a2) United States Patent
`US 7,524,320 B2
`(0) Patent No.:
`Tierneyet al.
`*Apr. 28, 2009
`(45) Date of Patent:
`
`US007524320B2
`
`MECHANICAL ACTUATOR INTERFACE
`SYSTEM FOR ROBOTIC SURGICAL TOOLS
`
`(56)
`
`(54)
`
`(75)
`
`Inventors: Michael J. Tierney, Pleasanton, CA
`(US); Thomas G. Cooper, Menlo Park,
`CA (US); Chris A. Julian, Los Gatos,
`CA (US); Stephen J. Blumenkranz,
`Redwood City, CA (US); GaryS.
`Guthart, Foster City, CA (US); Robert
`G.Younge, Portola Valley, CA (US)
`
`References Cited
`U.S. PATENT DOCUMENTS
`
`4,038,987 A
`
`8/1977 Komiya
`
`(Continued)
`FOREIGN PATENT DOCUMENTS
`
`JP
`
`7-194610
`
`8/1995
`
`(73)
`
`Assignee:
`
`Intuitive Surgical, Inc., Sunnyvale, CA
`(US)
`
`(Continued)
`OTHER PUBLICATIONS
`
`Notice:
`
`Subject to any disclaimer, the term ofthis
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 1036 days.
`
`Alexander, Arthur D., III., “Impacts of Telemanipulation on Modern
`Society,” International Centrefor Mechanical Sciences, Courses and
`Lectures No. 201, vol. II, pp. 122-136 (Sep. 5-8, 1973).
`
`This patent is subject to a terminal dis-
`claimer.
`
`(21)
`
`Appl. No.: 10/316,666
`
`(22)
`
`Filed:
`
`Dec. 10, 2002
`
`(65)
`
`(60)
`
`(60)
`
`(51)
`
`(52)
`(58)
`
`Prior Publication Data
`
`US 2003/0083673 Al
`
`May 1, 2003
`
`Related U.S. Application Data
`
`Continuation of application No. 09/929,453, filed on
`Aug. 13, 2001, now Pat. No. 7,048,745, which is a
`division of application No. 09/418,726, filed on Oct.
`15, 1999, now Pat. No. 6,331,181.
`
`Provisional application No. 60/111,713, filed on Dec.
`8, 1998.
`Int. Cl.
`
`(2006.01)
`AGIB 19/00
`US. C1.
`cic ecceccceceeseceeceseeeneseesenaeens 606/130; 606/1
`Field of Classification Search ..................... 606/1,
`606/130; 700/259, 260, 263
`See application file for complete search history.
`
`(Continued)
`
`Primary Examiner—Eduardo C Robert
`Assistant Examiner—James L Swiger, III
`
`(57)
`
`ABSTRACT
`
`Robotic surgical tools, systems, and methods for preparing
`for and performing robotic surgery include a memory
`mounted on the tool. The memory can perform a number of
`functions when the tool is loaded on the tool manipulator:
`first, the memory can provide a signal verifying that the tool
`is compatible with that particular robotic system. Secondly,
`the tool memory mayidentify the tool-type to the robotic
`system so that the robotic system can reconfigure its program-
`ming. Thirdly, the memory of the tool may indicate tool-
`specific information, including measuredcalibration offsets
`indicating misalignment of the tool drive system, tool life
`data, or the like. This information maybe stored in a read only
`memory (ROM), or in a nonvolatile memory which can be
`written to only a single time. The invention further provides
`improved engagementstructures for coupling robotic surgi-
`cal tools with manipulatorstructures.
`
`31 Claims, 22 Drawing Sheets
`
`
`
`1
`
`Exhibit 1027
`Intuitive v. Ethicon
`IPR2018-01247
`
`Exhibit 1027
`Intuitive v. Ethicon
`IPR2018-01247
`
`1
`
`

`

`US 7,524,320 B2
`
`Page 2
`
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`FOREIGN PATENT DOCUMENTS
`
`* cited by examiner
`
`2
`
`

`

`U.S. Patent
`
`Apr.28, 2009
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`Sheet 1 of 22
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`US 7,524,320 B2
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`150
`
`
`
`3
`
`

