A system for performing minimally invasive cardiac procedures. The system includes a pair of surgical instruments that are coupled to a pair of robotic arms. The instruments have end effectors that can be manipulated to hold and suture tissue. The robotic arms are coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the end effectors. The movement of the handles is scaled so that the end effectors have a corresponding movement that is different, typically smaller, than the movement performed by the hands of the surgeon. The scale factor is adjustable so that the surgeon can control the resolution of the end effector movement. The movement of the end effector can be controlled by an input button, so that the end effector only moves when the button is depressed by the surgeon. The input button allows the surgeon to adjust the position of the handles without moving the end effector, so that the handles can be moved to a more comfortable position. The system may also have a robotically controlled endoscope which allows the surgeon to remotely view the surgical site. A cardiac procedure can be performed by making small incisions in the patient's skin and inserting the instruments and endoscope into the patient. The surgeon manipulates the handles and moves the end effectors to perform a cardiac procedure such as a coronary artery bypass graft.

Method and apparatus for performing minimally invasive cardiac procedures

Robotic surgical tools, systems, and methods for preparing for, and performing robotic surgery include a memory (126) mounted on the tool (54). The memory (126) can perform a number of functions when the tool (54) is loaded on the tool manipulator (58). First, the memory can provide a signal verifying that the tool (54) is compatible with that particular robotic system. Secondly, the tool memory (126) may identify the tool-type to the robotic system so that the robotic system can reconfigure its programming. Thirdly, the memory (126) of the tool (54) 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.

Surgical robotic tools, data architecture, and use

The present invention provides systems and methods for performing robotics assisted surgical procedures on a patient. In particular, a three component surgical system (2) is provided that includes a non-sterile drive and control component (40), a sterilized end effector or surgical tool (20), and an intermediate connector component (24) that includes mechanical elements for coupling the surgical tool (20) with the drive and control component (40), and for transferring motion and electrical signals therebetween. The drive and control component (40) is shielded from the sterile surgical site, the surgical tool (20) is sterilized and disposable and the intermediate connector (24) is sterilized and reusable. In this manner, the intermediate connector (24) can be sterilized after a surgical procedure without damaging the motors (170) or electrical connections within the drive and control component (40) of the robotics system.

Multi-component telepresence system and method

This paper provides a broad overview of medical robot systems used in surgery. After introducing basic concepts of computer-integrated surgery, surgical CAD/CAM, and surgical assistants, it discusses some of the major design issues particular to medical robots. It then illustrates these issues and the broader themes introduced earlier with examples of current surgical CAD/CAM and surgical assistant systems. Finally, it provides a brief synopsis of current research challenges and closes with a few thoughts on the research/industry/clinician teamwork that is essential for progress in the field.

/pdf/medical-robotics-in-computer-integrated-surgery-551rsaf1dd.pdf

Medical robotics in computer-integrated surgery

The invention is directed to manipulator assembly (2) for holding and manipulating a surgical instrument (14) in a telerobotic system. The manipulator assembly includes an instrument holder removably coupled to a drive assembly so that the holder can be sterilized. The assembly further includes a force sensing element (52) mounted distal to the holder and the drive assembly for detecting forces exerted on the surgical instrument and providing feedback to the surgeon. The invention is also directed to a system and method for releasably holding a surgical instrument (14). The system includes an instrument support for automatically locking mounting pins on the instrument within locking slots on the instrument holder to releasably couple the instrument to the holder. With a twist-lock motion, the surgeon can rapidly engage and disengage various instruments from the holder during a surgical procedure, such as open surgery, laparoscopy or thoracoscopy.

Surgical manipulator for a telerobotic system

The authors' institute has established that precise surgical procedures can be carried out with Telepresence. Within this decade, Telepresence surgery may become an established component of a new, technologically enhanced mode of cost-effective health care delivery. Because of the substantial medical and financial benefit that Telepresence will bring to laparoscopic and other minimally invasive procedures, its first routine use is expected to be within the individual hospital and surgical center. Telepresence surgical procedures have been demonstrated over distances of 160 meters, and the authors are working toward demonstrating animal surgeries over a much greater distance by using microwave and fiber-optic links. Mobile Telepresence surgical equipment may prove especially effective for trauma care in combat and in civilian disasters. Because the stereographic images and the motions and forces can be readily scaled, microsurgeries of all kinds can be made easier with this technology. Arthroscopic procedures, especially difficult surgery on joints such as the wrist and shoulder, are good Telepresence candidates. In neurosurgery, excision of pituitary adenomas could benefit from the increased dexterity and tactile sensitivity of Telepresence. Eventually, neurosurgery under real-time magnetic resonance imaging could be performed by a Telepresence surgeon operating on a three dimensional reconstruction that is immediately updated to show the actual tissue changes caused by the telemanipulated instruments. >

Telepresence surgery

Endoscopic surgical methods are replacing open surgery in many procedures, but dexterity and force feedback are not adequate with current tools. To enhance the ability of surgeons to operate endoscopically, we have developed a telepresence system with integrated 3D stereo viewing, a prototype force-reflecting manipulator, and aural feedback. Careful attention was paid to the human factors in the endoscopic surgery setting to make the system natural to use in the hope of eliminating the long training period normally required. The 4-axis (plus gripper) manipulator provides the same degrees of freedom as the laproscopic tools now being used for surgery. The bilateral control system provides for magnified motion and/or force reflection. This approach eliminates the motion reversal, or fulcrum effect, in operating through the abdominal wall. Preliminary dexterity experiments with different force feedback and viewing conditions verify intuitive use and fast learning. >

Telepresence surgery demonstration system

A three-dimensional, volumetric, data acquisition and reconstruction system for ultrasonic imaging is described. The method entails storing the digitized waveforms from each element of a multielement annular array, with bidirectional mechanical scanning. The system was implemented through digitization of the RF signals from each of the rings of an annular-array transducer, storage of the signals in computer memory, and offline image reconstruction. Initial reflection and reflex transmission images acquired with this system are presented. The results of different image reconstruction algorithms are demonstrated. >

Three-dimensional ultrasonic reflection and attenuation imaging

Some of the novel image processing capabilities possible with image reconstructions from a three-dimensional data set are explored, and different methods for two-dimensional presentation of three-dimensional data are compared. The authors describe how B-scans, reflection C-scans, reflex-transmission imaging (RTI) scans, and various kinds of compensated and combined images can be reconstructed from a single acquisition of volumetric data. The authors also discuss several means for presenting these three-dimensional data, including oblique-angle imaging and stereoscopic methods. Images of phantoms illustrating some of the capabilities of volumetric data acquisition are presented. >

https://ieeexplore.ieee.org/iel2/169/4424/00171617.pdf

Volumetric acoustic reflection and attenuation imaging

The clinical ultrasound imaging system described is capable of multiple-plane, integrated reflection C-scanning and simultaneous reflex transmission imaging, as well as real-time B-scanning. The system interfaces directly with a commercial clinical B-scan imager. Two-dimensional sector scanning via an annular array probe enables rapid image acquisition and uniform sampling of the imaging volume. Image acquisition time for multiple C-scans and reflex transmission images is a function of field of view and resolution. Typical acquisition times range from 5 to 15 seconds, making single-breath-hold imaging possible. The architecture of the system is described and initial in vivo human images are presented. >

http://ieeexplore.ieee.org/iel2/1020/6834/00276002.pdf

A. Shah

Papers

Telepresence surgery

Telepresence surgery demonstration system

Three-dimensional ultrasonic reflection and attenuation imaging

Volumetric acoustic reflection and attenuation imaging

Clinical scanner for B-, C- and reflex transmission imaging