(12) United States Patent
`(10) Patent N0.:
`US 6,331,181 B1
`
`Tierney et al.
`(45) Date of Patent:
`Dec. 18, 2001
`
`USOO6331181B1
`
`(54) SURGICAL ROBOTIC TOOLS, DATA
`ARCHITECTURE, AND USE
`
`(75)
`
`,.
`'
`Inventors: Michael J. Tierney, Pleasanton;
`:fiflfifigggfi’s«$33531; Chm
`I
`’
`’
`.
`I
`Blumenkranz, Redwood City; Gary S.
`Quthart, Foster Clty; R0130“? G-
`Younge, Portola Valley, all of CA (US)
`
`4,996,975
`5,018,266
`5,078,140
`,
`,
`291:3)???
`5,174,300
`5,217,003
`5,221,283
`5,236,432
`5,255,429
`
`3/1991 Nakamura .
`5/1991 Hutchinson ct al. .
`1/1992 Kwoh .
`a sen.
`e a .
`131992 fiefnantm t
`1
`12/1992 Bales et al.
`.
`6/1993 Wilk.
`6/1993 Chang .
`8/1993 Matsen, 111 et al..
`10/1993 Nishi et a1.
`.
`
`.
`
`(73) Assignee:
`
`Intuitive Surgical, Inc., Mountain
`Vlew’ CA (Us)
`
`(List continued on next page.)
`FOREIGN PATENT DOCUMENTS
`
`( * ) Notice:
`
`Subject to any disclaimer, the term of this
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 0 days.
`
`(21) Appl. N0.: 09/418,726
`
`wo 93/13916
`WO 94/26167
`W0 95/16396
`wo 95/30964
`WO 96/39944
`
`7/1993 (wo) .
`11/1994 (W0) .
`6/1995 (W0) .
`11/1995 (wo) .
`12/1996 (W0) .
`
`(22)
`
`Filed‘
`.
`
`Oct. 15 1999
`’
`Related US. Application Data
`Provisional application No. 60/111,713, filed on Dec. 8,
`1998'
`Int. Cl.7 ..................................................... A61B 19/00
`(51)
`(52) US. Cl.
`606/130’ 600/429
`(58) Field of Searchiiiiiiiiiiiiiiiiiiiiiiiiiiiiii 606/130? 600/429
`""""""""""""""""
`’
`References Cited
`
`(60)
`
`(56)
`
`Primary Examiner—Gene Mancene
`Assistant Examiner—Michael B. Priddy
`('74) Attorney, Agent, or Firm—Townsend and 'l‘ownsend
`and Crew LLP
`(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 may identify the tool-type to the robotic
`system so that the robotic system can reconfigure its pro-
`gramming. Thirdly, the memory of the tool may indicate
`tool—specific information,
`including measured calibration
`offsets indicating misalignment of the tool drive system, tool
`life data, or the like. This information may be 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 engagement structures for coupling
`robotic surgical tools with manipulator structures.
`
`28 Claims, 22 Drawing Sheets
`
`U.S. PATENT DOCUMENTS
`8/1981 M'ller et al
`6/1982 Heiiley et al '
`12/1984 Tucker et a]: '.
`2/1985 Hennekes et al..
`4/1985 Hennekes et a1.
`.
`11/1987 Ferrero et al.
`.
`.
`12/1987 Zimmer 6t 81.
`12/1988 Zuccaro et ‘11-~
`2/1989 C1101]: “t al'
`'
`4132: {:1ng ’
`7/1990 Hoover.
`12/1990 Matsen, III et al.
`
`.
`
`4 281447
`4:332:066
`4:486:928
`4,500,065
`4,512,709
`4,706,372
`4,710,093
`477937053
`18,09?”
`$23318:
`4:943:939
`4,979,949
`
`50‘
`
`
`
`
`
`IS 1009
`
`1
`
`IS 1009
`
`