`

`
`
`4
`
`

`

`U.S. Patent
`
`US 7,524,320 B2
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`
`
`FIG. 2A.
`
`5
`
`

`

`U.S. Patent
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`Apr.28, 2009
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`Sheet 4 of 22
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`US 7,524,320 B2
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`
`
`
`6
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`

`

`U.S. Patent
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`Apr. 28, 2009
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`Sheet 5 of 22
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`US 7,524,320 B2
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`
`
`FIG. 3.
`
`7
`
`

`

`U.S. Patent
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`Apr.28, 2009
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`Sheet 6 of 22
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`US 7,524,320 B2
`
`l
`
` oo fs
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`= & KKe
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`OBES
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`
`

`

`U.S. Patent
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`Apr. 28, 2009
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`Sheet 7 of 22
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`US 7,524,320 B2
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`
`
`9
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`

`

`U.S. Patent
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`Apr.28, 2009
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`Sheet 8 of 22
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`US 7,524,320 B2
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`FIG.48.
`
`10
`
`

`

`U.S. Patent
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`Apr.28, 2009
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`Sheet 9 of 22
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`US 7,524,320 B2
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`
`
`11
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`

`

`U.S. Patent
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`Apr. 28, 2009
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`Sheet 10 of 22
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`US 7,524,320 B2
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`FIG, 5C.
`
`12
`
`

`

`U.S. Patent
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`Apr. 28, 2009
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`Sheet 11 of 22
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`US 7,524,320 B2
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`
`
`13
`
`13
`
`

`

`U.S. Patent
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`Apr. 28, 2009
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`Sheet 12 of 22
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`US 7,524,320 B2
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` Cy),
`
`FIG. 7H.
`
`FIG. 71.
`
`14
`
`14
`
`

`

`U.S. Patent
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`Apr. 28, 2009
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`Sheet 13 of 22
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`US 7,524,320 B2
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`
`
`15
`
`15
`
`

`

`U.S. Patent
`
`Apr.28, 2009
`
`Sheet 14 of 22
`
`US 7,524,320 B2
`
`ELBOW PCE
`
`ED) E38 RD ET
`« Sigp
`
`| HALF BRIDGE]
`ser aes|ee
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`
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`
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`RET ESL|(WHT £42
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`
`(OPTIONAL)
`
`
`
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`
`TOOL CHANGE SWITCH
`
`SLAVE CLUTCHING SWITCH
`
`FIG. 8.
`
`16
`
`

`

`Apr. 28, 2009
`
`US 7,524,320 B2
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`Sheet 15 of 22
`
`U.S. Patent
`
`FIG. 8A.
`
`17
`
`

`

`Sheet 16 of 22
`
`US 7,524,320 B2
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`6Old
`
`_
`
`«sowie
`
`U.S. Patent
`
`Apr. 28
`
`’
`
`2009
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`
`18
`
`18
`
`
`

`

`U.S. Patent
`
`Apr. 28, 2009
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`Sheet 17 of 22
`
`US 7,524,320 B2
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`
`
`
`MIDDLEMAN (CTP)
`
`
`
`SUPERVISOR (UMC)
`EXECUTES
`
`
`CONTROLS LOGICAL
`
`
`
`INSTRUCTIONS FROM
`FLOW
`
`
`
`SUPERVISOR
`
`
`PROCEDURE
`
`MANAGEMENT/DATA
`HANDLER (MDC)
`
`
`
`
`KERNEL (CTP AND CEs)
`
`
`
`
`
`LOCAL TOOL
`
`
`DETECTION(RIA)
`
`
`FIG. 10.
`
`19
`
`

`

`U.S. Patent
`
`Apr. 28, 2009
`
`Sheet 18 of 22
`
`US 7,524,320 B2
`
`SEQUENCE FLOW
`
`DETAILED SEQUENCE
`BLOCKS
`
`“
`
`147
`
`
`
`REED
`SWITCH
`OPEN
`
`-SIGNIFIES MESSAGESENT (0)
`HARDWARESTATE Ev
`
`TO INDICATE CHANGE IN
`
`CHECK
`FOR
`TOOL
`
`
`
`TOOL DALLAS
`
`TOOL DALLAS
`
`PRESET” foo)PRESENT“
`
`FIG. 11.
`
`20
`
`20
`
`

