | Vicarious Surgical Inc. | Virtual reality surgical camera system |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
US11490951B2 (en) | 2017-09-29 | 2022-11-08 | Cilag Gmbh International | Saline contact with electrodes |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10765429B2 (en) | 2017-09-29 | 2020-09-08 | Ethicon Llc | Systems and methods for providing alerts according to the operational state of a surgical instrument |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
US10973600B2 (en) * | 2017-09-29 | 2021-04-13 | Ethicon Llc | Power axle wrist for robotic surgical tool |
US11484358B2 (en) | 2017-09-29 | 2022-11-01 | Cilag Gmbh International | Flexible electrosurgical instrument |
US11033323B2 (en) | 2017-09-29 | 2021-06-15 | Cilag Gmbh International | Systems and methods for managing fluid and suction in electrosurgical systems |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
US10952708B2 (en) | 2017-10-30 | 2021-03-23 | Ethicon Llc | Surgical instrument with rotary drive selectively actuating multiple end effector functions |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US11129634B2 (en) | 2017-10-30 | 2021-09-28 | Cilag Gmbh International | Surgical instrument with rotary drive selectively actuating multiple end effector functions |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US10932804B2 (en) | 2017-10-30 | 2021-03-02 | Ethicon Llc | Surgical instrument with sensor and/or control systems |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
EP3709908A4 (en) | 2017-11-13 | 2021-08-18 | Vicarious Surgical Inc. | Virtual reality wrist assembly |
CN107928790B (en) * | 2017-12-01 | 2020-05-05 | 微创(上海)医疗机器人有限公司 | Snake-shaped surgical instrument |
EP3723650A4 (en) | 2017-12-14 | 2021-08-18 | Intuitive Surgical Operations, Inc. | Medical tools having tension bands |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US11197670B2 (en) | 2017-12-15 | 2021-12-14 | Cilag Gmbh International | Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
JP7005773B2 (en) | 2018-01-04 | 2022-01-24 | コヴィディエン リミテッド パートナーシップ | Robotic surgical instruments including high range of motion wrist assembly with torque transmission and mechanical manipulation |
USD874655S1 (en) | 2018-01-05 | 2020-02-04 | Medrobotics Corporation | Positioning arm for articulating robotic surgical system |
EP3761897A4 (en) | 2018-03-07 | 2021-11-24 | Intuitive Surgical Operations, Inc. | Low-friction, small profile medical tools having easy-to-assemble components |
US11298126B2 (en) | 2018-05-02 | 2022-04-12 | Covidien Lp | Shipping wedge for end effector installation onto surgical devices |
US11116500B2 (en) | 2018-06-28 | 2021-09-14 | Covidien Lp | Surgical fastener applying device, kits and methods for endoscopic procedures |
US11259798B2 (en) | 2018-07-16 | 2022-03-01 | Intuitive Surgical Operations, Inc. | Medical devices having tissue grasping surfaces and features for manipulating surgical needles |
WO2020017605A1 (en) * | 2018-07-18 | 2020-01-23 | リバーフィールド株式会社 | Joint of medical instrument and medical instrument |
JP2020018835A (en) * | 2018-07-18 | 2020-02-06 | リバーフィールド株式会社 | Joint of medical instrument and medical instrument |
US11612447B2 (en) | 2018-07-19 | 2023-03-28 | Intuitive Surgical Operations, Inc. | Medical devices having three tool members |
JP2020026019A (en) | 2018-08-14 | 2020-02-20 | 日本発條株式会社 | Instrument for operation support robot |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
WO2020041228A1 (en) * | 2018-08-20 | 2020-02-27 | Safavi Abbasi Sam | Neuromuscular enhancement system |
US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US11083458B2 (en) | 2018-08-20 | 2021-08-10 | Cilag Gmbh International | Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
CN110870793A (en) * | 2018-08-31 | 2020-03-10 | 新加坡国立大学 | Mechanical arm, minimally invasive surgery robot and manufacturing method thereof |
US11446156B2 (en) | 2018-10-25 | 2022-09-20 | Medos International Sarl | Expandable intervertebral implant, inserter instrument, and related methods |
US11213287B2 (en) | 2018-11-15 | 2022-01-04 | Intuitive Surgical Operations, Inc. | Support apparatus for a medical retractor device |
US11291514B2 (en) | 2018-11-15 | 2022-04-05 | Intuitive Surgical Operations, Inc. | Medical devices having multiple blades and methods of use |
US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
US20200360078A1 (en) * | 2019-05-16 | 2020-11-19 | Intuitive Surgical Operations, Inc. | Insert guide members for surgical instruments, and related devices, systems, and methods |
CN110215240A (en) * | 2019-05-30 | 2019-09-10 | 南开大学 | A kind of end effector mechanism of single-hole laparoscopic surgery |
US11523817B2 (en) | 2019-06-27 | 2022-12-13 | Covidien Lp | Endoluminal pursestring device |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
CN110368091A (en) * | 2019-07-23 | 2019-10-25 | 南开大学 | A kind of single hole abdominal operation robot system |
US11771507B2 (en) | 2019-08-21 | 2023-10-03 | Cilag Gmbh International | Articulable wrist with flexible member and pivot guides |
WO2021059238A1 (en) * | 2019-09-27 | 2021-04-01 | Auris Health, Inc. | Robotically-actuated medical retractors |
US11480068B2 (en) | 2019-10-15 | 2022-10-25 | General Electric Company | Systems and method of servicing a turbomachine |
CN113347916A (en) | 2019-10-15 | 2021-09-03 | 因普瑞缇夫护理公司 | System and method for multivariate stroke detection |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11576672B2 (en) | 2019-12-19 | 2023-02-14 | Cilag Gmbh International | Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
USD944985S1 (en) | 2019-12-19 | 2022-03-01 | Covidien Lp | Positioning guide cuff |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11197675B2 (en) | 2019-12-19 | 2021-12-14 | Covidien Lp | Positioning guide for surgical instruments and surgical instrument systems |
USD944984S1 (en) | 2019-12-19 | 2022-03-01 | Covidien Lp | Tubular positioning guide |
EP3868305A1 (en) * | 2020-02-19 | 2021-08-25 | UCL Business Ltd | End-effector for endoscopic surgical instrument |
US11426286B2 (en) | 2020-03-06 | 2022-08-30 | Eit Emerging Implant Technologies Gmbh | Expandable intervertebral implant |
WO2021181493A1 (en) * | 2020-03-10 | 2021-09-16 | オリンパス株式会社 | Medical manipulator |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
US11197725B1 (en) | 2020-06-19 | 2021-12-14 | Remedy Robotics, Inc. | Systems and methods for guidance of intraluminal devices within the vasculature |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
US11617577B2 (en) | 2020-10-29 | 2023-04-04 | Cilag Gmbh International | Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11737774B2 (en) * | 2020-12-04 | 2023-08-29 | Covidien Lp | Surgical instrument with articulation assembly |
US11819200B2 (en) | 2020-12-15 | 2023-11-21 | Covidien Lp | Surgical instrument with articulation assembly |
US11850160B2 (en) | 2021-03-26 | 2023-12-26 | Medos International Sarl | Expandable lordotic intervertebral fusion cage |
US11752009B2 (en) | 2021-04-06 | 2023-09-12 | Medos International Sarl | Expandable intervertebral fusion cage |
WO2023278789A1 (en) | 2021-07-01 | 2023-01-05 | Remedy Robotics, Inc. | Vision-based position and orientation determination for endovascular tools |
US11707332B2 (en) | 2021-07-01 | 2023-07-25 | Remedy Robotics, Inc. | Image space control for endovascular tools |
JP7212427B1 (en) * | 2021-09-01 | 2023-01-25 | リバーフィールド株式会社 | Treatment instrument unit |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
Citations (20)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3190286A (en) * | 1961-10-31 | 1965-06-22 | Bausch & Lomb | Flexible viewing probe for endoscopic use |
US3266059A (en) * | 1963-06-19 | 1966-08-16 | North American Aviation Inc | Prestressed flexible joint for mechanical arms and the like |
US4977886A (en) * | 1989-02-08 | 1990-12-18 | Olympus Optical Co., Ltd. | Position controlling apparatus |
US5209747A (en) * | 1990-12-13 | 1993-05-11 | Knoepfler Dennis J | Adjustable angle medical forceps |
US5238005A (en) * | 1991-11-18 | 1993-08-24 | Intelliwire, Inc. | Steerable catheter guidewire |
US5254130A (en) * | 1992-04-13 | 1993-10-19 | Raychem Corporation | Surgical device |
US5347987A (en) * | 1991-04-08 | 1994-09-20 | Feldstein David A | Self-centering endoscope system |
US5395367A (en) * | 1992-07-29 | 1995-03-07 | Wilk; Peter J. | Laparoscopic instrument with bendable shaft and removable actuator |
US5618294A (en) * | 1994-05-24 | 1997-04-08 | Aust & Taylor Medical Corporation | Surgical instrument |
US5746759A (en) * | 1992-06-24 | 1998-05-05 | Microsurge, Inc. | Reusable endoscopic surgical instrument |
US5766196A (en) * | 1994-06-06 | 1998-06-16 | Tnco, Inc. | Surgical instrument with steerable distal end |
US5784542A (en) * | 1995-09-07 | 1998-07-21 | California Institute Of Technology | Decoupled six degree-of-freedom teleoperated robot system |
US5792135A (en) * | 1996-05-20 | 1998-08-11 | Intuitive Surgical, Inc. | Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity |
US5823993A (en) * | 1994-02-18 | 1998-10-20 | Lemelson; Jerome H. | Computer controlled drug injection system and method |
US5845646A (en) * | 1996-11-05 | 1998-12-08 | Lemelson; Jerome | System and method for treating select tissue in a living being |
US5876325A (en) * | 1993-11-02 | 1999-03-02 | Olympus Optical Co., Ltd. | Surgical manipulation system |
US5977886A (en) * | 1997-10-10 | 1999-11-02 | Ericsson Inc. | Systems and methods for communicating between a user input device and an application using adaptively selected code sets |
US6058323A (en) * | 1996-11-05 | 2000-05-02 | Lemelson; Jerome | System and method for treating select tissue in a living being |
US6223100B1 (en) * | 1992-01-21 | 2001-04-24 | Sri, International | Apparatus and method for performing computer enhanced surgery with articulated instrument |
US6394998B1 (en) * | 1999-01-22 | 2002-05-28 | Intuitive Surgical, Inc. | Surgical tools for use in minimally invasive telesurgical applications |
Family Cites Families (203)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2978118A (en) | 1959-11-03 | 1961-04-04 | Raymond C Goertz | Manipulator for slave robot |
FR1455925A (en) * | 1965-06-11 | 1966-10-21 | Commissariat Energie Atomique | Solidarity device |
US3923166A (en) | 1973-10-11 | 1975-12-02 | Nasa | Remote manipulator system |
US4078766A (en) * | 1977-04-11 | 1978-03-14 | Saurwein Albert C | Powered nail extractor |
SE419421B (en) * | 1979-03-16 | 1981-08-03 | Ove Larson | RESIDENTIAL ARM IN SPECIAL ROBOT ARM |
US4604016A (en) | 1983-08-03 | 1986-08-05 | Joyce Stephen A | Multi-dimensional force-torque hand controller having force feedback |
IL74460A (en) * | 1983-09-02 | 1990-01-18 | Istec Ind & Technologies Ltd | Surgical implement particularly useful for suturing prosthetic valves |
JPS6233801U (en) * | 1985-08-14 | 1987-02-27 | ||
US4654024A (en) * | 1985-09-04 | 1987-03-31 | C.R. Bard, Inc. | Thermorecanalization catheter and method for use |
US5078140A (en) | 1986-05-08 | 1992-01-07 | Kwoh Yik S | Imaging device - aided robotic stereotaxis system |
JPH0829509B2 (en) * | 1986-12-12 | 1996-03-27 | 株式会社日立製作所 | Control device for manipulator |
US4979949A (en) | 1988-04-26 | 1990-12-25 | The Board Of Regents Of The University Of Washington | Robot-aided system for surgery |
US4887612A (en) * | 1988-04-27 | 1989-12-19 | Esco Precision, Inc. | Endoscopic biopsy forceps |
US5116180A (en) * | 1988-07-18 | 1992-05-26 | Spar Aerospace Limited | Human-in-the-loop machine control loop |
US4998923A (en) * | 1988-08-11 | 1991-03-12 | Advanced Cardiovascular Systems, Inc. | Steerable dilatation catheter |
US5052402A (en) * | 1989-01-31 | 1991-10-01 | C.R. Bard, Inc. | Disposable biopsy forceps |
US5172700A (en) * | 1989-01-31 | 1992-12-22 | C. R. Bard, Inc. | Disposable biopsy forceps |
US6179856B1 (en) * | 1989-07-05 | 2001-01-30 | Medtronic Ave, Inc. | Coaxial PTCA catheter with anchor joint |
US5271384A (en) | 1989-09-01 | 1993-12-21 | Mcewen James A | Powered surgical retractor |
US4941454A (en) | 1989-10-05 | 1990-07-17 | Welch Allyn, Inc. | Servo actuated steering mechanism for borescope or endoscope |
US5072361A (en) * | 1990-02-01 | 1991-12-10 | Sarcos Group | Force-reflective teleoperation control system |
US6033378A (en) | 1990-02-02 | 2000-03-07 | Ep Technologies, Inc. | Catheter steering mechanism |
US5084054A (en) * | 1990-03-05 | 1992-01-28 | C.R. Bard, Inc. | Surgical gripping instrument |
US5086401A (en) | 1990-05-11 | 1992-02-04 | International Business Machines Corporation | Image-directed robotic system for precise robotic surgery including redundant consistency checking |
US5174278A (en) * | 1990-11-26 | 1992-12-29 | Beth Babkow | Downward rotating speculum with conical shaped blades |
US5329923A (en) * | 1991-02-15 | 1994-07-19 | Lundquist Ingemar H | Torquable catheter |
US5217453A (en) * | 1991-03-18 | 1993-06-08 | Wilk Peter J | Automated surgical system and apparatus |
US5217003A (en) | 1991-03-18 | 1993-06-08 | Wilk Peter J | Automated surgical system and apparatus |
US5295958A (en) * | 1991-04-04 | 1994-03-22 | Shturman Cardiology Systems, Inc. | Method and apparatus for in vivo heart valve decalcification |
