US20030109877A1 - Minimally invasive surgical hook apparatus and method for using same - Google Patents

Minimally invasive surgical hook apparatus and method for using same Download PDF

Info

Publication number
US20030109877A1
US20030109877A1 US10/235,063 US23506302A US2003109877A1 US 20030109877 A1 US20030109877 A1 US 20030109877A1 US 23506302 A US23506302 A US 23506302A US 2003109877 A1 US2003109877 A1 US 2003109877A1
Authority
US
United States
Prior art keywords
hook
cautery
generally
distal
tip
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
Application number
US10/235,063
Inventor
Tracey Morley
David Baron
Daniel Wallace
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Intuitive Surgical Inc
Original Assignee
Intuitive Surgical Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Intuitive Surgical Inc filed Critical Intuitive Surgical Inc
Priority to US10/235,063 priority Critical patent/US20030109877A1/en
Publication of US20030109877A1 publication Critical patent/US20030109877A1/en
Priority to US11/581,311 priority patent/US7276065B2/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • A61B34/71Manipulators operated by drive cable mechanisms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1482Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00595Cauterization
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1422Hook
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B2034/305Details of wrist mechanisms at distal ends of robotic arms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots

Definitions

  • Minimally invasive medical techniques are aimed at reducing the amount of extraneous tissue that is damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and deleterious side effects.
  • the average length of a hospital stay for a standard surgery may also be shortened significantly using minimally invasive surgical techniques.
  • an increased adoption of minimally invasive techniques could save millions of hospital days, and millions of dollars annually in hospital residency costs alone.
  • Patient recovery times, patient discomfort, surgical side effects, and time away from work may also be reduced with minimally invasive surgery.
  • the most common form of minimally invasive surgery may be endoscopy.
  • laparoscopy which is minimally invasive inspection and surgery inside the abdominal cavity.
  • laparoscopic surgical instruments In standard laparoscopic surgery, a patient's abdomen is insufflated with gas, and cannula sleeves are passed through small (approximately 1 ⁇ 2 inch) incisions to provide entry ports for laparoscopic surgical instruments.
  • the laparoscopic surgical instruments generally include a laparoscope (for viewing the surgical field) and working tools.
  • the working tools are similar to those used in conventional (open) surgery, except that the working end or end effector of each tool is separated from its handle by an extension tube.
  • end effector means the actual working part of the surgical instrument and can include clamps, graspers, scissors, staplers, and needle holders, for example.
  • the surgeon passes these working tools or instruments through the cannula sleeves to an internal surgical site and manipulates them from outside the abdomen.
  • the surgeon monitors the procedure by means of a monitor that displays an image of the surgical site taken from the laparoscope.
  • Similar endoscopic techniques are employed in, e.g., arthroscopy, retroperitoneoscopy, pelviscopy, nephroscopy, cystoscopy, cisternoscopy, sinoscopy, hysteroscopy, urethroscopy and the like.
  • Minimally invasive telesurgical robotic systems are being developed to increase a surgeon's dexterity when working within an internal surgical site, as well as to allow a surgeon to operate on a patient from a remote location.
  • the surgeon is often provided with an image of the surgical site at a computer workstation. While viewing a three-dimensional image of the surgical site on a suitable viewer or display, the surgeon performs the surgical procedures on the patient by manipulating master input or control devices of the workstation. The master controls the motion of a servomechanically operated surgical instrument.
  • the telesurgical system can provide mechanical actuation and control of a variety of surgical instruments or tools having end effectors such as, e.g., tissue graspers, needle drivers, or the like, that perform various functions for the surgeon, e.g., holding or driving a needle, grasping a blood vessel, or dissecting tissue, or the like, in response to manipulation of the master control devices.
  • end effectors such as, e.g., tissue graspers, needle drivers, or the like, that perform various functions for the surgeon, e.g., holding or driving a needle, grasping a blood vessel, or dissecting tissue, or the like, in response to manipulation of the master control devices.
  • An electrosurgical instrument is an end effector for coagulating ruptured blood vessels or the like.
  • the instrument typically includes an electrode that applies current to living tissue at a surgical site. As the tissue current is conducted through the tissue, the tissue temperature rises, ultimately causing desiccation, cutting, and/or coagulation of the target tissue or vessel.
  • Some cautery instruments include a J-shaped or L-shaped distal hook conveniently configured to snag or capture anatomical tissue such as a blood vessel for cauterization.
  • the J-shaped or L-shaped hook often includes a distal hook portion connected to a substantially straight shank portion. The lateral dimension of the hook portion typically is substantially larger than that of the shank portion.
  • the hook portion When the cautery hook is passed through a cannula sleeve between the internal surgical site and the outside, the hook portion may get caught at an edge of the cannula sleeve or become stuck in the sleeve, particularly if the hook portion includes a sharp tip. In some cases, the hook portion may even break off when passing through the cannula sleeve.
  • the present invention is generally directed to robotic surgery methods, devices, and systems.
  • the invention provides a cautery hook that is configured to substantially avoid being caught inside a cannula sleeve and being damaged or broken when the cautery hook is passed through the cannula sleeve.
  • a cautery hook includes a proximal portion having a proximal end.
  • a shank portion is connected to the proximal portion at a bent knee protruding generally on a front side of the cautery hook.
  • a distal hook portion includes a distal hook tip generally on the front side of the cautery hook. The distal hook portion is connected to the shank portion at an ankle protruding generally on a rear side of the cautery hook opposite from the front side of the cautery hook.
  • the bent knee, ankle, and distal hook tip are the three most likely locations of contact between the cautery hook and a cannula sleeve when the cautery hook is passed through the cannular sleeve between an internal surgical site and the outside.
  • Each location of contact tends to self-align the cautery hook to allow the hook to pass through the cannula sleeve without getting stuck or damaged.
  • a proximal portion line extending generally between the proximal end and the bent knee is angularly spaced from a shank portion line extending generally between the bent knee and the ankle by a bent knee angle generally on the front side of the cautery hook.
  • the bent knee angle is greater than 180° and no greater than about 270°. In a specific embodiment, the bent knee angle is between about 200° and about 250°.
  • the distal hook tip coincides with, or is disposed rearward of, a proximal portion plane which extends from the proximal end toward the bent knee and which is generally transverse to a distal hook plane on which the distal hook portion lies.
  • a distal hook tip tangent which is generally tangential to the distal hook portion at the distal hook tip is angularly spaced by a master angle from a proximal portion line extending between the proximal end and the bent knee.
  • the master angle is disposed generally on the front side of the cautery hook, and is greater than 90°, preferably between about 110° and about 180°, and more preferably between about 120° and about 150°.
  • a rear support is disposed rearward of the bent knee and extends generally between the proximal end and the ankle.
  • the bent knee is spaced from the ankle by a shank portion length and the ankle is spaced from the distal hook tip by a distal hook portion length.
  • the shank portion length is approximately equal to or greater than the distal hook portion length.
  • the distal hook portion is generally linear.
  • the proximal portion, the shank portion, and the distal hook portion are generally planar and generally coplanar with each other.
  • the proximal portion includes an engagement base at the proximal end for coupling the cautery hook to a support shaft.
  • a cautery hook includes a generally linear proximal portion.
  • a generally linear shank portion is connected to the proximal portion at a bent knee.
  • the shank portion is generally coplanar with the proximal portion.
  • a generally linear distal hook portion includes a distal hook tip and is connected to the shank portion at an ankle.
  • the distal hook portion is generally coplanar with the shank portion.
  • the distal hook tip and the bent knee are disposed generally on a front side of the cautery hook and the ankle is disposed generally on a rear side of the cautery hook which is opposite from the front side.
  • the distal hook portion is angularly spaced by a master angle from the proximal portion.
  • the master angle is disposed generally on the front side of the cautery hook, and is greater than 90°.
  • the cautery hook further includes a proximal end.
  • a protruding portion is formed between the proximal end and the distal hook portion.
  • the protruding portion includes a protruding surface generally on the front side of the cautery hook.
  • the bent knee generally coincides with, or protrudes generally forward of, a plane extending between the proximal end and the distal hook tip.
  • the cautery hook further includes an ankle formed between the bent knee and the distal hook tip.
  • the ankle protrudes generally on the rear side of the cautery hook.
  • the protruding portion is formed between a proximal portion extending from the protruding portion to the proximal end and a shank portion extending from the protruding portion to the ankle.
  • Another aspect of the invention is directed to a system for cauterizing a target tissue in an internal surgical site of a patient body.
  • the system includes a cannula sleeve having a proximal end, a distal end, and a lumen therebetween. The distal end is insertable into the patient body for accessing the internal surgical site through the lumen.
  • a tool extends into the lumen of the cannula sleeve.
  • the tool includes a cautery hook coupled with a shaft by a joint.
  • the cautery hook has a tip supported by a bend so that the tip extends in a forward direction.
  • a surface of the cautery hook is disposed proximally of the bend and extends forward sufficiently that sliding engagement between the proximal hook surface and the lumen of the cannula sleeve aligns the cautery hook with the shaft so as to inhibit interference between the tip and the distal end of the cannula sleeve when the cautery hook moves proximally into the cannula sleeve.
  • the tool may be a robotic tool.
  • the bend of the cautery hook is generally planar.
  • the cautery hook is rotatable generally on a plane of rotation relative to the shaft at a pivotal connection with the bend lying generally on the plane of rotation.
  • the proximal cautery surface generally coincides with, or extends generally forward of, a plane which is perpendicular to the plane of rotation and extends between the pivotal connection and the tip.
  • FIG. 1 is a side view of a robotic arm and surgical instrument assembly according to a preferred embodiment of the invention
  • FIG. 2 is a perspective view of the robotic arm and surgical instrument assembly of FIG. 1;
  • FIG. 3 is a perspective view of a surgical instrument according to a preferred embodiment of the invention.
  • FIG. 4 is a schematic kinematic diagram corresponding to the side view of the robotic arm shown in FIG. 1, and indicates the arm having been displaced from one position into another position;
  • FIG. 5 is a front view of a wrist mechanism for a cautery hook in accordance with a preferred embodiment of the invention.
  • FIG. 6 is a side view of the wrist mechanism of FIG. 5 in the direction of arrow VI;
  • FIG. 7 is a sectional view of the wrist mechanism of FIG. 5 along arrows VII-VII;
  • FIG. 8 is a side view of a cautery hook in accordance with a preferred embodiment of the invention.
  • FIG. 8A is a simplified schematic view illustrating alternate embodiments of the cautery hook of FIG. 8;
  • FIG. 9 is a front view of the cautery hook of FIG. 8;
  • FIG. 10 is a side view of a cautery hook in accordance with another embodiment of the invention.
  • FIG. 10A is a simplified schematic view illustrating alternate embodiments of the cautery hook of FIG. 10;
  • FIG. 10B is a simplified schematic view illustrating additional alternate embodiments of the cautery hook of FIG. 10;
  • FIG. 11 is a front view of the cautery hook of FIG. 10;
  • FIG. 11A shows a hook having an insulating sheath according to another embodiment of the invention.
  • FIGS. 12 A- 12 C illustrate the self-aligning feature of the cautery hook of FIG. 10.
  • FIGS. 13 and 14 are front and side views of a cautery hook illustrating a sandwiched structure according to another embodiment of the present invention.
  • cautery instruments As used herein, the terms “cautery” and “cauterize” are used to describe delivery of electricity to tissue to heat the tissue as well as heating to burn/seal tissue. Therefore, cautery instruments as used herein include electrosurgical instruments.
  • FIGS. 1 and 2 illustrate a robotic arm and surgical instrument assembly 10 .
  • the assembly 10 includes a robotic arm 12 and a surgical instrument 14 .
  • FIG. 3 indicates the general appearance of the surgical instrument 14 .
  • the surgical instrument 14 includes an elongate shaft 14 . 1 .
  • a wrist-like mechanism 94 is located at a working end of the shaft 14 . 1 .
  • a housing 53 arranged releasably to couple the instrument 14 to the robotic arm 12 is located at an opposed end of the shaft 14 . 1 .
  • the shaft 14 . 1 extends along an axis indicated at 14 . 2 .
  • the instrument 14 is typically releasably mounted on a carriage 11 which is preferably driven to translate along a linear guide formation 24 in the direction of arrows P.
  • the surgical instrument 14 is described in greater detail herein below.
  • the robotic arm 12 is typically mounted on a base (not shown) by means of a bracket or mounting plate 16 .
  • the base is typically in the form of a mobile cart or trolley (not shown) which is retained in a stationary position during a surgical procedure.
  • the robotic arm 12 includes a cradle 18 , an upper arm portion 20 , a forearm portion 22 , and the guide formation 24 .
  • the cradle 18 is pivotally mounted on the plate 16 in a gimbaled fashion to permit rocking movement of the cradle in the direction of arrows 26 about a pivot axis 28 , as shown in FIG. 2.
  • the upper arm portion 20 includes link members 30 , 32 and the forearm portion 22 includes link members 34 , 36 .
  • the link members 30 , 32 are pivotally mounted on the cradle 18 and are pivotally connected to the link members 34 , 36 .
  • the link members 34 , 36 are pivotally connected to the guide formation 24 .
  • the pivotal connections between the link members 30 , 32 , 34 , 36 , the cradle 18 , and the guide formation 24 are arranged to enable the robotic arm to move in a specific manner.
  • FIG. 4 The movements of the preferred robotic arm 12 is illustrated schematically in FIG. 4.
  • the solid lines schematically indicate one position of the robotic arm and the dashed lines indicate another possible position into which the arm can be displaced from the position indicated in solid lines.
  • the pivot center 49 normally remains in the same position relative to a stationary cart on which the arm 12 may preferably be mounted.
  • the pivot center 49 is positioned at a port of entry into a patient's body when an internal surgical procedure is to be performed. It will be appreciated that the shaft 14 . 1 extends through such a port of entry, the wrist-like mechanism 94 then being positioned inside the patient's body.
  • the general position of the mechanism 94 relative to the surgical site in a patient's body can be changed by movement of the arm 12 . Since the pivot center 49 is coincident with the port of entry, such movement of the arm does not excessively effect the surrounding tissue at the port of entry. It is to be appreciated that the invention is not limited to this particular arrangement and the field of application of the invention is not limited to surgical procedures at internal surgical sites only, but can be used on open surgical sites as well.
  • the preferred robotic arm 12 provides three degrees of freedom of movement to the surgical instrument 14 when mounted thereon. These degrees of freedom of movement are firstly the gimbaled motion indicated by arrows 26 , pivoting or pitching movement as indicated by arrows 27 , and the linear displacement in the direction of arrows P. Movement of the arm as indicated by arrows 26 , 27 and P is controlled by appropriately positioned actuators, e.g., electrical motors or the like, which respond to inputs from its associated master control to drive the arm 12 to a desired position as dictated by movement of the master control.
