US20020165524A1 - Pivot point arm for a robotic system used to perform a surgical procedure - Google Patents

Abstract

A pivot port that can provide a pivot point for a surgical instrument. The pivot port may be held in a stationary position by a support arm assembly that is attached to a table. The pivot port may include either an adapter or a ball joint that can support the surgical instrument. The pivot port allows the instrument to pivot relative to a patient.

Description

BACKGROUND OF THE INVENTION
• 1. Field of the Invention[0001]
• The present invention relates to a pivot arm that can support a surgical instrument during a medical procedure.[0002]
• 2. Background Information[0003]
• There have been developed surgical robots that assist surgeons in performing medical procedures. By way of example, the assignee of the present invention, Computer Motion, Inc. of Goleta, Calif. sells a medical robotic arm under the trademark AESOP and a medical robotic system under the trademark ZEUS. The AESOP product includes a robotic arm that can be controlled through a foot pedal or voice commands from the surgeon. The AESOP arm is typically used to move an endoscope that is inserted into a patient during a laparoscopic procedure. The ZEUS system includes multiple robotic arms that can control surgical instrument used to perform minimally invasive procedures. The ZEUS robotic arms are controlled by handles that are manipulated by the surgeon.[0004]
• Coronary artery bypass graft (CABG) procedures can be performed minimally invasively using the ZEUS and AESOP products. The surgical instruments and endoscope are inserted through small incisions created in the chest of the patient. The robotic arms include both active and passive joints that move the instruments and endoscope about corresponding pivot points. The pivot points are created by the incisions formed in the patient.[0005]
• Some surgeons are uncomfortable performing minimally invasive CABG procedures and will only perform the procedure with an opened chest cavity. There may still be a desire to utilize robotic arms to control the instruments even during an open chest procedure. For example, the ZEUS system will filter the natural hand tremor of the surgeon.[0006]
• There are no incisions or corresponding pivot points in an open chest procedure. Unfortunately, the ZEUS and AESOP systems will not function properly without the pivot points created by the incisions. It is therefore desirable to create a pivot point for the robotic arms to function during a non-minimally invasive procedure.[0007]
• Computer motion has provided a support arm that could support an instrument during a non-minimally invasive procedure. The instrument could be inserted through a diaphragm located at the distal end of the arm. The diaphragm provided some flexibility to pivot the instrument but not enough to allow sufficient movement by a robotic arm to perform most medical procedures.[0008]
BRIEF SUMMARY OF THE INVENTION
• One embodiment of the present invention includes a pivot port that has an adapter coupled to a pivot arm by a joint. Another embodiment includes a ball joint that is coupled to a pivot arm.[0009]
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is an illustration of an embodiment of a medical system of the present invention;[0010]
• FIG. 2 is a perspective view of a pivot port of the medical system;[0011]
• FIG. 3 is a perspective view of an alternate embodiment of the pivot port.[0012]
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
• In general the present invention includes a pivot port that can provide a pivot point for a surgical instrument moved by a robotic arm. The pivot port may be held in a stationary position by a support arm assembly that is attached to a table. The pivot port may include either an adapter or a ball joint that can support the surgical instrument. The pivot port allows the instrument to pivot relative to a patient. The pivot arm allows the robotically controlled surgical instrument to be used in a non-minimally invasive procedure such as an open chest coronary artery bypass graft (CABG) procedure. Although use of the pivot arm in open chest CABG procedures is described, it is to be understood that the pivot arm can be used in other surgical procedures including minimally invasive procedures. For example, the pivot arm can be used to hold an instrument for a minimally invasive CABG procedure. Additionally, the pivot arm can hold instruments that are not robotically controlled.[0013]
• Referring to the drawings more particularly by reference numbers, FIG. 1 shows an embodiment of a medical system[0014]10 of the present invention. The system10 may include apivot port12 that is held in a stationary position by asupport arm assembly14. Thesupport arm assembly14 may be attached to a surgical table (not shown).
• A[0015]surgical instrument16 can be coupled to thepivot port12. Thesurgical instrument16 can be coupled to a robotic arm18. Thepivot port12 is constructed so that theinstrument16 can pivot relative to thearm12 with a sufficient range of motion so that medical procedures can be performed with the robotic arm18.
• The robotic arm[0016]18 may include a linear actuator20, a first rotary actuator22 and a secondrotary actuator24 that are controlled by a computer (not shown) to move thesurgical instrument16. The robotic arm18 may also have an end effector (not shown) to spin and/or actuate theinstrument16. The arm18 may also have passive joints (not shown) that allow theinstrument16 to pivot about thepivot port12. The robotic arm18 may be a product sold by Computer Motion, Inc. of Goleta, Calif. under the trademark AESOP or a Computer Motion product sold under the trademark ZEUS, which are hereby incorporated by reference.