US5339799A (en) | 1991-04-23 | 1994-08-23 | Olympus Optical Co., Ltd. | Medical system for reproducing a state of contact of the treatment section in the operation unit |
US5279309A (en) | 1991-06-13 | 1994-01-18 | International Business Machines Corporation | Signaling device and method for monitoring positions in a surgical operation |
US5417210A (en) | 1992-05-27 | 1995-05-23 | International Business Machines Corporation | System and method for augmentation of endoscopic surgery |
ATE150954T1 (en) | 1991-07-29 | 1997-04-15 | Smith & Nephew Richards Inc | TONGS |
US5184601A (en) | 1991-08-05 | 1993-02-09 | Putman John M | Endoscope stabilizer |
US5389100A (en) * | 1991-11-06 | 1995-02-14 | Imagyn Medical, Inc. | Controller for manipulation of instruments within a catheter |
US5271381A (en) * | 1991-11-18 | 1993-12-21 | Vision Sciences, Inc. | Vertebrae for a bending section of an endoscope |
US5631973A (en) | 1994-05-05 | 1997-05-20 | Sri International | Method for telemanipulation with telepresence |
GB9201214D0 (en) | 1992-01-21 | 1992-03-11 | Mcmahon Michael J | Surgical retractors |
DE69331315T2 (en) * | 1992-01-27 | 2002-08-22 | Medtronic Inc | ANULOPLASTIC AND SEAM RINGS |
US5626595A (en) * | 1992-02-14 | 1997-05-06 | Automated Medical Instruments, Inc. | Automated surgical instrument |
US5350355A (en) * | 1992-02-14 | 1994-09-27 | Automated Medical Instruments, Inc. | Automated surgical instrument |
US5238002A (en) * | 1992-06-08 | 1993-08-24 | C. R. Bard, Inc. | Disposable biopsy forceps |
US5325845A (en) * | 1992-06-08 | 1994-07-05 | Adair Edwin Lloyd | Steerable sheath for use with selected removable optical catheter |
US5372147A (en) | 1992-06-16 | 1994-12-13 | Origin Medsystems, Inc. | Peritoneal distension robotic arm |
US5361768A (en) * | 1992-06-30 | 1994-11-08 | Cardiovascular Imaging Systems, Inc. | Automated longitudinal position translator for ultrasonic imaging probes, and methods of using same |
US5762458A (en) | 1996-02-20 | 1998-06-09 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive cardiac procedures |
US5754741A (en) | 1992-08-10 | 1998-05-19 | Computer Motion, Inc. | Automated endoscope for optimal positioning |
US5657429A (en) | 1992-08-10 | 1997-08-12 | Computer Motion, Inc. | Automated endoscope system optimal positioning |
US5524180A (en) | 1992-08-10 | 1996-06-04 | Computer Motion, Inc. | Automated endoscope system for optimal positioning |
US5515478A (en) | 1992-08-10 | 1996-05-07 | Computer Motion, Inc. | Automated endoscope system for optimal positioning |
US5337732A (en) | 1992-09-16 | 1994-08-16 | Cedars-Sinai Medical Center | Robotic endoscopy |
US5662587A (en) | 1992-09-16 | 1997-09-02 | Cedars Sinai Medical Center | Robotic endoscopy |
DE4233333A1 (en) * | 1992-10-05 | 1994-04-07 | Basf Ag | Process for the preparation of O-substituted hydroxylammonium salts |
US5330502A (en) * | 1992-10-09 | 1994-07-19 | Ethicon, Inc. | Rotational endoscopic mechanism with jointed drive mechanism |
US5429144A (en) * | 1992-10-30 | 1995-07-04 | Wilk; Peter J. | Coronary artery by-pass method |
US5287861A (en) * | 1992-10-30 | 1994-02-22 | Wilk Peter J | Coronary artery by-pass method and associated catheter |
US5397323A (en) | 1992-10-30 | 1995-03-14 | International Business Machines Corporation | Remote center-of-motion robot for surgery |
US5409019A (en) * | 1992-10-30 | 1995-04-25 | Wilk; Peter J. | Coronary artery by-pass method |
US5330466A (en) | 1992-12-01 | 1994-07-19 | Cardiac Pathways Corporation | Control mechanism and system and method for steering distal extremity of a flexible elongate member |
JP2648274B2 (en) | 1993-01-28 | 1997-08-27 | 三鷹光器株式会社 | Medical position detection device |
EP0613661B1 (en) | 1993-01-29 | 1998-04-15 | Smith & Nephew, Inc. | Rotatable curved instrument |
US5643294A (en) | 1993-03-01 | 1997-07-01 | United States Surgical Corporation | Surgical apparatus having an increased range of operability |
US5636634A (en) * | 1993-03-16 | 1997-06-10 | Ep Technologies, Inc. | Systems using guide sheaths for introducing, deploying, and stabilizing cardiac mapping and ablation probes |
JP2501030Y2 (en) * | 1993-03-29 | 1996-06-12 | 株式会社アイエル | Flexible position fixing device for equipment |
US5410638A (en) | 1993-05-03 | 1995-04-25 | Northwestern University | System for positioning a medical instrument within a biotic structure using a micromanipulator |
WO1994026167A1 (en) * | 1993-05-14 | 1994-11-24 | Sri International | Remote center positioner |
US5606979A (en) * | 1993-05-28 | 1997-03-04 | The Microspring Company Inc. | Guide wire |
US5391199A (en) * | 1993-07-20 | 1995-02-21 | Biosense, Inc. | Apparatus and method for treating cardiac arrhythmias |
CA2167367A1 (en) * | 1993-07-21 | 1995-02-02 | Charles H. Klieman | Surgical instrument for endoscopic and general surgery |
US5382885A (en) | 1993-08-09 | 1995-01-17 | The University Of British Columbia | Motion scaling tele-operating system with force feedback suitable for microsurgery |
US5462529A (en) * | 1993-09-29 | 1995-10-31 | Technology Development Center | Adjustable treatment chamber catheter |
US5634897A (en) * | 1993-10-08 | 1997-06-03 | Lake Region Manufacturing, Inc. | Rheolytic occlusion removal catheter system and method |
US5540649A (en) | 1993-10-08 | 1996-07-30 | Leonard Medical, Inc. | Positioner for medical instruments |
WO1995016396A1 (en) | 1993-12-15 | 1995-06-22 | Computer Motion, Inc. | Automated endoscope system for optimal positioning |
DE4417400A1 (en) | 1994-05-18 | 1995-11-23 | D T I Dr Trippe Ingenieurgesel | Carrier system made of proboscis, which can be adjusted in their spatial shape |
US5821920A (en) | 1994-07-14 | 1998-10-13 | Immersion Human Interface Corporation | Control input device for interfacing an elongated flexible object with a computer system |
US6120433A (en) | 1994-09-01 | 2000-09-19 | Olympus Optical Co., Ltd. | Surgical manipulator system |
US5492131A (en) | 1994-09-06 | 1996-02-20 | Guided Medical Systems, Inc. | Servo-catheter |
US5803089A (en) | 1994-09-15 | 1998-09-08 | Visualization Technology, Inc. | Position tracking and imaging system for use in medical applications |
US6463361B1 (en) | 1994-09-22 | 2002-10-08 | Computer Motion, Inc. | Speech interface for an automated endoscopic system |
US5752973A (en) * | 1994-10-18 | 1998-05-19 | Archimedes Surgical, Inc. | Endoscopic surgical gripping instrument with universal joint jaw coupler |
JP3539645B2 (en) | 1995-02-16 | 2004-07-07 | 株式会社日立製作所 | Remote surgery support device |
DE19509116C2 (en) * | 1995-03-16 | 2000-01-05 | Deutsch Zentr Luft & Raumfahrt | Flexible structure |
US5667476A (en) | 1995-06-05 | 1997-09-16 | Vision-Sciences, Inc. | Endoscope articulation system to reduce effort during articulation of an endoscope |
US5814038A (en) | 1995-06-07 | 1998-09-29 | Sri International | Surgical manipulator for a telerobotic system |
US5649956A (en) | 1995-06-07 | 1997-07-22 | Sri International | System and method for releasably holding a surgical instrument |
AU6480096A (en) | 1995-06-30 | 1997-02-05 | Ross-Hime Designs, Inc. | Robotic manipulator |
JP2931890B2 (en) * | 1995-07-12 | 1999-08-09 | 三菱電機株式会社 | Data processing device |
US5825982A (en) | 1995-09-15 | 1998-10-20 | Wright; James | Head cursor control interface for an automated endoscope system for optimal positioning |
US5860992A (en) * | 1996-01-31 | 1999-01-19 | Heartport, Inc. | Endoscopic suturing devices and methods |
US5624398A (en) | 1996-02-08 | 1997-04-29 | Symbiosis Corporation | Endoscopic robotic surgical tools and methods |
US5800333A (en) | 1996-02-20 | 1998-09-01 | United States Surgical Corporation | Afterloader provided with remote control unit |
US5855583A (en) | 1996-02-20 | 1999-01-05 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive cardiac procedures |
US6063095A (en) | 1996-02-20 | 2000-05-16 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive surgical procedures |
US5971976A (en) | 1996-02-20 | 1999-10-26 | Computer Motion, Inc. | Motion minimization and compensation system for use in surgical procedures |
US6436107B1 (en) | 1996-02-20 | 2002-08-20 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive surgical procedures |
US6111577A (en) * | 1996-04-04 | 2000-08-29 | Massachusetts Institute Of Technology | Method and apparatus for determining forces to be applied to a user through a haptic interface |
US5833658A (en) * | 1996-04-29 | 1998-11-10 | Levy; Robert J. | Catheters for the delivery of solutions and suspensions |
US5746753A (en) * | 1996-05-13 | 1998-05-05 | Boston Scientific Corporation | Needle grasping apparatus |
US5807377A (en) | 1996-05-20 | 1998-09-15 | Intuitive Surgical, Inc. | Force-reflecting surgical instrument and positioning mechanism for performing minimally invasive surgery with enhanced dexterity and sensitivity |
US6496099B2 (en) | 1996-06-24 | 2002-12-17 | Computer Motion, Inc. | General purpose distributed operating room control system |
US6911916B1 (en) | 1996-06-24 | 2005-06-28 | The Cleveland Clinic Foundation | Method and apparatus for accessing medical data over a network |
GB2315020A (en) * | 1996-07-11 | 1998-01-21 | Intravascular Res Ltd | Ultrasonic visualisation catheters |
US6080170A (en) * | 1996-07-26 | 2000-06-27 | Kensey Nash Corporation | System and method of use for revascularizing stenotic bypass grafts and other occluded blood vessels |
US6652546B1 (en) * | 1996-07-26 | 2003-11-25 | Kensey Nash Corporation | System and method of use for revascularizing stenotic bypass grafts and other occluded blood vessels |
US6364888B1 (en) | 1996-09-09 | 2002-04-02 | Intuitive Surgical, Inc. | Alignment of master and slave in a minimally invasive surgical apparatus |
US5957941A (en) * | 1996-09-27 | 1999-09-28 | Boston Scientific Corporation | Catheter system and drive assembly thereof |
US5827313A (en) * | 1996-09-27 | 1998-10-27 | Boston Scientific Corporation | Device for controlled longitudinal movement of an operative element within a catheter sheath and method |
US5904647A (en) * | 1996-10-08 | 1999-05-18 | Asahi Kogyo Kabushiki Kaisha | Treatment accessories for an endoscope |
US6221070B1 (en) | 1996-10-18 | 2001-04-24 | Irvine Biomedical, Inc. | Steerable ablation catheter system having disposable shaft |
US5828197A (en) | 1996-10-25 | 1998-10-27 | Immersion Human Interface Corporation | Mechanical interface having multiple grounded actuators |
US6371907B1 (en) | 1996-11-18 | 2002-04-16 | Olympus Optical Co., Ltd. | Endoscope apparatus driving manipulation wires with drive motor in drum portion |
DE19748795B4 (en) | 1996-11-18 | 2006-08-17 | Olympus Corporation | endoscope |
US6132441A (en) | 1996-11-22 | 2000-10-17 | Computer Motion, Inc. | Rigidly-linked articulating wrist with decoupled motion transmission |
US6132368A (en) | 1996-12-12 | 2000-10-17 | Intuitive Surgical, Inc. | Multi-component telepresence system and method |
US6331181B1 (en) | 1998-12-08 | 2001-12-18 | Intuitive Surgical, Inc. | Surgical robotic tools, data architecture, and use |
US6203525B1 (en) | 1996-12-19 | 2001-03-20 | Ep Technologies, Inc. | Catheterdistal assembly with pull wires |
US6146355A (en) | 1996-12-30 | 2000-11-14 | Myelotec, Inc. | Steerable catheter |
US5964717A (en) * | 1997-01-06 | 1999-10-12 | Symbiosis Corporation | Biopsy forceps having detachable handle and distal jaws |
US6290675B1 (en) | 1997-01-09 | 2001-09-18 | Endosonics Corporation | Device for withdrawing a catheter |
US5868755A (en) * | 1997-01-16 | 1999-02-09 | Atrion Medical Products, Inc. | Sheath retractor mechanism and method |
US5928248A (en) * | 1997-02-14 | 1999-07-27 | Biosense, Inc. | Guided deployment of stents |
KR19980073528A (en) * | 1997-03-15 | 1998-11-05 | 구자홍 | MPEG System Decoder |
US5938678A (en) * | 1997-06-11 | 1999-08-17 | Endius Incorporated | Surgical instrument |
US5899914A (en) * | 1997-06-11 | 1999-05-04 | Endius Incorporated | Surgical instrument |
US6231565B1 (en) | 1997-06-18 | 2001-05-15 | United States Surgical Corporation | Robotic arm DLUs for performing surgical tasks |
US5861024A (en) | 1997-06-20 | 1999-01-19 | Cardiac Assist Devices, Inc | Electrophysiology catheter and remote actuator therefor |
WO1999000059A1 (en) * | 1997-06-27 | 1999-01-07 | The Trustees Of Columbia University In The City Of New York | Method and apparatus for circulatory valve repair |
EP0917886B1 (en) * | 1997-10-23 | 2003-10-01 | Schneider (Europe) GmbH | Seal for catheter assembly with dilation and occlusion balloon |
US6860878B2 (en) * | 1998-02-24 | 2005-03-01 | Endovia Medical Inc. | Interchangeable instrument |
US20020128662A1 (en) * | 1998-02-24 | 2002-09-12 | Brock David L. | Surgical instrument |
US7371210B2 (en) * | 1998-02-24 | 2008-05-13 | Hansen Medical, Inc. | Flexible instrument |
US7090683B2 (en) * | 1998-02-24 | 2006-08-15 | Hansen Medical, Inc. | Flexible instrument |
US6197017B1 (en) | 1998-02-24 | 2001-03-06 | Brock Rogers Surgical, Inc. | Articulated apparatus for telemanipulator system |
US6692485B1 (en) | 1998-02-24 | 2004-02-17 | Endovia Medical, Inc. | Articulated apparatus for telemanipulator system |
US6554844B2 (en) | 1998-02-24 | 2003-04-29 | Endovia Medical, Inc. | Surgical instrument |
US20020095175A1 (en) * | 1998-02-24 | 2002-07-18 | Brock David L. | Flexible instrument |