  • actuators e.g., electrical motors or the like
  • FIGS. 5 - 7 in which like reference numerals are used to designate similar parts unless otherwise stated, an end effector in the form of a cautery hook 90 is indicated.
  • the hook 90 preferably is removably mountable on a single pulley arrangement 92 .
  • the pulley arrangement 92 forms part of the wrist mechanism 94 .
  • the wrist mechanism 94 has single pulleys 96 , 98 , 100 , 102 .
  • the wrist-like mechanism 94 includes a rigid wrist member 91 .
  • One end portion of the wrist member 91 is pivotally mounted in a clevis 17 on the end 14 . 3 of the shaft 14 . 1 by means of a pivotal connection 54 .
  • the wrist member 91 can pivot in the direction of arrows 56 about the pivotal connection 54 .
  • the hook 90 is detachably coupled to the single pulley arrangement 92 , which is pivotally mounted in a clevis 19 on an opposed end of the wrist member 91 , by means of a pivotal connection 60 .
  • the hook 90 is angularly displaceable about the pivotal connection 60 as indicated by arrows 62 in FIG. 5.
  • the hook 90 has an engagement portion 90 . 1 .
  • the engagement portion 90 . 1 is removably insertable into a slot 92 . 1 defined in the pulley arrangement 92 . It will be appreciated that when the engagement portion 90 . 1 of the hook 90 is inserted into the slot 92 . 1 , a free end 90 . 2 of the engagement portion 90 . 1 is marginally and resiliently bent in the direction of arrow Z as shown in FIG. 7. Once inserted, and when the hook 90 is urged to be removed from the slot 92 . 1 , frictional engagement of the end 90 . 2 against an inner wall of the slot 92 . 1 tends to urge the free end 90 .
  • Locking the hook 90 in a mounted condition on the pulley arrangement 92 is important so as to inhibit the hook 90 from becoming dismounted from the pulley arrangement 92 during a surgical procedure. However, when removed from the surgical site, the hook 90 can be removed when a sufficient pulling force is applied so as to overcome the frictional locking action in the slot 92 . 1 .
  • the single pulley arrangement 92 defines a circumferentially extending channel 93 in which an elongate element in the form of, e.g., an activation cable C 1 , is carried.
  • a cable seat 95 defines a generally circumferentially directed hole generally in register with the circumferentially extending channel 93 .
  • the activation cable C 1 extends through the cable seat 95 , and has a thickened crimped portion along its length which seats against the larger side of the hole in the cable seat 95 .
  • the rest of the activation cable C 1 extends along the channel 93 in opposed directions.
  • the thickened portion is seated into position in the hole of the seat 95 so as to anchor the cable C 1 in the hole.
  • the wrist member 91 is flanked by two pulleys 96 , 100 which are coaxially positioned on the pivotal connection 54 and in the clevis 17 at the end 14 . 3 of the shaft 14 . 1 .
  • the other two pulleys 98 , 102 are rotatably mounted on opposed sides of the wrist member 91 .
  • the pulley 98 is generally co-planar with its associated pulley 96
  • the pulley 102 is generally co-planar with its associated pulley 100 .
  • each of the pulleys 98 , 102 is positioned such that its circumference is in close proximity to the circumference of its associated pulley 96 , 100 , respectively.
  • each of the pulley 98 , 102 and that of each of their associated pulleys 96 , 100 define between them a space 72 through which the activation cable C 1 can snugly pass.
  • the cable C 1 rides over the pulleys 100 , 102 , over part of circumferential channel 93 of the pulley arrangement 92 , through the hole in the cable seat 95 , again along part of the circumferential channel 93 of the pulley arrangement 92 , and over the pulleys 98 , 96 .
  • the electrocautery instrument 14 is used to generate an electrical current at a surgical site so as to burn or seal, e.g., ruptured blood vessels.
  • the patient is earthed and a voltage is supplied to the electrode 90 .
  • An electrically conductive cable 124 extends from a plug on the housing 53 to the electrode 90 .
  • This conductive cable, or cautery wire preferably includes a “service loop” around the distal joint axis 60 , as shown in FIGS. 5 and 6. This service loop single, loose wrap around the joint permits rotation of the electrode 90 about the axis without placing undue stress or stretch on the wire during such rotation.
  • FIG. 5 An activation cable C 2 as shown in FIG. 5 moves the wrist member 91 to pivot relative to the pivotal connection 54 in the direction of arrows 56 (FIG. 6).
  • the cables C 1 , C 2 pass from the wrist mechanism 94 through appropriately positioned holes in the base region of the clevis 17 , and internally along the shaft 14 . 1 , toward the housing 53 (FIG. 3).
  • the apparatus for operating the wrist mechanism 94 are described in greater detail in U.S. application Ser. No. ______ (Attorney Docket No. 17516-004410), entitled “Surgical Tools for Use in Minimally Invasive Telesurgical Applications”, filed on Sep. 17, 1999.
  • the cautery hook 90 includes a proximal portion 110 , a shank portion 112 , and a distal hook portion or foot portion 114 .
  • the proximal portion 110 includes the engagement portion 90 . 1 .
  • the proximal portion 110 is connected to the shank portion 112 to define a bent knee 116 which is disposed generally on a front side of the cautery hook 90 .
  • the shank portion 112 is connected to the hook portion 114 to define an ankle 118 which is disposed generally on a rear side of the cautery hook 90 .
  • the hook portion 114 has a hook tip 120 disposed generally on the front side of the cautery hook 90 .
  • the proximal portion 110 , shank portion 112 , and hook portion 114 are generally planar and generally uniform in thickness, and they are generally coplanar with each other.
  • the hook portion 114 is generally linear.
  • the cross-section of the hook 90 is generally flat and uniform in a preferred embodiment.
  • the distal hook tip 120 coincides with, or is generally rearward of, a proximal portion plane which extends from the proximal end 115 toward the knee 116 and which is generally transverse to a distal hook plane on which the distal hook portion 114 lies. That is, the knee 116 coincides with, or extends generally forward of, a plane extending between the proximal end 115 and the hook tip 120 . In this way, the distal hook tip 120 falls within the shadow of the knee 116 which shields the tip 120 , and substantially prevents the tip 120 from being caught in a cannula sleeve and reducing the risk of breakage.
  • the bent knee 116 is spaced from the ankle 118 by a shank portion length.
  • the ankle 118 is spaced from the distal hook tip 120 by a hook portion length.
  • the shank portion length is approximately equal to or greater than the hook portion length.
  • FIG. 8A illustrate schematically alternate embodiments of the hook 90 by varying the angle of the hook portion 114 with respect to the proximal portion 110 .
  • the hook portion 114 may be oriented in a wide range of angles while maintaining the distal tip 120 generally on the front side of the hook 90 .
  • the maximum length of the hook portion 114 between the ankle 118 and the tip 120 is shortest when the hook portion 114 is perpendicular to the proximal portion plane.
  • the hook 90 advantageously includes a rear support 113 extending between the proximal end 115 and the ankle 118 to protect the backside of the knee 116 and the ankle 118 from being caught in a cannula sleeve. Without this rear support 113 , the ankle would have to be angled so as to avoid interfering with a cannula distal portion during withdrawal from the surgical site, as is addressed for the embodiment shown in FIGS. 10 - 11 .
  • the proximal portion 110 includes a forward branch or extension 122 which makes an angle 126 with the trunk 123 , as shown in FIG. 8A. If the angle 126 is greater than about 90°, the knee 116 will aid in aligning the hook to prevent the front side of the proximal portion 110 from being caught in a cannula sleeve.
  • the angle 126 is typically between about 110° and about 180°, more preferably between about 120° and about 150°.
  • FIGS. 10 and 11 show another cautery hook 130 including a proximal portion 140 with a proximal end 141 , a shank portion 142 , and a distal hook portion 144 .
  • the proximal portion 140 is connected to the shank portion 142 to define a bent knee 146 which is disposed generally on a front side of the cautery hook 130 .
  • the shank portion 142 is connected to the hook portion 144 to define an ankle 148 which is disposed generally on a rear side of the cautery hook 130 .
  • the hook portion 144 has a hook tip 150 disposed generally on the front side of the cautery hook 130 .
  • a bent knee angle 156 is formed between the proximal portion 140 and the shank portion 142 , and is greater than 180°.
  • the proximal portion 140 , shank portion 142 , and hook portion 144 are generally linear portions, and are generally coplanar with each other.
  • An engagement portion similar to the portion 90 . 1 shown in FIG. 8 may be attached to the proximal portion 140 .
  • the hook portion 144 makes an angle 158 with a proximal portion line extending between the proximal end 141 and the knee 146 which is greater than about 90°, as illustrated in FIG. 10A. If this master angle 158 is equal to or less than about 90°, the distal tip 150 will tend to get caught in a cannula sleeve unless it is shielded by the knee 146 as in FIG. 8A. When the angle 158 increases beyond about 90°, the tendency of catching the tip 150 in a cannula sleeve decreases, even without shielding from the knee 146 .
  • the hook portion length between the ankle 148 and the tip 150 may be greater than (as well as smaller than or equal to) the shank portion length between the knee 146 and the ankle 148 .
  • the master angle 158 is between about 110° and 180°. In preferred embodiments, the master angle 158 is between about 120° and 150°.
  • FIG. 10A likewise depicts a knee angle 156 that results in the shank portion 142 having an angle (equal to 360° minus angle 156 ) of greater than 90°, preferably greater than about 110°. This angular positioning of the shank portion 142 permits the ankle to self-align upon contacting a cannula distal tip, for example.
  • FIG. 10B shows additional alternate embodiments in which the hook portion 144 is not linear but curved. Further, the ankle 148 in FIG. 10B could be eliminated by providing for a curved surface between the knee 146 and ankle 148 . In any event, as long as the knee 146 protects the distal hook tip 150 from the cannula, the lack of an ankle or curvature of certain of the hook portions is within the scope of the invention. However, if the distal hook tip is not protected, then the master angle should be of the magnitudes described previously. That is, for these embodiments, the master angle 158 is more appropriately defined based on a distal hook tip tangent 159 which is generally tangential to the hook portion 144 at the distal hook tip 150 .
  • the master angle 158 is the angle measure from the proximal portion 140 extending between the proximal end 141 and the bent knee 146 to the distal hook tip tangent 159 .
  • the master angle 158 is greater than 90°, typically between about 110° and 180°, more preferably between about 120° and 150°.
  • the bent knee angle 156 is greater than 180° and more typically is greater than about 200°.
  • the hook 130 in FIG. 10 does not include a rear support (such as the support 113 in FIG. 8) extending between the proximal end 141 and the ankle 148 to protect the backside of the knee 146 from being caught in a cannula sleeve.
  • the bent knee angle 156 between the proximal portion 140 and the shank portion 142 should typically be no greater than about 270°, and more preferably no greater than about 250°.
  • the hook 130 in a preferred embodiment has a round proximal cross-section extending from the proximal end 141 to a region 151 in the shank portion 142 between the knee 146 and the ankle 148 .
  • a preferred diameter is about 0.06 inch.
  • the distal cross-section extending from the region 151 to the distal tip 120 is generally slightly flattened (e.g., about 0.05 inch thickness) with corners that facilitate easier cutting over a round cross-sectional instrument.
  • a round distal cross-section is preferred for an electrosurgical instrument using RF (radiofrequency) current because of the uniformly dense current across the skin or surface area of the instrument.
  • RF radiofrequency
  • the current is concentrated at the corners so that the hooks are better suited for cutting tissue than rounded hooks, although they do not coagulate as well because of the nonuniform concentration of current and the general sharpness of a generally flat hook of, e.g., 15 thousandths of an inch thick.
  • Various portions of the hook 90 or 130 can be sheathed with insulating (e.g., PTFE/Teflon or silicon) tubing or injection molding, leaving exposed only the portion of the hook that is used to cauterize (typically the internal portion of the ankle).
  • insulating e.g., PTFE/Teflon or silicon
  • the insulating material is advantageous in limiting the electrically active surface area of the tool that is exposed to the surgical environment.
  • a gasket 153 (e.g., made of low durometer silicon) may be used to cover the exposed portion of the hook between the distalmost portion of the wrist joint (with joint axis 60 ) of the wrist 91 and the proximalmost portion of the insulating material 155 , as shown in FIG. 11A.
  • the gasket 153 prevents a small portion of the metallic hook material (before the insulating material begins) from being undesirably exposed to the surgical environment.
  • the cautery hooks 90 , 130 of FIGS. 8 - 11 advantageously can self-align as they are passed through a cannula sleeve to avoid getting stuck in the sleeve, to avoid any delay to a surgical procedure during tool exchange, and/or to protect the distal hook portions 114 , 144 from being bent or broken off.
  • FIGS. 12 A- 12 C illustrate the self-aligning feature of the cautery hook 130 which is being withdrawn through a cannula sleeve 160 .
  • the cautery hook 130 may be mounted on the shaft 14 . 1 of the surgical instrument 14 (FIG. 3) or connected to a cable or the like when it is passed through the sleeve 160 .
  • FIG. 12A the bent knee 146 of the cautery hook 130 contacts the edge of the cannula sleeve 160 , causing the hook 130 to rotate in the direction 162 to self-align the hook 130 .
  • the ankle 148 produces self-alignment of the cautery hook 130 in the sleeve 160 in the direction 164 when it contacts the sleeve 160 .
  • FIG. 12C the contact between the distal hook tip 150 and the sleeve 160 causes the cautery hook 130 to self-align with respect to the sleeve 160 in the direction 166 .
  • the bent knee 146 is preferably sufficiently forward that sliding engagement between the front surface of the bent knee 46 and the lumen of the cannula sleeve 160 aligns the cautery hook 130 relative to the lumen so as to inhibit interference between the distal hook tip 150 and the cannula when the cautery hook 130 moves proximally into the cannular sleeve 160 .
  • the bent knee 146 coincides with, or extends generally forward of, a plane extending between the proximal end 141 and the distal hook tip 150 .
  • the proximal portion 140 is generally linear with a longitudinal axis
  • the distal hook tip 150 generally coincides with the longitudinal axis extending from the proximal portion 140 .
  • the bent knee 146 , ankle 148 , and distal hook tip 150 are the three most likely locations of contact between the cautery hook 130 and the cannula sleeve 160 . Each contact tends to self-align the hook 130 to allow the hook 130 to pass through the sleeve 160 without getting stuck or damaged.
  • the bent knee 116 , ankle 118 , and distal hook tip 120 of the cautery hook 90 of FIGS. 8 and 9 provide self-alignment in a similar manner.
  • FIGS. 13 and 14 show another hook 200 which can be used as a bipolar cautery hook.
  • the hook 200 includes a sandwiched structure having a core 202 sandwiched between two shell layers or coatings 204 .
  • the core 202 includes an insulative material such as ceramic or silicon.
  • the shell layers 204 include a metallic electrode material such as gold (Au). The metallic electrode material may be masked and sputter-deposited so that the deposited metal would not reach around the insulative core 202 to complete an undesired circuit.
  • the present invention is not limited to cautery or electrosurgical hooks, but applies, in general, to any hook-shaped instrument that is usable in minimally invasive surgery.
  • the function required of the hooked structure should not be understood as limiting the invention.
  • hooks that are used to retract tissue that are delivered through a cannula or other tubular delivery device can benefit from the self aligning structure.
  • Other hook structures might be used for dissection, e.g., to hook and then peel the IMA (internal mammary artery) away from the chest wall (instead of having to use scalpel and/or cautery instruments to achieve that function) or for retraction of certain tissues at the surgical site.
  • IMA internal mammary artery
  • hooks having self-aligning features in accordance with the present invention can be of a variety of cross sections, and are not limited to the specific cross sections shown herein.