• FIG. 2 shows an embodiment of the[0017]pivot port12. Thepivot port12 may include a first link26 that is coupled to a pivot arm28 by a first joint30. The first link26 may be coupled to a ring32 by a second joint34.
• The[0018]pivot port12 may include an adapter36 that can be coupled to the ring32. Thesurgical instrument16 can extend through an aperture38 of the adapter36. The aperture38 should have a diameter that allows theinstrument16 to spin and translate relative to thepivot port12. The first30 and second34 joints allow the ring32 and corresponding instrument to pivot about the arm28 to provide yaw and pitch rotation.
• The adapter[0019]36 may have an outer annular flange40 that rests on an inner annular lip42 of the ring32. The adapter36 may be constructed to be readily attached and detached from the ring32. This allows adapters having different aperture diameters to be inserted into the pivot port10 to accommodate different instrument sizes.
• FIG. 3 shows an alternate embodiment of a[0020]pivot port43 that includes aball joint44 that can pivot relative to aring45. Thering45 is attached to a pivot arm46. Theball joint44 may have a plurality ofapertures48 that can receive asurgical instrument16. The ball joint42 allows theinstrument16 to pivot relative to the arm46. Opposing pairs ofapertures48 can be constructed to have different diameters to receive instruments of different sizes. The ball joint44 thus provides a joint that can accommodate different instrument sizes without having to replace the joint as may be required in the embodiment shown in FIG. 2.
• Referring again to FIG. 1,[0021]support arm assembly14 includes a support arm50 that is coupled to a table mount52. The table mount52 is adapted to be secured to a surgical table (not shown). Thesupport arm assembly14 further includes anend effector54 that is coupled to the arm50. Theend effector54 is adapted to hold the pivot arm28 or46 of thepivot port12, or43, respectively.
• The arm[0022]50 may include a first linkage56 that is coupled to the table mount52 and asecond linkage58 coupled to the first linkage56. The arm50 may further have a third linkage60 coupled to thesecond linkage58.
• The first linkage[0023]56 may extend through a clearance hole (not shown) in abase62 of the table mount52. The table mount52 may have anarm clamp64 that can be rotated to engage the first linkage56 and secure the position of theend effector54 in a vertical direction. Thearm clamp64 can be rotated in an opposite direction to disengage theclamp64 and allow an end user to move the first linkage56 and adjust the height of theend effector54 and pivot port.
• The[0024]table mount base24 may include a jaw section66 that can clasp onto the rail of an operating table (not shown). The jaw section66 can be secured to the table rail by a table clamp68.
• The[0025]second linkage58 may be coupled to the first linkage56 by a first ball joint70. Likewise, theend effector54 may be coupled to the third linkage60 by a second ball joint72. The third linkage60 may be coupled to the second linkage20 by a pivot joint74. The ball joints70 and72, and pivot joint74 provide the support arm six degrees of freedom. The position of the arm50 andend effector54 can be secured and locked in place by rotating a locking knob76. The locking knob76 clamps the pivot joint74 to prevent relative movement between the third60 and second58 linkages. Rotation of the locking knob76 also moves corresponding wedges (not shown) into the ball joints70 and72 to secure and lock thesecond linkage58 and theend effector54, respectively. The arm50 and table mount52 can be purchased from KARL STORZ under part number28172H. Theend effector54 may have a spring biasedretractable jaw78 that can capture thepivot port12. Theretractable jaw78 allows an operator to readily attach and detach thepivot port12 to thesupport arm assembly14. Thejoints70,72 and74 allow the operator to adjust thepivot port12 location and theinstrument16.
• The following medical procedure can be performed with the[0026]pivot point12 of the present invention. A patient's chest cavity may be opened and thepivot port12 may be attached to thesupport arm assembly14 adjacent to the open chest cavity. Asurgical instrument16 may then be inserted through thepivot port12 and attached to the robotic arm18. The robotic arm18 may then be actuated to move theinstrument16 and perform a procedure. Thepivot port12 allows the instrument to pivot about theport12. When the procedure is completed, theinstrument16 may be decoupled from the robotic arm18 and pulled out of thepivot port12. Thepivot port12 may then be detached from thesupport arm assembly14.
• While certain exemplary embodiments have been described and shown in the accompanying drawings, it is to be understood that such embodiments are merely illustrative of and not restrictive on the broad invention, and that this invention not be limited to the specific constructions and arrangements shown and described, since various other modifications may occur to those ordinarily skilled in the art. For example, although an open chest procedure is described, the pivot port can provide a pivot point for any type of medical procedure.[0027]