IL123646A (en) | 1998-03-11 | 2010-05-31 | Refael Beyar | Remote control catheterization |
US6233504B1 (en) | 1998-04-16 | 2001-05-15 | California Institute Of Technology | Tool actuation and force feedback on robot-assisted microsurgery system |
US6004271A (en) * | 1998-05-07 | 1999-12-21 | Boston Scientific Corporation | Combined motor drive and automated longitudinal position translator for ultrasonic imaging system |
US6096004A (en) | 1998-07-10 | 2000-08-01 | Mitsubishi Electric Information Technology Center America, Inc. (Ita) | Master/slave system for the manipulation of tubular medical tools |
US6375471B1 (en) | 1998-07-10 | 2002-04-23 | Mitsubishi Electric Research Laboratories, Inc. | Actuator for independent axial and rotational actuation of a catheter or similar elongated object |
US6352503B1 (en) * | 1998-07-17 | 2002-03-05 | Olympus Optical Co., Ltd. | Endoscopic surgery apparatus |
WO2000007503A1 (en) | 1998-08-04 | 2000-02-17 | Intuitive Surgical, Inc. | Manipulator positioning linkage for robotic surgery |
US6319227B1 (en) * | 1998-08-05 | 2001-11-20 | Scimed Life Systems, Inc. | Automatic/manual longitudinal position translator and rotary drive system for catheters |
US6332889B1 (en) * | 1998-08-27 | 2001-12-25 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
US6267781B1 (en) | 1998-08-31 | 2001-07-31 | Quantum Therapeutics Corp. | Medical device and methods for treating valvular annulus |
US6171234B1 (en) * | 1998-09-25 | 2001-01-09 | Scimed Life Systems, Inc. | Imaging gore loading tool |
US6398755B1 (en) * | 1998-10-06 | 2002-06-04 | Scimed Life Systems, Inc. | Driveable catheter system |
US6490490B1 (en) | 1998-11-09 | 2002-12-03 | Olympus Optical Co., Ltd. | Remote operation support system and method |
US6468265B1 (en) * | 1998-11-20 | 2002-10-22 | Intuitive Surgical, Inc. | Performing cardiac surgery without cardioplegia |
US6852107B2 (en) | 2002-01-16 | 2005-02-08 | Computer Motion, Inc. | Minimally invasive surgical training using robotics and tele-collaboration |
US6951535B2 (en) | 2002-01-16 | 2005-10-04 | Intuitive Surgical, Inc. | Tele-medicine system that transmits an entire state of a subsystem |
US6459926B1 (en) | 1998-11-20 | 2002-10-01 | Intuitive Surgical, Inc. | Repositioning and reorientation of master/slave relationship in minimally invasive telesurgery |
US6659939B2 (en) | 1998-11-20 | 2003-12-09 | Intuitive Surgical, Inc. | Cooperative minimally invasive telesurgical system |
US6398726B1 (en) * | 1998-11-20 | 2002-06-04 | Intuitive Surgical, Inc. | Stabilizer for robotic beating-heart surgery |
US6799065B1 (en) | 1998-12-08 | 2004-09-28 | Intuitive Surgical, Inc. | Image shifting apparatus and method for a telerobotic system |
US6325808B1 (en) | 1998-12-08 | 2001-12-04 | Advanced Realtime Control Systems, Inc. | Robotic system, docking station, and surgical tool for collaborative control in minimally invasive surgery |
US6720988B1 (en) | 1998-12-08 | 2004-04-13 | Intuitive Surgical, Inc. | Stereo imaging system and method for use in telerobotic systems |
US6522906B1 (en) | 1998-12-08 | 2003-02-18 | Intuitive Surgical, Inc. | Devices and methods for presenting and regulating auxiliary information on an image display of a telesurgical system to assist an operator in performing a surgical procedure |
US6620173B2 (en) | 1998-12-08 | 2003-09-16 | Intuitive Surgical, Inc. | Method for introducing an end effector to a surgical site in minimally invasive surgery |
US6770081B1 (en) | 2000-01-07 | 2004-08-03 | Intuitive Surgical, Inc. | In vivo accessories for minimally invasive robotic surgery and methods |
US6309397B1 (en) | 1999-12-02 | 2001-10-30 | Sri International | Accessories for minimally invasive robotic surgery and methods |
US6493608B1 (en) | 1999-04-07 | 2002-12-10 | Intuitive Surgical, Inc. | Aspects of a control system of a minimally invasive surgical apparatus |
US6451027B1 (en) | 1998-12-16 | 2002-09-17 | Intuitive Surgical, Inc. | Devices and methods for moving an image capture device in telesurgical systems |
KR100299210B1 (en) | 1999-03-12 | 2001-09-22 | 박호군 | Master device having force reflective function |
US6569084B1 (en) * | 1999-03-31 | 2003-05-27 | Olympus Optical Co., Ltd. | Endoscope holder and endoscope device |
US6565554B1 (en) | 1999-04-07 | 2003-05-20 | Intuitive Surgical, Inc. | Friction compensation in a minimally invasive surgical apparatus |
US6594552B1 (en) | 1999-04-07 | 2003-07-15 | Intuitive Surgical, Inc. | Grip strength with tactile feedback for robotic surgery |
US6424885B1 (en) | 1999-04-07 | 2002-07-23 | Intuitive Surgical, Inc. | Camera referenced control in a minimally invasive surgical apparatus |
EP1176921B1 (en) | 1999-05-10 | 2011-02-23 | Hansen Medical, Inc. | Surgical instrument |
US6517565B1 (en) | 1999-06-02 | 2003-02-11 | Power Medical Interventions, Inc. | Carriage assembly for controlling a steering wire steering mechanism within a flexible shaft |
US6793652B1 (en) * | 1999-06-02 | 2004-09-21 | Power Medical Interventions, Inc. | Electro-mechanical surgical device |
US6315184B1 (en) * | 1999-06-02 | 2001-11-13 | Powermed, Inc. | Stapling device for use with an electromechanical driver device for use with anastomosing, stapling, and resecting instruments |
US6626899B2 (en) * | 1999-06-25 | 2003-09-30 | Nidus Medical, Llc | Apparatus and methods for treating tissue |
JP4576521B2 (en) * | 1999-06-25 | 2010-11-10 | ハンセン メディカル, インコーポレイテッド | Apparatus and method for treating tissue |
US6788018B1 (en) | 1999-08-03 | 2004-09-07 | Intuitive Surgical, Inc. | Ceiling and floor mounted surgical robot set-up arms |
US6936001B1 (en) | 1999-10-01 | 2005-08-30 | Computer Motion, Inc. | Heart stabilizer |
US6817972B2 (en) | 1999-10-01 | 2004-11-16 | Computer Motion, Inc. | Heart stabilizer |
US6485489B2 (en) * | 1999-10-02 | 2002-11-26 | Quantum Cor, Inc. | Catheter system for repairing a mitral valve annulus |
US6206903B1 (en) | 1999-10-08 | 2001-03-27 | Intuitive Surgical, Inc. | Surgical tool with mechanical advantage |
US6491691B1 (en) | 1999-10-08 | 2002-12-10 | Intuitive Surgical, Inc. | Minimally invasive surgical hook apparatus and method for using same |
US6312435B1 (en) | 1999-10-08 | 2001-11-06 | Intuitive Surgical, Inc. | Surgical instrument with extended reach for use in minimally invasive surgery |
JP2001157661A (en) * | 1999-12-02 | 2001-06-12 | Asahi Optical Co Ltd | Connection structure of operating wire for endoscope |
US6377011B1 (en) | 2000-01-26 | 2002-04-23 | Massachusetts Institute Of Technology | Force feedback user interface for minimally invasive surgical simulator and teleoperator and other similar apparatus |
US6858005B2 (en) * | 2000-04-03 | 2005-02-22 | Neo Guide Systems, Inc. | Tendon-driven endoscope and methods of insertion |
US6645196B1 (en) * | 2000-06-16 | 2003-11-11 | Intuitive Surgical, Inc. | Guided tool change |
US6702826B2 (en) * | 2000-06-23 | 2004-03-09 | Viacor, Inc. | Automated annular plication for mitral valve repair |
US6746443B1 (en) | 2000-07-27 | 2004-06-08 | Intuitive Surgical Inc. | Roll-pitch-roll surgical tool |
US6726699B1 (en) | 2000-08-15 | 2004-04-27 | Computer Motion, Inc. | Instrument guide |
US6860877B1 (en) | 2000-09-29 | 2005-03-01 | Computer Motion, Inc. | Heart stabilizer support arm |
US20020087151A1 (en) * | 2000-12-29 | 2002-07-04 | Afx, Inc. | Tissue ablation apparatus with a sliding ablation instrument and method |
US6840938B1 (en) | 2000-12-29 | 2005-01-11 | Intuitive Surgical, Inc. | Bipolar cauterizing instrument |
US20030135204A1 (en) * | 2001-02-15 | 2003-07-17 | Endo Via Medical, Inc. | Robotically controlled medical instrument with a flexible section |
EP1303228B1 (en) | 2001-02-15 | 2012-09-26 | Hansen Medical, Inc. | Flexible surgical instrument |
US6783524B2 (en) | 2001-04-19 | 2004-08-31 | Intuitive Surgical, Inc. | Robotic surgical tool with ultrasound cauterizing and cutting instrument |
US6994708B2 (en) | 2001-04-19 | 2006-02-07 | Intuitive Surgical | Robotic tool with monopolar electro-surgical scissors |
EP1408846B1 (en) | 2001-06-29 | 2012-03-07 | Intuitive Surgical Operations, Inc. | Platform link wrist mechanism |
US6817974B2 (en) | 2001-06-29 | 2004-11-16 | Intuitive Surgical, Inc. | Surgical tool having positively positionable tendon-actuated multi-disk wrist joint |
US6676684B1 (en) | 2001-09-04 | 2004-01-13 | Intuitive Surgical, Inc. | Roll-pitch-roll-yaw surgical tool |
US6728599B2 (en) | 2001-09-07 | 2004-04-27 | Computer Motion, Inc. | Modularity system for computer assisted surgery |
US6587750B2 (en) | 2001-09-25 | 2003-07-01 | Intuitive Surgical, Inc. | Removable infinite roll master grip handle and touch sensor for robotic surgery |
US6793653B2 (en) | 2001-12-08 | 2004-09-21 | Computer Motion, Inc. | Multifunctional handle for a medical robotic system |
-
2002
- 2002-11-18 US US10/299,588 patent/US20030135204A1/en not_active Abandoned
-
2004
- 2004-10-28 US US10/976,066 patent/US7608083B2/en not_active Expired - Fee Related
-
2008
- 2008-01-31 US US12/024,013 patent/US7819884B2/en not_active Expired - Fee Related
- 2008-01-31 US US12/023,981 patent/US7744608B2/en not_active Expired - Lifetime
- 2008-01-31 US US12/024,039 patent/US7854738B2/en not_active Expired - Fee Related
-
2010
- 2010-12-06 US US12/960,861 patent/US20110144656A1/en not_active Abandoned
Patent Citations (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3190286A (en) * | 1961-10-31 | 1965-06-22 | Bausch & Lomb | Flexible viewing probe for endoscopic use |
US3266059A (en) * | 1963-06-19 | 1966-08-16 | North American Aviation Inc | Prestressed flexible joint for mechanical arms and the like |
US4977886A (en) * | 1989-02-08 | 1990-12-18 | Olympus Optical Co., Ltd. | Position controlling apparatus |
US5209747A (en) * | 1990-12-13 | 1993-05-11 | Knoepfler Dennis J | Adjustable angle medical forceps |
US5347987A (en) * | 1991-04-08 | 1994-09-20 | Feldstein David A | Self-centering endoscope system |
US5238005A (en) * | 1991-11-18 | 1993-08-24 | Intelliwire, Inc. | Steerable catheter guidewire |
US5497784A (en) * | 1991-11-18 | 1996-03-12 | Intelliwire, Inc. | Flexible elongate device having steerable distal extremity |
US5520644A (en) * | 1991-11-18 | 1996-05-28 | Intelliwire, Inc. | Flexible elongate device having steerable distal extremity and apparatus for use therewith and method |
US6223100B1 (en) * | 1992-01-21 | 2001-04-24 | Sri, International | Apparatus and method for performing computer enhanced surgery with articulated instrument |
US5254130A (en) * | 1992-04-13 | 1993-10-19 | Raychem Corporation | Surgical device |
US5746759A (en) * | 1992-06-24 | 1998-05-05 | Microsurge, Inc. | Reusable endoscopic surgical instrument |
US5395367A (en) * | 1992-07-29 | 1995-03-07 | Wilk; Peter J. | Laparoscopic instrument with bendable shaft and removable actuator |
US5876325A (en) * | 1993-11-02 | 1999-03-02 | Olympus Optical Co., Ltd. | Surgical manipulation system |
US5823993A (en) * | 1994-02-18 | 1998-10-20 | Lemelson; Jerome H. | Computer controlled drug injection system and method |
US5618294A (en) * | 1994-05-24 | 1997-04-08 | Aust & Taylor Medical Corporation | Surgical instrument |
US5766196A (en) * | 1994-06-06 | 1998-06-16 | Tnco, Inc. | Surgical instrument with steerable distal end |
US5784542A (en) * | 1995-09-07 | 1998-07-21 | California Institute Of Technology | Decoupled six degree-of-freedom teleoperated robot system |
US5792135A (en) * | 1996-05-20 | 1998-08-11 | Intuitive Surgical, Inc. | Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity |
US5845646A (en) * | 1996-11-05 | 1998-12-08 | Lemelson; Jerome | System and method for treating select tissue in a living being |
US6058323A (en) * | 1996-11-05 | 2000-05-02 | Lemelson; Jerome | System and method for treating select tissue in a living being |
US6233474B1 (en) * | 1996-11-05 | 2001-05-15 | Jerome Lemelson | System and method for treating select tissue in a living being |
US5977886A (en) * | 1997-10-10 | 1999-11-02 | Ericsson Inc. | Systems and methods for communicating between a user input device and an application using adaptively selected code sets |
US6394998B1 (en) * | 1999-01-22 | 2002-05-28 | Intuitive Surgical, Inc. | Surgical tools for use in minimally invasive telesurgical applications |
Cited By (595)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8123675B2 (en) * | 1992-05-27 | 2012-02-28 | International Business Machines Corporation | System and method for augmentation of endoscopic surgery |
US20090048611A1 (en) * | 1992-05-27 | 2009-02-19 | International Business Machines Corporation | System and method for augmentation of endoscopic surgery |
US7713190B2 (en) | 1998-02-24 | 2010-05-11 | Hansen Medical, Inc. | Flexible instrument |
US20080119872A1 (en) * | 1998-02-24 | 2008-05-22 | Hansen Medical, Inc. | Surgical instrument |
US8523883B2 (en) | 1999-06-25 | 2013-09-03 | Hansen Medical, Inc. | Apparatus and methods for treating tissue |
US8333204B2 (en) | 1999-06-25 | 2012-12-18 | Hansen Medical, Inc. | Apparatus and methods for treating tissue |
US9795394B2 (en) | 2000-01-14 | 2017-10-24 | Bonutti Skeletal Innovations Llc | Method for placing implant using robotic system |
US20060195071A1 (en) * | 2000-07-20 | 2006-08-31 | Doyle Mark C | Hand-actuated articulating surgical tool |