`

`U.S. Patent
`
`Apr. 28, 2009
`
`Sheet 19 of 22
`
`US 7,524,320 B2
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`POWER ON
`
`
`
`
`INITIALIZATION
`
`TOOL IS
`
`
`BEING INSERTED
`(S4)
`
`
`
`TOOL IS
`Initialization
`OUT(S2)
`complete
`
`
`
`
`
`
`
`Sadapter Dchip
`
`111
`
`
`D = Dallas chip ( 1 = present, 0 = notpresent)
`E = End ofuse indicator (0 = Open, 1 = Shorted)
`R = Reed Switch ( 0= open, 1 = shorted)
`
`Events occur in DER order
`
`e.g. 101 means Dallas chip present, End of use
`indicator is open, Reed switch is closed)
`
`A= 110, 100, 010, 110, 101, 111
`B=011, 101, 001
`C = 001, 010, 011, 100, 101, 110, 111
`
`
`Logging occursif the situation
`
`persists for more than 1 second
`
`12.
`
`21
`
`21
`
`

`

`Sheet 20 of 22
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`US 7,524,320 B2
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`TOOL
`CHANGE
`
`ENGAGE
`SA‘
`
`ENGAGE
`SA2
`
`U.S. Patent Apr. 28, 2009
`
`CHANGE
`DONE
`
`ENGAGE
`SA3
`
`22
`
`22
`
`

`

`U.S. Patent
`
`Apr.28, 2009
`
`Sheet 21 of 22
`
`US 7,524,320 B2
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`FIG.
`
`/4C.
`
`23
`
`23
`
`

`

`U.S. Patent
`
`Apr.28, 2009
`
`Sheet 22 of 22
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`US 7,524,320 B2
`
`166 ALGORITHM
`
`164
`
`TOOL PRODUCTION
`
`TOOL COMPATIBILITY VERIFICATION
`
`166
`
`ALGORITHM
`
`TOOL
`
`PROCESSOR
`
`FIG. 15.
`
`24
`
`24
`
`