Abstract

A cautery hook includes a proximal portion, a shank portion, and a distal hook portion. The shank portion is connected to the proximal portion at a bent knee protruding generally on a front side of the cautery hook. The distal hook portion is connected to the shank portion at an ankle protruding generally on a rear side of the cautery hook opposite from the front side of the cautery hook. The distal hook portion includes a distal hook tip generally on the front side of the cautery hook. The bent knee, ankle, and distal hook tip are the three most likely locations of contact between the cautery hook and a cannula sleeve when the cautery hook is passed through the cannular sleeve between an internal surgical site and the outside. Each contact tends to self-align the cautery hook to allow the hook to pass through the cannula sleeve without getting stuck or damaged.

Description

    CROSS-REFERENCES TO RELATED APPLICATIONS
  • This application is related to the following patents and patent applications, the full disclosures of which are incorporated herein by reference: PCT International Application No. PCT/US98/19508, entitled “Robotic Apparatus”, filed on Sep. 18, 1998, U.S. Application Serial No. 60/111,713, entitled “Surgical Robotic Tools, Data Architecture, and Use”, filed on Dec. 8, 1998; U.S. Application Serial No. 60/111,711, entitled “Image Shifting for a Telerobotic System”, filed on Dec. 8, 1998; U.S. application Ser. No. ______ (Attorney Docket No. 17516-001510), entitled “Stereo Viewer System for Use in Telerobotic System”, filed on Aug. 20, 1999; U.S. application Ser. No. 09/398,507, entitled “Master Having Redundant Degrees of Freedom”, filed on Sep. 17, 1999, U.S. application Ser. No. 09/399,457, entitled “Cooperative Minimally Invasive Telesurgery System”, filed on Sep. 17, 1999; U.S. Provisional application Ser. No. 09/373,678, entitled “Camera Referenced Control in a Minimally Invasive Surgical Apparatus”, filed on Aug. 13, 1999; U.S. Provisional application Ser. No. ______ (Attorney Docket No. 17516-004410), entitled “Surgical Tools for Use in Minimally Invasive Telesurgical Applications”, filed on Sep. 17, 1999; and U.S. Pat. No. 5,808,665, entitled “Endoscopic Surgical Instrument and Method for Use”, issued on Sep. 15, 1998.[0001]
  • BACKGROUND OF THE INVENTION
  • Advances in minimally invasive surgical technology could dramatically increase the number of surgeries performed in a minimally invasive manner. Minimally invasive medical techniques are aimed at reducing the amount of extraneous tissue that is damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and deleterious side effects. The average length of a hospital stay for a standard surgery may also be shortened significantly using minimally invasive surgical techniques. Thus, an increased adoption of minimally invasive techniques could save millions of hospital days, and millions of dollars annually in hospital residency costs alone. Patient recovery times, patient discomfort, surgical side effects, and time away from work may also be reduced with minimally invasive surgery. [0002]
  • The most common form of minimally invasive surgery may be endoscopy. Probably the most common form of endoscopy is laparoscopy, which is minimally invasive inspection and surgery inside the abdominal cavity. In standard laparoscopic surgery, a patient's abdomen is insufflated with gas, and cannula sleeves are passed through small (approximately ½ inch) incisions to provide entry ports for laparoscopic surgical instruments. The laparoscopic surgical instruments generally include a laparoscope (for viewing the surgical field) and working tools. The working tools are similar to those used in conventional (open) surgery, except that the working end or end effector of each tool is separated from its handle by an extension tube. As used herein, the term “end effector” means the actual working part of the surgical instrument and can include clamps, graspers, scissors, staplers, and needle holders, for example. To perform surgical procedures, the surgeon passes these working tools or instruments through the cannula sleeves to an internal surgical site and manipulates them from outside the abdomen. The surgeon monitors the procedure by means of a monitor that displays an image of the surgical site taken from the laparoscope. Similar endoscopic techniques are employed in, e.g., arthroscopy, retroperitoneoscopy, pelviscopy, nephroscopy, cystoscopy, cisternoscopy, sinoscopy, hysteroscopy, urethroscopy and the like. [0003]
  • Minimally invasive telesurgical robotic systems are being developed to increase a surgeon's dexterity when working within an internal surgical site, as well as to allow a surgeon to operate on a patient from a remote location. In a telesurgery system, the surgeon is often provided with an image of the surgical site at a computer workstation. While viewing a three-dimensional image of the surgical site on a suitable viewer or display, the surgeon performs the surgical procedures on the patient by manipulating master input or control devices of the workstation. The master controls the motion of a servomechanically operated surgical instrument. During the surgical procedure, the telesurgical system can provide mechanical actuation and control of a variety of surgical instruments or tools having end effectors such as, e.g., tissue graspers, needle drivers, or the like, that perform various functions for the surgeon, e.g., holding or driving a needle, grasping a blood vessel, or dissecting tissue, or the like, in response to manipulation of the master control devices. [0004]
  • An electrosurgical instrument is an end effector for coagulating ruptured blood vessels or the like. The instrument typically includes an electrode that applies current to living tissue at a surgical site. As the tissue current is conducted through the tissue, the tissue temperature rises, ultimately causing desiccation, cutting, and/or coagulation of the target tissue or vessel. Some cautery instruments include a J-shaped or L-shaped distal hook conveniently configured to snag or capture anatomical tissue such as a blood vessel for cauterization. The J-shaped or L-shaped hook often includes a distal hook portion connected to a substantially straight shank portion. The lateral dimension of the hook portion typically is substantially larger than that of the shank portion. When the cautery hook is passed through a cannula sleeve between the internal surgical site and the outside, the hook portion may get caught at an edge of the cannula sleeve or become stuck in the sleeve, particularly if the hook portion includes a sharp tip. In some cases, the hook portion may even break off when passing through the cannula sleeve. [0005]
  • SUMMARY OF THE INVENTION
  • The present invention is generally directed to robotic surgery methods, devices, and systems. The invention provides a cautery hook that is configured to substantially avoid being caught inside a cannula sleeve and being damaged or broken when the cautery hook is passed through the cannula sleeve. [0006]
  • In accordance with an aspect of the present invention, a cautery hook includes a proximal portion having a proximal end. A shank portion is connected to the proximal portion at a bent knee protruding generally on a front side of the cautery hook. A distal hook portion includes a distal hook tip generally on the front side of the cautery hook. The distal hook portion is connected to the shank portion at an ankle protruding generally on a rear side of the cautery hook opposite from the front side of the cautery hook. [0007]
  • In use, the bent knee, ankle, and distal hook tip are the three most likely locations of contact between the cautery hook and a cannula sleeve when the cautery hook is passed through the cannular sleeve between an internal surgical site and the outside. Each location of contact tends to self-align the cautery hook to allow the hook to pass through the cannula sleeve without getting stuck or damaged. [0008]
  • In some preferred embodiments, a proximal portion line extending generally between the proximal end and the bent knee is angularly spaced from a shank portion line extending generally between the bent knee and the ankle by a bent knee angle generally on the front side of the cautery hook. The bent knee angle is greater than 180° and no greater than about 270°. In a specific embodiment, the bent knee angle is between about 200° and about 250°. [0009]
  • In some preferred embodiments, the distal hook tip coincides with, or is disposed rearward of, a proximal portion plane which extends from the proximal end toward the bent knee and which is generally transverse to a distal hook plane on which the distal hook portion lies. [0010]
  • In some preferred embodiments, a distal hook tip tangent which is generally tangential to the distal hook portion at the distal hook tip is angularly spaced by a master angle from a proximal portion line extending between the proximal end and the bent knee. The master angle is disposed generally on the front side of the cautery hook, and is greater than 90°, preferably between about 110° and about 180°, and more preferably between about 120° and about 150°. [0011]
  • In a preferred embodiment, a rear support is disposed rearward of the bent knee and extends generally between the proximal end and the ankle. [0012]
  • In another preferred embodiment, the bent knee is spaced from the ankle by a shank portion length and the ankle is spaced from the distal hook tip by a distal hook portion length. The shank portion length is approximately equal to or greater than the distal hook portion length. [0013]
  • In specific embodiments, the distal hook portion is generally linear. The proximal portion, the shank portion, and the distal hook portion are generally planar and generally coplanar with each other. The proximal portion includes an engagement base at the proximal end for coupling the cautery hook to a support shaft. [0014]
  • In accordance with another aspect of the invention, a cautery hook includes a generally linear proximal portion. A generally linear shank portion is connected to the proximal portion at a bent knee. The shank portion is generally coplanar with the proximal portion. A generally linear distal hook portion includes a distal hook tip and is connected to the shank portion at an ankle. The distal hook portion is generally coplanar with the shank portion. The distal hook tip and the bent knee are disposed generally on a front side of the cautery hook and the ankle is disposed generally on a rear side of the cautery hook which is opposite from the front side. [0015]
  • In some preferred embodiment, the distal hook portion is angularly spaced by a master angle from the proximal portion. The master angle is disposed generally on the front side of the cautery hook, and is greater than 90°. [0016]
  • In accordance with another aspect of the invention, a cautery hook configured to self-align when passed through a cannula sleeve includes a distal hook portion having a distal hook tip disposed generally on a front side of the cautery hook. The cautery hook further includes a proximal end. A protruding portion is formed between the proximal end and the distal hook portion. The protruding portion includes a protruding surface generally on the front side of the cautery hook. [0017]
  • In some preferred embodiments, the bent knee generally coincides with, or protrudes generally forward of, a plane extending between the proximal end and the distal hook tip. The cautery hook further includes an ankle formed between the bent knee and the distal hook tip. The ankle protrudes generally on the rear side of the cautery hook. The protruding portion is formed between a proximal portion extending from the protruding portion to the proximal end and a shank portion extending from the protruding portion to the ankle. [0018]
  • Another aspect of the invention is directed to a system for cauterizing a target tissue in an internal surgical site of a patient body. The system includes a cannula sleeve having a proximal end, a distal end, and a lumen therebetween. The distal end is insertable into the patient body for accessing the internal surgical site through the lumen. A tool extends into the lumen of the cannula sleeve. The tool includes a cautery hook coupled with a shaft by a joint. The cautery hook has a tip supported by a bend so that the tip extends in a forward direction. A surface of the cautery hook is disposed proximally of the bend and extends forward sufficiently that sliding engagement between the proximal hook surface and the lumen of the cannula sleeve aligns the cautery hook with the shaft so as to inhibit interference between the tip and the distal end of the cannula sleeve when the cautery hook moves proximally into the cannula sleeve. The tool may be a robotic tool. [0019]
  • In some preferred embodiments, the bend of the cautery hook is generally planar. The cautery hook is rotatable generally on a plane of rotation relative to the shaft at a pivotal connection with the bend lying generally on the plane of rotation. The proximal cautery surface generally coincides with, or extends generally forward of, a plane which is perpendicular to the plane of rotation and extends between the pivotal connection and the tip.[0020]
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a side view of a robotic arm and surgical instrument assembly according to a preferred embodiment of the invention; [0021]
  • FIG. 2 is a perspective view of the robotic arm and surgical instrument assembly of FIG. 1; [0022]
  • FIG. 3 is a perspective view of a surgical instrument according to a preferred embodiment of the invention; [0023]
  • FIG. 4 is a schematic kinematic diagram corresponding to the side view of the robotic arm shown in FIG. 1, and indicates the arm having been displaced from one position into another position; [0024]
  • FIG. 5 is a front view of a wrist mechanism for a cautery hook in accordance with a preferred embodiment of the invention; [0025]
  • FIG. 6 is a side view of the wrist mechanism of FIG. 5 in the direction of arrow VI; [0026]
  • FIG. 7 is a sectional view of the wrist mechanism of FIG. 5 along arrows VII-VII; [0027]
  • FIG. 8 is a side view of a cautery hook in accordance with a preferred embodiment of the invention; [0028]
  • FIG. 8A is a simplified schematic view illustrating alternate embodiments of the cautery hook of FIG. 8; [0029]
  • FIG. 9 is a front view of the cautery hook of FIG. 8; [0030]
  • FIG. 10 is a side view of a cautery hook in accordance with another embodiment of the invention; [0031]
  • FIG. 10A is a simplified schematic view illustrating alternate embodiments of the cautery hook of FIG. 10; [0032]
  • FIG. 10B is a simplified schematic view illustrating additional alternate embodiments of the cautery hook of FIG. 10; [0033]
  • FIG. 11 is a front view of the cautery hook of FIG. 10; [0034]
  • FIG. 11A shows a hook having an insulating sheath according to another embodiment of the invention; [0035]
  • FIGS. [0036] 12A-12C illustrate the self-aligning feature of the cautery hook of FIG. 10; and
  • FIGS. 13 and 14 are front and side views of a cautery hook illustrating a sandwiched structure according to another embodiment of the present invention.[0037]
  • DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • As used herein, the terms “cautery” and “cauterize” are used to describe delivery of electricity to tissue to heat the tissue as well as heating to burn/seal tissue. Therefore, cautery instruments as used herein include electrosurgical instruments. [0038]
  • FIGS. 1 and 2 illustrate a robotic arm and [0039] surgical instrument assembly 10. The assembly 10 includes a robotic arm 12 and a surgical instrument 14. FIG. 3 indicates the general appearance of the surgical instrument 14.
  • The [0040] surgical instrument 14 includes an elongate shaft 14.1. A wrist-like mechanism 94 is located at a working end of the shaft 14.1. A housing 53 arranged releasably to couple the instrument 14 to the robotic arm 12 is located at an opposed end of the shaft 14.1. In FIG. 1, and when the instrument 14 is coupled or mounted on the robotic arm 12, the shaft 14.1 extends along an axis indicated at 14.2. The instrument 14 is typically releasably mounted on a carriage 11 which is preferably driven to translate along a linear guide formation 24 in the direction of arrows P. The surgical instrument 14 is described in greater detail herein below.
  • The [0041] robotic arm 12 is typically mounted on a base (not shown) by means of a bracket or mounting plate 16. The base is typically in the form of a mobile cart or trolley (not shown) which is retained in a stationary position during a surgical procedure.
  • The [0042] robotic arm 12 includes a cradle 18, an upper arm portion 20, a forearm portion 22, and the guide formation 24. The cradle 18 is pivotally mounted on the plate 16 in a gimbaled fashion to permit rocking movement of the cradle in the direction of arrows 26 about a pivot axis 28, as shown in FIG. 2. The upper arm portion 20 includes link members 30, 32 and the forearm portion 22 includes link members 34, 36. The link members 30, 32 are pivotally mounted on the cradle 18 and are pivotally connected to the link members 34, 36. The link members 34, 36 are pivotally connected to the guide formation 24. The pivotal connections between the link members 30, 32, 34, 36, the cradle 18, and the guide formation 24 are arranged to enable the robotic arm to move in a specific manner.
  • The movements of the preferred [0043] robotic arm 12 is illustrated schematically in FIG. 4. The solid lines schematically indicate one position of the robotic arm and the dashed lines indicate another possible position into which the arm can be displaced from the position indicated in solid lines.
  • It will be understood that the axis [0044] 14.2 along which the shaft 14.1 of the instrument 14 extends when mounted on the robotic arm 12 pivots about a pivot center or fulcrum 49. Thus, irrespective of the movement of the robotic arm 12, the pivot center 49 normally remains in the same position relative to a stationary cart on which the arm 12 may preferably be mounted. In use, the pivot center 49 is positioned at a port of entry into a patient's body when an internal surgical procedure is to be performed. It will be appreciated that the shaft 14.1 extends through such a port of entry, the wrist-like mechanism 94 then being positioned inside the patient's body. Thus, the general position of the mechanism 94 relative to the surgical site in a patient's body can be changed by movement of the arm 12. Since the pivot center 49 is coincident with the port of entry, such movement of the arm does not excessively effect the surrounding tissue at the port of entry. It is to be appreciated that the invention is not limited to this particular arrangement and the field of application of the invention is not limited to surgical procedures at internal surgical sites only, but can be used on open surgical sites as well.