`

`US 6,331,181 B1
`Page 2
`
`US. PATENT DOCUMENTS
`
`5,257,998
`5,271,384
`5,294,209
`5,305,203
`5,312,212
`5,313,935
`5,343,385
`5,354,314
`5,355,743
`5,359,993
`5,372,147
`5,397,323
`5,399,951
`
`11/1993
`12/1993
`3/1994
`4/1994
`5/1994
`5/1994
`8/1994
`10/1994
`10/1994
`11/1994
`12/1994
`3/1995
`3/1995
`
`.
`
`.
`Ota et a].
`McEwen et al.
`Naka et al.
`.
`Raab .
`Naumec .
`Kortenbach et al.
`Joskowicz et al.
`.
`Hardy et al. .
`Tesar .
`.
`Slater et al.
`Lathrop, Jr. et al.
`Taylor .
`Lavallee et al.
`
`.
`
`.
`
`.
`
`5,400,267
`5,402,801
`5,403,319
`5,417,210
`5,427,097
`5,451,368
`5,649,956 ~
`5,697,939
`5,762,458
`5,792,135
`5,800,423
`6,132,368
`
`3/1995
`4/1995
`4/1995
`5/1995
`6/1995
`9/1995
`7/1997
`12/1997
`6/1998
`8/1998
`9/1998
`10/2000
`
`.................. 606/88
`
`Denen et al. .
`Taylor .
`Matsen, III et al.
`Funda et al. .
`Depp .
`Jacob .
`........................ 606/205
`Jensen el al.
`
`.
`. 606/130
`Kubota et al.
`............................. 414/1
`Wang et al.
`Madhani et al. .
`Jensen .
`Cooper ................................. 600/102
`
`* cited by examiner
`
`2
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 1 0f 22
`
`US 6,331,181 B1
`
`150
`
`/l0
`
`V l
`
`3
`
`

`

`
`
`4
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 3 0f 22
`
`US 6,331,181 B1
`
`
`
`FIG: 2A.
`
`5
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 4 0f 22
`
`US 6,331,181 B1
`
`
`
`
`6
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 5 0f 22
`
`US 6,331,181 B1
`
`
`
`FIG 3.
`
`7
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 6 0f 22
`
`US 6,331,181 B1
`
`
`
`
`
`8
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 7 0f 22
`
`US 6,331,181 B1
`
`
`
`9
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 8 0f 22
`
`US 6,331,181 B1
`
`FIG:
`
`45.
`
`10
`
`10
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 9 0f 22
`
`US 6,331,181 B1
`
`
`
`11
`
`11
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 10 0f 22
`
`US 6,331,181 B1
`
`
`
`12
`
`12
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 11 0122
`
`US 6,331,181 B1
`
`
`
`A-A
`FIG. 70.
`
`A
`F[63 7E.
`
`13
`
`13
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 12 0f 22
`
`US 6,331,181 B1
`
`
`
`
`
`
`
`
`
`14
`
`14
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 13 0f 22
`
`US 6,331,181 B1
`
`
`
`15
`
`15
`
`

`

`US. Patent
`
`Dec. 18,2001
`
`Sheet 14 0f 22
`
`US 6,331,181 B1
`
`ELBOW PCE
`+SIG> @186 R-EDE37 +
`-51G)BLKE38 _ HALF BRIDGE
`RH) WISE-MEL]
`SHlELD>
`
`.1111
`
`FORCE SENSOR #l
`
`BLU E40
`RED E33
`+Sm>
`m) ”—1!-EL E4I
`RET> =--w111111E42
`“'2
`
`
`
`HALF BRIDGE]
`
`
`
`CARRIAGE PCB
`
`SR1ELD
`
`FORCE SENSOR 1E2
`REED/m
`DALLAS
`1113E21|42 124
`“”0“
`WL_§2.1 A ;.
`ENE” Inn-1%”"
`-2“B _
`1111-1,I! -
`4A 43.
`DAM
`DALLAS CHIP
`SHIELD>
`m,“ 33
`TOOL mm -mem1:m-
`.5A 53
`(STERILE ADAPTOR)
`
`> Duml=mm1MI1ze
`—
`
`
`
`6"“
`'flII-Ell'fil- STEREEADAPT-
`SHIELD>
`0R PINS
`.10
`
`I
`-E29
`GND
`
`(TOOL)
`
`LOOP BACK
`
`”8/(OPTIONAL)
`
`TOOLEXPIRED) ER 525
`TO0L_ EXPIRED)
`
`ROLLING LOOP
`
`DALLAS CHIP
`
`RED
`TOOL-CHAN-5111 >
`
`[El—2:7
`TOOL-GHAILGNDSENSE)
`TOOL-ORANGES111>RED [Elma-3
`GND>BLKEHELI- 17’
`
`E43
`
`TOOL CHANGE SWITCH
`
`E47
`SLAVE_CLUTCH 51MED
`END MEET-J
`SLAVE GLUTGHINB SWITCH
`
`FIG 8.
`
`16
`
`16
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 15 0f 22
`
`US 6,331,181 B1
`
`
`
`FIG? 8A.
`
`17
`
`17
`
`