US20090105727A1 (en) * | 2000-07-20 | 2009-04-23 | Allegiance Corporation | Hand-actuated articulating surgical tool |
US8105319B2 (en) | 2000-07-20 | 2012-01-31 | Carefusion 2200, Inc. | Hand-actuated articulating surgical tool |
US8187229B2 (en) | 2001-02-15 | 2012-05-29 | Hansen Medical, Inc. | Coaxial catheter system |
US20040193146A1 (en) * | 2001-02-15 | 2004-09-30 | Endo Via Medical, Inc. | Robotically controlled surgical instruments |
US7955316B2 (en) | 2001-02-15 | 2011-06-07 | Han Sen Medical, Inc. | Coaxial catheter system |
US7699835B2 (en) | 2001-02-15 | 2010-04-20 | Hansen Medical, Inc. | Robotically controlled surgical instruments |
US10321918B2 (en) | 2001-08-28 | 2019-06-18 | Bonutti Skeletal Innovations Llc | Methods for robotic surgery using a cannula |
US9763683B2 (en) | 2001-08-28 | 2017-09-19 | Bonutti Skeletal Innovations Llc | Method for performing surgical procedures using optical cutting guides |
US10231739B1 (en) | 2001-08-28 | 2019-03-19 | Bonutti Skeletal Innovations Llc | System and method for robotic surgery |
US10470780B2 (en) | 2001-08-28 | 2019-11-12 | Bonutti Skeletal Innovations Llc | Systems and methods for ligament balancing in robotic surgery |
US20130274760A1 (en) * | 2002-03-20 | 2013-10-17 | P Tech, Llc | Robotic fastening system |
US9271779B2 (en) | 2002-03-20 | 2016-03-01 | P Tech, Llc | Methods of using a robotic spine system |
US10368953B2 (en) | 2002-03-20 | 2019-08-06 | P Tech, Llc | Robotic system for fastening layers of body tissue together and method thereof |
US9155544B2 (en) | 2002-03-20 | 2015-10-13 | P Tech, Llc | Robotic systems and methods |
US10959791B2 (en) * | 2002-03-20 | 2021-03-30 | P Tech, Llc | Robotic surgery |
US9629687B2 (en) * | 2002-03-20 | 2017-04-25 | P Tech, Llc | Robotic arthroplasty system |
US20200060775A1 (en) * | 2002-03-20 | 2020-02-27 | P Tech, Llc | Robotic surgery |
US9585725B2 (en) | 2002-03-20 | 2017-03-07 | P Tech, Llc | Robotic arthroplasty system |
US9149281B2 (en) | 2002-03-20 | 2015-10-06 | P Tech, Llc | Robotic system for engaging a fastener with body tissue |
US20190282308A1 (en) * | 2002-03-20 | 2019-09-19 | P Tech, Llc | Robotic surgery |
US10932869B2 (en) * | 2002-03-20 | 2021-03-02 | P Tech, Llc | Robotic surgery |
US10869728B2 (en) * | 2002-03-20 | 2020-12-22 | P Tech, Llc | Robotic surgery |
US9486227B2 (en) | 2002-03-20 | 2016-11-08 | P Tech, Llc | Robotic retractor system |
US9271741B2 (en) | 2002-03-20 | 2016-03-01 | P Tech, Llc | Robotic ultrasonic energy system |
US9808318B2 (en) | 2002-03-20 | 2017-11-07 | P Tech, Llc | Robotic arthroplasty system |
US9192395B2 (en) * | 2002-03-20 | 2015-11-24 | P Tech, Llc | Robotic fastening system |
US10265128B2 (en) | 2002-03-20 | 2019-04-23 | P Tech, Llc | Methods of using a robotic spine system |
US9877793B2 (en) | 2002-03-20 | 2018-01-30 | P Tech, Llc | Robotic arthroplasty system |
US8005571B2 (en) | 2002-08-13 | 2011-08-23 | Neuroarm Surgical Ltd. | Microsurgical robot system |
US9220567B2 (en) | 2002-08-13 | 2015-12-29 | Neuroarm Surgical Ltd. | Microsurgical robot system |
US8396598B2 (en) | 2002-08-13 | 2013-03-12 | Neuroarm Surgical Ltd. | Microsurgical robot system |
US8170717B2 (en) | 2002-08-13 | 2012-05-01 | Neuroarm Surgical Ltd. | Microsurgical robot system |
US8041459B2 (en) | 2002-08-13 | 2011-10-18 | Neuroarm Surgical Ltd. | Methods relating to microsurgical robot system |
US20130197540A1 (en) * | 2003-05-21 | 2013-08-01 | The Johns Hopkins University | Devices, systems and methods for minimally invasive surgery of the throat and other portions of mammalian body |
US10058390B2 (en) * | 2003-05-21 | 2018-08-28 | The Johns Hopkins University | Devices, systems and methods for minimally invasive surgery of the throat and other portions of mammalian body |
US9072427B2 (en) | 2003-05-23 | 2015-07-07 | Intuitive Surgical Operations, Inc. | Tool with articulation lock |
US9440364B2 (en) | 2003-05-23 | 2016-09-13 | Intuitive Surgical Operations, Inc. | Articulating instrument |
US9085085B2 (en) | 2003-05-23 | 2015-07-21 | Intuitive Surgical Operations, Inc. | Articulating mechanisms with actuatable elements |
US20060094931A1 (en) * | 2003-05-23 | 2006-05-04 | Novare Surgical Systems, Inc. | Articulating mechanism for remote manipulation of a surgical or diagnostic tool |
US8100824B2 (en) | 2003-05-23 | 2012-01-24 | Intuitive Surgical Operations, Inc. | Tool with articulation lock |
US11547287B2 (en) | 2003-05-23 | 2023-01-10 | Intuitive Surgical Operations, Inc. | Surgical instrument |
US9498888B2 (en) | 2003-05-23 | 2016-11-22 | Intuitive Surgical Operations, Inc. | Articulating instrument |
US10342626B2 (en) | 2003-05-23 | 2019-07-09 | Intuitive Surgical Operations, Inc. | Surgical instrument |
US20100262180A1 (en) * | 2003-05-23 | 2010-10-14 | Danitz David J | Articulating mechanisms with bifurcating control |
US8535347B2 (en) | 2003-05-23 | 2013-09-17 | Intuitive Surgical Operations, Inc. | Articulating mechanisms with bifurcating control |
US20070250113A1 (en) * | 2003-05-23 | 2007-10-25 | Hegeman David E | Tool with articulation lock |
US9550300B2 (en) | 2003-05-23 | 2017-01-24 | Intuitive Surgical Operations, Inc. | Articulating retractors |
US9434077B2 (en) | 2003-05-23 | 2016-09-06 | Intuitive Surgical Operations, Inc | Articulating catheters |
US20050251112A1 (en) * | 2003-05-23 | 2005-11-10 | Danitz David J | Articulating mechanism for remote manipulation of a surgical or diagnostic tool |
US20100261964A1 (en) * | 2003-05-23 | 2010-10-14 | Danitz David J | Articulating endoscopes |
US7682307B2 (en) | 2003-05-23 | 2010-03-23 | Novare Surgical Systems, Inc. | Articulating mechanism for remote manipulation of a surgical or diagnostic tool |
US20100262161A1 (en) * | 2003-05-23 | 2010-10-14 | Danitz David J | Articulating instruments with joystick control |
US10722314B2 (en) | 2003-05-23 | 2020-07-28 | Intuitive Surgical Operations, Inc. | Articulating retractors |
US20100261971A1 (en) * | 2003-05-23 | 2010-10-14 | Danitz David J | Articulating retractors |
US20100262075A1 (en) * | 2003-05-23 | 2010-10-14 | Danitz David J | Articulating catheters |
US9370868B2 (en) | 2003-05-23 | 2016-06-21 | Intuitive Surgical Operations, Inc. | Articulating endoscopes |
US9737365B2 (en) | 2003-05-23 | 2017-08-22 | Intuitive Surgical Operations, Inc. | Tool with articulation lock |
US8007511B2 (en) | 2003-06-06 | 2011-08-30 | Hansen Medical, Inc. | Surgical instrument design |
US8864794B2 (en) * | 2003-06-11 | 2014-10-21 | Intuitive Surgical Operations, Inc. | Surgical instrument with a universal wrist |
US20070066986A1 (en) * | 2003-06-11 | 2007-03-22 | Intuitive Surgical Inc. | Surgical instrument with a universal wrist |
US11559301B2 (en) * | 2003-06-17 | 2023-01-24 | Covidien Lp | Surgical stapling device |
US7686826B2 (en) | 2003-10-30 | 2010-03-30 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US7364582B2 (en) | 2003-10-30 | 2008-04-29 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US7338513B2 (en) | 2003-10-30 | 2008-03-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US8221450B2 (en) | 2003-10-30 | 2012-07-17 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20080262537A1 (en) * | 2003-10-30 | 2008-10-23 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20060020287A1 (en) * | 2003-10-30 | 2006-01-26 | Woojin Lee | Surgical instrument |
US7147650B2 (en) | 2003-10-30 | 2006-12-12 | Woojin Lee | Surgical instrument |
US20050096694A1 (en) * | 2003-10-30 | 2005-05-05 | Woojin Lee | Surgical instrument |
US20060206101A1 (en) * | 2003-10-30 | 2006-09-14 | Woojin Lee | Surgical instrument |
EP1709910A4 (en) * | 2004-01-27 | 2014-01-15 | Olympus Corp | Surgical treatment appliance |
EP1709910A1 (en) * | 2004-01-27 | 2006-10-11 | Olympus Corporation | Surgical treatment appliance |
US8926603B2 (en) | 2004-03-05 | 2015-01-06 | Hansen Medical, Inc. | System and method for denaturing and fixing collagenous tissue |
US20060293643A1 (en) * | 2004-03-05 | 2006-12-28 | Wallace Daniel T | Robotic catheter system |
US20060084945A1 (en) * | 2004-03-05 | 2006-04-20 | Hansen Medical, Inc. | Instrument driver for robotic catheter system |
US7850642B2 (en) * | 2004-03-05 | 2010-12-14 | Hansen Medical, Inc. | Methods using a robotic catheter system |
US20060095022A1 (en) * | 2004-03-05 | 2006-05-04 | Moll Frederic H | Methods using a robotic catheter system |
US9629682B2 (en) | 2004-03-05 | 2017-04-25 | Hansen Medical, Inc. | Robotic catheter system |
US8394054B2 (en) | 2004-03-05 | 2013-03-12 | Hansen Medical, Inc. | Robotic catheter system |
US20050222554A1 (en) * | 2004-03-05 | 2005-10-06 | Wallace Daniel T | Robotic catheter system |
US8974408B2 (en) * | 2004-03-05 | 2015-03-10 | Hansen Medical, Inc. | Robotic catheter system |
US11883121B2 (en) * | 2004-03-05 | 2024-01-30 | Auris Health, Inc. | Robotic catheter system |
US7972298B2 (en) * | 2004-03-05 | 2011-07-05 | Hansen Medical, Inc. | Robotic catheter system |
US7974681B2 (en) * | 2004-03-05 | 2011-07-05 | Hansen Medical, Inc. | Robotic catheter system |
US7976539B2 (en) | 2004-03-05 | 2011-07-12 | Hansen Medical, Inc. | System and method for denaturing and fixing collagenous tissue |
US8409136B2 (en) | 2004-03-05 | 2013-04-02 | Hansen Medical, Inc. | Robotic catheter system |
US20170215978A1 (en) * | 2004-03-05 | 2017-08-03 | Hansen Medical, Inc. | Robotic catheter system |
US20130231679A1 (en) * | 2004-03-05 | 2013-09-05 | Hansen Medical, Inc. | Robotic catheter system |
US20070043338A1 (en) * | 2004-03-05 | 2007-02-22 | Hansen Medical, Inc | Robotic catheter system and methods |
US8052636B2 (en) * | 2004-03-05 | 2011-11-08 | Hansen Medical, Inc. | Robotic catheter system and methods |
US10874468B2 (en) * | 2004-03-05 | 2020-12-29 | Auris Health, Inc. | Robotic catheter system |
US20210137620A1 (en) * | 2004-03-05 | 2021-05-13 | Auris Health, Inc. | Robotic catheter system |
US8021326B2 (en) * | 2004-03-05 | 2011-09-20 | Hansen Medical, Inc. | Instrument driver for robotic catheter system |
US20110230896A1 (en) * | 2004-03-05 | 2011-09-22 | Hansen Medical, Inc. | Robotic catheter system |
US8323297B2 (en) | 2004-06-07 | 2012-12-04 | Intuitive Surgical Operations, Inc. | Articulating mechanism with flex-hinged links |
US11491310B2 (en) | 2004-06-07 | 2022-11-08 | Intuitive Surgical Operations, Inc. | Articulating mechanism with flex-hinged links |
US7678117B2 (en) * | 2004-06-07 | 2010-03-16 | Novare Surgical Systems, Inc. | Articulating mechanism with flex-hinged links |
US7828808B2 (en) | 2004-06-07 | 2010-11-09 | Novare Surgical Systems, Inc. | Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools |
US8419747B2 (en) | 2004-06-07 | 2013-04-16 | Intuitive Surgical Operations, Inc. | Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools |
US20050273084A1 (en) * | 2004-06-07 | 2005-12-08 | Novare Surgical Systems, Inc. | Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools |
US10729885B2 (en) | 2004-06-07 | 2020-08-04 | Intuitive Surgical Operations, Inc. | Articulating mechanism with flex-hinged links |
US20050273085A1 (en) * | 2004-06-07 | 2005-12-08 | Novare Surgical Systems, Inc. | Articulating mechanism with flex-hinged links |
US8920429B2 (en) | 2004-06-07 | 2014-12-30 | Intuitive Surgical Operations, Inc. | Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools |
US9861786B2 (en) | 2004-06-07 | 2018-01-09 | Intuitive Surgical Operations, Inc. | Articulating mechanism with flex hinged links |
US20100234831A1 (en) * | 2004-06-07 | 2010-09-16 | Hinman Cameron D | Articulating mechanism with flex-hinged links |
US9095253B2 (en) | 2004-06-07 | 2015-08-04 | Intuitive Surgical Operations, Inc. | Articulating mechanism with flex hinged links |
US20100249759A1 (en) * | 2004-06-07 | 2010-09-30 | Cameron Dale Hinman | Link systems and articulation mechanisms for remote manipulation of surgical of diagnostic tools |
US9517326B2 (en) | 2004-06-07 | 2016-12-13 | Intuitive Surgical Operations, Inc. | Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools |
US20100286670A1 (en) * | 2004-06-16 | 2010-11-11 | Mark Doyle | Surgical tool kit |
US8021358B2 (en) | 2004-06-16 | 2011-09-20 | Carefusion 2200, Inc. | Surgical tool kit |
US8353897B2 (en) | 2004-06-16 | 2013-01-15 | Carefusion 2200, Inc. | Surgical tool kit |
US20060111692A1 (en) * | 2004-07-19 | 2006-05-25 | Hlavka Edwin J | Robotically controlled intravascular tissue injection system |
US8311626B2 (en) | 2004-07-19 | 2012-11-13 | Hansen Medical, Inc. | Robotically controlled intravascular tissue injection system |
US8005537B2 (en) * | 2004-07-19 | 2011-08-23 | Hansen Medical, Inc. | Robotically controlled intravascular tissue injection system |
US11882987B2 (en) | 2004-07-28 | 2024-01-30 | Cilag Gmbh International | Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
US11890012B2 (en) | 2004-07-28 | 2024-02-06 | Cilag Gmbh International | Staple cartridge comprising cartridge body and attached support |
US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
US11638590B2 (en) | 2004-11-23 | 2023-05-02 | Intuitive Surgical Operations, Inc. | Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools |
US20060111210A1 (en) * | 2004-11-23 | 2006-05-25 | Novare Surgical Systems, Inc. | Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools |
US9155449B2 (en) | 2004-11-23 | 2015-10-13 | Intuitive Surgical Operations Inc. | Instrument systems and methods of use |
US7785252B2 (en) | 2004-11-23 | 2010-08-31 | Novare Surgical Systems, Inc. | Articulating sheath for flexible instruments |
US20060111209A1 (en) * | 2004-11-23 | 2006-05-25 | Novare Surgical Systems, Inc. | Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools |
US20110087071A1 (en) * | 2004-11-23 | 2011-04-14 | Intuitive Surgical Operations, Inc. | Articulation sheath for flexible instruments |
US8277375B2 (en) | 2004-11-23 | 2012-10-02 | Intuitive Surgical Operations, Inc. | Flexible segment system |
US20060111615A1 (en) * | 2004-11-23 | 2006-05-25 | Novare Surgical Systems, Inc. | Articulating sheath for flexible instruments |
US9700334B2 (en) | 2004-11-23 | 2017-07-11 | Intuitive Surgical Operations, Inc. | Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools |
US10321927B2 (en) | 2004-11-23 | 2019-06-18 | Intuitive Surgical Operations, Inc. | Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools |
US20060111616A1 (en) * | 2004-11-24 | 2006-05-25 | Novare Surgical Systems, Inc. | Articulating mechanism components and system for easy assembly and disassembly |
US8182417B2 (en) | 2004-11-24 | 2012-05-22 | Intuitive Surgical Operations, Inc. | Articulating mechanism components and system for easy assembly and disassembly |
US20060201130A1 (en) * | 2005-01-31 | 2006-09-14 | Danitz David J | Articulating mechanisms with joint assembly and manual handle for remote manipulation of instruments and tools |
US10368951B2 (en) * | 2005-03-04 | 2019-08-06 | Auris Health, Inc. | Robotic catheter system and methods |
US20170086929A1 (en) * | 2005-03-04 | 2017-03-30 | Hansen Medical, Inc. | Robotic catheter system and methods |
US7842028B2 (en) | 2005-04-14 | 2010-11-30 | Cambridge Endoscopic Devices, Inc. | Surgical instrument guide device |
US20100308195A1 (en) * | 2005-05-03 | 2010-12-09 | Hansen Medical, Inc. | Support assembly for robotic catheter system |
US8968333B2 (en) * | 2005-05-03 | 2015-03-03 | Hansen Medical, Inc. | Support assembly for robotic catheter system |
US9549716B2 (en) | 2005-06-22 | 2017-01-24 | Boston Scientific Scimed, Inc. | Medical device control system |
US20100114116A1 (en) * | 2005-06-22 | 2010-05-06 | Boston Scientific Scimed, Inc. | Medical Device Control System |
US9089356B2 (en) | 2005-06-22 | 2015-07-28 | Boston Scientific Scimed, Inc. | Medical device control system |
US9763650B2 (en) | 2005-06-22 | 2017-09-19 | Boston Scientific Scimed, Inc. | Medical device control system |
US8057462B2 (en) * | 2005-06-22 | 2011-11-15 | Boston Scientific Scimed, Inc. | Medical device control system |
US20070010801A1 (en) * | 2005-06-22 | 2007-01-11 | Anna Chen | Medical device control system |
US8257303B2 (en) * | 2005-07-01 | 2012-09-04 | Hansen Medical, Inc. | Robotic catheter system and methods |
US9457168B2 (en) * | 2005-07-01 | 2016-10-04 | Hansen Medical, Inc. | Robotic catheter system and methods |
US20140296875A1 (en) * | 2005-07-01 | 2014-10-02 | Hansen Medical, Inc. | Robotic catheter system and methods |
US8617102B2 (en) | 2005-07-01 | 2013-12-31 | Hansen Medical, Inc. | Robotic catheter system and methods |
US8801661B2 (en) | 2005-07-01 | 2014-08-12 | Hansen Medical, Inc. | Robotic catheter system and methods |
US20120065467A1 (en) * | 2005-07-01 | 2012-03-15 | Hansen Medical, Inc. | Robotic catheter system and methods |
US20090299344A1 (en) * | 2005-07-20 | 2009-12-03 | Woojin Lee | Surgical instrument guide device |
US8926597B2 (en) | 2005-07-20 | 2015-01-06 | Cambridge Endoscopic Devices, Inc. | Surgical instrument guide device |
US8409175B2 (en) | 2005-07-20 | 2013-04-02 | Woojin Lee | Surgical instrument guide device |
US20080269727A1 (en) * | 2005-07-20 | 2008-10-30 | Cambridge Endoscopic Devices, Inc. | Surgical instrument guide device |
US10188372B2 (en) | 2005-07-20 | 2019-01-29 | Cambridge Endoscopic Devices, Inc. | Surgical instrument guide device |
US9427256B2 (en) | 2005-07-20 | 2016-08-30 | Cambridge Endoscopic Devices, Inc. | Surgical instrument guide device |
US11730474B2 (en) | 2005-08-31 | 2023-08-22 | Cilag Gmbh International | Fastener cartridge assembly comprising a movable cartridge and a staple driver arrangement |
US11771425B2 (en) | 2005-08-31 | 2023-10-03 | Cilag Gmbh International | Stapling assembly for forming staples to different formed heights |
US11793512B2 (en) | 2005-08-31 | 2023-10-24 | Cilag Gmbh International | Staple cartridges for forming staples having differing formed staple heights |
US11839375B2 (en) | 2005-08-31 | 2023-12-12 | Cilag Gmbh International | Fastener cartridge assembly comprising an anvil and different staple heights |
US10702285B2 (en) | 2005-12-20 | 2020-07-07 | Quantum Medical Innovations, LLC | Method and apparatus for performing minimally invasive arthroscopic procedures |
US9962168B2 (en) | 2005-12-20 | 2018-05-08 | CroJor, LLC | Method and apparatus for performing minimally invasive arthroscopic procedures |
US20090171159A1 (en) * | 2005-12-20 | 2009-07-02 | Orthodynamix Llc | Method and Devices for Minimally Invasive Arthroscopic Procedures |
US8679097B2 (en) * | 2005-12-20 | 2014-03-25 | Orthodynamix Llc | Method and devices for minimally invasive arthroscopic procedures |
US11883020B2 (en) | 2006-01-31 | 2024-01-30 | Cilag Gmbh International | Surgical instrument having a feedback system |
US11890029B2 (en) | 2006-01-31 | 2024-02-06 | Cilag Gmbh International | Motor-driven surgical cutting and fastening instrument |
US11648008B2 (en) | 2006-01-31 | 2023-05-16 | Cilag Gmbh International | Surgical instrument having force feedback capabilities |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US11890008B2 (en) | 2006-01-31 | 2024-02-06 | Cilag Gmbh International | Surgical instrument with firing lockout |
US11660110B2 (en) | 2006-01-31 | 2023-05-30 | Cilag Gmbh International | Motor-driven surgical cutting and fastening instrument with tactile position feedback |
US8105350B2 (en) | 2006-05-23 | 2012-01-31 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20070276430A1 (en) * | 2006-05-23 | 2007-11-29 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US7615067B2 (en) | 2006-06-05 | 2009-11-10 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US9561045B2 (en) | 2006-06-13 | 2017-02-07 | Intuitive Surgical Operations, Inc. | Tool with rotation lock |
US11304769B2 (en) * | 2006-06-13 | 2022-04-19 | Intuitive Surgical Operations, Inc. | Side looking minimally invasive surgery instrument assembly |
US20070287993A1 (en) * | 2006-06-13 | 2007-12-13 | Hinman Cameron D | Tool with rotation lock |
US9844388B2 (en) * | 2006-06-14 | 2017-12-19 | Karl Storz Gmbh & Co. Kg | Surgical gripping forceps |
US20090259248A1 (en) * | 2006-06-14 | 2009-10-15 | Hans Ganter | Surgical gripping forceps |
US8029531B2 (en) | 2006-07-11 | 2011-10-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20080021278A1 (en) * | 2006-07-24 | 2008-01-24 | Leonard Robert F | Surgical device with removable end effector |
US7708758B2 (en) | 2006-08-16 | 2010-05-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US8709037B2 (en) | 2006-08-16 | 2014-04-29 | Woojin Lee | Surgical instrument |
US20080046000A1 (en) * | 2006-08-16 | 2008-02-21 | Woojin Lee | Surgical instrument |
US20100023050A1 (en) * | 2006-08-30 | 2010-01-28 | Josef Reinauer | Surgical gripping forceps |
US9700335B2 (en) * | 2006-08-30 | 2017-07-11 | Karl Storz Gmbh & Co. Kg | Surgical gripping forceps |
US7648519B2 (en) | 2006-09-13 | 2010-01-19 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20100168722A1 (en) * | 2006-09-13 | 2010-07-01 | Cambridge Endoscopic Devices, Inc. | Surgical Instrument |
US8083765B2 (en) | 2006-09-13 | 2011-12-27 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US11622785B2 (en) | 2006-09-29 | 2023-04-11 | Cilag Gmbh International | Surgical staples having attached drivers and stapling instruments for deploying the same |
US11877748B2 (en) | 2006-10-03 | 2024-01-23 | Cilag Gmbh International | Robotically-driven surgical instrument with E-beam driver |
US20100241136A1 (en) * | 2006-12-05 | 2010-09-23 | Mark Doyle | Instrument positioning/holding devices |
US11812961B2 (en) | 2007-01-10 | 2023-11-14 | Cilag Gmbh International | Surgical instrument including a motor control system |
US11918211B2 (en) | 2007-01-10 | 2024-03-05 | Cilag Gmbh International | Surgical stapling instrument for use with a robotic system |
US11771426B2 (en) | 2007-01-10 | 2023-10-03 | Cilag Gmbh International | Surgical instrument with wireless communication |
US11849947B2 (en) | 2007-01-10 | 2023-12-26 | Cilag Gmbh International | Surgical system including a control circuit and a passively-powered transponder |
US11844521B2 (en) | 2007-01-10 | 2023-12-19 | Cilag Gmbh International | Surgical instrument for use with a robotic system |
US11839352B2 (en) | 2007-01-11 | 2023-12-12 | Cilag Gmbh International | Surgical stapling device with an end effector |
US9566201B2 (en) | 2007-02-02 | 2017-02-14 | Hansen Medical, Inc. | Mounting support assembly for suspending a medical instrument driver above an operating table |
US20100004508A1 (en) * | 2007-03-29 | 2010-01-07 | Olympus Medical Systems Corp. | Multijointed bending mechanism and multijointed medical equipment having multijointed bending mechanism |
EP2130504A4 (en) * | 2007-03-29 | 2013-03-13 | Olympus Medical Systems Corp | Articulated bending mechanism and articulated medical device with articulated bending mechanism |
EP2130504A1 (en) * | 2007-03-29 | 2009-12-09 | Olympus Medical Systems Corporation | Articulated bending mechanism and articulated medical device with articulated bending mechanism |
US20170258483A1 (en) * | 2007-03-30 | 2017-09-14 | Ethicon Endo-Surgery, Inc. | Detachable End Effectors |
US10194931B2 (en) * | 2007-03-30 | 2019-02-05 | Ethicon Endo-Surgery, Inc. | Detachable end effectors |
US20080262492A1 (en) * | 2007-04-11 | 2008-10-23 | Cambridge Endoscopic Devices, Inc. | Surgical Instrument |
US7862554B2 (en) | 2007-04-16 | 2011-01-04 | Intuitive Surgical Operations, Inc. | Articulating tool with improved tension member system |
US20080255608A1 (en) * | 2007-04-16 | 2008-10-16 | Hinman Cameron D | Tool with end effector force limiter |
US8409244B2 (en) | 2007-04-16 | 2013-04-02 | Intuitive Surgical Operations, Inc. | Tool with end effector force limiter |
US20080255421A1 (en) * | 2007-04-16 | 2008-10-16 | David Elias Hegeman | Articulating tool with improved tension member system |
US8562640B2 (en) | 2007-04-16 | 2013-10-22 | Intuitive Surgical Operations, Inc. | Tool with multi-state ratcheted end effector |
US20080255588A1 (en) * | 2007-04-16 | 2008-10-16 | Hinman Cameron D | Tool with multi-state ratcheted end effector |
US8811777B2 (en) | 2007-04-20 | 2014-08-19 | Koninklijke Philips Electronics N.V. | Optical fiber shape sensing systems |
US8705903B2 (en) | 2007-04-20 | 2014-04-22 | Koninklijke Philips N.V. | Optical fiber instrument system for detecting and decoupling twist effects |
US8050523B2 (en) | 2007-04-20 | 2011-11-01 | Koninklijke Philips Electronics N.V. | Optical fiber shape sensing systems |
US8818143B2 (en) | 2007-04-20 | 2014-08-26 | Koninklijke Philips Electronics N.V. | Optical fiber instrument system for detecting twist of elongated instruments |
US20080285909A1 (en) * | 2007-04-20 | 2008-11-20 | Hansen Medical, Inc. | Optical fiber shape sensing systems |
US8515215B2 (en) | 2007-04-20 | 2013-08-20 | Koninklijke Philips Electronics N.V. | Optical fiber shape sensing systems |
US20110172680A1 (en) * | 2007-04-20 | 2011-07-14 | Koninklijke Philips Electronics N.V. | Optical fiber shape sensing systems |
US20090138025A1 (en) * | 2007-05-04 | 2009-05-28 | Hansen Medical, Inc. | Apparatus systems and methods for forming a working platform of a robotic instrument system by manipulation of components having controllably rigidity |
US8409245B2 (en) | 2007-05-22 | 2013-04-02 | Woojin Lee | Surgical instrument |
US20080294191A1 (en) * | 2007-05-22 | 2008-11-27 | Woojin Lee | Surgical instrument |
EP2522282A1 (en) * | 2007-05-30 | 2012-11-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting instrument with articulatable end effector |
US11857181B2 (en) | 2007-06-04 | 2024-01-02 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US11648006B2 (en) | 2007-06-04 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US11911028B2 (en) | 2007-06-04 | 2024-02-27 | Cilag Gmbh International | Surgical instruments for use with a robotic surgical system |
US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
US20090054734A1 (en) * | 2007-08-23 | 2009-02-26 | Tyco Healthcare Group Lp | Endoscopic surgical devices |
US9005238B2 (en) | 2007-08-23 | 2015-04-14 | Covidien Lp | Endoscopic surgical devices |
US20090069842A1 (en) * | 2007-09-11 | 2009-03-12 | Woojin Lee | Surgical instrument |
US8257386B2 (en) | 2007-09-11 | 2012-09-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
EP2200516A2 (en) * | 2007-10-17 | 2010-06-30 | National Cancer Center | Small caliber laparoscope surgical apparatus |
US8702748B2 (en) * | 2007-10-17 | 2014-04-22 | National Cancer Center | Small caliber laparoscope surgical apparatus |
EP2200516A4 (en) * | 2007-10-17 | 2010-12-01 | Nat Cancer Ct | Small caliber laparoscope surgical apparatus |