  • As can best be seen in FIG. 4, the preferred [0045] robotic arm 12 provides three degrees of freedom of movement to the surgical instrument 14 when mounted thereon. These degrees of freedom of movement are firstly the gimbaled motion indicated by arrows 26, pivoting or pitching movement as indicated by arrows 27, and the linear displacement in the direction of arrows P. Movement of the arm as indicated by arrows 26, 27 and P is controlled by appropriately positioned actuators, e.g., electrical motors or the like, which respond to inputs from its associated master control to drive the arm 12 to a desired position as dictated by movement of the master control.
  • Referring now to FIGS. [0046] 5-7, in which like reference numerals are used to designate similar parts unless otherwise stated, an end effector in the form of a cautery hook 90 is indicated. The hook 90 preferably is removably mountable on a single pulley arrangement 92. The pulley arrangement 92 forms part of the wrist mechanism 94. The wrist mechanism 94 has single pulleys 96, 98, 100, 102.
  • The wrist-[0047] like mechanism 94 includes a rigid wrist member 91. One end portion of the wrist member 91 is pivotally mounted in a clevis 17 on the end 14.3 of the shaft 14.1 by means of a pivotal connection 54. As best seen in FIG. 6, the wrist member 91 can pivot in the direction of arrows 56 about the pivotal connection 54.
  • The [0048] hook 90 is detachably coupled to the single pulley arrangement 92, which is pivotally mounted in a clevis 19 on an opposed end of the wrist member 91, by means of a pivotal connection 60. As a result, the hook 90 is angularly displaceable about the pivotal connection 60 as indicated by arrows 62 in FIG. 5.
  • In the specific embodiment shown, the [0049] hook 90 has an engagement portion 90.1. The engagement portion 90.1 is removably insertable into a slot 92.1 defined in the pulley arrangement 92. It will be appreciated that when the engagement portion 90.1 of the hook 90 is inserted into the slot 92.1, a free end 90.2 of the engagement portion 90.1 is marginally and resiliently bent in the direction of arrow Z as shown in FIG. 7. Once inserted, and when the hook 90 is urged to be removed from the slot 92.1, frictional engagement of the end 90.2 against an inner wall of the slot 92.1 tends to urge the free end 90.2 in an outward direction as indicated by arrow X, thus locking the engagement portion 90.1 in the slot 92.1. Locking the hook 90 in a mounted condition on the pulley arrangement 92 is important so as to inhibit the hook 90 from becoming dismounted from the pulley arrangement 92 during a surgical procedure. However, when removed from the surgical site, the hook 90 can be removed when a sufficient pulling force is applied so as to overcome the frictional locking action in the slot 92.1.
  • As best seen in FIG. 6, the [0050] single pulley arrangement 92 defines a circumferentially extending channel 93 in which an elongate element in the form of, e.g., an activation cable C1, is carried. A cable seat 95 defines a generally circumferentially directed hole generally in register with the circumferentially extending channel 93.
  • In use, the activation cable C[0051] 1 extends through the cable seat 95, and has a thickened crimped portion along its length which seats against the larger side of the hole in the cable seat 95. The rest of the activation cable C1 extends along the channel 93 in opposed directions. The thickened portion is seated into position in the hole of the seat 95 so as to anchor the cable C1 in the hole.
  • As best seen in FIG. 5, the [0052] wrist member 91 is flanked by two pulleys 96, 100 which are coaxially positioned on the pivotal connection 54 and in the clevis 17 at the end 14.3 of the shaft 14.1. The other two pulleys 98, 102 are rotatably mounted on opposed sides of the wrist member 91. The pulley 98 is generally co-planar with its associated pulley 96, and the pulley 102 is generally co-planar with its associated pulley 100. Furthermore, each of the pulleys 98, 102 is positioned such that its circumference is in close proximity to the circumference of its associated pulley 96, 100, respectively. Thus, the circumferentially extending channel formation of each of the pulley 98, 102 and that of each of their associated pulleys 96, 100, respectively, define between them a space 72 through which the activation cable C1 can snugly pass. The cable C1 rides over the pulleys 100, 102, over part of circumferential channel 93 of the pulley arrangement 92, through the hole in the cable seat 95, again along part of the circumferential channel 93 of the pulley arrangement 92, and over the pulleys 98, 96.
  • It will be appreciated that the [0053] electrocautery instrument 14 is used to generate an electrical current at a surgical site so as to burn or seal, e.g., ruptured blood vessels. In use, the patient is earthed and a voltage is supplied to the electrode 90. An electrically conductive cable 124 extends from a plug on the housing 53 to the electrode 90. This conductive cable, or cautery wire, preferably includes a “service loop” around the distal joint axis 60, as shown in FIGS. 5 and 6. This service loop single, loose wrap around the joint permits rotation of the electrode 90 about the axis without placing undue stress or stretch on the wire during such rotation.
  • Other elongate elements, e.g., cables, are used to effect additional movement of the [0054] wrist mechanism 94. For example, an activation cable C2 as shown in FIG. 5 moves the wrist member 91 to pivot relative to the pivotal connection 54 in the direction of arrows 56 (FIG. 6). The cables C1, C2 pass from the wrist mechanism 94 through appropriately positioned holes in the base region of the clevis 17, and internally along the shaft 14.1, toward the housing 53 (FIG. 3). The apparatus for operating the wrist mechanism 94 are described in greater detail in U.S. application Ser. No. ______ (Attorney Docket No. 17516-004410), entitled “Surgical Tools for Use in Minimally Invasive Telesurgical Applications”, filed on Sep. 17, 1999.
  • As shown in FIGS. 8 and 9, the [0055] cautery hook 90 includes a proximal portion 110, a shank portion 112, and a distal hook portion or foot portion 114. The proximal portion 110 includes the engagement portion 90.1. The proximal portion 110 is connected to the shank portion 112 to define a bent knee 116 which is disposed generally on a front side of the cautery hook 90. The shank portion 112 is connected to the hook portion 114 to define an ankle 118 which is disposed generally on a rear side of the cautery hook 90. The hook portion 114 has a hook tip 120 disposed generally on the front side of the cautery hook 90. In the embodiment shown, the proximal portion 110, shank portion 112, and hook portion 114 are generally planar and generally uniform in thickness, and they are generally coplanar with each other. The hook portion 114 is generally linear. The cross-section of the hook 90 is generally flat and uniform in a preferred embodiment.
  • In this embodiment, the [0056] distal hook tip 120 coincides with, or is generally rearward of, a proximal portion plane which extends from the proximal end 115 toward the knee 116 and which is generally transverse to a distal hook plane on which the distal hook portion 114 lies. That is, the knee 116 coincides with, or extends generally forward of, a plane extending between the proximal end 115 and the hook tip 120. In this way, the distal hook tip 120 falls within the shadow of the knee 116 which shields the tip 120, and substantially prevents the tip 120 from being caught in a cannula sleeve and reducing the risk of breakage. Furthermore, the bent knee 116 is spaced from the ankle 118 by a shank portion length. The ankle 118 is spaced from the distal hook tip 120 by a hook portion length. In some preferred embodiments, the shank portion length is approximately equal to or greater than the hook portion length.
  • FIG. 8A illustrate schematically alternate embodiments of the [0057] hook 90 by varying the angle of the hook portion 114 with respect to the proximal portion 110. As long as the distal tip 120 is shielded by the knee 116 (by coinciding with or being disposed rearward of the proximal portion plane), the hook portion 114 may be oriented in a wide range of angles while maintaining the distal tip 120 generally on the front side of the hook 90. The maximum length of the hook portion 114 between the ankle 118 and the tip 120 is shortest when the hook portion 114 is perpendicular to the proximal portion plane.
  • As shown in FIG. 8, the [0058] hook 90 advantageously includes a rear support 113 extending between the proximal end 115 and the ankle 118 to protect the backside of the knee 116 and the ankle 118 from being caught in a cannula sleeve. Without this rear support 113, the ankle would have to be angled so as to avoid interfering with a cannula distal portion during withdrawal from the surgical site, as is addressed for the embodiment shown in FIGS. 10-11.
  • The [0059] proximal portion 110 includes a forward branch or extension 122 which makes an angle 126 with the trunk 123, as shown in FIG. 8A. If the angle 126 is greater than about 90°, the knee 116 will aid in aligning the hook to prevent the front side of the proximal portion 110 from being caught in a cannula sleeve. The angle 126 is typically between about 110° and about 180°, more preferably between about 120° and about 150°.
  • FIGS. 10 and 11 show another [0060] cautery hook 130 including a proximal portion 140 with a proximal end 141, a shank portion 142, and a distal hook portion 144. The proximal portion 140 is connected to the shank portion 142 to define a bent knee 146 which is disposed generally on a front side of the cautery hook 130. The shank portion 142 is connected to the hook portion 144 to define an ankle 148 which is disposed generally on a rear side of the cautery hook 130. The hook portion 144 has a hook tip 150 disposed generally on the front side of the cautery hook 130. A bent knee angle 156 is formed between the proximal portion 140 and the shank portion 142, and is greater than 180°. In the embodiment shown, the proximal portion 140, shank portion 142, and hook portion 144 are generally linear portions, and are generally coplanar with each other. An engagement portion similar to the portion 90.1 shown in FIG. 8 may be attached to the proximal portion 140.
  • In this embodiment, the [0061] hook portion 144 makes an angle 158 with a proximal portion line extending between the proximal end 141 and the knee 146 which is greater than about 90°, as illustrated in FIG. 10A. If this master angle 158 is equal to or less than about 90°, the distal tip 150 will tend to get caught in a cannula sleeve unless it is shielded by the knee 146 as in FIG. 8A. When the angle 158 increases beyond about 90°, the tendency of catching the tip 150 in a cannula sleeve decreases, even without shielding from the knee 146. The hook portion length between the ankle 148 and the tip 150 may be greater than (as well as smaller than or equal to) the shank portion length between the knee 146 and the ankle 148. Typically, the master angle 158 is between about 110° and 180°. In preferred embodiments, the master angle 158 is between about 120° and 150°. FIG. 10A likewise depicts a knee angle 156 that results in the shank portion 142 having an angle (equal to 360° minus angle 156) of greater than 90°, preferably greater than about 110°. This angular positioning of the shank portion 142 permits the ankle to self-align upon contacting a cannula distal tip, for example.
  • FIG. 10B shows additional alternate embodiments in which the [0062] hook portion 144 is not linear but curved. Further, the ankle 148 in FIG. 10B could be eliminated by providing for a curved surface between the knee 146 and ankle 148. In any event, as long as the knee 146 protects the distal hook tip 150 from the cannula, the lack of an ankle or curvature of certain of the hook portions is within the scope of the invention. However, if the distal hook tip is not protected, then the master angle should be of the magnitudes described previously. That is, for these embodiments, the master angle 158 is more appropriately defined based on a distal hook tip tangent 159 which is generally tangential to the hook portion 144 at the distal hook tip 150. The master angle 158 is the angle measure from the proximal portion 140 extending between the proximal end 141 and the bent knee 146 to the distal hook tip tangent 159. The master angle 158 is greater than 90°, typically between about 110° and 180°, more preferably between about 120° and 150°.
  • The [0063] bent knee angle 156 is greater than 180° and more typically is greater than about 200°. The hook 130 in FIG. 10 does not include a rear support (such as the support 113 in FIG. 8) extending between the proximal end 141 and the ankle 148 to protect the backside of the knee 146 from being caught in a cannula sleeve. To avoid catching the cannula sleeve, the bent knee angle 156 between the proximal portion 140 and the shank portion 142 should typically be no greater than about 270°, and more preferably no greater than about 250°.
  • As shown in FIG. 11, the [0064] hook 130 in a preferred embodiment has a round proximal cross-section extending from the proximal end 141 to a region 151 in the shank portion 142 between the knee 146 and the ankle 148. A preferred diameter is about 0.06 inch. The distal cross-section extending from the region 151 to the distal tip 120 is generally slightly flattened (e.g., about 0.05 inch thickness) with corners that facilitate easier cutting over a round cross-sectional instrument.
  • A round distal cross-section is preferred for an electrosurgical instrument using RF (radiofrequency) current because of the uniformly dense current across the skin or surface area of the instrument. For a flat, rectangular cross-section as in the embodiments shown in FIGS. [0065] 8-11, the current is concentrated at the corners so that the hooks are better suited for cutting tissue than rounded hooks, although they do not coagulate as well because of the nonuniform concentration of current and the general sharpness of a generally flat hook of, e.g., 15 thousandths of an inch thick.
  • Various portions of the [0066] hook 90 or 130 can be sheathed with insulating (e.g., PTFE/Teflon or silicon) tubing or injection molding, leaving exposed only the portion of the hook that is used to cauterize (typically the internal portion of the ankle). The insulating material is advantageous in limiting the electrically active surface area of the tool that is exposed to the surgical environment. If an insulating tubing or molding is provided to insulate, e.g., the proximal portion of the hook, a gasket 153 (e.g., made of low durometer silicon) may be used to cover the exposed portion of the hook between the distalmost portion of the wrist joint (with joint axis 60) of the wrist 91 and the proximalmost portion of the insulating material 155, as shown in FIG. 11A. The gasket 153 prevents a small portion of the metallic hook material (before the insulating material begins) from being undesirably exposed to the surgical environment.
  • The cautery hooks [0067] 90, 130 of FIGS. 8-11 advantageously can self-align as they are passed through a cannula sleeve to avoid getting stuck in the sleeve, to avoid any delay to a surgical procedure during tool exchange, and/or to protect the distal hook portions 114, 144 from being bent or broken off. FIGS. 12A-12C illustrate the self-aligning feature of the cautery hook 130 which is being withdrawn through a cannula sleeve 160. The cautery hook 130 may be mounted on the shaft 14.1 of the surgical instrument 14 (FIG. 3) or connected to a cable or the like when it is passed through the sleeve 160.
  • In FIG. 12A, the [0068] bent knee 146 of the cautery hook 130 contacts the edge of the cannula sleeve 160, causing the hook 130 to rotate in the direction 162 to self-align the hook 130. In FIG. 12B, the ankle 148 produces self-alignment of the cautery hook 130 in the sleeve 160 in the direction 164 when it contacts the sleeve 160. In FIG. 12C, the contact between the distal hook tip 150 and the sleeve 160 causes the cautery hook 130 to self-align with respect to the sleeve 160 in the direction 166. The bent knee 146 is preferably sufficiently forward that sliding engagement between the front surface of the bent knee 46 and the lumen of the cannula sleeve 160 aligns the cautery hook 130 relative to the lumen so as to inhibit interference between the distal hook tip 150 and the cannula when the cautery hook 130 moves proximally into the cannular sleeve 160. Typically, the bent knee 146 coincides with, or extends generally forward of, a plane extending between the proximal end 141 and the distal hook tip 150. In the specific embodiment shown in FIGS. 10 and 11, the proximal portion 140 is generally linear with a longitudinal axis, and the distal hook tip 150 generally coincides with the longitudinal axis extending from the proximal portion 140.
  • The [0069] bent knee 146, ankle 148, and distal hook tip 150 are the three most likely locations of contact between the cautery hook 130 and the cannula sleeve 160. Each contact tends to self-align the hook 130 to allow the hook 130 to pass through the sleeve 160 without getting stuck or damaged. The bent knee 116, ankle 118, and distal hook tip 120 of the cautery hook 90 of FIGS. 8 and 9 provide self-alignment in a similar manner.
  • FIGS. 13 and 14 show another [0070] hook 200 which can be used as a bipolar cautery hook. The hook 200 includes a sandwiched structure having a core 202 sandwiched between two shell layers or coatings 204. The core 202 includes an insulative material such as ceramic or silicon. The shell layers 204 include a metallic electrode material such as gold (Au). The metallic electrode material may be masked and sputter-deposited so that the deposited metal would not reach around the insulative core 202 to complete an undesired circuit.
  • It is appreciated that the present invention is not limited to cautery or electrosurgical hooks, but applies, in general, to any hook-shaped instrument that is usable in minimally invasive surgery. Thus, the function required of the hooked structure should not be understood as limiting the invention. For example, hooks that are used to retract tissue that are delivered through a cannula or other tubular delivery device can benefit from the self aligning structure. Other hook structures might be used for dissection, e.g., to hook and then peel the IMA (internal mammary artery) away from the chest wall (instead of having to use scalpel and/or cautery instruments to achieve that function) or for retraction of certain tissues at the surgical site. [0071]
  • It is further appreciated that the hooks having self-aligning features in accordance with the present invention can be of a variety of cross sections, and are not limited to the specific cross sections shown herein. [0072]
  • The above-described arrangements of apparatus and methods are merely illustrative of applications of the principles of this invention and many other embodiments and modifications may be made without departing from the spirit and scope of the invention as defined in the claims. The scope of the invention should, therefore, be determined not with reference to the above description, but instead should be determined with reference to the appended claims along with their full scope of equivalents. [0073]