`

`US. Patent
`
`0
`
`m
`
`US 6,331,181 B1
`
`1529%.
`
`m05v35%2.33zw<._._<n_z.1055
`409<m.8%AIfix
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`
`18
`
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`
`18
`
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 17 0f 22
`
`US 6,331,181 B1
`
`
`
`
`
`
`
`
`hMDDLEMAN(CTP)
`SUPERVISOR (UMC)
`
`EXECUTES
`
`CONTROLS LOGICAL
`
`INSTRUCTIONS FROM
`
`
`FLOW
`SUPERVBOR
`
`
`
`
`
`PROCEDURE
` KERNEL (CTP AND CES)
`MANAGEMENWDATA
`
`
`
`HANDLER(MDC)
`
`
`
`
`
`LOCALTOOL
`
`
`DETECWON(WA)
`
`
`FIG. 10.
`
`19
`
`19
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 18 0f 22
`
`US 6,331,181 B1
`
`SEQUENCE FLOW
`
`DETAILED SEQUENCE
`BLOCKS
`
`
`
`REED
`
`REED
`
`147
`
`SWITCH
`LOSED*
`
`
`
`SWITCH
`OPEN
`
`NO SA
`
`PRESENT*
`
`TO INDICATE CHANGE IN
`
`CHECK
`
`FOR
`TOOL
`
`TOOL DALLAS
`
`OT PRESENT*
`
`* — SIGNIFIES MESSAGE SENT @
`HARDWARE STATE a
`
`
`
`
`
`TOOL DALLAS
`
`TOOL DALLAS
`
`PRESET* @NOTPRESENT*
`
`FIG. 11.
`
`20
`
`20
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 19 0f 22
`
`US 6,331,181 B1
`
`POWER ON
`
`INITIALIZATION
`
` TOOL IS
`BEING INSERTED
`
`
`(S4)
`
`
`
`
` Initialization
`
`complete
`
`
` TOOL IS
`OUT (32)
`
` Sterile ad ter engaged
`
`
`
` Sadapter D chip
`
`ADAPTER
`
`
`
`
`OFF (31)
`
`111
`
`D = Dallas chip ( 1 = present, 0 = not present)
`E = End of use indicator (0 = Open, 1 = Shorted)
`R = Reed Switch ( 0: open, 1 = shorted)
`
`
`
`
`
`
`Events occur in DER order
`
`9.9. 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
`FIG. 12.
`
`21
`
`Logging occurs if the situation
`persists for more than 1 second
`
`
`
`
`s
`
`STERILE
`
`off > 500
`
`21
`
`