US20100280543A1 (en) * | 2007-10-17 | 2010-11-04 | Dong Jun Kim | Small caliber laparoscope surgical apparatus |
US20090171147A1 (en) * | 2007-12-31 | 2009-07-02 | Woojin Lee | Surgical instrument |
US11801047B2 (en) | 2008-02-14 | 2023-10-31 | Cilag Gmbh International | Surgical stapling system comprising a control circuit configured to selectively monitor tissue impedance and adjust control of a motor |
US20090320637A1 (en) * | 2008-06-27 | 2009-12-31 | Allegiance Corporation | Flexible wrist-type element and methods of manufacture and use thereof |
US8398619B2 (en) | 2008-06-27 | 2013-03-19 | Carefusion 2200, Inc. | Flexible wrist-type element and methods of manufacture and use thereof |
US20110184232A1 (en) * | 2008-07-31 | 2011-07-28 | Vhairi Maxwell | Endoscopic surgical instrument |
US20100030018A1 (en) * | 2008-08-04 | 2010-02-04 | Richard Fortier | Articulating surgical device |
US8801752B2 (en) | 2008-08-04 | 2014-08-12 | Covidien Lp | Articulating surgical device |
US9883880B2 (en) | 2008-08-04 | 2018-02-06 | Covidien Lp | Articulating surgical device |
US8968355B2 (en) | 2008-08-04 | 2015-03-03 | Covidien Lp | Articulating surgical device |
US20110184459A1 (en) * | 2008-08-04 | 2011-07-28 | Malkowski Jaroslaw T | Articulating Surgical Device |
US20100041945A1 (en) * | 2008-08-18 | 2010-02-18 | Isbell Jr Lewis | Instrument with articulation lock |
US8465475B2 (en) | 2008-08-18 | 2013-06-18 | Intuitive Surgical Operations, Inc. | Instrument with multiple articulation locks |
US20170325812A1 (en) * | 2008-08-18 | 2017-11-16 | Intuitive Surgical Operations, Inc. | Instrument With Multiple Articulation Locks |
US9737298B2 (en) | 2008-08-18 | 2017-08-22 | Intuitive Surgical Operations, Inc. | Instrument with articulation lock |
US9033960B2 (en) | 2008-08-18 | 2015-05-19 | Intuitive Surgical Operations, Inc. | Instrument with multiple articulation locks |
US11234694B2 (en) * | 2008-08-18 | 2022-02-01 | Intuitive Surgical Operations, Inc. | Instrument with multiple articulation locks |
US11812954B2 (en) | 2008-09-23 | 2023-11-14 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US11684361B2 (en) | 2008-09-23 | 2023-06-27 | Cilag Gmbh International | Motor-driven surgical cutting instrument |
US11871923B2 (en) | 2008-09-23 | 2024-01-16 | Cilag Gmbh International | Motorized surgical instrument |
US11730477B2 (en) | 2008-10-10 | 2023-08-22 | Cilag Gmbh International | Powered surgical system with manually retractable firing system |
US20100125285A1 (en) * | 2008-11-20 | 2010-05-20 | Hansen Medical, Inc. | Automated alignment |
US8657781B2 (en) | 2008-11-20 | 2014-02-25 | Hansen Medical, Inc. | Automated alignment |
US8317746B2 (en) * | 2008-11-20 | 2012-11-27 | Hansen Medical, Inc. | Automated alignment |
US9375288B2 (en) | 2009-03-09 | 2016-06-28 | Intuitive Surgical Operations, Inc. | Adaptable integrated energy control system for electrosurgical tools in robotic surgical systems |
US20150012134A1 (en) * | 2009-03-09 | 2015-01-08 | Intuitive Surgical Operations, Inc. | Adaptable integrated energy control system for electrosurgical tools in robotic surgical systems |
US9827059B2 (en) | 2009-03-09 | 2017-11-28 | Intuitive Surgical Operations, Inc. | Adaptable integrated energy control system for electrosurgical tools in robotic surgical systems |
US10575909B2 (en) | 2009-03-09 | 2020-03-03 | Intuitive Surgical Operations, Inc. | Adaptable integrated energy control system for electrosurgical tools in robotic surgical systems |
US10898287B2 (en) | 2009-03-09 | 2021-01-26 | Intuitive Surgical Operations, Inc. | Adaptable integrated energy control system for electrosurgical tools in robotic surgical systems |
US20100249497A1 (en) * | 2009-03-30 | 2010-09-30 | Peine William J | Surgical instrument |
US10363103B2 (en) | 2009-04-29 | 2019-07-30 | Auris Health, Inc. | Flexible and steerable elongate instruments with shape control and support elements |
US11464586B2 (en) | 2009-04-29 | 2022-10-11 | Auris Health, Inc. | Flexible and steerable elongate instruments with shape control and support elements |
US9221179B2 (en) | 2009-07-23 | 2015-12-29 | Intuitive Surgical Operations, Inc. | Articulating mechanism |
WO2011025886A1 (en) * | 2009-08-26 | 2011-03-03 | Carefusion 2200, Inc. | Mechanisms for positioning and/or holding surgical instruments and performing other functions, and methods of manufacture and use thereof |
US9872605B2 (en) | 2009-08-26 | 2018-01-23 | Carefusion 2200, Inc. | Mechanisms for positioning and/or holding surgical instruments and performing other functions, and methods of manufacture and use thereof |
US9333001B2 (en) | 2009-10-08 | 2016-05-10 | Ethicon Endo-Surgery, Inc. | Articulable laparoscopic instrument |
US9474540B2 (en) | 2009-10-08 | 2016-10-25 | Ethicon-Endo-Surgery, Inc. | Laparoscopic device with compound angulation |
ES2388867A1 (en) * | 2009-10-27 | 2012-10-19 | Universitat Politècnica De Catalunya | Minimally invasive laparoscopic surgical pliers |
US20210038293A1 (en) * | 2009-10-30 | 2021-02-11 | Covidien Lp | Jaw roll joint |
US8357161B2 (en) * | 2009-10-30 | 2013-01-22 | Covidien Lp | Coaxial drive |
US20110106078A1 (en) * | 2009-10-30 | 2011-05-05 | Tyco Healthcare Group Lp | Coaxial Drive |
US20110112517A1 (en) * | 2009-11-06 | 2011-05-12 | Peine Willliam J | Surgical instrument |
CN104887326A (en) * | 2009-11-13 | 2015-09-09 | 直观外科手术操作公司 | Method and system for hand presence detection in a minimally invasive surgical system |
US10206701B2 (en) | 2010-05-07 | 2019-02-19 | Ethicon Llc | Compound angle laparoscopic methods and devices |
US9468426B2 (en) | 2010-05-07 | 2016-10-18 | Ethicon Endo-Surgery, Inc. | Compound angle laparoscopic methods and devices |
US9226760B2 (en) * | 2010-05-07 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Laparoscopic devices with flexible actuation mechanisms |
US20110276084A1 (en) * | 2010-05-07 | 2011-11-10 | Ethicon Endo-Surgery, Inc. | Laparoscopic devices with flexible actuation mechanisms |
US9033998B1 (en) * | 2010-05-13 | 2015-05-19 | Titan Medical Inc. | Independent roll wrist mechanism |
US8661927B2 (en) * | 2010-05-14 | 2014-03-04 | Intuitive Surgical Operations, Inc. | Cable re-ordering device |
CN104958111A (en) * | 2010-05-14 | 2015-10-07 | 直观外科手术操作公司 | Surgical system sterile drape |
US20110277579A1 (en) * | 2010-05-14 | 2011-11-17 | Intuitive Surgical Operations, Inc. | Cable Re-ordering Device |
EP2613728A2 (en) * | 2010-09-10 | 2013-07-17 | CareFusion 2200 Inc. | Protective sheath |
EP2613728A4 (en) * | 2010-09-10 | 2014-03-19 | Carefusion 2200 Inc | Protective sheath |
US10130427B2 (en) | 2010-09-17 | 2018-11-20 | Auris Health, Inc. | Systems and methods for positioning an elongate member inside a body |
US10555780B2 (en) | 2010-09-17 | 2020-02-11 | Auris Health, Inc. | Systems and methods for positioning an elongate member inside a body |
US9314306B2 (en) | 2010-09-17 | 2016-04-19 | Hansen Medical, Inc. | Systems and methods for manipulating an elongate member |
US11213356B2 (en) | 2010-09-17 | 2022-01-04 | Auris Health, Inc. | Systems and methods for positioning an elongate member inside a body |
US11707336B2 (en) | 2010-09-21 | 2023-07-25 | Intuitive Surgical Operations, Inc. | Method and system for hand tracking in a robotic system |
US10543050B2 (en) | 2010-09-21 | 2020-01-28 | Intuitive Surgical Operations, Inc. | Method and system for hand presence detection in a minimally invasive surgical system |
US9901402B2 (en) | 2010-09-21 | 2018-02-27 | Intuitive Surgical Operations, Inc. | Method and apparatus for hand gesture control in a minimally invasive surgical system |
US9743989B2 (en) | 2010-09-21 | 2017-08-29 | Intuitive Surgical Operations, Inc. | Method and system for hand presence detection in a minimally invasive surgical system |
US11737754B2 (en) | 2010-09-30 | 2023-08-29 | Cilag Gmbh International | Surgical stapler with floating anvil |
US11672536B2 (en) | 2010-09-30 | 2023-06-13 | Cilag Gmbh International | Layer of material for a surgical end effector |
US11857187B2 (en) | 2010-09-30 | 2024-01-02 | Cilag Gmbh International | Tissue thickness compensator comprising controlled release and expansion |
US11883025B2 (en) | 2010-09-30 | 2024-01-30 | Cilag Gmbh International | Tissue thickness compensator comprising a plurality of layers |
US11911027B2 (en) | 2010-09-30 | 2024-02-27 | Cilag Gmbh International | Adhesive film laminate |
US11849952B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US11925354B2 (en) | 2010-09-30 | 2024-03-12 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US11850310B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge including an adjunct |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US9358076B2 (en) | 2011-01-20 | 2016-06-07 | Hansen Medical, Inc. | System and method for endoluminal and translumenal therapy |
US10350390B2 (en) | 2011-01-20 | 2019-07-16 | Auris Health, Inc. | System and method for endoluminal and translumenal therapy |
US11832900B2 (en) | 2011-02-15 | 2023-12-05 | Intuitive Surgical Operations, Inc. | Systems and methods for operating an end effector |
US11026755B2 (en) * | 2011-02-15 | 2021-06-08 | Intuitive Surgical Operations, Inc. | Systems and methods for operating an end effector |
EP2666429A4 (en) * | 2011-03-11 | 2015-04-29 | Olympus Corp | Medical treatment tool and manipulator |
EP2666429A1 (en) * | 2011-03-11 | 2013-11-27 | Olympus Corporation | Medical treatment tool and manipulator |
US9168050B1 (en) | 2011-03-24 | 2015-10-27 | Cambridge Endoscopic Devices, Inc. | End effector construction |
US11357526B2 (en) | 2011-05-13 | 2022-06-14 | Intuitive Surgical Operations, Inc. | Medical instrument with snake wrist structure |
US10335177B2 (en) | 2011-05-13 | 2019-07-02 | Intuitive Surgical Operations, Inc. | Medical instrument with snake wrist structure |
US9161771B2 (en) | 2011-05-13 | 2015-10-20 | Intuitive Surgical Operations Inc. | Medical instrument with snake wrist structure |
US11918208B2 (en) | 2011-05-27 | 2024-03-05 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US20140358163A1 (en) * | 2011-07-11 | 2014-12-04 | EON Surgical Ltd. | Laparoscopic graspers |
US20130023859A1 (en) * | 2011-07-21 | 2013-01-24 | Tyco Healthcare Group Lp | Articulating Links with Middle Link Control System |
US11419518B2 (en) | 2011-07-29 | 2022-08-23 | Auris Health, Inc. | Apparatus and methods for fiber integration and registration |
US10667720B2 (en) | 2011-07-29 | 2020-06-02 | Auris Health, Inc. | Apparatus and methods for fiber integration and registration |
US9138166B2 (en) | 2011-07-29 | 2015-09-22 | Hansen Medical, Inc. | Apparatus and methods for fiber integration and registration |
EP2779919A4 (en) * | 2011-11-16 | 2015-08-26 | Olympus Corp | Medical treatment tool and manipulator including the same |
US9775677B2 (en) | 2011-11-16 | 2017-10-03 | Olympus Corporation | Medical treatment tool and manipulator including the same |
US20170360462A1 (en) * | 2011-11-29 | 2017-12-21 | Covidien Lp | Coupling mechanisms for surgical instruments |
US8652031B2 (en) | 2011-12-29 | 2014-02-18 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Remote guidance system for medical devices for use in environments having electromagnetic interference |
US11918220B2 (en) | 2012-03-28 | 2024-03-05 | Cilag Gmbh International | Tissue thickness compensator comprising tissue ingrowth features |
US11793509B2 (en) | 2012-03-28 | 2023-10-24 | Cilag Gmbh International | Staple cartridge including an implantable layer |
US9687303B2 (en) * | 2012-04-20 | 2017-06-27 | Vanderbilt University | Dexterous wrists for surgical intervention |
US10500002B2 (en) | 2012-04-20 | 2019-12-10 | Vanderbilt University | Dexterous wrists |
US10300599B2 (en) | 2012-04-20 | 2019-05-28 | Vanderbilt University | Systems and methods for safe compliant insertion and hybrid force/motion telemanipulation of continuum robots |
US20150073434A1 (en) * | 2012-04-20 | 2015-03-12 | Vanderbilt University | Dexterous wrists for surgical intervention |
US9700377B2 (en) * | 2012-04-27 | 2017-07-11 | Koh Young Technology Inc. | Surgical robot for changing position of surgical equipment |
US20150088160A1 (en) * | 2012-04-27 | 2015-03-26 | Industry-University Cooperation Foundation Hanyang University Erica Campus | Surgical robot for changing position of surgical equipment |
US20150150633A1 (en) * | 2012-06-07 | 2015-06-04 | Medrobotics Corporation | Articulating surgical instruments and methods of deploying the same |
US11707273B2 (en) | 2012-06-15 | 2023-07-25 | Cilag Gmbh International | Articulatable surgical instrument comprising a firing drive |
US11857189B2 (en) | 2012-06-28 | 2024-01-02 | Cilag Gmbh International | Surgical instrument including first and second articulation joints |
US11779420B2 (en) | 2012-06-28 | 2023-10-10 | Cilag Gmbh International | Robotic surgical attachments having manually-actuated retraction assemblies |
US11806013B2 (en) | 2012-06-28 | 2023-11-07 | Cilag Gmbh International | Firing system arrangements for surgical instruments |
US11918213B2 (en) | 2012-06-28 | 2024-03-05 | Cilag Gmbh International | Surgical stapler including couplers for attaching a shaft to an end effector |
WO2014012780A1 (en) * | 2012-07-17 | 2014-01-23 | Richard Wolf Gmbh | Endoscopic instrument |