Claims (25)

What is claimed is:
1. A cautery hook comprising:
a proximal portion having a proximal end;
a shank portion connected to the proximal portion at a bent knee protruding generally on a front side of the cautery hook; and
a distal hook portion including a distal hook tip generally on the front side of the cautery hook, the distal hook portion being connected to the shank portion at an ankle protruding generally on a rear side of the cautery hook opposite from the front side of the cautery hook.
2. The cautery hook of claim 1 wherein a proximal portion line extending generally between the proximal end and the bent knee is angularly spaced from a shank portion line extending generally between the bent knee and the ankle by a bent knee angle generally on the front side of the cautery hook, the bent knee angle being greater than 180°.
3. The cautery hook of claim 2 wherein the bent knee angle is no greater than about 270°.
4. The cautery hook of claim 3 wherein the bent knee angle is between about 200° and about 250°.
5. The cautery hook of claim 1 wherein the distal hook tip coincides with, or is disposed rearward of, a proximal portion plane which extends from the proximal end toward the bent knee and which is generally transverse to a distal hook plane on which the distal hook portion lies.
6. The cautery hook of claim 1 wherein a distal hook tip tangent which is generally tangential to the distal hook portion at the distal hook tip is angularly spaced by a master angle from a proximal portion line extending between the proximal end and the bent knee, the master angle being disposed generally on the front side of the cautery hook and being greater than 90°.
7. The cautery hook of claim 6 wherein the master angle is between about 110° and about 180°.
8. The cautery hook of claim 7 wherein the master angle is between about 120° and about 150°.
9. The cautery hook of claim 1 further comprising a rear support disposed rearward of the bent knee and extending generally between the proximal end and the ankle.
10. The cautery hook of claim 1 wherein the bent knee is spaced from the ankle by a shank portion length and the ankle is spaced from the distal hook tip by a distal hook portion length, the shank portion length being approximately equal to or greater than the distal hook portion length.
11. The cautery hook of claim 1 wherein the distal hook portion is generally linear.
12. The cautery hook of claim 1 wherein the proximal portion, the shank portion, and the distal hook portion are generally planar and generally coplanar with each other.
13. The cautery hook of claim 1 wherein the proximal portion includes an engagement base at the proximal end for coupling the cautery hook to a support shaft.
14. A cautery hook comprising:
a generally linear proximal portion;
a generally linear shank portion connected to the proximal portion at a bent knee, the shank portion being generally coplanar with the proximal portion; and
a generally linear distal hook portion including a distal hook tip and being connected to the shank portion at an ankle, the distal hook portion being generally coplanar with the shank portion, the distal hook tip and the bent knee being disposed generally on a front side of the cautery hook and the ankle being disposed generally on a rear side of the cautery hook which is opposite from the front side.
15. The cautery hook of claim 14 wherein the distal hook tip coincides with, or is disposed rearward of, a proximal portion plane which extends from the proximal end toward the bent knee and which is generally transverse to a distal hook plane on which the distal hook portion lies.
16. The cautery hook of claim 14 wherein the distal hook portion is angularly spaced by a master angle from the proximal portion, the master angle being disposed generally on the front side of the cautery hook and being greater than 90°.
17. The cautery hook of claim 14 wherein the proximal portion is angularly spaced from the shank portion by a bent knee angle generally on the front side of the cautery hook, the bent knee angle being greater than 180° and being no greater than about 270°.
18. A cautery hook configured to self-align when passed through a cannula sleeve, the cautery hook comprising:
a distal hook portion having a distal hook tip disposed generally on a front side of the cautery hook;
a proximal end;
a protruding portion formed between the proximal end and the distal hook portion, the protruding portion including a protruding surface generally on the front side of the cautery hook.
19. The cautery hook of claim 18 wherein the protruding surface generally coincides with, or protrudes generally forward of, a plane extending between the proximal end and the distal hook tip.
20. The cautery hook of claim 18 further comprising an ankle formed between the protruding portion and the distal hook tip, the ankle protruding generally on the rear side of the cautery hook.
21. The cautery hook of claim 20 wherein the protruding portion is formed between a proximal portion extending from the protruding portion to the proximal end and a shank portion extending from the protruding portion to the ankle.
22. The cautery hook of claim 21 wherein a distal hook tip tangent which is generally tangential to the distal hook portion at the distal hook tip is angularly spaced by a master angle from the a proximal portion line extending between the proximal end and the protruding portion, the master angle being disposed generally on a front side of the cautery hook and being greater than 90°.
23. A system for cauterizing a target tissue in an internal surgical site of a patient body, the system comprising:
a cannula sleeve having a proximal end, a distal end, and a lumen therebetween, the distal end insertable into the patient body for accessing the internal surgical site through the lumen; and
a tool extending into the lumen of the cannula sleeve, the tool including a cautery hook coupled with a shaft by a joint, the cautery hook having a tip supported by a bend so that the tip extends in a forward direction, a surface of the cautery hook disposed proximally of the bend and extending forward sufficiently that sliding engagement between the proximal hook surface and the lumen of the cannula sleeve aligns the cautery hook with the shaft so as to inhibit interference between the tip and the distal end of the cannula sleeve when the cautery hook moves proximally into the cannula sleeve.
24. The system of claim 23 wherein the tool is a robotic tool.
25. The system of claim 23 wherein the bend of the cautery hook is generally planar, and wherein the cautery hook is rotatable generally on a plane of rotation relative to the shaft at a pivotal connection with the bend lying generally on the plane of rotation, the proximal cautery surface generally coinciding with, or extending generally forward of, a plane which is perpendicular to the plane of rotation and extends between the pivotal connection and the tip.
US10/235,063 1999-10-08 2002-09-04 Minimally invasive surgical hook apparatus and method for using same Abandoned US20030109877A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US10/235,063 US20030109877A1 (en) 1999-10-08 2002-09-04 Minimally invasive surgical hook apparatus and method for using same
US11/581,311 US7276065B2 (en) 1999-10-08 2006-10-16 Minimally invasive surgical hook apparatus