`

`[LS.IEn£nt
`
`Ikc1&2mn
`
`Shwtfl)M22
`
`'US633L181B1
`
`
`
`TOOL
`I
`/ CHANGE
`A
`
`PA\1
`
`CHANGE
`D
`
`ENGAGE
`
`8A1
`
`II IDLE i/
`
`
`
` TOOL
`TOOL
`CHANGE
`
`
`
`B
`
`
`
`
`
`
`
`
`
`
`
`ENGAGE
`
`TOOL1
`
`ENGAGE
`
`TOOLZ
`
`ENGAGE
`TOOL3
`
`PD
`
`
`
`ENGAGE
`
`TOOL 4
`
`O.
`
`CHANGE
`
`DONE
`
`
`CAM
`
`
`CHANGE
`
`
`FOLLOW
`
`DONE
`CHK1
`
`
`
`
`
`TOOL
`FOLLOW
`
`CHK2
`
`TOOL
`
`
`
`22
`
`22
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 21 0f 22
`
`US 6,331,181 B1
`
`
`
`FIGS I461
`
`23
`
`23
`
`

`

`US. Patent
`
`Dec. 18, 2001
`
`Sheet 22 0f 22
`
`US 6,331,181 B1
`
`166
`
`ALGORITHM
`
`162
`
`
`
`164
`
`TOOL PRODUCTION
`
`TOOL COMPATIBILITY VERIFICATION
`
`166
`
`ALGORITHM
`
`TOOL
`
`PROCESSOR
`
`FIG. 15.
`
`24
`
`24
`
`

`

`US 6,331,181 B1
`
`1
`SURGICAL ROBOTIC TOOLS, DATA
`ARCHITECTURE, AND USE
`CROSS—REFERENCES TO RELATED
`APPLICATIONS
`
`This application claims priority to US Provisional Patent
`Appl. No. 60/111,713 filed on Dec. 8, 1998, the entirety of
`which is herein incorporated by reference.
`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
`completely 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 manipu-
`lator or “slave” supporting the surgical instrument based on
`the surgeon’s manipulation of the hand input devices. Dur—
`ing an operation, the surgeon may employ, Via the robotic
`surgery system, a variety of surgical instruments such as
`tissue graspers, 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 coagu-
`lating tissue.
`This new method of performing robotic surgery has, of
`course, created many new challenges. One such challenge is
`that a surgeon will typically employ a significant number of
`dilferent surgical instruments during each surgical proce-
`dure. The number of independent surgical manipulators will
`often be limited due to space constraints and cost.
`Additionally, patient trauma can generally be reduced by
`eliminating the number of tools used at any given time.
`More specifically, in minimally invasive procedures,
`the
`number of entry ports into a patient is generally limited
`because of space constraints, as well as a desire to avoid
`unnecessary incisions in the patient. Hence, a number of
`dilferent surgical instruments will typically be introduced
`through the same trocar sleeve into the abdomen during, for
`example,
`laparoscopic procedures. Likewise,
`in open
`surgery,
`there is typically not enough room adjacent
`the
`surgical site to position more than a few surgical
`manipulators, particularly where each manipulator/tool
`combination has a relatively large range of motion. As a
`result, a number of 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 assigned to the present assignee (the full
`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 advancement of the art, as is often true, still
`
`10
`
`15
`
`30
`
`35
`
`40
`
`45
`
`50
`
`55
`
`60
`
`65
`
`2
`further improvements would be desirable. In particular, each
`tool change which occurs during a surgical procedure
`increases the overall surgery time. While still further
`improvements in the mechanical tool/manipulator interface
`may help reduce a portion of this tool change time, work in
`connection with the present invention has shown that the
`mechanical removal and replacement of the tool may rep-
`resent only one portion of the total interruption for a tool
`change. US. Pat. No. 5,400,267 describes a memory feature
`for electrically powered medical equipment, and is also
`incorporated herein by reference.
`As more and more different 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. Many of these surgical tools will have one or more
`degrees of motion between the surgical end effectors and the
`proximal interface which engages the tool to the holder of
`the manipulator. The desired and/or practicable ranges of
`motion for an electrosurgical scalpel may be significantly
`different than those of a clip applier, for example. W'ork in
`connection with the present invention has found that even
`after a tool is properly placed on the surgical manipulator,
`the time involved in reconfiguring the robotic system to take
`advantage of a dilferent 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 reduc-
`ing the total delay associated with each tool change. It would
`be especially desirable if these enhanced, and often more
`rapid, robotic tool change techniques resulted in still further
`improvement in the safety and reliability of these promising
`surgical systems.
`SUMMARY OF THE INVENTION
`
`invention generally provides improved
`The present
`robotic surgical devices, systems, and methods for preparing
`for and performing robotic surgery. The robotic tools of the
`present invention will often make use of a memory structure
`mounted on a tool, manipulator arm, or movable support
`structure. The memory can, for example, perform a number
`of important functions when a tool is loaded on the tool
`manipulator: first, the memory can provide a signal verify-
`ing that the tool is compatible with that particular robotic
`system. Secondly, the tool memory may identify the tool-
`type (whether it is a scalpel, needle grasper, jaws, scissors,
`clip applier, electroeautery blade, or the like) to the robotic
`system so that the robotic system can reconfigure its pro-
`gramming to take full advantage of the tools’ specialized
`capabilities. This tool-type data may simply be an identifi-
`cation signal referencing further data in a look-up table of
`the robotic system. Alternatively, the tool—type signal pro—
`vided by the tool may define the tool characteristics in
`sufficient detail
`to allow reconfiguration of the robotic
`programming without having to resort to an external table.
`Thirdly, the memory of the tool may indicate tool-specific
`information, including (for example) measured calibration
`offsets indicating misalignment between the tool drive sys-
`tem and the tool end effector elements, tool life data (such
`as the number of 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-
`
`25
`
`25
`
`