`

`US 7,524,320 B2
`
`1
`MECHANICAL ACTUATOR INTERFACE
`SYSTEM FOR ROBOTIC SURGICAL TOOLS
`
`CROSS-REFERENCES TO RELATED
`APPLICATIONS
`
`The present application is a continuation of U.S. patent
`application Ser. No. 09/929,453 filed on Aug. 13, 2001, and is
`a divisional application of U.S. patent application Ser. No.
`09/759,542 filed Jan. 12, 2001, now U.S. Pat. No. 6,491,701,
`whichis a continuation application of U.S. patent application
`Ser. No. 09/418,726 filed Dec. 6, 1999, and in turn also claims
`priority to U.S. Provisional Patent Application No. 60/111,
`713 filed on Dec. 8, 1998; U.S. patent application Ser. No.
`09/398,958 filed Sep. 17, 1999, now U.S. Pat. No. 6,394,998;
`and U.S. Provisional Patent Application No. 60/116,844 filed
`on Jan. 2, 1999, entitled “Surgical Tools For Use In Mini-
`mally Invasive Telesurgical Applications”. The entirety ofthe
`above-referenced applications is herein incorporated by ref-
`erence.
`
`This application also incorporates by references the fol-
`lowing U.S. Design patent application Ser. Nos. 29/097,544
`filed on Dec. 8, 1998, entitled “Portion OfAn Interface For A
`Medical Instrument”; 29/097,552 filed on Dec. 8, 1998,
`entitled “Interface For A Medical Instrument”; 29/097,550
`filed on Dec. 8, 1998, entitled “Portion OfAn Adaptor For A
`Medical Instrument”; and 29/097,551 filed on Dec. 8, 1998,
`entitled “Adaptor For A Medical Instrument”.
`
`BACKGROUND OF THE INVENTION
`
`This invention relates to robotically assisted surgery, and
`more particularly provides surgical tools having improved
`mechanical and/or data interface capabilities to enhance the
`safety, accuracy, and speed of minimally invasive and other
`robotically enhanced surgical procedures.
`In robotically assisted surgery, the surgeon typically oper-
`ates a master controller to remotely control the motion of
`surgical instruments at the surgical site. The controller may be
`separated from the patient by a significant distance (e.g.,
`across the operating room, in a different room, or in a com-
`pletely different building than the patient). Alternatively, a
`controller may be positioned quite near the patient in the
`operating room. Regardless,
`the controller will typically
`include one or more hand input devices (such as joysticks,
`exoskeletol gloves, master manipulators, or the like) which
`are coupled by a servo mechanism to the surgical instrument.
`More specifically, servo motors move a manipulator or
`“slave” supporting the surgical instrument based on the sur-
`geon’s manipulation of the hand input devices. During an
`operation, the surgeon may employ, via the robotic surgery
`system,a variety of surgical instruments such astissue grasp-
`ers, needle drivers, electrosurgical cautery probes, etc. Each
`of these structures performs functions for the surgeon, for
`example, holding or driving a needle, grasping a blood vessel,
`or dissecting, cauterizing, or coagulating tissue.
`This new method of performing robotic surgery has, of
`course, created many new challenges. One such challengeis
`that a surgeon will typically employ a significant number of
`different surgical instruments during each surgical procedure.
`The numberof independent surgical manipulators will often
`be limited due to space constraints and cost. Additionally,
`patient trauma can generally be reduced by eliminating the
`numberoftools used at any given time. More specifically, in
`minimally invasive procedures, the numberofentry ports into
`a patient is generally limited because of space constraints, as
`well as a desire to avoid unnecessary incisions in the patient.
`
`2
`Hence, a numberof different surgical instruments will typi-
`cally be introduced through the sametrocar sleeve into the
`abdomen during,
`for example,
`laparoscopic procedures.
`Likewise, in open surgery, there is typically not enough room
`adjacentthe surgical site to position more than a few surgical
`manipulators, particularly where each manipulator/tool com-
`bination hasa relatively large range of motion. Asa result, a
`numberof surgical instruments will often be attached and
`detached from a single instrument holder of a manipulator
`during an operation.
`Published PCT application WO98/25666, filed on Dec. 10,
`1997 and assignedto the present assignee(thefull disclosure
`of which is incorporated herein by reference) describes a
`Multicomponent Telepresence System and Method which
`significantly improves the safety and speed with which
`robotic surgical tools can be removed and replaced during a
`surgical procedure. While this represents a significant
`advancementoftheart, as is often true, still further improve-
`ments would be desirable. In particular, each tool change
`which occurs during a surgical procedure increases the over-
`all surgery time. While still further improvements in the
`mechanical tool/manipulatorinterface may help reduce a por-
`tion of this tool change time, work in connection with the
`present invention has shownthat the mechanical removal and
`replacementof the tool may represent only oneportion ofthe
`total interruption for a tool change. U.S. Pat. No. 5,400,267
`describes a memory feature for electrically powered medical
`equipment, andis also incorporated herein by reference.
`As more and moredifferent surgical tools are provided for
`use with a robotic system, the differences between the tool
`structures (and the interaction between the tool and the other
`components of the robotic system) become more pro-