Claims (24)

What is claimed is:

1. A pivot port that can support a surgical instrument controlled by a robotic arm, comprising:

a pivot arm;

an adapter that has an aperture adapted to receive the surgical instrument; and,

a first joint that couples said adapter to said pivot arm.

2. The pivot port ofclaim 1, further comprising a second joint that couples said adapter to said pivot arm.

3. The pivot port ofclaim 2, further comprising a ring that supports said adapter and is coupled to said first and second joints.

4. The pivot port ofclaim 3, wherein said adapter includes a flange that is adjacent to an inner lip of said ring.

5. A pivot port that can support a surgical instrument controlled by a robotic arm, comprising:

a pivot arm; and,

a ball joint that is coupled to said pivot arm and has an aperture adapted to receive the surgical instrument.

6. The pivot port ofclaim 5, wherein said ball joint has a plurality of apertures.

7. The pivot port ofclaim 5, further comprising a ring that is attached to said pivot arm and supports said ball joint.

8. A medical system, comprising:

a pivot arm;

an adapter that has an aperture;

a first joint that couples said adapter to said pivot arm;

a surgical instrument that extends through said aperture of said adapter; and,

a robotic arm that can move said surgical instrument.

9. The system ofclaim 8, further comprising a second joint that couples said adapter to said pivot arm.

10. The system ofclaim 8, further comprising a ring that supports said adapter and is coupled to said first and second joints.

11. The system ofclaim 10, wherein said adapter includes a flange that is adjacent to an inner lip of said ring.

12. The system ofclaim 8, further comprising a support arm assembly that supports said pivot arm.

13. The system ofclaim 12, wherein said support arm assembly includes a table mount, a support arm coupled to said table mount and an end effector coupled to said support arm and said pivot arm.

14. The system ofclaim 13, wherein said support arm assembly includes a first linkage pivotally connected to said table mount, a second linkage pivotally connected to said first linkage, and a third linkage pivotally connected to said second linkage and said end effector.

15. A medical system, comprising:

a pivot arm;

a ball joint that is coupled to said pivot arm and has an adapter;

a surgical instrument that extends through said aperture of said ball joint; and,

a robotic arm that can move said surgical instrument.

16. The system ofclaim 15, wherein said ball joint has a plurality of apertures.

17. The system ofclaim 15, further comprising a ring that is attached to said pivot arm and supports said ball joint.

18. The system ofclaim 15, further comprising a support arm assembly that supports said pivot arm.

19. The system ofclaim 18, wherein said support arm assembly includes a table mount, an support arm coupled to said table mount and an end effector coupled to said support arm and said pivot arm.

20. The system ofclaim 19, wherein said support arm assembly includes a first linkage pivotally connected to said table mount, a second linkage pivotally connected to said first linkage, and a third linkage pivotally connected to said second linkage and said end effector.

21. A method for performing a medical procedure on a patient, comprising:

creating an opening in the patient;

locating a pivot port adjacent to the opening in the patient,

coupling a surgical instrument to the pivot port; and,

moving the surgical instrument with a robotic arm to perform the medical procedure.

22. The method ofclaim 21, wherein the surgical instrument is inserted through an aperture of an adapter of the pivot port.

23. The method ofclaim 21, wherein the patient has an open chest.

24. The method ofclaim 21, wherein the surgical instrument is inserted through an aperture of a ball joint of the pivot port.

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