`

`US 6,331,181 B1
`
`3
`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 of alternative
`hardware, firmware, or software. The invention further pro-
`vides improved engagement structures for coupling robotic
`surgical tools with manipulator structures.
`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. Asurgical end effector is disposed adjacent
`the distal end of the probe. An interface is disposed adjacent
`to 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 processor so as to indicate compatibility of the tool
`with the system.
`The tool will often comprise a surgical instrument suitable
`for manipulating tissue, an endoscope or other image cap-
`ture device, or the like. Preferably, the signal will comprise
`unique tool
`idcntificr data. The processor of the robotic
`surgical system may include programming to manipulate the
`tool
`identifier according to a predetermined function or
`algorithm so as to derive verification data. The signal
`transmitted to the processor will often include the verifica-
`tion data. Alternative compatibility signals may include a
`signal which is listed in a table accessible to the processor,
`an arbitrary compatibility data string, or the like.
`In another aspect, the invention provides a robotic surgi-
`cal component for use in a robotic surgical system having a
`processor and a component holder. The component com-
`prises a component body having an interface mountable to
`the component holder. 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 com-
`patibility of the component with the system, may define a
`component type of the component, may indicate coupling of
`the component to the system, and/or may indicate calibra-
`tion of the component. Typically, the component will com-
`prise 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 componcnt in a robotic surgical
`system. The method comprises mounting the component to
`a component holder. A signal is transmitted from the com-
`ponent to a processor of the robotic surgical system. The
`component
`is articulated in response to the signal per
`commands of the processor.
`In many embodiments, compatibility of the component
`with the robotic surgical system will be verified using the
`signal transmitted from the component to 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 verifica-
`tion data is stored with a memory of the component, the
`signal transmitted to the processor including both the iden-
`tification and verification data. The algorithm may then be
`performed on the transmitted unique identification data with
`the processor, 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 surgi-
`cal tool for use in robotic surgical systems having a proces-
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`sor. The tool comprises a shaft having a proximal end anc a
`distal end. A surgical end effector is disposed adjacent tle
`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 of the shaft. T1e
`interface can be releasably coupled with a robotic probe
`holder. The interface comprises a plurality of driven ele-
`ments. A plurality of tool drive systems couple the driven
`elements to the degrees of motion of the end effector. T1e
`tool drive system has calibration oifsets between a nominal
`relative position of the end effector and the driven elemen s,
`and a measured relative position of the end effector and
`driven elements. Amemory stores data indicating the offse s.
`The memory is coupled to the interface so as to transmit I16
`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 sur-
`gical site within a patient body via a minimally invasive
`opening. Adistal 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 of the
`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 includ-
`ing a linkage supporting a tool holder. The tool holder
`releasably receives the interface. A manipulator drive motor
`drivingly engages the linkage so as to move the tool holder
`relative to the opening and position the shaft within the
`surgical site. Atool drive motor is coupled to the tool holder
`so as to drivingly engage the tool drive system and articulate
`the joint. A processor is coupled to the tool holder. The
`processor has programming that eifects a desired movement
`of the end effector by transmitting drive signals to the tool
`drive motors of the manipulator. The processor reconfigures
`the program for the different joint geometries based on the