US9615846B2 (en) | 2012-07-17 | 2017-04-11 | Richard Wolf Gmbh | Endoscopic instrument |
US10624706B2 (en) | 2012-09-17 | 2020-04-21 | Intuitive Surgical Operations, Inc. | Methods and systems for assigning input devices to teleoperated surgical instrument functions |
US9301811B2 (en) | 2012-09-17 | 2016-04-05 | Intuitive Surgical Operations, Inc. | Methods and systems for assigning input devices to teleoperated surgical instrument functions |
US9814536B2 (en) | 2012-09-17 | 2017-11-14 | Intuitive Surgical Operations, Inc. | Methods and systems for assigning input devices to teleoperated surgical instrument functions |
US11160622B2 (en) | 2012-09-17 | 2021-11-02 | Intuitive Surgical Operations, Inc. | Methods and systems for assigning input devices to teleoperated surgical instrument functions |
US10631939B2 (en) | 2012-11-02 | 2020-04-28 | Intuitive Surgical Operations, Inc. | Systems and methods for mapping flux supply paths |
US10864048B2 (en) | 2012-11-02 | 2020-12-15 | Intuitive Surgical Operations, Inc. | Flux disambiguation for teleoperated surgical systems |
US10583271B2 (en) | 2012-11-28 | 2020-03-10 | Auris Health, Inc. | Method of anchoring pullwire directly articulatable region in catheter |
US11925774B2 (en) | 2012-11-28 | 2024-03-12 | Auris Health, Inc. | Method of anchoring pullwire directly articulatable region in catheter |
US9517557B2 (en) * | 2013-02-27 | 2016-12-13 | Olympus Corporation | Manipulator |
US20150352715A1 (en) * | 2013-02-27 | 2015-12-10 | Olympus Corporation | Manipulator |
US11779414B2 (en) | 2013-03-14 | 2023-10-10 | Auris Health, Inc. | Active drive for robotic catheter manipulators |
US9326822B2 (en) | 2013-03-14 | 2016-05-03 | Hansen Medical, Inc. | Active drives for robotic catheter manipulators |
US10556092B2 (en) | 2013-03-14 | 2020-02-11 | Auris Health, Inc. | Active drives for robotic catheter manipulators |
US11517717B2 (en) | 2013-03-14 | 2022-12-06 | Auris Health, Inc. | Active drives for robotic catheter manipulators |
US10687903B2 (en) | 2013-03-14 | 2020-06-23 | Auris Health, Inc. | Active drive for robotic catheter manipulators |
US11006975B1 (en) | 2013-03-15 | 2021-05-18 | Southern Methodist University | Steerable extendable devices |
US9408669B2 (en) | 2013-03-15 | 2016-08-09 | Hansen Medical, Inc. | Active drive mechanism with finite range of motion |
US11426095B2 (en) * | 2013-03-15 | 2022-08-30 | Auris Health, Inc. | Flexible instrument localization from both remote and elongation sensors |
US11504195B2 (en) | 2013-03-15 | 2022-11-22 | Auris Health, Inc. | Active drive mechanism for simultaneous rotation and translation |
US11660153B2 (en) | 2013-03-15 | 2023-05-30 | Auris Health, Inc. | Active drive mechanism with finite range of motion |
US10524867B2 (en) | 2013-03-15 | 2020-01-07 | Auris Health, Inc. | Active drive mechanism for simultaneous rotation and translation |
US10792112B2 (en) | 2013-03-15 | 2020-10-06 | Auris Health, Inc. | Active drive mechanism with finite range of motion |
US9282993B1 (en) | 2013-03-15 | 2016-03-15 | Southern Methodist University | Steerable extendable devices |
US20150367508A1 (en) * | 2013-03-18 | 2015-12-24 | Olympus Corporation | Manipulator |
US9550293B2 (en) * | 2013-03-18 | 2017-01-24 | Olympus Corporation | Manipulator |
US11638581B2 (en) | 2013-04-16 | 2023-05-02 | Cilag Gmbh International | Powered surgical stapler |
US11633183B2 (en) | 2013-04-16 | 2023-04-25 | Cilag International GmbH | Stapling assembly comprising a retraction drive |
US11690615B2 (en) | 2013-04-16 | 2023-07-04 | Cilag Gmbh International | Surgical system including an electric motor and a surgical instrument |
US9357984B2 (en) | 2013-04-23 | 2016-06-07 | Covidien Lp | Constant value gap stabilizer for articulating links |
US10278683B2 (en) | 2013-06-19 | 2019-05-07 | Titan Medical Inc. | Articulated tool positioner and system employing same |
US11786230B2 (en) | 2013-06-19 | 2023-10-17 | Covidien Lp | Articulated tool positioner and system employing same |
US11026666B2 (en) | 2013-06-19 | 2021-06-08 | Titan Medical Inc. | Articulated tool positioner and system employing same |
US11439377B2 (en) | 2013-06-19 | 2022-09-13 | Titan Medical Inc. | Articulated tool positioner and system employing same |
EP3238650A1 (en) * | 2013-06-19 | 2017-11-01 | Titan Medical Inc. | Articulated tool positioner and system employing same |
CN110063794A (en) * | 2013-06-19 | 2019-07-30 | 提坦医疗公司 | Radial type tool locator and the system for using it |
US11369353B2 (en) | 2013-06-19 | 2022-06-28 | Titan Medical Inc. | Articulated tool positioner and system employing same |
US11607206B2 (en) | 2013-06-19 | 2023-03-21 | Titan Medical Inc. | Articulated tool positioner and system employing same |
US11701110B2 (en) | 2013-08-23 | 2023-07-18 | Cilag Gmbh International | Surgical instrument including a drive assembly movable in a non-motorized mode of operation |
US20150088152A1 (en) * | 2013-09-25 | 2015-03-26 | Terumo Kabushiki Kaisha | Elongated member for medical use |
US10166061B2 (en) | 2014-03-17 | 2019-01-01 | Intuitive Surgical Operations, Inc. | Teleoperated surgical system equipment with user interface |
US11439454B2 (en) | 2014-03-17 | 2022-09-13 | Intuitive Surgical Operations, Inc. | Teleoperated surgical system equipment with user interface |
AU2015242144B2 (en) * | 2014-03-31 | 2019-05-02 | Human Extensions Ltd. | Steerable medical device |
US20170007224A1 (en) * | 2014-03-31 | 2017-01-12 | Human Extensions Ltd. | Steerable medical device |
US11730461B2 (en) | 2014-03-31 | 2023-08-22 | Human Xtensions Ltd. | Steerable medical device |
EP3125738A4 (en) * | 2014-03-31 | 2017-12-06 | Human Extensions Ltd. | Steerable medical device |
EP3653105A1 (en) * | 2014-03-31 | 2020-05-20 | Human Extensions Ltd. | Steerable medical device |
EP3130304A4 (en) * | 2014-04-09 | 2017-12-20 | Olympus Corporation | Treatment tool and surgical system |
US11925353B2 (en) | 2014-04-16 | 2024-03-12 | Cilag Gmbh International | Surgical stapling instrument comprising internal passage between stapling cartridge and elongate channel |
US11883026B2 (en) | 2014-04-16 | 2024-01-30 | Cilag Gmbh International | Fastener cartridge assemblies and staple retainer cover arrangements |
US11918222B2 (en) | 2014-04-16 | 2024-03-05 | Cilag Gmbh International | Stapling assembly having firing member viewing windows |
US11717294B2 (en) | 2014-04-16 | 2023-08-08 | Cilag Gmbh International | End effector arrangements comprising indicators |
US11278703B2 (en) | 2014-04-21 | 2022-03-22 | Auris Health, Inc. | Devices, systems, and methods for controlling active drive systems |
US10046140B2 (en) | 2014-04-21 | 2018-08-14 | Hansen Medical, Inc. | Devices, systems, and methods for controlling active drive systems |
CN110251048A (en) * | 2014-04-28 | 2019-09-20 | 柯惠Lp公司 | For accommodating the surgical assembly of force transmitting member |
US10660718B2 (en) | 2014-04-28 | 2020-05-26 | Covidien Lp | Surgical assemblies for housing force transmitting members |
EP3137009A4 (en) * | 2014-04-28 | 2017-12-27 | Covidien LP | Surgical assemblies for housing force transmitting members |
US10258359B2 (en) | 2014-08-13 | 2019-04-16 | Covidien Lp | Robotically controlling mechanical advantage gripping |
CN106572889A (en) * | 2014-08-13 | 2017-04-19 | 柯惠Lp公司 | Robotically controlling mechanical advantage gripping |
US10390853B2 (en) | 2014-08-13 | 2019-08-27 | Covidien Lp | Robotically controlling mechanical advantage gripping |
EP3179952A4 (en) * | 2014-08-13 | 2018-02-07 | Covidien LP | Robotically controlling mechanical advantage gripping |
JP2017529893A (en) * | 2014-08-13 | 2017-10-12 | コヴィディエン リミテッド パートナーシップ | Robot control for grasping mechanical profit |
US11246614B2 (en) | 2014-08-13 | 2022-02-15 | Covidien Lp | Robotically controlling mechanical advantage gripping |
US11717297B2 (en) | 2014-09-05 | 2023-08-08 | Cilag Gmbh International | Smart cartridge wake up operation and data retention |
US11653918B2 (en) | 2014-09-05 | 2023-05-23 | Cilag Gmbh International | Local display of tissue parameter stabilization |
US20220287699A1 (en) * | 2014-09-26 | 2022-09-15 | Intuitive Surgical Operations, Inc. | Surgical instrument with flexible shaft and actuation element guide |
US11918210B2 (en) | 2014-10-16 | 2024-03-05 | Cilag Gmbh International | Staple cartridge comprising a cartridge body including a plurality of wells |
WO2016067436A1 (en) * | 2014-10-30 | 2016-05-06 | オリンパス株式会社 | Medical treatment tool |
JPWO2016067436A1 (en) * | 2014-10-30 | 2017-08-10 | オリンパス株式会社 | Medical treatment tool |
US11812958B2 (en) | 2014-12-18 | 2023-11-14 | Cilag Gmbh International | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US11678877B2 (en) | 2014-12-18 | 2023-06-20 | Cilag Gmbh International | Surgical instrument including a flexible support configured to support a flexible firing member |
US10098706B2 (en) * | 2015-01-06 | 2018-10-16 | Olympus Corporation | Operation input device and medical manipulator system |
CN106794048A (en) * | 2015-01-06 | 2017-05-31 | 奥林巴斯株式会社 | Operation input unit and medical manipulator system |
US11744588B2 (en) | 2015-02-27 | 2023-09-05 | Cilag Gmbh International | Surgical stapling instrument including a removably attachable battery pack |
US20160270807A1 (en) * | 2015-03-16 | 2016-09-22 | Ethicon Endo-Surgery, Llc | Surgical Jaw Coupling Methods and Devices |
US11134968B2 (en) * | 2015-03-16 | 2021-10-05 | Cilag Gmbh International | Surgical jaw coupling methods and devices |
US11918212B2 (en) | 2015-03-31 | 2024-03-05 | Cilag Gmbh International | Surgical instrument with selectively disengageable drive systems |
US10753439B2 (en) | 2015-04-03 | 2020-08-25 | The Regents Of The University Of Michigan | Tension management apparatus for cable-driven transmission |
CN104856760A (en) * | 2015-04-16 | 2015-08-26 | 段友建 | Automatic nursing device for orthopedic inspection |
US10039532B2 (en) | 2015-05-06 | 2018-08-07 | Covidien Lp | Surgical instrument with articulation assembly |
US10667873B2 (en) | 2015-06-23 | 2020-06-02 | Covidien Lp | Surgical end effectors with mechanical advantage |
US10881475B2 (en) * | 2015-07-09 | 2021-01-05 | Kawasaki Jukogyo Kabushiki Kaisha | Surgical robot |
CN107708596A (en) * | 2015-07-09 | 2018-02-16 | 川崎重工业株式会社 | Operation manipulator |
CN107683120A (en) * | 2015-07-09 | 2018-02-09 | 川崎重工业株式会社 | Operation manipulator |
CN107708597A (en) * | 2015-07-09 | 2018-02-16 | 川崎重工业株式会社 | Operation robot |
US11198226B2 (en) * | 2015-07-09 | 2021-12-14 | Kawasaki Jukogyo Kabushiki Kaisha | Surgical robot |
US20180214226A1 (en) * | 2015-07-09 | 2018-08-02 | Kawasaki Jukogyo Kabushiki Kaisha | Surgical robot |
US11849946B2 (en) | 2015-09-23 | 2023-12-26 | Cilag Gmbh International | Surgical stapler having downstream current-based motor control |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US11712244B2 (en) | 2015-09-30 | 2023-08-01 | Cilag Gmbh International | Implantable layer with spacer fibers |
US11903586B2 (en) | 2015-09-30 | 2024-02-20 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US10959797B2 (en) | 2015-10-05 | 2021-03-30 | Flexdex, Inc. | Medical devices having smoothly articulating multi-cluster joints |
US11896255B2 (en) | 2015-10-05 | 2024-02-13 | Flexdex, Inc. | End-effector jaw closure transmission systems for remote access tools |
CN108472025A (en) * | 2015-10-05 | 2018-08-31 | 弗莱克斯德克斯公司 | The medical treatment device of more cluster connectors with smooth articulation |
EP3359054A4 (en) * | 2015-10-05 | 2019-08-14 | Flexdex, Inc. | Medical devices having smoothly articulating multi-cluster joints |
US11141233B2 (en) | 2015-10-16 | 2021-10-12 | Medical Microinstruments S.p.A. | Surgical tool for robotic surgery and robotic surgical assembly |
EP3977957A2 (en) | 2015-10-16 | 2022-04-06 | Medical Microinstruments S.P.A. | Surgical tool for robotic surgery and robotic surgical assembly |
WO2017064306A1 (en) | 2015-10-16 | 2017-04-20 | Medical Microinstruments S.R.L. | A surgical tool |
US10582975B2 (en) | 2015-10-16 | 2020-03-10 | Medical Microinstruments S.p.A. | Surgical tool |
US11096748B2 (en) | 2015-10-16 | 2021-08-24 | Medical Microinstruments S.p.A. | Surgical tool |
WO2017064303A1 (en) | 2015-10-16 | 2017-04-20 | Medical Microinstruments S.R.L. | Surgical tool for robotic surgery and robotic surgical assembly |
CN108366836A (en) * | 2015-10-16 | 2018-08-03 | 医疗显微器具股份公司 | Operation tool |
EP4218650A2 (en) | 2015-10-16 | 2023-08-02 | Medical Microinstruments, Inc. | Medical instrument and robotic surgical assembly |
US11103319B2 (en) | 2015-10-16 | 2021-08-31 | Medical Microinstruments S.p.A. | Surgical tool |
US11376031B2 (en) | 2015-10-20 | 2022-07-05 | Lumendi Ltd. | Medical instruments for performing minimally-invasive procedures |
US11446081B2 (en) | 2015-10-20 | 2022-09-20 | Lumedi Ltd. | Medical instruments for performing minimally-invasive procedures |
US11504104B2 (en) | 2015-10-20 | 2022-11-22 | Lumendi Ltd. | Medical instruments for performing minimally-invasive procedures |
US10765484B2 (en) | 2015-10-21 | 2020-09-08 | P Tech, Llc | Systems and methods for navigation and visualization |
US11744651B2 (en) | 2015-10-21 | 2023-09-05 | P Tech, Llc | Systems and methods for navigation and visualization |