`nounced. Manyofthese surgical tools will have one or more
`degrees of motion between the surgical end effectors and the
`proximalinterface which engagesthe tool to the holder ofthe
`manipulator. The desired and/or practicable ranges ofmotion
`for an electrosurgical scalpel may be significantly different
`than those of a clip applier, for example. Work in connection
`with the present invention has foundthat even after a tool is
`properly placed on the surgical manipulator,
`the time
`involved in reconfiguring the robotic system to take advan-
`tage of a different tool, and to perfect the master controller’s
`effective control over the degrees of motion of the tool, may
`add significantly to the total tool change delay.
`In light of the above, it would be desirable to provide
`improved robotic surgery tools, systems, and method. It
`would further be desirable to provide techniques for reducing
`the total delay associated with each tool change. It would be
`especially desirable if these enhanced, and often morerapid,
`robotic tool change techniques resulted in still
`further
`improvementin the safety andreliability of these promising
`surgical systems.
`
`BRIEF SUMMARY OF THE INVENTION
`
`The presentinvention generally provides improvedrobotic
`surgical devices, systems, and methodsfor preparing for and
`performing robotic surgery. The robotic tools of the present
`invention will often make use of a memory structure mounted
`ona tool, manipulator arm, or movable support structure. The
`memory can, for example, perform a number of important
`functions whena tool is loaded on the tool manipulator:first,
`the memory can provide a signal verifying that the tool is
`compatible with that particular robotic system. Secondly, the
`tool memory mayidentify the tool-type (whetherit is a scal-
`pel, needle grasper, jaws, scissors, clip applier, electrocautery
`blade, or the like) to the robotic system so that the robotic
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`US 7,524,320 B2
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`system can reconfigure its programming to take full advan-
`tage ofthe tools’ specialized capabilities. This tool-type data
`may simply be an identification signal referencing further
`data in a look-uptable ofthe robotic system. Alternatively, the
`tool-type signal provided by the tool may define the tool
`characteristics in sufficient detail to allow reconfiguration of
`the robotic programming without havingto resort to an exter-
`nal table. Thirdly, the memory ofthe tool may indicate tool-
`specific information, including (for example) measuredcali-
`bration offsets indicating misalignment between the tool
`drive system andthe tool end effector elements, toollife data
`(such as the numberof times the tool has been loaded onto a
`surgical system,
`the number of surgical procedures per-
`formed with the tool, and/or the total time the tools has been
`used), or the like. The information may be stored in some
`form of non-volatile memory such as one-time program-
`mable EPROM,Flash EPROM, EEPROM,battery-backed-
`up SRAM,or similar memory technology where data can be
`updated and retained in either a serial or random access
`method,or with any of a wide variety ofalternative hardware,
`firmware, or software. The invention further provides
`improved engagementstructures for coupling robotic surgi-
`cal tools with manipulatorstructures.
`In a first aspect, the invention provides a robotic surgical
`tool for use in a robotic surgical system. The robotic surgical
`system has a processor which directs movement of a tool
`holder. The tool comprises a probe having a proximal end and
`a distal end. A surgical end effector is disposed adjacent the
`distal end ofthe probe. An interface is disposed adjacentto the
`proximal end of the probe. The interface can be releasably
`coupled with the tool holder. Circuitry is mounted on the
`probe. The circuitry defines a signal for transmitting to the
`processorso as to indicate compatibility of the tool with the
`system.
`Thetool will often comprise a surgical instrument suitable
`for manipulating tissue, an endoscopeor other image capture
`device, or the like. Preferably, the signal will comprise unique
`tool identifier data. The processor of the robotic surgical
`system may include programming to manipulate the tool
`identifier according to a pre-determined function or algorithm
`so as to derive verification data. The signal transmitted to the
`processor will often includethe verification data. Alternative
`compatibility signals may include a signal which 1s listed in a
`table accessible to the processor, an arbitrary compatibility
`data string, or the like.
`In anotheraspect, the invention provides a robotic surgical
`component for use in a robotic surgical system having a
`processor and a componentholder. The component comprises
`a componentbody having an interface mountable to the com-
`ponentholder. The body supports a surgical end effector, and
`a drive system is coupled to the body for moving the end
`effector per commands from the processor. Circuitry is
`mounted on the body and defines a signal for transmitting to
`the processor. The signal may indicate compatibility of the
`componentwith the system, may define a componenttype of
`the component, may indicate coupling of the component to
`the system, and/or mayindicate calibration ofthe component.
`Typically, the component will comprise a surgical tool, a
`manipulator arm, a pre-positioning linkage supporting the
`manipulator arm,or the like.