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US09/415,568 US6491691B1 (en) 1999-10-08 1999-10-08 Minimally invasive surgical hook apparatus and method for using same
US10/235,063 US20030109877A1 (en) 1999-10-08 2002-09-04 Minimally invasive surgical hook apparatus and method for using same

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US09/415,568 Division US6491691B1 (en) 1999-10-08 1999-10-08 Minimally invasive surgical hook apparatus and method for using same

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US11/581,311 Division US7276065B2 (en) 1999-10-08 2006-10-16 Minimally invasive surgical hook apparatus

Publications (1)

Publication Number Publication Date
US20030109877A1 true US20030109877A1 (en) 2003-06-12

Family

ID=23646235

Family Applications (3)

Application Number Title Priority Date Filing Date
US09/415,568 Expired - Lifetime US6491691B1 (en) 1999-10-08 1999-10-08 Minimally invasive surgical hook apparatus and method for using same
US10/235,063 Abandoned US20030109877A1 (en) 1999-10-08 2002-09-04 Minimally invasive surgical hook apparatus and method for using same
US11/581,311 Expired - Lifetime US7276065B2 (en) 1999-10-08 2006-10-16 Minimally invasive surgical hook apparatus

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US09/415,568 Expired - Lifetime US6491691B1 (en) 1999-10-08 1999-10-08 Minimally invasive surgical hook apparatus and method for using same

Family Applications After (1)

Application Number Title Priority Date Filing Date
US11/581,311 Expired - Lifetime US7276065B2 (en) 1999-10-08 2006-10-16 Minimally invasive surgical hook apparatus

Country Status (1)

Country Link
US (3) US6491691B1 (en)

Cited By (41)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060195071A1 (en) * 2000-07-20 2006-08-31 Doyle Mark C Hand-actuated articulating surgical tool
US20080125770A1 (en) * 2006-11-24 2008-05-29 Expandoheat, Llc. Ablation apparatus
US20090320637A1 (en) * 2008-06-27 2009-12-31 Allegiance Corporation Flexible wrist-type element and methods of manufacture and use thereof
US20100241136A1 (en) * 2006-12-05 2010-09-23 Mark Doyle Instrument positioning/holding devices
US20100286670A1 (en) * 2004-06-16 2010-11-11 Mark Doyle Surgical tool kit
US8005571B2 (en) 2002-08-13 2011-08-23 Neuroarm Surgical Ltd. Microsurgical robot system
US8021358B2 (en) 2004-06-16 2011-09-20 Carefusion 2200, Inc. Surgical tool kit
US9486189B2 (en) 2010-12-02 2016-11-08 Hitachi Aloka Medical, Ltd. Assembly for use with surgery system
CN109689625A (en) * 2016-09-14 2019-04-26 住友化学株式会社 The manufacturing method of epsilon-caprolactams
US20200054408A1 (en) * 2018-08-15 2020-02-20 Auris Health, Inc. Medical instruments for tissue cauterization
US10639109B2 (en) 2015-04-01 2020-05-05 Auris Health, Inc. Microsurgical tool for robotic applications
US10639108B2 (en) 2015-10-30 2020-05-05 Auris Health, Inc. Process for percutaneous operations
US10639114B2 (en) 2018-08-17 2020-05-05 Auris Health, Inc. Bipolar medical instrument
US10744035B2 (en) 2013-06-11 2020-08-18 Auris Health, Inc. Methods for robotic assisted cataract surgery
US10743751B2 (en) 2017-04-07 2020-08-18 Auris Health, Inc. Superelastic medical instrument
US10751140B2 (en) 2018-06-07 2020-08-25 Auris Health, Inc. Robotic medical systems with high force instruments
US10792466B2 (en) 2017-03-28 2020-10-06 Auris Health, Inc. Shaft actuating handle
US10959792B1 (en) 2019-09-26 2021-03-30 Auris Health, Inc. Systems and methods for collision detection and avoidance
US10980669B2 (en) 2013-01-18 2021-04-20 Auris Health, Inc. Method, apparatus and system for a water jet
US10987174B2 (en) 2017-04-07 2021-04-27 Auris Health, Inc. Patient introducer alignment
US11033330B2 (en) 2008-03-06 2021-06-15 Aquabeam, Llc Tissue ablation and cautery with optical energy carried in fluid stream
US11109928B2 (en) 2019-06-28 2021-09-07 Auris Health, Inc. Medical instruments including wrists with hybrid redirect surfaces
US11350964B2 (en) 2007-01-02 2022-06-07 Aquabeam, Llc Minimally invasive treatment device for tissue resection
US11357586B2 (en) 2020-06-30 2022-06-14 Auris Health, Inc. Systems and methods for saturated robotic movement
US11369386B2 (en) 2019-06-27 2022-06-28 Auris Health, Inc. Systems and methods for a medical clip applier
US11382650B2 (en) 2015-10-30 2022-07-12 Auris Health, Inc. Object capture with a basket
US11399905B2 (en) 2018-06-28 2022-08-02 Auris Health, Inc. Medical systems incorporating pulley sharing
US11439419B2 (en) 2019-12-31 2022-09-13 Auris Health, Inc. Advanced basket drive mode
US11464536B2 (en) 2012-02-29 2022-10-11 Procept Biorobotics Corporation Automated image-guided tissue resection and treatment
US11534248B2 (en) 2019-03-25 2022-12-27 Auris Health, Inc. Systems and methods for medical stapling
US11571229B2 (en) 2015-10-30 2023-02-07 Auris Health, Inc. Basket apparatus
US11576738B2 (en) 2018-10-08 2023-02-14 Auris Health, Inc. Systems and instruments for tissue sealing
US11589913B2 (en) 2019-01-25 2023-02-28 Auris Health, Inc. Vessel sealer with heating and cooling capabilities
US11642242B2 (en) 2013-08-13 2023-05-09 Auris Health, Inc. Method and apparatus for light energy assisted surgery
US11737835B2 (en) 2019-10-29 2023-08-29 Auris Health, Inc. Braid-reinforced insulation sheath
US11737845B2 (en) 2019-09-30 2023-08-29 Auris Inc. Medical instrument with a capstan
US11839969B2 (en) 2020-06-29 2023-12-12 Auris Health, Inc. Systems and methods for detecting contact between a link and an external object
US11864849B2 (en) 2018-09-26 2024-01-09 Auris Health, Inc. Systems and instruments for suction and irrigation
US11896330B2 (en) 2019-08-15 2024-02-13 Auris Health, Inc. Robotic medical system having multiple medical instruments
US11931901B2 (en) 2020-06-30 2024-03-19 Auris Health, Inc. Robotic medical system with collision proximity indicators
US11950872B2 (en) 2020-12-22 2024-04-09 Auris Health, Inc. Dynamic pulley system