US11317974B2 (en) | 2015-10-21 | 2022-05-03 | P Tech, Llc | Systems and methods for navigation and visualization |
US11684430B2 (en) | 2015-10-21 | 2023-06-27 | P Tech, Llc | Systems and methods for navigation and visualization |
US10058393B2 (en) | 2015-10-21 | 2018-08-28 | P Tech, Llc | Systems and methods for navigation and visualization |
US11759208B2 (en) | 2015-12-30 | 2023-09-19 | Cilag Gmbh International | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10932861B2 (en) | 2016-01-14 | 2021-03-02 | Auris Health, Inc. | Electromagnetic tracking surgical system and method of controlling the same |
US11911113B2 (en) | 2016-01-14 | 2024-02-27 | Auris Health, Inc. | Electromagnetic tracking surgical system and method of controlling the same |
US10932691B2 (en) | 2016-01-26 | 2021-03-02 | Auris Health, Inc. | Surgical tools having electromagnetic tracking components |
CN112370008A (en) * | 2016-02-05 | 2021-02-19 | 得克萨斯系统大学董事会 | Surgical device |
US11730471B2 (en) | 2016-02-09 | 2023-08-22 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
US11779336B2 (en) | 2016-02-12 | 2023-10-10 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10583270B2 (en) | 2016-03-14 | 2020-03-10 | Covidien Lp | Compound curve navigation catheter |
US11744991B2 (en) | 2016-03-14 | 2023-09-05 | Covidien Lp | Compound curve navigation catheter |
US10864053B2 (en) | 2016-04-08 | 2020-12-15 | Olympus Corporation | Flexible manipulator |
US11324554B2 (en) | 2016-04-08 | 2022-05-10 | Auris Health, Inc. | Floating electromagnetic field generator system and method of controlling the same |
US11811253B2 (en) | 2016-04-18 | 2023-11-07 | Cilag Gmbh International | Surgical robotic system with fault state detection configurations based on motor current draw |
US20170340316A1 (en) * | 2016-05-25 | 2017-11-30 | Medtronic, Inc. | Interventional medical device retrieval |
US10542964B2 (en) * | 2016-05-25 | 2020-01-28 | Medtronic, Inc. | Interventional medical device retrieval |
US11701192B2 (en) | 2016-08-26 | 2023-07-18 | Auris Health, Inc. | Steerable catheter with shaft load distributions |
US10463439B2 (en) | 2016-08-26 | 2019-11-05 | Auris Health, Inc. | Steerable catheter with shaft load distributions |
US11241559B2 (en) | 2016-08-29 | 2022-02-08 | Auris Health, Inc. | Active drive for guidewire manipulation |
EP4218653A1 (en) * | 2016-09-09 | 2023-08-02 | Intuitive Surgical Operations, Inc. | Push-pull surgical instrument end effector actuation using flexible tension member |
EP3509523A4 (en) * | 2016-09-09 | 2020-05-13 | Intuitive Surgical Operations Inc. | Push-pull surgical instrument end effector actuation using flexible tension member |
WO2018049217A1 (en) | 2016-09-09 | 2018-03-15 | Intuitive Surgical Operations, Inc. | Push-pull surgical instrument end effector actuation using flexible tension member |
CN109688959A (en) * | 2016-09-09 | 2019-04-26 | 直观外科手术操作公司 | It is activated using the plug-type surgical operating instrument end effector of flexible tensioning member |
US11020138B2 (en) | 2016-09-09 | 2021-06-01 | Intuitive Surgical Operations, Inc. | Push-pull surgical instrument end effector actuation using flexible tension member |
EP3949892A1 (en) * | 2016-09-09 | 2022-02-09 | Intuitive Surgical Operations, Inc. | Push-pull surgical instrument end effector actuation using flexible tension member |
US11793394B2 (en) | 2016-12-02 | 2023-10-24 | Vanderbilt University | Steerable endoscope with continuum manipulator |
US11701115B2 (en) | 2016-12-21 | 2023-07-18 | Cilag Gmbh International | Methods of stapling tissue |
US11918215B2 (en) | 2016-12-21 | 2024-03-05 | Cilag Gmbh International | Staple cartridge with array of staple pockets |
WO2018189722A1 (en) | 2017-04-14 | 2018-10-18 | Medical Microinstruments S.p.A. | Robotic microsurgical assembly |
US11357585B2 (en) | 2017-04-14 | 2022-06-14 | Medical Microinstruments S.p.A. | Robotic microsurgical assembly |
WO2018189721A1 (en) | 2017-04-14 | 2018-10-18 | Medical Microinstruments S.p.A. | Robotic microsurgical assembly |
US11317981B2 (en) | 2017-04-14 | 2022-05-03 | Medical Microinstruments S.p.A. | Robotic microsurgical assembly |
US11793513B2 (en) | 2017-06-20 | 2023-10-24 | Cilag Gmbh International | Systems and methods for controlling motor speed according to user input for a surgical instrument |
US11672532B2 (en) | 2017-06-20 | 2023-06-13 | Cilag Gmbh International | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US11871939B2 (en) | 2017-06-20 | 2024-01-16 | Cilag Gmbh International | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
US11696759B2 (en) | 2017-06-28 | 2023-07-11 | Cilag Gmbh International | Surgical stapling instruments comprising shortened staple cartridge noses |
US11890005B2 (en) | 2017-06-29 | 2024-02-06 | Cilag Gmbh International | Methods for closed loop velocity control for robotic surgical instrument |
US10967504B2 (en) | 2017-09-13 | 2021-04-06 | Vanderbilt University | Continuum robots with multi-scale motion through equilibrium modulation |
US11897129B2 (en) | 2017-09-13 | 2024-02-13 | Vanderbilt University | Continuum robots with multi-scale motion through equilibrium modulation |
JPWO2019073859A1 (en) * | 2017-10-12 | 2020-11-19 | 日本発條株式会社 | Flexible tubes and flexible structures for medical manipulators |
US10624708B2 (en) | 2017-10-26 | 2020-04-21 | Ethicon Llc | Auto cable tensioning system |
WO2019083802A1 (en) * | 2017-10-26 | 2019-05-02 | Ethicon Llc | Auto cable tensioning system |
EP3476351A1 (en) * | 2017-10-26 | 2019-05-01 | Ethicon LLC | Auto cable tensioning system |
US11896222B2 (en) | 2017-12-15 | 2024-02-13 | Cilag Gmbh International | Methods of operating surgical end effectors |
US11751867B2 (en) | 2017-12-21 | 2023-09-12 | Cilag Gmbh International | Surgical instrument comprising sequenced systems |
US11849939B2 (en) | 2017-12-21 | 2023-12-26 | Cilag Gmbh International | Continuous use self-propelled stapling instrument |
US11864762B2 (en) | 2018-02-12 | 2024-01-09 | Intuitive Surgical Operations, Inc. | Surgical instrument with lockout mechanism |
US11883006B2 (en) | 2018-06-04 | 2024-01-30 | Valuebiotech Israel Ltd. | Articulation arm link |
US20210178610A1 (en) * | 2018-08-31 | 2021-06-17 | Industry-University Cooperation Foundation Hanyang University Erica Campus | Flexible mechanism |
US11857188B2 (en) | 2018-12-21 | 2024-01-02 | Intuitive Surgical Operations, Inc. | Articulation assemblies for surgical instruments |
US20220071632A1 (en) * | 2018-12-21 | 2022-03-10 | Intuitive Surgical Operations, Inc. | Actuation mechanisms for surgical instruments |
US11806015B2 (en) | 2018-12-21 | 2023-11-07 | Intuitive Surgical Operations, Inc. | Surgical instruments having mechanisms for identifying and/or deactivating stapler cartridges |
US11234783B2 (en) | 2018-12-28 | 2022-02-01 | Titan Medical Inc. | Articulated tool positioner for robotic surgery system |
US11931032B2 (en) | 2018-12-28 | 2024-03-19 | Cilag Gmbh International | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
US20210339398A1 (en) * | 2019-01-31 | 2021-11-04 | Kawasaki Jukogyo Kabushiki Kaisha | Robot and method of operating the same |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
CN110772334A (en) * | 2019-04-25 | 2020-02-11 | 深圳市精锋医疗科技有限公司 | Surgical instrument |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
CN110037758A (en) * | 2019-05-15 | 2019-07-23 | 成都五义医疗器械有限公司 | A kind of installation pedestal and elongated shaft assembly |
US11123146B2 (en) | 2019-05-30 | 2021-09-21 | Titan Medical Inc. | Surgical instrument apparatus, actuator, and drive |
US11382708B2 (en) | 2019-05-30 | 2022-07-12 | Titan Medical Inc. | Surgical instrument apparatus, actuator, and drive |
US11653989B2 (en) | 2019-05-30 | 2023-05-23 | Titan Medical Inc. | Surgical instrument apparatus, actuator, and drive |
US11896224B2 (en) | 2019-05-31 | 2024-02-13 | Intuitive Surgical Operations, Inc. | Staple cartridge for a surgical instrument |
US11744593B2 (en) | 2019-06-28 | 2023-09-05 | Cilag Gmbh International | Method for authenticating the compatibility of a staple cartridge with a surgical instrument |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11684369B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Method of using multiple RFID chips with a surgical assembly |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11786325B2 (en) | 2019-07-02 | 2023-10-17 | Intuitive Surgical Operations, Inc. | Remotely controlling a system using video |
US11877817B2 (en) * | 2019-07-16 | 2024-01-23 | Asensus Surgical Us, Inc. | Dynamic scaling for a robotic surgical system |
US20210000558A1 (en) * | 2019-07-16 | 2021-01-07 | Transenterix Surgical, Inc. | Dynamic scaling for a robotic surgical system |
US20210137624A1 (en) * | 2019-07-16 | 2021-05-13 | Transenterix Surgical, Inc. | Dynamic scaling of surgical manipulator motion based on surgeon stress parameters |
US11751959B2 (en) * | 2019-07-16 | 2023-09-12 | Asensus Surgical Us, Inc. | Dynamic scaling for a robotic surgical system |
US20230050243A1 (en) * | 2019-07-16 | 2023-02-16 | Asensus Surgical Us, Inc. | Dynamic scaling for a robotic sugical system |
US20220117688A1 (en) * | 2019-07-16 | 2022-04-21 | Asensus Surgical Us, Inc. | Dynamic scaling for a robotic surgical system |
US20220117687A1 (en) * | 2019-07-16 | 2022-04-21 | Asensus Surgical Us, Inc. | Dynamic scaling for a robotic surgical system |
JP2022535011A (en) * | 2019-07-29 | 2022-08-04 | ボストン サイエンティフィック サイムド,インコーポレイテッド | tissue clipping device |
AU2020321811B2 (en) * | 2019-07-29 | 2023-07-27 | Boston Scientific Scimed, Inc. | Tissue clipping device |
WO2021021397A1 (en) * | 2019-07-29 | 2021-02-04 | Boston Scientific Scimed, Inc. | Tissue clipping device |
US20210030425A1 (en) * | 2019-07-29 | 2021-02-04 | Boston Scientific Scimed, Inc. | Tissue clipping device |
CN113939237A (en) * | 2019-07-29 | 2022-01-14 | 波士顿科学国际有限公司 | Tissue clamping device |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
CN111388083A (en) * | 2020-03-26 | 2020-07-10 | 平阴县中医医院 | Multi-angle operation electric coagulation forceps for stomatology department |
ES2891180A1 (en) * | 2020-07-14 | 2022-01-26 | Univ Madrid Carlos Iii | Link for soft joint and soft joint comprising said link (Machine-translation by Google Translate, not legally binding) |
WO2022013469A1 (en) * | 2020-07-14 | 2022-01-20 | Universidad Carlos Iii De Madrid | Link for soft joint and soft joint comprising the link |
US11871925B2 (en) | 2020-07-28 | 2024-01-16 | Cilag Gmbh International | Surgical instruments with dual spherical articulation joint arrangements |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
USD1018577S1 (en) | 2020-11-11 | 2024-03-19 | Cilag Gmbh International | Display screen or portion thereof with a graphical user interface for a surgical instrument |
US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
US11931034B2 (en) | 2021-01-12 | 2024-03-19 | Cilag Gmbh International | Surgical stapling instruments with smart staple cartridges |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US20220304715A1 (en) * | 2021-03-24 | 2022-09-29 | Ethicon Llc | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11744603B2 (en) * | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US20220304714A1 (en) * | 2021-03-24 | 2022-09-29 | Ethicon Llc | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
US11918217B2 (en) | 2021-05-28 | 2024-03-05 | Cilag Gmbh International | Stapling instrument comprising a staple cartridge insertion stop |
EP4094705A3 (en) * | 2021-05-28 | 2023-02-22 | Endo Robotics Co., Ltd. | Tendon-sheath driving apparatus, surgical member driving apparatus, and method of operating the same |
US11723662B2 (en) | 2021-05-28 | 2023-08-15 | Cilag Gmbh International | Stapling instrument comprising an articulation control display |
US11903572B2 (en) | 2021-09-14 | 2024-02-20 | Nuvasive, Inc. | Surgical instruments, systems, and methods with optical sensors |
US20230107005A1 (en) * | 2021-09-29 | 2023-04-06 | Cilag Gmbh International | Surgical systems with port devices for instrument control |
US11931028B2 (en) | 2022-02-03 | 2024-03-19 | Cilag Gmbh International | Surgical instrument with multiple program responses during a firing motion |
WO2023231804A1 (en) * | 2022-05-31 | 2023-12-07 | 四川省肿瘤医院 | Bending mechanism and surgical robotic arm using same |
CN115005993A (en) * | 2022-05-31 | 2022-09-06 | 四川省肿瘤医院 | Bending mechanism and surgical mechanical arm applying same |
WO2024007472A1 (en) * | 2022-07-04 | 2024-01-11 | 中国科学院自动化研究所 | Feeding system and feeding method for medical instrument having controllable flexible tail end |
US11931092B2 (en) | 2022-08-19 | 2024-03-19 | Intuitive Surgical Operations, Inc. | Teleoperated surgical system equipment with user interface |
US11931038B2 (en) | 2022-10-03 | 2024-03-19 | Cilag Gmbh International | Cartridge assemblies for surgical staplers |
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US20050216033A1 (en) | 2005-09-29 |
US7819884B2 (en) | 2010-10-26 |
US7744608B2 (en) | 2010-06-29 |
US7854738B2 (en) | 2010-12-21 |
US7608083B2 (en) | 2009-10-27 |
US20080177284A1 (en) | 2008-07-24 |
US20110144656A1 (en) | 2011-06-16 |
US20080177283A1 (en) | 2008-07-24 |
US20080177282A1 (en) | 2008-07-24 |
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