`In another aspect, the invention provides a method for
`installing a robotic surgical componentin a robotic surgical
`system. The method comprises mounting the componentto a
`componentholder. A signal is transmitted from the compo-
`nent to a processorof the robotic surgical system. The com-
`ponentis articulated in responseto the signal per commands
`ofthe processor.
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`In many embodiments, compatibility of the component
`with the robotic surgical system will be verified using the
`signal transmitted from the componentto the processor. This
`can be accomplished by providing unique identification data
`on the component, and deriving verification data from the
`identification data according to an algorithm. The verification
`data is stored with a memory of the component, the signal
`transmitted to the processor including both the identification
`and verification data. The algorithm may then be performed
`on the transmitted unique identification data with the proces-
`sor, and the results compared with the verification data.
`Advantageously, this method can take advantage of unique
`identification data which is often unalterably stored in a
`memory of commercially available integrated circuits.
`In another aspect, the invention provides a robotic surgical
`tool for use in robotic surgical systems having a processor.
`The tool comprises a shaft having a proximal end and a distal
`end. A surgical endeffectoris disposed adjacent the distal end
`of the shaft. The end effector has a plurality of degrees of
`motion relative to the proximal end. An interface is disposed
`adjacent the proximal end ofthe shaft. The interface can be
`releasably coupled with a robotic probe holder. The interface
`comprises a plurality of driven elements. A plurality of tool
`drive systems couple the driven elements to the degrees of
`motion of the end effector. The tool drive system has calibra-
`tion offsets between a nominalrelative position of the end
`effector and the driven elements, and a measuredrelative
`position of the end effector and driven elements. A memory
`stores data indicating the offsets. The memory is coupled to
`the interface so as to transmit the offsets to the processor.
`In yet another aspect, the invention provides a robotic
`surgical system comprising a plurality of tools of different
`tool-types. Each tool comprises an elongate shaft with a
`cross-section suitable for introduction into an internal surgi-
`cal site within a patient body via a minimally invasive open-
`ing. A distal surgical end effector is coupled to the shaft by at
`least one joint. The joint is drivingly coupled to a proximal
`interface by a tool drive system. Circuitry ofthe tool transmits
`a tool-type via the interface. The tool types may optionally
`differ in at least one characteristic such as joint geometry, end
`effector geometry, drive system characteristics, end effector
`or drive system strength,or the like. The system also includes
`a robotic manipulator including a linkage supporting a tool
`holder. The tool holder releasably receives the interface. A
`manipulator drive motor drivingly engages the linkage so as
`to movethe tool holderrelative to the opening and position
`the shaft within the surgicalsite. A tool drive motoris coupled
`to the tool holder so as to drivingly engage the tool drive
`system andarticulate the joint. A processor is coupled to the
`tool holder. The processor has programming that effects a
`desired movementof the end effector by transmitting drive
`signals to the tool drive motors of the manipulator. The pro-
`cessor reconfigures the program for the different joint geom-
`etries based on the tool-type signals.
`In another aspect, the invention provides a robotic surgical
`system comprising a surgicaltool having a surgical end effec-
`tor and an interface. A manipulator assembly has a base and a
`tool holder for releasably engaging the interface. A plurality
`of tool engagement sensors are coupled to the tool holder.
`Each tool sensor producesa signal whenthe interface engages
`the holder. A processor is coupled to the tool engagement
`sensors. The processor has a tool change mode and a tissue
`manipulation mode. The processor requires tool signals from
`each of the sensors before changing the tool change modeto
`the tissue manipulation mode. The processor remains in the
`tissue manipulation mode whenatleastone, but notall, ofthe
`tool signals is lost.
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`US 7,524,320 B2
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`6
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`FIGS. 7J through L illustrate the holder, its driving ele-
`The tools used in robotic surgery will be subjected to
`ments, andits electrical contacts.
`significantstructural stress during use. The stress may result
`FIG.8 is a wiring diagram for the tool of FIG.4, the adapter
`in temporary loss of an engagement signal from an engage-
`of FIG. 7A-E, and related componentsofthe robotic system.
`ment sensor. By providing at least two, and preferably three
`FIGS. 8A andBare rear and front views of the master
`engagement sensors, the surgical procedure can continue
`safely with the loss of an engagement signal from an indi-
`vidual sensor so long as the system canstill verify proper
`engagement between the manipulator andtool. This arrange-
`mentresults in a robust tool engagement sensing system that
`avoids frequent delays during the surgical procedure as might