`tool-type signals.
`In another aspect, the invention provides a robotic surgi-
`cal system comprising a surgical tool having a surgical end
`effector 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 produces a signal when the 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 mode to the tissue manipulation mode. The proces-
`sor remains in the tissue manipulation mode when at least
`one, but not all, of the tool signals is lost.
`The tools used in robotic surgery will be subjected to
`significant structural stress during use. The stress may result
`in temporary loss of an engagement signal from an engage-
`ment sensor. By providing at least two, and preferably three
`engagement sensors, the surgical procedure can continue
`safely with the loss of an engagement signal
`from an
`individual sensor so long as the system can still verify proper
`engagement between the manipulator and tool. This arrange-
`ment results 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 moves relative to the base. The
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`US 6,331,181 B1
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`tool holder has a plurality of drive elements. A sterile drape
`covers at least a portion of the manipulator. Asterile tool has
`a proximal interface 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
`adjacent the sterile drape between the holder and the inter-
`face. The adapter comprises a plurality of movable bodies.
`Each movable body has a first surface driven by the drive
`elements of the holder, and a second surface driving the
`driven elements of the 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 tool comprises a probe having a proximal end and a
`distal end. A surgical end effector is disposed adjacent the
`distal end of the probe. An interface adjacent the proximal
`end of the probe is releasably coupleable with the holder.
`The interface comprises a magnet positioned so as to actuate
`the circuitry of the holder.
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`FIG. 1 illustrates a robotic surgical procedure in which a
`surgeon at a master station directs movement of robotic
`surgical tools effected by a slave manipulator, and shows an
`assistant preparing to change a tool mounted to a tool holder
`of the slave.
`
`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
`manipulator for use in the cart system of FIG. 2.
`FIGS. 2B and C are side and front views, respectively, of
`the linkage of the robotic manipulator of FIG. 2, showing
`how the manipulator maintains a remote center of 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 accord-
`ing to the principles of the present invention.
`FIGS. 4A and B are schematic views of alternative drive
`
`systems for the tool of FIG. 4.
`FIGS. 5A through H are illustrations of a variety of
`surgical end effectors of differing tool-types.
`FIG. 6 illustrates the mechanical and electrical interface
`of the tool of FIG. 4.
`
`FIGS. 7A through E illustrate an adapter for coupling the
`interface of FIG. 6 to the surgical manipulator.
`FIGS. 7G through I illustrate the adapter of FIGS. 7A
`through E mounted to a holder or carriage of the manipu-
`lator.
`
`its driving
`
`FIGS. 7] through L illustrate the holder,
`elements, and its electrical contacts.
`the
`FIG. 8 is a wiring diagram for the tool of FIG. 4,
`adapter of FIG. 7A—E, and related components of the robotic
`system.
`FIGS. 8A and B are rear and front views of the master
`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.
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`FIG. 11 is a logic flow chart illustrating an exemplary
`method for sensing engagement of a tool with the manipu-
`lator.
`
`FIG. 12 is a flow diagram illustrating how the tool
`engagement signals are used to change the operating state of
`the robotic system.
`FIG. 13 illustrates the tool engagement method steps
`initiated by the processor in response to a change in oper-
`ating 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 according to the principles
`of the present invention.
`DESCRIPTION OF THE SPECIFIC
`EMBODIMENTS
`
`The present invention provides robotic surgery systems,
`devices, and methods. Robotic surgery will generally
`involve the use of multiple robotic arms. One or more of the
`robotic arms will often support a surgical tool which may be
`articulated (such as jaws, scissors, graspers, needle holders,