Families Citing this family (189)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7775972B2 (en) 1998-02-24 2010-08-17 Hansen Medical, Inc. Flexible instrument
US6949106B2 (en) 1998-02-24 2005-09-27 Endovia Medical, Inc. Surgical instrument
US8414598B2 (en) 1998-02-24 2013-04-09 Hansen Medical, Inc. Flexible instrument
US7713190B2 (en) 1998-02-24 2010-05-11 Hansen Medical, Inc. Flexible instrument
US7758569B2 (en) 1998-02-24 2010-07-20 Hansen Medical, Inc. Interchangeable surgical instrument
US8303576B2 (en) 1998-02-24 2012-11-06 Hansen Medical, Inc. Interchangeable surgical instrument
US7789875B2 (en) 1998-02-24 2010-09-07 Hansen Medical, Inc. Surgical instruments
US7901399B2 (en) 1998-02-24 2011-03-08 Hansen Medical, Inc. Interchangeable surgical instrument
US7090683B2 (en) 1998-02-24 2006-08-15 Hansen Medical, Inc. Flexible instrument
AU4708100A (en) 1999-05-10 2000-11-21 Brock Rogers Surgical Inc. Surgical instrument
US20030135204A1 (en) 2001-02-15 2003-07-17 Endo Via Medical, Inc. Robotically controlled medical instrument with a flexible section
US7766894B2 (en) 2001-02-15 2010-08-03 Hansen Medical, Inc. Coaxial catheter system
US8414505B1 (en) 2001-02-15 2013-04-09 Hansen Medical, Inc. Catheter driver system
US7699835B2 (en) 2001-02-15 2010-04-20 Hansen Medical, Inc. Robotically controlled surgical instruments
US8398634B2 (en) 2002-04-18 2013-03-19 Intuitive Surgical Operations, Inc. Wristed robotic surgical tool for pluggable end-effectors
US7367973B2 (en) * 2003-06-30 2008-05-06 Intuitive Surgical, Inc. Electro-surgical instrument with replaceable end-effectors and inhibited surface conduction
US7824401B2 (en) * 2004-10-08 2010-11-02 Intuitive Surgical Operations, Inc. Robotic tool with wristed monopolar electrosurgical end effectors
US6994708B2 (en) * 2001-04-19 2006-02-07 Intuitive Surgical Robotic tool with monopolar electro-surgical scissors
US20040176751A1 (en) 2002-08-14 2004-09-09 Endovia Medical, Inc. Robotic medical instrument system
US7331967B2 (en) 2002-09-09 2008-02-19 Hansen Medical, Inc. Surgical instrument coupling mechanism
US7083615B2 (en) * 2003-02-24 2006-08-01 Intuitive Surgical Inc Surgical tool having electrocautery energy supply conductor with inhibited current leakage
US8007511B2 (en) 2003-06-06 2011-08-30 Hansen Medical, Inc. Surgical instrument design
US7042184B2 (en) 2003-07-08 2006-05-09 Board Of Regents Of The University Of Nebraska Microrobot for surgical applications
US7960935B2 (en) 2003-07-08 2011-06-14 The Board Of Regents Of The University Of Nebraska Robotic devices with agent delivery components and related methods
US7429259B2 (en) 2003-12-02 2008-09-30 Cadeddu Jeffrey A Surgical anchor and system
SE529053C2 (en) * 2005-07-08 2007-04-17 Plasma Surgical Invest Ltd Plasma generating device, plasma surgical device and use of a plasma surgical device
SE529058C2 (en) 2005-07-08 2007-04-17 Plasma Surgical Invest Ltd Plasma generating device, plasma surgical device, use of a plasma surgical device and method for forming a plasma
SE529056C2 (en) 2005-07-08 2007-04-17 Plasma Surgical Invest Ltd Plasma generating device, plasma surgical device and use of a plasma surgical device
EP2012697A4 (en) 2006-04-29 2010-07-21 Univ Texas Devices for use in transluminal and endoluminal surgery
US8679096B2 (en) 2007-06-21 2014-03-25 Board Of Regents Of The University Of Nebraska Multifunctional operational component for robotic devices
US9579088B2 (en) 2007-02-20 2017-02-28 Board Of Regents Of The University Of Nebraska Methods, systems, and devices for surgical visualization and device manipulation
WO2007149559A2 (en) 2006-06-22 2007-12-27 Board Of Regents Of The University Of Nebraska Magnetically coupleable robotic devices and related methods
US8713582B2 (en) * 2006-10-26 2014-04-29 International Business Machines Corporation Providing policy-based operating system services in an operating system on a computing system
US7935130B2 (en) * 2006-11-16 2011-05-03 Intuitive Surgical Operations, Inc. Two-piece end-effectors for robotic surgical tools
US7928338B2 (en) * 2007-02-02 2011-04-19 Plasma Surgical Investments Ltd. Plasma spraying device and method
US7655004B2 (en) 2007-02-15 2010-02-02 Ethicon Endo-Surgery, Inc. Electroporation ablation apparatus, system, and method
US7815662B2 (en) 2007-03-08 2010-10-19 Ethicon Endo-Surgery, Inc. Surgical suture anchors and deployment device
US8075572B2 (en) 2007-04-26 2011-12-13 Ethicon Endo-Surgery, Inc. Surgical suturing apparatus
US8100922B2 (en) 2007-04-27 2012-01-24 Ethicon Endo-Surgery, Inc. Curved needle suturing tool
WO2009014917A2 (en) 2007-07-12 2009-01-29 Board Of Regents Of The University Of Nebraska Methods and systems of actuation in robotic devices
US7589473B2 (en) * 2007-08-06 2009-09-15 Plasma Surgical Investments, Ltd. Pulsed plasma device and method for generating pulsed plasma
US8735766B2 (en) * 2007-08-06 2014-05-27 Plasma Surgical Investments Limited Cathode assembly and method for pulsed plasma generation
JP5475662B2 (en) 2007-08-15 2014-04-16 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Modular and segmented medical devices and related systems
JP2010536435A (en) 2007-08-15 2010-12-02 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Medical inflation, attachment and delivery devices and associated methods
US8579897B2 (en) 2007-11-21 2013-11-12 Ethicon Endo-Surgery, Inc. Bipolar forceps
US8262655B2 (en) 2007-11-21 2012-09-11 Ethicon Endo-Surgery, Inc. Bipolar forceps
US8568410B2 (en) 2007-08-31 2013-10-29 Ethicon Endo-Surgery, Inc. Electrical ablation surgical instruments
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
US20090112059A1 (en) 2007-10-31 2009-04-30 Nobis Rudolph H Apparatus and methods for closing a gastrotomy
US8262680B2 (en) 2008-03-10 2012-09-11 Ethicon Endo-Surgery, Inc. Anastomotic device
US8679003B2 (en) 2008-05-30 2014-03-25 Ethicon Endo-Surgery, Inc. Surgical device and endoscope including same
US8114072B2 (en) 2008-05-30 2012-02-14 Ethicon Endo-Surgery, Inc. Electrical ablation device
US8771260B2 (en) 2008-05-30 2014-07-08 Ethicon Endo-Surgery, Inc. Actuating and articulating surgical device
US8652150B2 (en) 2008-05-30 2014-02-18 Ethicon Endo-Surgery, Inc. Multifunction surgical device
US8317806B2 (en) 2008-05-30 2012-11-27 Ethicon Endo-Surgery, Inc. Endoscopic suturing tension controlling and indication devices
US8070759B2 (en) 2008-05-30 2011-12-06 Ethicon Endo-Surgery, Inc. Surgical fastening device
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
US8262563B2 (en) 2008-07-14 2012-09-11 Ethicon Endo-Surgery, Inc. Endoscopic translumenal articulatable steerable overtube
US8888792B2 (en) 2008-07-14 2014-11-18 Ethicon Endo-Surgery, Inc. Tissue apposition clip application devices and methods
US8771270B2 (en) * 2008-07-16 2014-07-08 Intuitive Surgical Operations, Inc. Bipolar cautery instrument
US9204923B2 (en) 2008-07-16 2015-12-08 Intuitive Surgical Operations, Inc. Medical instrument electronically energized using drive cables
US8211125B2 (en) 2008-08-15 2012-07-03 Ethicon Endo-Surgery, Inc. Sterile appliance delivery device for endoscopic procedures
US8529563B2 (en) 2008-08-25 2013-09-10 Ethicon Endo-Surgery, Inc. Electrical ablation devices
US8241204B2 (en) 2008-08-29 2012-08-14 Ethicon Endo-Surgery, Inc. Articulating end cap
US8480689B2 (en) 2008-09-02 2013-07-09 Ethicon Endo-Surgery, Inc. Suturing device
US8409200B2 (en) 2008-09-03 2013-04-02 Ethicon Endo-Surgery, Inc. Surgical grasping device
US8114119B2 (en) 2008-09-09 2012-02-14 Ethicon Endo-Surgery, Inc. Surgical grasping device
US8337394B2 (en) 2008-10-01 2012-12-25 Ethicon Endo-Surgery, Inc. Overtube with expandable tip
US8157834B2 (en) 2008-11-25 2012-04-17 Ethicon Endo-Surgery, Inc. Rotational coupling device for surgical instrument with flexible actuators
US8172772B2 (en) 2008-12-11 2012-05-08 Ethicon Endo-Surgery, Inc. Specimen retrieval device
US8361066B2 (en) 2009-01-12 2013-01-29 Ethicon Endo-Surgery, Inc. Electrical ablation devices
US8828031B2 (en) 2009-01-12 2014-09-09 Ethicon Endo-Surgery, Inc. Apparatus for forming an anastomosis
US8252057B2 (en) 2009-01-30 2012-08-28 Ethicon Endo-Surgery, Inc. Surgical access device
US9226772B2 (en) 2009-01-30 2016-01-05 Ethicon Endo-Surgery, Inc. Surgical device
US8037591B2 (en) 2009-02-02 2011-10-18 Ethicon Endo-Surgery, Inc. Surgical scissors
US10172669B2 (en) 2009-10-09 2019-01-08 Ethicon Llc Surgical instrument comprising an energy trigger lockout
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
US8353487B2 (en) 2009-12-17 2013-01-15 Ethicon Endo-Surgery, Inc. User interface support devices for endoscopic surgical instruments
US8496574B2 (en) 2009-12-17 2013-07-30 Ethicon Endo-Surgery, Inc. Selectively positionable camera for surgical guide tube assembly
CA2784883A1 (en) 2009-12-17 2011-06-23 Board Of Regents Of The University Of Nebraska Modular and cooperative medical devices and related systems and methods
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
US8486116B2 (en) * 2010-01-08 2013-07-16 Biomet Manufacturing Ring Corporation Variable angle locking screw
US8613742B2 (en) * 2010-01-29 2013-12-24 Plasma Surgical Investments Limited Methods of sealing vessels using plasma
US9005198B2 (en) 2010-01-29 2015-04-14 Ethicon Endo-Surgery, Inc. Surgical instrument comprising an electrode
GB2480498A (en) 2010-05-21 2011-11-23 Ethicon Endo Surgery Inc Medical device comprising RF circuitry
US9089319B2 (en) 2010-07-22 2015-07-28 Plasma Surgical Investments Limited Volumetrically oscillating plasma flows
JP2014529414A (en) 2010-08-06 2014-11-13 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Method and system for handling or delivery of natural orifice surgical material
US8728129B2 (en) 2011-01-07 2014-05-20 Biomet Manufacturing, Llc Variable angled locking screw
US10092291B2 (en) 2011-01-25 2018-10-09 Ethicon Endo-Surgery, Inc. Surgical instrument with selectively rigidizable features
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
US9314620B2 (en) 2011-02-28 2016-04-19 Ethicon Endo-Surgery, Inc. Electrical ablation devices and methods
WO2012125785A1 (en) 2011-03-17 2012-09-20 Ethicon Endo-Surgery, Inc. Hand held surgical device for manipulating an internal magnet assembly within a patient
EP2717796B1 (en) 2011-06-10 2020-02-26 Board of Regents of the University of Nebraska In vivo vessel sealing end effector
CA3082073C (en) 2011-07-11 2023-07-25 Board Of Regents Of The University Of Nebraska Robotic surgical devices, systems, and related methods
US9421060B2 (en) 2011-10-24 2016-08-23 Ethicon Endo-Surgery, Llc Litz wire battery powered device
EP3970784A1 (en) 2012-01-10 2022-03-23 Board of Regents of the University of Nebraska Systems and devices for surgical access and insertion
US8986199B2 (en) 2012-02-17 2015-03-24 Ethicon Endo-Surgery, Inc. Apparatus and methods for cleaning the lens of an endoscope
US9198722B2 (en) 2012-03-01 2015-12-01 Stewart And Stien Enterprises, Llc Medical instrument and method of performing a surgical procedure with the medical instrument
US9017327B2 (en) 2012-03-01 2015-04-28 Stewart And Stien Enterprises, Llc Medical instrument and method of performing a surgical procedure with the medical instrument
CA2871149C (en) 2012-05-01 2020-08-25 Board Of Regents Of The University Of Nebraska Single site robotic device and related systems and methods
US9427255B2 (en) 2012-05-14 2016-08-30 Ethicon Endo-Surgery, Inc. Apparatus for introducing a steerable camera assembly into a patient
JP6228196B2 (en) 2012-06-22 2017-11-08 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Locally controlled robotic surgical device
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
US9572623B2 (en) 2012-08-02 2017-02-21 Ethicon Endo-Surgery, Inc. Reusable electrode and disposable sheath
US10314649B2 (en) 2012-08-02 2019-06-11 Ethicon Endo-Surgery, Inc. Flexible expandable electrode and method of intraluminal delivery of pulsed power
JP2015526171A (en) 2012-08-08 2015-09-10 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Robotic surgical device, system and related methods
US9770305B2 (en) 2012-08-08 2017-09-26 Board Of Regents Of The University Of Nebraska Robotic surgical devices, systems, and related methods
US9277957B2 (en) 2012-08-15 2016-03-08 Ethicon Endo-Surgery, Inc. Electrosurgical devices and methods
US10098527B2 (en) 2013-02-27 2018-10-16 Ethidcon Endo-Surgery, Inc. System for performing a minimally invasive surgical procedure
WO2014152418A1 (en) 2013-03-14 2014-09-25 Board Of Regents Of The University Of Nebraska Methods, systems, and devices relating to force control surgical systems
US9743987B2 (en) 2013-03-14 2017-08-29 Board Of Regents Of The University Of Nebraska Methods, systems, and devices relating to robotic surgical devices, end effectors, and controllers
EP3970604A1 (en) 2013-03-15 2022-03-23 Board of Regents of the University of Nebraska Robotic surgical devices and systems
EP3021779A4 (en) 2013-07-17 2017-08-23 Board of Regents of the University of Nebraska Robotic surgical devices, systems and related methods
CN105813582B (en) 2013-12-11 2019-05-28 柯惠Lp公司 Wrist units and clamp assemblies for robotic surgical system
US10159525B2 (en) 2013-12-18 2018-12-25 Covidien Lp Electrosurgical end effectors
US10342561B2 (en) 2014-09-12 2019-07-09 Board Of Regents Of The University Of Nebraska Quick-release end effectors and related systems and methods
JP6608928B2 (en) 2014-11-11 2019-11-20 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Robotic device with miniature joint design and related systems and methods
US10159524B2 (en) 2014-12-22 2018-12-25 Ethicon Llc High power battery powered RF amplifier topology
EP3258874B1 (en) 2015-02-19 2024-01-17 Covidien LP Input device for robotic surgical system
CN107405172B (en) 2015-03-10 2021-04-13 柯惠Lp公司 Measuring health of connector components of a robotic surgical system
US10314638B2 (en) 2015-04-07 2019-06-11 Ethicon Llc Articulating radio frequency (RF) tissue seal with articulating state sensing
CN107666866A (en) 2015-06-03 2018-02-06 柯惠Lp公司 Bias apparatus driver element
CN107743384B (en) 2015-06-16 2020-12-22 柯惠Lp公司 Robotic surgical system torque sensing
AU2016284040B2 (en) 2015-06-23 2020-04-30 Covidien Lp Robotic surgical assemblies
CA2994823A1 (en) 2015-08-03 2017-02-09 Board Of Regents Of The University Of Nebraska Robotic surgical devices, systems and related methods
EP3352699B1 (en) 2015-09-25 2023-08-23 Covidien LP Robotic surgical assemblies and instrument drive connectors thereof
US10959771B2 (en) 2015-10-16 2021-03-30 Ethicon Llc Suction and irrigation sealing grasper
US10912449B2 (en) 2015-10-23 2021-02-09 Covidien Lp Surgical system for detecting gradual changes in perfusion
US10660714B2 (en) 2015-11-19 2020-05-26 Covidien Lp Optical force sensor for robotic surgical system
US10959806B2 (en) 2015-12-30 2021-03-30 Ethicon Llc Energized medical device with reusable handle
US11576562B2 (en) 2016-04-07 2023-02-14 Titan Medical Inc. Camera positioning method and apparatus for capturing images during a medical procedure
US10987156B2 (en) 2016-04-29 2021-04-27 Ethicon Llc Electrosurgical instrument with electrically conductive gap setting member and electrically insulative tissue engaging members
US10856934B2 (en) 2016-04-29 2020-12-08 Ethicon Llc Electrosurgical instrument with electrically conductive gap setting and tissue engaging members
JP7176757B2 (en) 2016-05-18 2022-11-22 バーチャル インシジョン コーポレイション ROBOTIC SURGICAL DEVICES, SYSTEMS AND RELATED METHODS
CN109152614B (en) 2016-05-26 2021-09-10 柯惠Lp公司 Instrument drive unit
JP7021114B2 (en) 2016-05-26 2022-02-16 コヴィディエン リミテッド パートナーシップ Robot Surgery Assembly
US10874470B2 (en) 2016-06-03 2020-12-29 Covidien Lp Passive axis system for robotic surgical systems
WO2017210499A1 (en) 2016-06-03 2017-12-07 Covidien Lp Control arm for robotic surgical systems
WO2017210500A1 (en) 2016-06-03 2017-12-07 Covidien Lp Robotic surgical system with an embedded imager
EP3463162A4 (en) 2016-06-03 2020-06-24 Covidien LP Systems, methods, and computer-readable program products for controlling a robotically delivered manipulator
JP2019524371A (en) 2016-08-25 2019-09-05 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Quick release tool coupler and related systems and methods
CN114872081A (en) 2016-08-30 2022-08-09 内布拉斯加大学董事会 Robotic devices with compact joint design and additional degrees of freedom and related systems and methods
US10751117B2 (en) 2016-09-23 2020-08-25 Ethicon Llc Electrosurgical instrument with fluid diverter
EP3544539A4 (en) 2016-11-22 2020-08-05 Board of Regents of the University of Nebraska Improved gross positioning device and related systems and methods
EP3548773A4 (en) 2016-11-29 2020-08-05 Virtual Incision Corporation User controller with user presence detection and related systems and methods
US10722319B2 (en) 2016-12-14 2020-07-28 Virtual Incision Corporation Releasable attachment device for coupling to medical devices and related systems and methods
AU2018221456A1 (en) 2017-02-15 2019-07-11 Covidien Lp System and apparatus for crush prevention for medical robot applications
US11033325B2 (en) 2017-02-16 2021-06-15 Cilag Gmbh International Electrosurgical instrument with telescoping suction port and debris cleaner
US10799284B2 (en) 2017-03-15 2020-10-13 Ethicon Llc Electrosurgical instrument with textured jaws
US11497546B2 (en) 2017-03-31 2022-11-15 Cilag Gmbh International Area ratios of patterned coatings on RF electrodes to reduce sticking
EP3629979A4 (en) 2017-05-24 2021-02-17 Covidien LP Presence detection for electrosurgical tools in a robotic system
CN110177518B (en) 2017-05-25 2023-01-31 柯惠Lp公司 System and method for detecting objects within a field of view of an image capture device
US11839441B2 (en) 2017-05-25 2023-12-12 Covidien Lp Robotic surgical system with automated guidance
CN110621255B (en) 2017-05-25 2023-03-07 柯惠Lp公司 Robotic surgical system and drape for covering components of robotic surgical system
US10603117B2 (en) 2017-06-28 2020-03-31 Ethicon Llc Articulation state detection mechanisms
GB2565113B (en) * 2017-08-02 2022-06-15 Gyrus Medical Ltd Electrosurgical instrument
CN111031950B (en) * 2017-08-16 2023-03-31 柯惠Lp公司 End effector for a robotic surgical system including a wrist assembly and a monopolar tool
CA3074443A1 (en) 2017-09-05 2019-03-14 Covidien Lp Collision handling algorithms for robotic surgical systems
JP2020533061A (en) 2017-09-06 2020-11-19 コヴィディエン リミテッド パートナーシップ Boundary scaling of surgical robots
US11051894B2 (en) 2017-09-27 2021-07-06 Virtual Incision Corporation Robotic surgical devices with tracking camera technology and related systems and methods
US11490951B2 (en) 2017-09-29 2022-11-08 Cilag Gmbh International Saline contact with electrodes
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
US11364067B2 (en) * 2017-10-06 2022-06-21 Cilag Gmbh International Electrical isolation of electrosurgical instruments
AU2019205201B2 (en) 2018-01-04 2020-11-05 Covidien Lp Systems and assemblies for mounting a surgical accessory to robotic surgical systems, and providing access therethrough
EP3735341A4 (en) 2018-01-05 2021-10-06 Board of Regents of the University of Nebraska Single-arm robotic device with compact joint design and related systems and methods
US11189379B2 (en) 2018-03-06 2021-11-30 Digital Surgery Limited Methods and systems for using multiple data structures to process surgical data
AU2019232675B2 (en) 2018-03-08 2020-11-12 Covidien Lp Surgical robotic systems
CN111989065A (en) 2018-04-20 2020-11-24 柯惠Lp公司 Compensation of observer movement in a robotic surgical system with a stereoscopic display
CN112105312A (en) 2018-07-03 2020-12-18 柯惠Lp公司 Systems, methods, and computer-readable media for detecting image degradation during a surgical procedure
US11259798B2 (en) 2018-07-16 2022-03-01 Intuitive Surgical Operations, Inc. Medical devices having tissue grasping surfaces and features for manipulating surgical needles
US11612447B2 (en) 2018-07-19 2023-03-28 Intuitive Surgical Operations, Inc. Medical devices having three tool members
US11109746B2 (en) 2018-10-10 2021-09-07 Titan Medical Inc. Instrument insertion system, method, and apparatus for performing medical procedures
US11586106B2 (en) 2018-12-28 2023-02-21 Titan Medical Inc. Imaging apparatus having configurable stereoscopic perspective
CN114302665A (en) 2019-01-07 2022-04-08 虚拟切割有限公司 Robot-assisted surgical system and related devices and methods
US11717355B2 (en) 2019-01-29 2023-08-08 Covidien Lp Drive mechanisms for surgical instruments such as for use in robotic surgical systems
US11576733B2 (en) 2019-02-06 2023-02-14 Covidien Lp Robotic surgical assemblies including electrosurgical instruments having articulatable wrist assemblies
US11484372B2 (en) 2019-02-15 2022-11-01 Covidien Lp Articulation mechanisms for surgical instruments such as for use in robotic surgical systems
USD912813S1 (en) * 2019-11-05 2021-03-09 H&H Medical Corporation Tissue hook for a cricothyrotomy
USD963851S1 (en) 2020-07-10 2022-09-13 Covidien Lp Port apparatus
WO2022047227A2 (en) 2020-08-28 2022-03-03 Plasma Surgical Investments Limited Systems, methods, and devices for generating predominantly radially expanded plasma flow
CN112168342A (en) * 2020-09-30 2021-01-05 山东威高手术机器人有限公司 Monopole electric hook surgical instrument
US11948226B2 (en) 2021-05-28 2024-04-02 Covidien Lp Systems and methods for clinical workspace simulation