`occur from the loss of an individual signal.
`In yet another aspect, the invention provides a robotic
`surgical system comprising a manipulator assembly having a
`base and tool holder which movesrelative to the base. The
`
`console, respectively.
`FIG. 9 is a functional block diagram schematically illus-
`trating the signal path hardware of the tool change system.
`FIG. 10 is a schematic diagram illustrating the interaction
`between the software modules related to tool change.
`FIG. 11 is a logic flow chart illustrating an exemplary
`method for sensing engagementof a tool with the manipula-
`tor.
`
`FIG.12is a flow diagram illustrating how the tool engage-
`ment signals are used to change the operating state of the
`robotic system.
`FIG.13 illustrates the tool engagement methodsteps ini-
`tiated by the processor in response to a change in operating
`state during tool changes.
`FIGS. 14A through C illustrate mounting of the adapter of
`FIGS. 7A through E to a manipulator arm, and of mounting
`the tool of FIG. 4 onto the adapter.
`FIG. 15 schematically illustrates an exemplary tool com-
`patibility verification algorithm accordingto the principles of
`the present invention.
`
`DETAILED DESCRIPTION OF THE INVENTION
`
`tool holder has a plurality of drive elements. A sterile drape
`coversat least a portion of the manipulator. A sterile tool has
`a proximalinterface and distal end effector. The distal end
`effector has a plurality of degrees of motion relative to the
`proximal interface. The degrees of motion are coupled to
`drive elements of the interface. An adapter is disposed adja-
`cent the sterile drape between the holder and the interface.
`The adapter comprises a plurality of movable bodies. Each
`movable bodyhasa first surface driven by the drive elements
`of the holder, and a second surface driving the driven ele-
`ments ofthe tool.
`In yet another aspect, the invention provides a robotic
`surgical tool for use with a robotic manipulator having a tool
`holder. The tool holder has magnetically actuatable circuitry.
`The present invention provides robotic surgery systems,
`The tool comprises a probe having a proximal end andadistal
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`devices, and methods. Robotic surgery will generally involve
`end. A surgical endeffector is disposed adjacentthe distal end
`the use of multiple robotic arms. One or more of the robotic
`of the probe. An interface adjacent the proximal end of the
`arms will often support a surgical tool which maybearticu-
`probeis releasably coupleable with the holder. The interface
`lated (such as jaws, scissors, graspers, needle holders, micro-
`comprises a magnetpositionedso asto actuate the circuitry of
`the holder.
`dissectors, staple appliers, tackers, suction/irrigation tools,
`clip appliers, or the like) or non-articulated (such as cutting
`blades, cautery probes, irrigators, catheters, suction orifices,
`or the like). One or more ofthe robotic armswill often be used
`to support one or moresurgical image capture devices such as
`an endoscope (which may beany ofthe variety of structures
`such as a laparoscope,an arthroscope, a hysteroscope,or the
`like), or optionally, some other imaging modality (such as
`ultrasound, fluoroscopy, magnetic resonance imaging,or the
`like). Typically, the robotic arms will support at least two
`surgical tools correspondingto the two hands of a surgeon and
`one optical image capture device.
`The present invention will find application in a variety of
`surgical procedures. The most immediate applications will be
`to improve existing minimally invasive surgical procedures,
`such as coronary artery bypass grafting and mitral andaortic
`valve repair and/or replacement. The invention will also have
`applications for surgical procedures which are difficult to
`perform using existing minimally invasive techniques, such
`as Nissen Fundoplications. Additionally, it is anticipated that
`these surgical systems will find uses in entirely new surgeries
`that would be difficult and/or impossible to perform using
`traditionally open or known minimally invasive techniques.
`For example, by synchronizing the movements of the image
`capture device and/or surgical tools with a tissue undergoing
`physiological movement(such a beating heart), the moving
`tissue may be accurately manipulated and treated without
`halting the physiological movement. Additional potential
`applications include vascular surgery (suchasfor the repair of
`thoracic and abdominal aneurysms), general and digestive
`surgeries (such as cholecystectomy, inguinale hernia repair,
`colon resection, and the like), gynecology(for fertility pro-
`cedures, hysterectomies, and the like), and a wide variety of
`alternative procedures.
`
`FIG.2 is a perspective view of a robotic surgical arm cart
`system in which a series of passive set-up joints support
`robotically actuated manipulators (typically, the center arm
`would support a camera).
`FIG. 2A is a perspective view of a robotic surgical manipu-
`lator for use in the cart system of FIG.2.
`FIGS. 2B and C are side and front views, respectively, of
`the linkage ofthe robotic manipulator ofFIG. 2, showing how
`the manipulator maintains a remote centerof rotation along a
`shaft of the surgical tool.
`FIGS. 3 and 3A are perspective views of exemplary cart
`structures with positioning linkages which support
`the
`robotic manipulators in the system of FIG. 2.
`FIG.4 is a perspective view of an exemplary tool accordin