`microdissectors, 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 of the robotic arms will
`often be used to support one or more surgical image capture
`devices such as an endoscope (which may be any of the
`variety of structures such as a laparoscope, an arthroscope,
`a hysteroscope, or the like), or optionally, some other
`imaging modality (such as ultrasound, fluoroscopy, mag—
`netic resonance imaging, or the like). Typically, the robotic
`arms will support at least two surgical tools corresponding
`to 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 and aortic 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 (such as for the repair of thoracic
`and abdominal aneurysms), general and digestive surgeries
`(such as cholecystectomy,
`inguinal hernia repair, colon
`resection, and the like), gynecology (for fertility procedures,
`hysterectomies, and the like), and a wide variety of alter-
`native procedures.
`Referring now to FIG. 1, the robotic surgical system 10
`generally includes master controller 150 and a robotic arm
`slave cart 50. Master controller 150 generally includes
`master controllers (not shown) which are grasped by the
`surgeon and manipulated in space while the surgeon views
`the procedure views a stereo display. The master controllers
`are manual input devices which preferably move with six
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`US 6,331,181 B1
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`7
`degrees of freedom, and which often further have an actu-
`atable handle for actuating tools (for example, for closing
`grasping saws, applying an electrical potential
`to an
`electrode, or the like).
`In this embodiment,
`the master
`control station 150 also includes a processor, as will be
`described in more detail hereinbelow.
`
`Robotic arm cart 50 is positioned adjacent to patient body
`P and moves tools having shafts. The shafts extend into an
`internal surgical site within the patient body via openings 0.
`As illustrated in FIG. 1, one or more assistant may be present
`during surgery to assist
`the surgeon, particularly during
`removal and replacement of tools. Robotic surgery systems
`and methods are further described in co-pending U.S. patent
`application Ser. No. 08/975,617, filed Nov. 21, 1997, the full
`disclosure of which is incorporated herein by reference.
`Robotic arm cart 50 is shown in isolation in FIG. 2. Cart
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`50 includes a base 52 from which three surgical tools 54 are
`supported. More specifically, tools 54 are each supported by
`a series of manually articulatable linkages, generally
`referred to as set-up joints 56, and a robotic manipulator 58.
`It should be noted that these structures are here illustrated
`
`with protective covers extending over much of the robotic
`linkage. It should be understood that these protective covers
`are optional, and may be limited in size or entirely elimi-
`nated in some embodiments to minimize the inertia that is
`
`manipulated by the servo mechanism, to limit the volume of
`moving components so as to avoid collisions, and to limit
`the overall weight of cart 50.
`Cart 50 will generally have dimensions suitable for trans-
`porting the cart between operating rooms. The cart will
`typically fit through standard operating room doors and onto
`standard hospital elevators. The cart should have a weight
`and wheel (or other transportation) system that allows the
`cart to be positioned adjacent an operating table by a single
`attendant. The cart should have sufficient stability in the
`transport configuration to avoid tipping at minor disconti-
`nuities of the floor, and to easily withstand overturning
`moments that will be imposed at the ends of the robotic arms
`during use.
`Referring now to FIGS. 2A—C, robotic manipulators 58
`preferably include a linkage 62 that constrains movement of
`tool 54. More specifically, linkage 62 includes rigid links
`coupled together by rotational joints in a parallelogram
`arrangement so that tool 54 rotates around a point in space
`64, as more fully described in issued U.S. Pat. No. 5,817,
`084, the full disclosure of which is incorporated herein by
`reference. The parallelogram arrangement constrains rota-
`tion to pivoting about an axis 64a, sometimes called the
`pitch axis. The links supporting the parallelogram linkage
`are pivotally mounted to set-up joints 56 so that tool 54
`further rotates about an axis 64b, sometime