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5429596A (en) * 1992-10-09 1995-07-04 Symbiosis Corporation Endoscopic electrosurgical suction-irrigation instrument
US5792135A (en) * 1996-05-20 1998-08-11 Intuitive Surgical, Inc. Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5797900A (en) * 1996-05-20 1998-08-25 Intuitive Surgical, Inc. Wrist mechanism for surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US6090120A (en) * 1998-04-13 2000-07-18 Ethicon Endo-Surgery, Inc. Articulating ultrasonic surgical instrument
US6110170A (en) * 1996-03-20 2000-08-29 Cardiothoracic Systems, Inc. Surgical instrument for facilitating the detachment of an artery and the like

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5429596A (en) * 1992-10-09 1995-07-04 Symbiosis Corporation Endoscopic electrosurgical suction-irrigation instrument
US6110170A (en) * 1996-03-20 2000-08-29 Cardiothoracic Systems, Inc. Surgical instrument for facilitating the detachment of an artery and the like
US5792135A (en) * 1996-05-20 1998-08-11 Intuitive Surgical, Inc. Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5797900A (en) * 1996-05-20 1998-08-25 Intuitive Surgical, Inc. Wrist mechanism for surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US6090120A (en) * 1998-04-13 2000-07-18 Ethicon Endo-Surgery, Inc. Articulating ultrasonic surgical instrument

Cited By (66)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8105319B2 (en) 2000-07-20 2012-01-31 Carefusion 2200, Inc. Hand-actuated articulating surgical tool
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
US8041459B2 (en) 2002-08-13 2011-10-18 Neuroarm Surgical Ltd. Methods relating to microsurgical robot system
US8170717B2 (en) 2002-08-13 2012-05-01 Neuroarm Surgical Ltd. Microsurgical robot system
US9220567B2 (en) 2002-08-13 2015-12-29 Neuroarm Surgical Ltd. Microsurgical robot system
US8005571B2 (en) 2002-08-13 2011-08-23 Neuroarm Surgical Ltd. Microsurgical robot system
US8396598B2 (en) 2002-08-13 2013-03-12 Neuroarm Surgical Ltd. Microsurgical robot system
US20100286670A1 (en) * 2004-06-16 2010-11-11 Mark Doyle Surgical tool kit
US8353897B2 (en) 2004-06-16 2013-01-15 Carefusion 2200, Inc. Surgical tool kit
US8021358B2 (en) 2004-06-16 2011-09-20 Carefusion 2200, Inc. Surgical tool kit
US20080125770A1 (en) * 2006-11-24 2008-05-29 Expandoheat, Llc. Ablation apparatus
US20100241136A1 (en) * 2006-12-05 2010-09-23 Mark Doyle Instrument positioning/holding devices
US11478269B2 (en) 2007-01-02 2022-10-25 Aquabeam, Llc Minimally invasive methods for multi-fluid tissue ablation
US11350964B2 (en) 2007-01-02 2022-06-07 Aquabeam, Llc Minimally invasive treatment device for tissue resection
US11172986B2 (en) 2008-03-06 2021-11-16 Aquabeam Llc Ablation with energy carried in fluid stream
US11759258B2 (en) 2008-03-06 2023-09-19 Aquabeam, Llc Controlled ablation with laser energy
US11033330B2 (en) 2008-03-06 2021-06-15 Aquabeam, Llc Tissue ablation and cautery with optical energy carried in fluid stream
US8398619B2 (en) 2008-06-27 2013-03-19 Carefusion 2200, Inc. Flexible wrist-type element and methods of manufacture and use thereof
US20090320637A1 (en) * 2008-06-27 2009-12-31 Allegiance Corporation Flexible wrist-type element and methods of manufacture and use thereof
US9486189B2 (en) 2010-12-02 2016-11-08 Hitachi Aloka Medical, Ltd. Assembly for use with surgery system
US11737776B2 (en) 2012-02-29 2023-08-29 Procept Biorobotics Corporation Automated image-guided tissue resection and treatment
US11464536B2 (en) 2012-02-29 2022-10-11 Procept Biorobotics Corporation Automated image-guided tissue resection and treatment
US10980669B2 (en) 2013-01-18 2021-04-20 Auris Health, Inc. Method, apparatus and system for a water jet
US10744035B2 (en) 2013-06-11 2020-08-18 Auris Health, Inc. Methods for robotic assisted cataract surgery
US11642242B2 (en) 2013-08-13 2023-05-09 Auris Health, Inc. Method and apparatus for light energy assisted surgery
US11723730B2 (en) 2015-04-01 2023-08-15 Auris Health, Inc. Microsurgical tool for robotic applications
US10639109B2 (en) 2015-04-01 2020-05-05 Auris Health, Inc. Microsurgical tool for robotic applications
US11571229B2 (en) 2015-10-30 2023-02-07 Auris Health, Inc. Basket apparatus
US11559360B2 (en) 2015-10-30 2023-01-24 Auris Health, Inc. Object removal through a percutaneous suction tube
US11534249B2 (en) 2015-10-30 2022-12-27 Auris Health, Inc. Process for percutaneous operations
US11382650B2 (en) 2015-10-30 2022-07-12 Auris Health, Inc. Object capture with a basket
US10639108B2 (en) 2015-10-30 2020-05-05 Auris Health, Inc. Process for percutaneous operations
CN109689625A (en) * 2016-09-14 2019-04-26 住友化学株式会社 The manufacturing method of epsilon-caprolactams
US10792466B2 (en) 2017-03-28 2020-10-06 Auris Health, Inc. Shaft actuating handle
US10743751B2 (en) 2017-04-07 2020-08-18 Auris Health, Inc. Superelastic medical instrument
US10987174B2 (en) 2017-04-07 2021-04-27 Auris Health, Inc. Patient introducer alignment
US11826117B2 (en) 2018-06-07 2023-11-28 Auris Health, Inc. Robotic medical systems with high force instruments
US10751140B2 (en) 2018-06-07 2020-08-25 Auris Health, Inc. Robotic medical systems with high force instruments
US11399905B2 (en) 2018-06-28 2022-08-02 Auris Health, Inc. Medical systems incorporating pulley sharing
US20210007819A1 (en) * 2018-08-15 2021-01-14 Auris Health, Inc. Medical instruments for tissue cauterization
US11896335B2 (en) * 2018-08-15 2024-02-13 Auris Health, Inc. Medical instruments for tissue cauterization
US10828118B2 (en) * 2018-08-15 2020-11-10 Auris Health, Inc. Medical instruments for tissue cauterization
CN112566584A (en) * 2018-08-15 2021-03-26 奥瑞斯健康公司 Medical instrument for tissue cauterization
US20200054408A1 (en) * 2018-08-15 2020-02-20 Auris Health, Inc. Medical instruments for tissue cauterization
US10639114B2 (en) 2018-08-17 2020-05-05 Auris Health, Inc. Bipolar medical instrument
US11857279B2 (en) 2018-08-17 2024-01-02 Auris Health, Inc. Medical instrument with mechanical interlock
US11864849B2 (en) 2018-09-26 2024-01-09 Auris Health, Inc. Systems and instruments for suction and irrigation
US11576738B2 (en) 2018-10-08 2023-02-14 Auris Health, Inc. Systems and instruments for tissue sealing
US11589913B2 (en) 2019-01-25 2023-02-28 Auris Health, Inc. Vessel sealer with heating and cooling capabilities
US11534248B2 (en) 2019-03-25 2022-12-27 Auris Health, Inc. Systems and methods for medical stapling
US11369386B2 (en) 2019-06-27 2022-06-28 Auris Health, Inc. Systems and methods for a medical clip applier
US11877754B2 (en) 2019-06-27 2024-01-23 Auris Health, Inc. Systems and methods for a medical clip applier
US11109928B2 (en) 2019-06-28 2021-09-07 Auris Health, Inc. Medical instruments including wrists with hybrid redirect surfaces
US11896330B2 (en) 2019-08-15 2024-02-13 Auris Health, Inc. Robotic medical system having multiple medical instruments
US11701187B2 (en) 2019-09-26 2023-07-18 Auris Health, Inc. Systems and methods for collision detection and avoidance
US10959792B1 (en) 2019-09-26 2021-03-30 Auris Health, Inc. Systems and methods for collision detection and avoidance
US11737845B2 (en) 2019-09-30 2023-08-29 Auris Inc. Medical instrument with a capstan
US11737835B2 (en) 2019-10-29 2023-08-29 Auris Health, Inc. Braid-reinforced insulation sheath
US11950863B2 (en) 2019-12-11 2024-04-09 Auris Health, Inc Shielding for wristed instruments
US11439419B2 (en) 2019-12-31 2022-09-13 Auris Health, Inc. Advanced basket drive mode
US11839969B2 (en) 2020-06-29 2023-12-12 Auris Health, Inc. Systems and methods for detecting contact between a link and an external object
US11931901B2 (en) 2020-06-30 2024-03-19 Auris Health, Inc. Robotic medical system with collision proximity indicators
US11357586B2 (en) 2020-06-30 2022-06-14 Auris Health, Inc. Systems and methods for saturated robotic movement
US11950872B2 (en) 2020-12-22 2024-04-09 Auris Health, Inc. Dynamic pulley system
US11957428B2 (en) 2021-08-17 2024-04-16 Auris Health, Inc. Medical instruments including wrists with hybrid redirect surfaces

Also Published As

Publication number Publication date
US6491691B1 (en) 2002-12-10
US20070038214A1 (en) 2007-02-15
US7276065B2 (en) 2007-10-02

Similar Documents

Publication Publication Date Title
US6491691B1 (en) Minimally invasive surgical hook apparatus and method for using same
US8182476B2 (en) In vivo accessories for minimally invasive robotic surgery
US6309397B1 (en) Accessories for minimally invasive robotic surgery and methods
US20180338805A1 (en) Roll-Pitch-Roll Surgical Tool
US9358031B2 (en) Wristed robotic tool with replaceable end-effector cartridges
US6840938B1 (en) Bipolar cauterizing instrument
US6394998B1 (en) Surgical tools for use in minimally invasive telesurgical applications
US20030100892A1 (en) Roll-pitch-roll surgical tool
US20030018323A1 (en) Platform link wrist mechanism
US20230111832A1 (en) Methods of electrosurgical instruments with otomy feature for teleoperated medical systems

Legal Events

Date Code Title Description
STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION