US20070156121A1 - Robotic surgical systems with fluid flow control for irrigation, aspiration, and blowing - Google Patents

Abstract

In one embodiment of the invention, a robotic surgical system is provided including a master control console and a surgical manipulator. The master control console generates control signals to cause one or more fluids to flow into or out of a surgical site. The surgical manipulator is coupled to the console to receive the control signals and includes at least one robotic arm and a surgical instrument coupled thereto. The surgical manipulator controls the surgical instrument in response to the control signals to control the flow of the one or more fluids into or out of the surgical site. The surgical instrument has a first robotically controlled valve that is responsive to the surgical manipulator and a hollow tube having a first end coupled to the first robotically controlled valve with an opening at a second end to direct the flow of one or more fluids.

Description

CROSS-REFERENCE TO RELATED APPLICATION
• This non-provisional United States (U.S.) patent application claims the benefit of U.S. provisional patent Application No. 60/696,482 entitled “IRRIGATION, ASPIRATION, AND BLOWING FOR ROBOTIC SURGERY” filed on Jun. 30, 2005 by inventors Paul Millman et al.
FIELD
• The embodiments of the invention relate generally to surgical instruments for robotic surgery. More particularly, the embodiments of the invention relate to irrigation/aspiration/blowing devices for surgery.
BACKGROUND
• During surgery on a patient, it is often desirable to irrigate a surgical site with a fluid, such as water, to clean or clear away blood, tissue, or other items obscuring the vision of a surgeon in the surgical site. Suction or aspiration in the surgical site may also be used to vacuum away blood, tissue, or other items obscuring the vision of the surgeon in the surgical site.
• Hand held surgical instruments have typically been used to provide irrigation and/or aspiration. The surgeon typically does not operate the hand held surgical instrument that provides irrigation and/or aspiration. An assistant surgeon or nurse handling such instruments may provide irrigation and/or aspiration of the surgical site. The surgeon gives verbal instructions to the assistant surgeon or nurse to provide irrigation and/or aspiration of the surgical site. If the surgeon could both control the surgical instruments and the irrigation and aspiration of the surgical site, verbal instructions could be reduced and surgical procedures may be more efficient.
BRIEF SUMMARY
• The embodiments of the invention are summarized by the claims that follow below.
BRIEF DESCRIPTIONS OF THE DRAWINGS
• FIG. 1 is a block diagram of a robotic surgery system to perform minimally invasive robotic surgical procedures using an irrigation/aspiration/blowing robotic surgical tool.
• FIG. 2A is a perspective view of a robotic surgical manipulator with a plurality of robotic surgical arms at least one of which includes an irrigation/aspiration/blowing robotic surgical tool.
• FIG. 2B is a perspective view of the robotic surgical arm including the irrigation/aspiration/blowing robotic surgical tool mounted thereto.
• FIG. 2C illustrates mounting of the irrigation/aspiration/blowing robotic surgical tool to an adapter of the robotic surgical arm ofFIG. 2B.
• FIG. 2D illustrates a top view of the adapter of the robotic surgical arm ofFIG. 2C to which the irrigation/aspiration/blowing robotic surgical tool may be mounted.
• FIG. 3A is a perspective view of a robotic surgical master control console.
• FIG. 3B is a perspective view of an exemplary gimbaled device pivotally supporting a touch sensitive handle for the robotic surgical master control console ofFIG. 3A to control robotic surgical tools including an irrigation/aspiration/blowing robotic surgical tool.
• FIG. 3C is a cross-sectional view schematically illustrating mounting of the touch sensitive handle ofFIG. 3B with sensors to sense gripping and rotation of the handle to control robotic surgical tools, including an irrigation/aspiration/blowing robotic surgical tool.
• FIG. 4A is a perspective view of an irrigation/aspiration/blowing robotic surgical tool.
• FIG. 4B is a back side view of a portion of the irrigation/aspiration/blowing robotic surgical tool ofFIG. 4A.
• FIG. 5A is a schematic flow diagram of an irrigation/aspiration robotic surgical tool using two-way two-position valves.
• FIG. 5B is a schematic flow diagram of an irrigation/aspiration robotic surgical tool using a three-way three-position valve.
• FIG. 5C is a schematic flow diagram of an irrigation/aspiration/blowing robotic surgical tool using a four-way four-position valve.
• FIG. 5D is a schematic flow diagram of an irrigation/aspiration/blowing robotic surgical tool using two-way two-position valves.
• FIGS. 6A-6C are top views of rotationally actuated rotatable valves for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
• FIGS. 7A-7C are cross-sections of linearly actuated linear valves for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
• FIG. 8 is a top view of exemplary linear actuation of a rotatable valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
• FIG. 9A is a top view of exemplary rotational actuation of a linear valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm with an optional manual push arm.
• FIG. 9B is a top view of exemplary rotational actuation of a linear valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm with an optional manual push side-arm.
• FIG. 10A is a top view to illustrate rotational actuation of a rotatable pinch valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
• FIG. 10B is a side view to illustrate linear actuation of a linear pinch valve for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
• FIG. 11A is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show a solid valve body.
• FIG. 11B is a bottom exploded of the irrigation/aspiration/blowing robotic surgical tool ofFIG. 11A with the solid valve body.
• FIG. 11C is a cross sectional view of the valve assembly with the solid valve body in a closed position for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 11A.
• FIG. 11D is a cross sectional view of the valve assembly with the solid valve body in an open position for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 11A.
• FIG. 11E is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with a solid valve body including robotically actuated valves and manually actuated valves.
• FIG. 12 is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show the replaceable valves.
• FIG. 13A is a top perspective view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show rotatable pinch valves.
• FIG. 13B is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool ofFIG. 13A with cover in place to show manual handles and a cleaning position of the handles.
• FIG. 14 is a top view of an irrigation/aspiration/blowing robotic surgical tool with cover removed to show the pinch valves and replaceable tubing.
• FIGS. 15A-15B are top views of irrigation/aspiration/blowing robotic surgical tools with covers removed to respectively show three-way and four-way couplers and replaceable tubing coupled thereto.
• FIG. 16A is a side view of the touch sensitive handle of the diagram of the touch sensitive handle illustrated inFIG. 3B for the robotic surgical master control console ofFIG. 3A.
• FIGS. 16B-16D are side views of grip positions of the touch sensitive handle to control the irrigation/aspiration/blowing robotic surgical tool in a surgical site.
• FIG. 17 is a graph showing exemplary control of irrigation and aspiration using grip control of the touch sensitive handle corresponding to the side views of the touch sensitive handle illustrated inFIGS. 16B-16D.
• FIG. 18A is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with light emitting diodes at the distal end to provide user feedback.
• FIG. 18B is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a light pipe along side the flow tube that is coupled to a light emitting diode at the proximal end to provide user feedback.
• FIG. 18C is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a sliding sleeve around the flow tube that is moved to reveal a scale at the distal end to provide user feedback by mechanical means.
• FIG. 18D is a top perspective view of the irrigation/aspiration/blowing robotic surgical tool with a rotational sleeve around the flow tube that rotates to reveal a scale at the distal end and provide user feedback by mechanical means.
• FIG. 18E is a perspective view of a first tip for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback.
• FIG. 18F is a perspective view of a second tip for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback.
• FIG. 18G is a perspective view of a third tip for the irrigation/aspiration/blowing robotic surgical tool ofFIG. 18D with a rotational sleeve around the flow tube that rotates to reveal a scale and provide user feedback.
• FIG. 19 is a viewer of the robotic surgical master control console ofFIG. 3A with an icon overlaid onto the displayed images to provide user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool.
• FIG. 20A illustrates a viewer of the master control console ofFIG. 3A with an icon overlay in a single side to provide user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool.
• FIG. 20B illustrates a viewer of the master control console ofFIG. 3A with an icon overlay in both left and right sides to provide three-dimensional user feedback as to the control of the irrigation/aspiration/blowing robotic surgical tool.
DETAILED DESCRIPTION
• In the following detailed description of the embodiments of the invention, numerous specific details are set forth in order to provide a thorough understanding of the embodiments of the invention. However, it will be obvious to one skilled in the art that the embodiments of the invention may be practiced without these specific details. In other instances well known methods, procedures, components, and circuits have not been described in detail so as not to unnecessarily obscure aspects of the embodiments of the invention.
• The embodiments of the invention include a method, apparatus, and system for robotically controlled irrigation/aspiration/blowing of an internal or external surgical area or site where robotic surgery is being performed. Aspiration may also be referred to as suction.
• In one embodiment of the invention a robotic surgical system is provided including a master control console, a surgical manipulator, a first hose, and a first pump. The master control console is used to generate control signals to cause one or more fluids to flow into or out of a surgical site. The surgical manipulator is coupled to the master control console to receive the control signals. The surgical manipulator includes at least one robotic arm to manipulate at least one robotic surgical instrument, and a surgical instrument coupled to the robotic arm. The surgical manipulator controls the surgical instrument in response to the control signals to control the flow of the one or more fluids into or out of the surgical site. The surgical instrument has a first robotically controlled valve responsive to the surgical manipulator and a hollow tube having an opening at one end to direct the flow of one or more fluids in the surgical site. The first robotically controlled valve has a first port and a second port and the hollow tube has a first end coupled to the second port of the first robotically controlled valve. The first hose has a first end coupled to the first port of the first robotically controlled valve. The first hose transports a first fluid to the first robotically controlled valve. The first pump has a port coupled to a second end of the first hose. The first pump pumps a first fluid through the first hose to the first robotically controlled valve of the surgical instrument.
• In another embodiment of the invention, a robotic surgical system is provided including a master control console, a surgical manipulator, and a first pump. The master control console generates control signals to cause a fluid to flow into or out of a surgical site. The surgical manipulator is coupled to the master control console to receive the control signals. The surgical manipulator includes at least one robotic arm to manipulate at least one surgical instrument. A surgical instrument is coupled to the robotic arm to control the flow of a fluid into or out of the surgical site. The surgical instrument has a first hose, a first robotically controlled pinch valve, and a hollow tube. The first hose is flexible and has a first end and a second end. The first robotically controlled pinch valve receives the first hose. The first robotically controlled pinch valve squeezes and pinches closed the first hose and releases and opens the first hose. The hollow tube has a first end to couple to the first end of the first hose. The first pump has a port coupled to the second end of the first hose.
• In another embodiment of the invention, a method is provided. The method includes generating a first control signal to control a robotic surgical instrument; coupling the first control signal into the robotic surgical instrument; and opening a first valve in the robotic surgical instrument to flow a first fluid over a surgical site in response to the first control signal.
• In another embodiment of the invention, another method is provided. The method includes mounting an irrigation-aspiration robotic surgical instrument to a robotic arm of a robotic surgical manipulator; coupling at least one hose from the irrigation-aspiration robotic surgical instrument to at least one pump; inserting a tip of a hollow tube of the irrigation-aspiration robotic surgical instrument into a patient near a surgical site; controlling a flow of a fluid between the surgical site and the irrigation-aspiration robotic surgical instrument; and monitoring a level of the flow of the fluid between the surgical site and the irrigation-aspiration robotic surgical instrument.
• In yet another embodiment of the invention, a robotic surgical instrument is provided for the control of flows of one or more fluids into and out of a surgical site. The robotic surgical instrument includes a housing, a flow control system mounted in the housing, a hollow tube having a first end mounted in the housing, and one or more hose fittings having a first end coupled to the flow control system. The housing can couple the robotic surgical instrument to a robotic arm. The flow control system includes one or more controlled valves to control the flow of one or more fluids through the robotic surgical instrument. The first end of the hollow tube couples to the flow control system. The one or more hose fittings have a second end to respectively couple to one or more hoses.
• In still another embodiment of the invention, another robotic surgical instrument is provided for the control of flows of one or more fluids into and out of a surgical site.
• The robotic surgical instrument includes an interface base, a hollow tube having a proximal end mounted to the interface base, a three-way coupler having a first port coupled to the proximal end of the hollow tube, a first robotically controlled valve coupled to the interface base, and a second robotically controlled valve coupled to the interface base. The interface base can mechanically and electrically couple to an end of a robotic arm. The hollow tube further has a distal end for placement in a surgical site to allow the flow of fluids into and out of a surgical site. The three-way coupler further has a second port and a third port to couple the first port, the second port, and the third port together to flow fluids there-between. The first robotically controlled valve having a first port to couple to a first hose and a second port coupled to the second port of the three-way coupler. The first robotically controlled valve controls the flows of a first fluid. The second robotically controlled valve having a first port to couple to a second hose and a second port coupled to the third port of the three-way coupler. The second robotically controlled valve controls the flows of a second fluid.
• Robotic surgery generally involves the use of a robot manipulator that has multiple robotic manipulator arms. One or more of the robotic manipulator arms often support a surgical tool which may be articulated (such as jaws, scissors, graspers, needle holders, micro dissectors, staple appliers, tackers, suction/irrigation tools, clip appliers, or the like) or non-articulated (such as cutting blades, cautery probes, irrigators, catheters, suction orifices, or the like). One or more of the robotic manipulator arms are often used to support a surgical image capture device such as an endoscope (which may be any of a variety of structures such as a laparoscope, an arthroscope, a hysteroscope, or the like), or, optionally, some other imaging modality (such as ultrasound, fluoroscopy, magnetic resonance imaging, or the like). Typically, the arms will support at least two surgical tools corresponding to the two hands of a surgeon and one image capture device.
• Robotic surgery may be used to perform a wide variety of surgical procedures, including but not limited to open surgery, neurosurgical procedures (such as stereotaxy), endoscopic procedures (such as laparoscopy, arthroscopy, thoracoscopy), and the like.
Robotic Surgical System
• Referring now toFIG. 1, a block diagram of arobotic surgery system100 is illustrated to perform minimally invasive robotic surgical procedures using an irrigation/aspiration/blowing (IAB) roboticsurgical tool101A. The irrigation/aspiration/blowing roboticsurgical tool101A is a robotic endoscopic surgical instrument that is manipulated by a slaved robotic manipulator and remotely controlled by control signals received from a master control console. In contrast, manual endoscopic surgical instruments are directly controlled by hand.
• A user or operator O (generally a surgeon) performs a minimally invasive surgical procedure on patient P by manipulating input devices at amaster control console150. Acomputer151 of theconsole150 directs movement of robotically controlled endoscopic surgical instruments (generally numbered101), effecting movement of the instruments using a roboticsurgical manipulator152. The roboticsurgical manipulator152 may also be referred to as robotic patient-side cart system or simply as a cart. The roboticsurgical manipulator152 has one or morerobotic arms153. Typically, the roboticsurgical manipulator152 includes at least threerobotic manipulator arms153 supported by linkages, with a central arm supporting an endoscopic camera and therobotic arms153 to left and right of center supporting tissue manipulation tools and the irrigation/aspiration/blowing roboticsurgical tool101A such as therobotic manipulator arm153C.
• An assistant A may assist in pre-positioning of the roboticsurgical manipulator152 relative to patient P as well as swapping tools orinstruments101 for alternative tool structures, and the like, while viewing the internal surgical site via an assistant'sdisplay154. The image of the internal surgical site shown to A by the assistant'sdisplay154 and operator O by surgeon'sconsole150 is provided by one of thesurgical instruments101 supported by the roboticsurgical manipulator152.
• Generally, therobotic arms153 of roboticsurgical manipulator152 include a positioning portion and a driven portion. The positioning portion of the roboticsurgical manipulator152 remains in a fixed configuration during surgery while manipulating tissue. The driven portion of the roboticsurgical manipulator152 is actively articulated under the direction of the operator O generating control signals at the surgeon'sconsole150 during surgery. The actively driven portion of thearms153 is herein referred to as anend effector158. The positioning portion of therobotic arms153 that are in a fixed configuration during surgery may be referred to as positioning linkage and/or “set-up joint”56,56′.
• To support the irrigation/aspiration/blowing roboticsurgical tool101A, the robotic surgical system may further include one ormore pumps102A-102C, one or moreinline filters104A-104C, and one ormore hoses106A-106C. For irrigation, thepump102A is a sterile fluid pump and may be an intravenous (IV) pump with an input port or inlet coupled to anIV bag108 through ahose106D. The output port or outlet of thepump102A may couple to the roboticsurgical instrument101A directly or through theinline filter104A. TheIV bag108 may have a pressure cuff. For aspiration, thepump102B is avacuum pump102B with anoutput port110 exhausting to atmosphere and an input port coupling to asuction canister105 through theinline filter104B. In an alternate embodiment of the invention, suction may be provided to rooms at a wall inlet to isolate the noise of thevacuum pump102B. For blowing, thepump102C is a gas compressor with an input port coupled to a source ofgas111, such as oxygen or air, and an output port coupled to theinstrument101A through theinline filter104C.
• The one ormore hoses106A-106C may be joined together along a portion of their length and into one end to couple to theinstrument101A for ease of coupling and to readily manage a plurality of hoses as one unit at therobotic manipulator152. Towards the opposite end, the one ormore hoses106A-106C may separate to couple to the inline filters, the pumps, thecanister105, or other pipe fittings as the case may be.
• In one embodiment of the invention, themaster control console150 may control the one ormore pumps102A-102C and any valves thereat in order to control fluid flow between the pumps and theinstrument101A into and out of the surgical site. One or morecontrol signal lines109A-109C may couple between thecomputer151 and the one ormore pumps102A-102C and any valves thereat in order that they may be controlled by control signals from themaster control console150. In which case, thehoses106A-106C may simply couple to a coupler within theinstrument101A as is discussed further below with reference toFIGS. 15A-15B.
• Referring now toFIG. 2A, a perspective view of the roboticsurgical manipulator152 is illustrated. The roboticsurgical manipulator152 has one or more roboticsurgical arms153. Therobotic arm153C includes an irrigation/aspiration/blowing roboticsurgical tool101A coupled thereto at theend effector158. The roboticsurgical manipulator152 further includes a base202 from which the roboticsurgical instruments101 may be supported. More specifically, the roboticsurgical instruments101 are each supported by thepositioning linkage156 and theend effector158 of thearms153. It should be noted that these linkage structures are here illustrated withprotective covers206,208 extending over much of the robotic arms. It should be understood that theseprotective covers206,208 are optional, and may be limited in size or entirely eliminated in some embodiments to minimize the inertia that is manipulated by the servomechanism, and to limit the overall weight of roboticsurgical manipulator152.
• The roboticsurgical manipulator152 generally has dimensions suitable for transporting between operating rooms. It typically can fit through standard operating room doors and onto standard hospital elevators. The roboticsurgical manipulator152 may have a weight and a wheel (or other transportation) system that allows the cart to be positioned adjacent an operating table by a single attendant. The roboticsurgical manipulator152 may be sufficient stable during transport to avoid tipping, and to easily withstand overturning moments that may be imposed at the ends of the robotic arms during use.
• Referring now toFIG. 2B, a perspective view of the roboticsurgical arm153C is illustrated including the irrigation/aspiration/blowing roboticsurgical tool101A mounted thereto. Each of the robotic manipulatingarms153 preferably includes alinkage212 that constrains the movement of thesurgical tool101 mounted thereto. More specifically,linkage212 includes rigid links coupled together by rotational joints in a parallelogram arrangement so that the roboticsurgical tool101A rotates around apoint215 in space. At thepoint215, the robotic arm can pivot the roboticsurgical tool101A about apitch axis215A and ayaw axis215B. The pitch and yaw axes intersect at thepoint215, which is aligned along ashaft216 of roboticsurgical tool101A. In the case of the IAB roboticsurgical tool101A, the shaft is a hollow tube as is further discussed below.
• The robotic arm provides further degrees of freedom of movement to the roboticsurgical tool101A. Along aninsertion axis215C, parallel to the central axis of theshaft216 of the roboticsurgical tool101A, the roboticsurgical tool101A may slide into and out from a surgical site. The roboticsurgical tool101A can also rotate about theinsertion axis215C. As the roboticsurgical tool101A slides along or rotates about theinsertion axis215C, thecenter point215 is relatively fixed with respect to thebase218. That is, the entire robotic arm is generally moved in order to maintain or re-position back to thecenter point215.
• Thelinkage212 of therobotic arm153 is driven by a series ofmotors217 therein in response to commands from a processor or computer. Themotors217 in the robotic arm are also used to rotate and/or pivot the roboticsurgical tool101A at thepoint215 around theaxes215A-215C. If a roboticsurgical tool101 further has end effectors to be articulated or actuated, stillother motors217 in the robotic arm may be used to do so. A flow control system in the IAB roboticsurgical tool101A may be actuated by these other motors in therobotic arm153. However, alternative means may also be used to actuate or control the flow control system in the IAB roboticsurgical tool101A. Additionally, the motion provided by themotors217 may be mechanically transferred to a different location such as by using pulleys, cables, gears, links, cams, cam followers, and the like or other known means of transfer, such as pneumatics, hydraulics, or electronics.
• For endoscopic surgical procedures, theend effector158 of therobotic arm153 is often fitted with ahollow cannula219. The shaft or tube of the roboticsurgical tool101 may be inserted into thehollow cannula219. Thecannula219, which may be releasably coupled to therobotic arm153, supports the shaft or tube of the roboticsurgical tool101, preferably allowing the tool to rotate around theaxis215C and move axially through the central bore of the cannula along theaxis215C.
• The roboticsurgical tools101 are generally sterile structures, often being sterilizable and/or being provided in hermetically sealed packages for use. As the roboticsurgical tools101 will be removed and replaced repeatedly during many procedures, a tool holder could potentially be exposed to contamination if the interface directly engages the tool holder. To avoid contamination to a tool holder and possible cross contamination between patients, an adaptor for coupling to roboticsurgical tools101 is provided in a robotic arm of the robotic surgical manipulator.
• Referring now toFIGS. 2C, 2D, and4B, the mounting of the irrigation/aspiration/blowing roboticsurgical tool101A to anadapter228 of the robotic surgical arm is now briefly described.
• The roboticsurgical arm153 may include anadapter228 to which the IAB roboticsurgical tool101A or othersurgical tool101 may be mounted.FIG. 2D illustrates a front side of anexemplary adapter228. The front side of the adaptor128 is generally referred to as atool side230 and the opposite side is generally referred to as a holder side (not shown).
• FIG. 4B illustrates a back side of an exemplary IAB roboticsurgical tool400 as the IAB surgicalrobotic tool101A. The roboticsurgical tool400 includes an exemplarymountable housing401 including aninterface base412 that can be coupled to theadapter228. Theinterface base412 and theadapter228 may be electrically and mechanically coupled together to actuate the flow control system of the IAB roboticsurgical tool101A. Rotatably coupled to theinterface base412 are one or more rotatable receivingmembers418. Each of the one or more rotatable receivingmembers418 includes a pair ofpins422A and422B generally referred to as pins422.Pin422A is located closer to the center of each rotatable receivemember418 thanpin422B. The one or more rotatable receivingmembers418 can mechanically couple respectively to one or morerotatable drivers234 of theadapter228. The roboticsurgical tool101A may further include release levers416 to release it from theadapter228.
• Theinterface base412 may further include one or more electrical contacts or pins424 to electrically couple toelectrical connector242 of theadapter228. Theinterface base412 may further include a printedcircuit board425 and one or moreintegrated circuits426 coupled thereto and to the one or more pins424. The one or moreintegrated circuits426 may be used to identify the type of robotic surgical tool coupled to the robotic arm, so that it may be properly controlled by themaster control console150.
• Theadapter228 includes one or morerotatable drivers234 rotatably coupled to a floatingplate236. Therotatable drivers234 are resiliently mounted to the floatingplate236 by resilient radial members which extend into a circumferential indentation about the rotatable drivers. Therotatable drivers234 can move axially relative to floatingplate236 by deflection of these resilient structures.
• The floatingplate236 has a limited range of movement relative to the surrounding adaptor structure normal to the major surfaces of the adaptor. Axial movement of the floating plate helps decouple therotatable drivers234 from a roboticsurgical tool101 when its release levers416 are actuated.
• The one or morerotatable drivers234 of theadapter228 may mechanically couple to a part of thesurgical tools101. Each of therotatable drivers234 may include one ormore openings240 to receive protrusions or pins422 of rotatable receivingmembers418 of the roboticsurgical tools101. Theopenings240 in therotatable drivers234 are configured to accurately align with therotatable receiving elements418 of thesurgical tools101.
• Theinner pins422A and theouter pins422B of therotatable receiving elements418 respectively align with theopening240A and theopening240B in each rotatable driver. Thepins422A andopenings240A are at differing distances from the axis of rotation than thepins422B andopenings240B so as to ensure thatrotatable drivers234 and therotatable receiving elements418 are not aligned 180 degrees out of phase from their intended position. Additionally, each of theopenings240 in the rotatable drivers may be slightly radially elongated so as to fittingly receive the pins in the circumferential orientation. This allows thepins422 to slide radially within theopenings240 and accommodate some axial misalignment between the tool and theadapter228, while minimizing any angular misalignment and backlash between therotatable drivers234 and therotatable receiving elements418. Additionally, the interaction betweenpins422 andopenings240 helps restrain the roboticsurgical tool101 in the engaged position with theadapter228 until the release levers416 along the sides of thehousing401 push on the floatingplate236 axially from the interface so as to release thetool101.
• When disposed in a first axial position (away from the tool side230) the rotatable drivers are free to rotate without angular limitation. The one or morerotatable drivers234 may rotate clockwise or counter-clockwise to further actuate the systems and tools of the roboticsurgical instruments101. However, as the rotatable drivers move axially toward thetool side230, tabs (extending radially from the rotatable drivers) may laterally engage detents on the floating plates so as to limit the angular rotation of the rotatable drivers about their axes. This limited rotation can be used to help engage the rotatable drivers the rotating members of the tool as thepins422 may push the rotatable bodies into the limited rotation position until the pins are aligned with (and slide into) the openings140 in the rotatable drivers.
• Whilerotatable drivers234 are described here, other types of drivers or actuators may be provided in theadapter228 to actuate systems or tools of the roboticsurgical instruments101. Theadapter228 further includes anelectrical connector242 to electrically couple tosurgical instruments101.
• The mounting of roboticsurgical tool101A to theadapter228 generally includes inserting the tip or distal end of the shaft or hollow tube of the robotic surgical tool through thecannula219 and sliding theinterface base412 into engagement with theadapter228, as illustrated inFIG. 2C. Alip232 on the tool side130 of the adaptor128 slidably receives the laterally extending portions of theinterface base412 of the robotic surgical tool. Acatch244 ofadapter228 may latch onto the back end of theinterface base412 to hold thetool101A in position. The protrusions or pins422 extending from the one or morerotatable members418 of the robotic surgical tool couple into theholes240 in therotatable drivers234 of theadapter228.
• The range of motion of therotatable receiving elements418 in the robotic surgical tool may be limited. To complete the mechanical coupling between the rotatable drivers of the adapter and therotatable receiving elements418, the operator O at the surgicalmaster control console150 may turn the rotatable drivers in one direction from center, turn the rotatable drivers in a second direction opposite the first, and then return the rotatable drivers to center. Further, to ensure that thepins422enter openings240 ofadapter228, theadapter228 andtool101A mounted thereto may be moved along theaxis215C. Theadapter228 andtool101A mounted thereto may be moved to an initial position so that the tip or distal end of the shaft or hollow tube is disposed within thecannula219.
• To dismount and remove the roboticsurgical tool101A, the release levers416 may be squeezed pushing out on themountable housing401 to release thepins422 from theholes240 and thecatch244 from the back end of the interface base. Themountable housing401 is then pulled up to slide theinterface base412 up and out from theadapter228. Themountable housing401 is continually pulled up to remove the tip or distal end of the shaft or hollow tube out from thecannula219. After the roboticsurgical tool101A is dismounted, another robotic surgical tool may be mounted in its place, including a new or freshly sterilized IAB roboticsurgical tool101A.
• As previously discussed, the roboticsurgical tool101A may include one or moreintegrated circuits426 to identify the type of robotic surgical tool coupled to the robotic arm, such that it may be properly controlled by themaster control console150. However, the robotic surgical system may determine whether or not the robotic surgical tool is compatible or not, prior to its use.
• The system verifies that the tool is of the type which may be used with the roboticsurgical system100. The one or moreintegrated circuits426 may signal to thecomputer151 in themaster control console150 data regarding compatibility and tool-type to determine compatibility as well as control information. One of theintegrated circuits426 may include a non-volatile memory to store and read out data regarding system compatibility, the tool-type and the control information. In an exemplary embodiment, the data read from the memory includes a character string indicating tool compatibility with the roboticsurgical system100. Additionally, the data from the tool memory will often include a tool-type to signal to the master control console how it is to be controlled. In some cases, the data will also include tool calibration information. The data may be provided in response to a request signal from thecomputer151.
• Tool-type data will generally indicate what kind of tool has been attached in a tool change operation. For example, the tool-type data might indicate that an IAB roboticsurgical instrument101A has been mounted to the robotic arm. The tool-type data may include information on wrist axis geometries, tool strengths, grip force, the range of motion of each joint, singularities in the joint motion space, the maximum force to be applied via therotatable receiving elements418, the tool transmission system characteristics including information regarding the coupling of rotatable receivingelements418 to actuation or articulation of a system within the robotic surgical instrument.
• Instead of storing all of the tool-type date in the one or moreintegrated circuits426, most of the tool-type data may optionally be stored in memory or a hard drive of thecomputer151 in the roboticsurgical system100. An identifier may be stored in the one or moreintegrated circuits426 to signal thecomputer151 to read the relevant portions of data in a look up table store in the memory or the hard drive of the computer. The tool-type data in the look-up table may be loaded into a memory ofcomputer151 by the manufacturer of the roboticsurgical system100. The look-up table may be stored in a flash memory, EEPROM, or other type of non-volatile memory. As a new tool-type is provided, the manufacturer can revise the look-up table to accommodate the new tool-specific information. It should be recognized that the use of tools which are not compatible with the robotic surgery system, for example, which do not have the appropriate tool-type data in an information table, could result in inadequate robotic control over robotic surgical tool by thecomputer151 and the operator O.
• In addition to the tool-type data, tool specific information may be stored in theintegrated circuit426, such as for reconfiguring the programming ofcomputer151 to control the tool. There may be calibration information, such an offset, to correct a misalignment in the robotic surgical tool. The calibration information may be factored into the overall control of the robotic surgical tool. The storing of such calibration information can be used to overcome minor mechanical inconsistencies between tools of a single type. For example, the tool-type data including the tool-specific data may be used to generate appropriate coordinate transformations and servo drive signals to manipulate the robotic arm and rotate therotatable drivers234.
• Additionally, some robotic surgical tools have a limited life span. Tool life and cumulative tool use information may also be stored on the tool memory and used by the computer to determine if the tool is still safe for use. Total tool life may be measured by clock time, by procedure, by the number of times the tool has been loaded onto a holder, and in other ways specific to the type of tool. Tool life data is preferably stored in the memory of the tool using an irreversible writing process.
• Referring now toFIG. 3A, a perspective view of a robotic surgicalmaster control console150 is illustrated. Themaster control console150 of the roboticsurgical system100 includes thecomputer151, abinocular viewer312, anarm support314, amicrophone315, a pair of control input wrists and control input arms in aworkspace316, aspeech recognizer317, foot pedals318 (includingfoot pedals318A-318B), and aviewing sensor320.
• Thecomputer151 may include one ormicroprocessors302 to execute instructions and astorage device304 to store software with executable instructions that may be used to generate control signals to control the roboticsurgical system100. Themaster control console150 generates the control signals to control the fluid flows through the embodiments of the IAB robotic surgical instruments into and out of a surgical site.
• Theviewer312 has at least one display where images of a surgical site may be viewed to perform minimally invasive surgery. As discussed further below, theviewer312 may be used to provide user-feedback to the operator O as to the control of the fluid flow through the IAB robotic surgical instruments into and out of a surgical site
• The arm support14 can be used to rest the elbows or forearms of the operator O (typically a surgeon) while gripping touch sensitive handles325 (seeFIGS. 3B-3C), one in each hand, of the pair ofcontrol input wrists352 in theworkspace316 to generate control signals. The touchsensitive handles325 are positioned in theworkspace316 disposed beyond thearm support314 and below theviewer312.
• When using the master control console, the operator O typically sits in a chair, moves his or her head into alignment with thebinocular viewer312, and grips the touchsensitive handles325 of thecontrol input wrists352, one in each hand, while resting their forearms against thearm support314. This allows the touch sensitive handles to be moved easily in thecontrol space316 in both position and orientation to generate control signals.
• Additionally, the operator O can use his feet to control the foot-pedals to change the configuration of the surgical system and generate additional control signals to control robotic surgical instruments.
• To ensure that the operator is viewing the surgical site when controlling the roboticsurgical tools101, themaster control console150 may include theviewing sensor320 disposed adjacent thebinocular display312. When the system operator aligns his or her eyes with the binocular eye pieces of thedisplay312 to view a stereoscopic image of the surgical worksite, the operator's head sets off theviewing sensor320 to enable the control of the roboticsurgical tools101. When the operator's head is removed the area of thedisplay312, theviewing sensor320 can disable or stop generating new control signals in response to movements of the touch sensitive handles in order to hold the state of the robotic surgical tools.
• Thecomputer151 with itsmicroprocessors302 interprets movements and actuation of the touch sensitive handles325 (and other inputs from the operator O or other personnel) to generate control signals to control the roboticsurgical instruments101 in the surgical worksite. In one embodiment of the invention, thecomputer151 and theviewer312 map the surgical worksite into thecontroller workspace316 so it feels and appears to the operator that the touchsensitive handles325 are working over surgical worksite.
• Referring now toFIG. 3B, a perspective view of acontrol input wrist352 with a touchsensitive handle325 is illustrated. Thecontrol input wrist352 is a gimbaled device that pivotally supports the touchsensitive handle325 of themaster control console150 to generate control signals that are used to control the roboticsurgical manipulator152 and the roboticsurgical tools101, including an IAB roboticsurgical tool101A. A pair ofcontrol input wrists352 are supported by a pair of control input arms in theworkspace316 of themaster control console150.
• Thecontrol input wrist352 includes first, second, andthird gimbal members362,364, and366. The third gimbal member is rotationally mounted to a control input arm (not shown).
• The touchsensitive handle325 includes atubular support structure351, afirst grip350A, and asecond grip350B. The first grip and the second grip are supported at one end by thestructure351. The touchsensitive handle325 can be rotated about axis G illustrated inFIGS. 3B-3C. Thegrips350A,350B can be squeezed or pinched together about thetubular structure351. The “pinching” or grasping degree of freedom in the grips is indicated by arrows Ha,Hb inFIG. 3B and arrows H inFIG. 3C.
• The touchsensitive handle325 is rotatably supported by thefirst gimbal member362 by means of a rotational joint356g. Thefirst gimbal member362 is in turn, rotatably supported by thesecond gimbal member364 by means of the rotational joint356f. Similarly, thesecond gimbal member364 is rotatably supported by thethird gimbal member366 using a rotational joint356d. In this manner, the control wrist allows the touchsensitive handle325 to be moved and oriented in theworkspace316 using three degrees of freedom.
• The movements in the gimbals of thecontrol wrist352 to reorient the touch sensitive handle in space can be translated into control signals to control the roboticsurgical manipulator152 and the roboticsurgical tools101. In particular, the rotational motion of the touchsensitive handle325 about axis G inFIGS. 3B-3C may be used to control the flow of fluids through the IAB robotic surgical tools.
• The movements in thegrips350A,350B of the touchsensitive handle325 can also be translated into control signals to control the roboticsurgical manipulator152 and the roboticsurgical tools101. In particular, the squeezing motion of thegrips350A,350B over their freedom of movement indicated by arrows Ha,Hb or H, may be used to control the flow of fluids through the IAB robotic surgical tools.
• In embodiments of the invention, one or a combination of both the rotational motion of the touchsensitive handle325 and the squeezing motion of thegrips350A,350B may be used to control the flow of fluids through the IAB robotic surgical tools. For example, the rotational motion of the touchsensitive handle325 may be used for the control of irrigation while the squeezing motion of thegrips350A,350B may be used for controlling suction in a surgical site.
• To sense the movements in the touch sensitive handle and generate controls signals for the IAB robotic surgical tool, sensors can be mounted in thehandle325 as well as thegimbal member362 of thecontrol input wrist352. Exemplary sensors may be a Hall effect transducer, a potentiometer, an encoder, or the like.
• Referring now toFIG. 3C, a cross-sectional view of the touchsensitive handle325 andgimbal member362 of thecontrol input wrist352 is illustrated.FIG. 3C provides an example as to how the touchsensitive handle325 can be mounted to thecontrol input wrist352 to sense the gripping and rotation of the handle to control roboticsurgical tools101, including IAB roboticsurgical tools101A.
• As illustrated inFIG. 3C, theexemplary gimbal member362 includes beveled gears368a,368bwhich can couple the rotational motion of the touchsensitive handle325 to aroll sensor370. Theroll sensor370 may use a potentiometer orencoder370bincluded in aroll motor370ato sense the rotation. Alternatively, a separate roll sensor, such as a potentiometer, may be directly coupled to theshaft380 to sense the rotation of the touch sensitive handle. In any case, a roll sensor senses the roll motion of the touchsensitive handle325 and generates control signals in response thereto to control the roboticsurgical tools101. The control of IAB roboticsurgical tools101A using the roll motion of the touchsensitive handle325 is discussed below with reference toFIG. 16A.
• To sense a squeezing motion in thegrips350A,350B of the touchsensitive handle325, aremote sensing assembly386 may be included by thegimbal member362. The first andsecond grips350A,350B are adapted to be squeezed together by a hand of an operator O so as to define a variable grip separation. The grip separation may be determined as a function of a variable grip angle with an axis or as a function of a variable grip separation distance, or the like. Alternative handle actuations, such as movement of a thumbwheel or knob may also be provided in the handle to control the roboticsurgical instruments101.
• In the exemplary embodiment, theremote sensor assembly386 includes acircuit board394 on which a first and a second Hall effect sensors, HE1, HE2 are mounted. Amagnet396 is disposed distally beyond thecircuit board394 and the Hall effect sensors. Amagnetic mass398 is axially coupled to the proximally orientedsurface390 of a push rod84. Thus, themagnetic mass398 moves (as shown by Arrow J) with thepush rod384 and varies the magnetic field at the Hall effect sensors in response actuation of thegrips350A,350B.
• To translate the squeezing action of thegrips350A,350B to thesensor386, thegimbal member362 includes apush rod384 within thetubular handle structure351. Each of thegrips350A,350B pivot about arespective pivot334a,334bin thetubular handle structure351. Urginglinks335a,335brespectively couple between thegrips350A,350B and a first end of thepush rod384. The squeezing action of thegrips350A,350B is translated into a linear motion on thepush rod384 by means of urginglinks335a,335bas shown by arrow A inFIG. 3C. A second end of thepush rod384 couples to thesensor386. As discussed previously, themagnetic mass398 is axially coupled to thesurface390 of thepush rod384 in order to sense the linear motion in the push rod and the squeezing motion of thegrips350A,350B.
• A biasing mechanism such as spring392 applies a force against the squeezing motion of the grips to return them to full open when the grips are released. The biasing spring392 may be a linear or non-linear elastic device biasing against the depression ofgrips350A,350B, e.g., a single or multiple element assembly including springs or other elastic members. For example, spring392 may comprise a concentric dual spring assembly whereby one spring provides a “softer” bias response as thegrips350A,350B are initially depressed, and a second spring provides a superimposed “firm” bias response as thegrips350A,350B approach a fully depressed state. Such a non-linear bias may provide a pseudo force-feedback to the operator.
• It should be noted that a wide variety of alternative sensing arrangements may be used to translate the mechanical actuation of the touch sensitive handle and control input wrist into control signals. While Hall effect sensors are included in the exemplary embodiment, alternative embodiments may include encoders, potentiometers, or a variety of alternative optical, electrical, magnetic, or other sensing structures.
Irrigation/Aspiration/Blowing Robotic Surgical Instrument
• A number of embodiments of irrigation/aspiration/blowing (IAB) robotic surgical tools that can be mounted to a robotic arm in a robotic surgical system are now described.
• Referring toFIGS. 4A-4B, an irrigation/aspiration/blowing (IAB) robotic surgical tool orinstrument400 is illustrated in greater detail than that ofinstrument101A. In one embodiment of the invention, the IAB roboticsurgical instrument400 has an interface that is backward compatible to theadapter228 that is typically used for other types of robotic surgical instruments. In yet another embodiment of the invention, the IAB roboticsurgical instrument400 has a reusable instrument housing with modular valve components that are disposable. In yet another embodiment of the invention, the entire IAB roboticsurgical instrument400 is disposable.
• The IAB roboticsurgical instrument400 includes amountable housing401 at a proximal end and ahollow tube404 coupled together as shown inFIG. 4A. Themountable housing401 maybe a reusable housing including some reusable components therein. Themountable housing401 is backward compatible and includes aninterface base412 that can couple to theadapter228 to which other surgical tools may also couple. Themountable housing401 may further include one ormore tube fittings410A-410C, acover414, and one or more release levers416.
• Thehollow tube404 is elongated and has anopening424 at itstip406, the distal end of theinstrument400. Thehollow tube404 may also be referred to as a hollow instrument shaft or a hollow probe. Thehollow tube404 may be reusable or disposable. Thehollow tube404 maybe coupled to theinterface base412 for additional support. Alternative, thehollow tube404 may couple directly to a modular disposable valve subassembly and avoid coupling to the interface base such that it too is disposable.
• In one embodiment of the invention, thehollow tube404 is a hollow circular cylindrical shape. Fluids (e.g., gas, liquid, with or without solids) may flow in thehollow tube404 and into or out from a surgical site through theopening424 at thetip406. Thehollow tube404 may further include one or moresmaller openings422 around its circumference substantially near thetip406 to further allow fluid to flow into and out of a surgical site. The diameter of theopening424 may be substantially same as the inner diameter of thetube404. In one embodiment of the invention, the diameter of thehollow tube404 may be between 5 mm and 8 mm. Thehollow tube404 may be formed out of metal, plastic or other rigid material that can be hollow to allow fluid to flow therein while being positioned within a patient's body at a surgical site or over a surgical area.
• Theinterface base412 is used to mount theinstrument400 to a robotic arm of a surgical robotic manipulator. Theinterface base412 both mechanically and electrically couples the IAB roboticsurgical instrument400 to a robotic arm of the surgicalrobotic manipulator152. The release levers416 are located at the sides of the mountable housing and may be used to release the roboticsurgical instrument400 from a robotic arm.
• A first end of the one ormore tube fittings410A-410C may respectively couple to the one ormore hoses106A-106C, respectively. The one ormore tube fittings410A-410C may be barb fittings, luer fittings, or other types of hose or tube fittings. A second end of the one ormore tube fittings410A-410C couples to aflow control system417 within themountable housing401. In some embodiments of the invention, the one ormore hoses106A-106C may directly couple to the flow control system without the one ormore tube fittings410A-410C. The end of thehollow tube404 opposite thetip406, also couples to theflow control system417.
• Theflow control system417 controls the flow of fluids, including any solids that may be transported by the fluid, between the surgical site and the one ormore hoses106A-106C through the IAB roboticsurgical instrument400. Theflow control system417 may include one or more valves of a valve subassembly to control the flow of fluids and any solids that may be transported by the fluid. Note that a fluid may be a liquid, a gas, a vacuum, or any combination thereof. Theflow control system417 may be controlled by control signals generated by an operator O at themaster control console150 to control the fluid flow through the IAB roboticsurgical instrument400. In addition to robotic control, a number of embodiments of the invention include an optional manual actuation of the valves of the IAB roboticsurgical instrument400. In which case, either an assistant A can manually operate theflow control system417 and control the fluid flow or the operator O at themaster control console150 may robotically operate theflow control system417 to control the fluid flow through the IAB roboticsurgical instrument400. The operator O at themaster control console150 can position the IAB roboticsurgical instrument400 where the operator wants it within the surgical site. Then, to free up the operator's hands to perform some other task at the master control console, the IAB roboticsurgical instrument400 may be controlled manually by an assistant, remaining attached to a robotic arm. The operator can then give verbal instructions to the assistant to manually control the irrigation/suction/blowing in the surgical site selected by the operator.
• Thecover414 covers over to protect theflow control system417 such as a valve subassembly from damage and to maintain a sterile surgical environment during surgery. As thesurgical instrument400 is used during an operation or surgery at a surgical site of human patient, it is important that its components be sterilized.
• As body fluids of a human patient will be flowing through thesurgical instrument400 during use, it may be desirable to re-sterilize the IAB robotic surgical tool for reuse. However, it may be difficult to re-sterilize portions of theflow control system417, such as valves, within the IAB roboticsurgical tool400. Thus, portions of theflow control system417 may be replaced instead of sterilized after usage. If components forming the IAB roboticsurgical instrument400 are relatively inexpensive, the IAB roboticsurgical instrument400 may be discarded in its entirety instead of re-sterilzing or replacing components.
• FIG. 4B illustrates a back side view of a portion of the IAB roboticsurgical tool400, some elements of which were previously discussed. In particular, theinterface base412 is illustrated with rotatable receivingelements418 rotatably coupled thereto. Therotatable receiving elements418 provide a mechanical coupling to therotatable drivers234 and drive motors mounted of the roboticsurgical manipulator152. Each of therotatable receiving elements418 include a pair ofpins422 extending from a surface thereof. Aninner pin422A is closer to an axis of rotation of each rotatable receivingelements418 than anouter pin422B, which helps to ensure positive angular alignment of therotatable receiving elements418. In one embodiment of the invention, therotatable receiving elements418 are disk shaped and may be referred to as rotatable disks.
• Theinterface base412 further includes an array of electrical connectingpins424 and one or moreintegrated circuits426 coupled to a printedcircuit board425 within themountable housing401. As theinterface base412 is backward compatible to theadapter228, it maybe mechanically actuated by pre-existing driver motors found in the roboticsurgical manipulator152. While theinterface base412 has been described herein with reference to mechanical and electrical coupling elements, it should be understood that other modalities maybe used, including infrared coupling, magnetic coupling, inductive coupling, or the like.
• Referring now toFIGS. 5A-5D, schematic flow diagrams of roboticsurgical tools500A-500D are respectively illustrated to provide irrigation, suction, blowing, or any combination thereof within a surgical site.
• FIG. 5A is a schematic flow diagram of an irrigation/aspiration roboticsurgical tool500A that uses a pair of valves mounted within ahousing501A. Thetool500A includes thehollow tube504, avalve subassembly506, a three-way coupler508, andtube fittings509A-509B. Thetube fittings509A-509B may have anirrigation hose106A and asuction hose106B respectively coupled thereto.
• Thevalve subassembly506 includes a first two-way two-position valve510A and a second two-way two-position valve510B. After use, thevalve subassembly506 may be removed and replaced by a new sterilized valve subassembly for reuse of thetool500A. The valves are a component of the tool that is more difficult to clean and sterilize for reuse.
• Each of the twoway valves510A-510B includes two ports. A first port couples to the three-way coupler508 while a second port couples to thefittings509A or509B, respectively. A three-way coupler508 includes three ports one of which is coupled to thehollow tube504. The second port of the three-way coupler couples to a port of thevalve510A. A third port of the three-way coupler508 couples to a port of thevalve510B.
• A fluid may flow in or out of thehollow tube504 as illustrated by the double-headed arrow near the tip. Eithervalve510A or510B may be open so that a fluid may flow through thehollow tube504. Withvalve510B open andvalve510A substantially closed, a suction may be applied near the tip of thesurgical instrument500A so that a surgical site may be aspirated. Withvalve510B substantially closed andvalve510A open, a liquid may flow through thesurgical instrument500A out through thehollow tube504 into a surgical site so that it may be irrigated. The liquid is coupled to thesurgical instrument500A by thehose106A.
• FIG. 5B is a schematic flow diagram of an irrigation/aspiration roboticsurgical tool500B that uses a single valve mounted within ahousing501B to provide irrigation, or aspiration. Thesurgical instrument500B includes a single three-way valve516 with three ports, thehollow tube504, and thetube fittings509A-509B. The threeway coupler508 is not needed.
• The three-way valve516 has three ports. A first port of the three-way valve couples to the proximal end of thehollow tube504. A second port couples to the tube fitting509A that may couple to thehose106A. A third port of thevalve516 couples to the tube fitting509B that may in turn couple tohose106B.
• The three-way valve516 has three-positions of operation. In a closed position, the valve is completely shut off so that no fluid flows through thehollow tube504. In a second position suction is shut off, the first port and the second port of the valve couple together such that the surgical site may be irrigated by a liquid flowing throughvalve516 and into thehollow tube504. In a third position irrigation is shut off, the first port and the third port of the valve couple together such that a vacuum or a suction may flow throughvalve516 and a surgical site may be aspirated at the tip of thehollow tube504.
• FIG. 5C is a schematic flow diagram of an irrigation/aspiration/blowing roboticsurgical tool500C that uses a single valve mounted within ahousing501C to provide irrigation, aspiration or blowing. Thesurgical instrument500C includes a single four-way fourposition valve526, thehollow tube504, and thetube fittings509A-509B coupled together as illustrated in themountable housing501C. A fourway coupler508 is not needed.
• The single four-way valve526 includes four ports. A first port of the four-way valve526 couples to the proximal end of thehollow tube504. A second port of thevalve526 couples to one end of the tube fitting509A. A third port of thevalve526 couples to an end of the tube fitting509B. A fourth port of thevalve526 couples to an end of the tube fitting509C.Hoses106A-106C may respectively couple to thetube fittings509A-509C. In this manner three of the four ports ofvalve526 may receive a liquid for irrigation, a vacuum for suction and a pressurized gas for blowing, respectively.
• The four-way valve526 has four positions of operation. In a closed position, the valve is completely shut off so that no fluid flows through thehollow tube504. In a second position suction/blowing are shut off, the first port and the second port of the valve couple together such that the surgical site may be irrigated by a liquid flowing throughvalve526 and into thehollow tube504. In a third position irrigation/suction are shut off, the first port and the third port of the valve couple together such that a pressurized gas may flow throughvalve516 and out through the tip of thehollow tube504 to blow a surgical site with a pressurized gas. In a fourth position irrigation/blowing are shut off, the first port and the fourth port of the valve couple together such that a vacuum may provide suction through thevalve516 and thehollow tube504 to a surgical site to remove fluids and solids transported therein at the tip of thehollow tube504.
• FIG. 5D is a schematic flow diagram of an irrigation/aspiration/blowing roboticsurgical tool500D that uses three two-way valves in a valve subassembly mounted within ahousing501D to provide irrigation, aspiration or blowing. The roboticsurgical instrument500D includes a valve subassembly536, a four-way coupler538, thehollow tube504, and thetube fittings509A-509C. Thetube fittings509A-509C may couple to thehoses106A-106C, respectively.
• In place of the four-way valve526 illustrated inFIG. 5C, the valve subassembly536 includes three two-way two-position valves510A-510C of a valve subassembly536 in conjunction with a four-way coupler538. In comparison with thetool500A ofFIG. 5A, a third two-way valve510C is provided so that a third fluid may flow into and out of thehollow tube504. In this case, a pressurized gas may be supplied byhose106C, flow throughvalve510C when opened, flow through the fourway coupler538, and into thehollow tube504 to blow a pressurized gas near the surgical site.
• Each of the two way twoposition valves510A-510C includes two ports. A first port of each couples to respective ports of the four-way coupler538 while a second port of each couples to thefittings509A,509B or509C, respectively. The four-way coupler538 includes four ports one of which is coupled to thehollow tube504. The second port of the four-way coupler538 couples to a port of thevalve510A. A third port of the four-way coupler538 couples to a port of thevalve510B. A fourth port of the four-way coupler538 couples to a port of thevalve510C.
• Valve subassembly536 may be replaceable with a sterile component while the other elements mounted in thehousing501D may be separately sterilized and reused with a new valve subassembly536.
• Various types of valves may be used as part of theflow control system417 in the IAB roboticsurgical instrument400,101A to control the flow of fluids to provide irrigation, aspiration, or blowing. For example, a linear motion type of valve (“linear valve”) may be used such as a spool-type valve, a trumpet-type valve, a piston-type valve, a poppet-type valve, or a sliding-plate-type valve. Alternatively, a rotational motion type of valve (“rotatable valve”) may be used such as a ball-type valve, a screw-type valve, a gate-type valve, a disc-type valve, a cock-type valve, a globe-type valve, or a rotary-plate-type valve. Additionally, the various types of valves within the IAB robotic surgical instrument may be actuated in different ways by the roboticsurgical manipulator152. While three-way and two-way valves have been separately shown and described, any mixed combination of one or more two-way valves and one or more three-way valves, or other multi-port valve, may be used within an IAB robotic surgical instrument with different types of couplers to provide a flow control system therein. For example, an IAB robotic surgical instrument may include a three-way valve516 for gas pressure and suction and a two-way valve510A for irrigation by a liquid coupled to a three-way coupler508, which is in turn coupled to thetube504.
• Moreover, the valves used in the flow control system may be automatically returned to a closed position so that no fluid flows through the IAB robotic surgical tool when it is dismounted from the robotic arm or when the modular valve assembly is not mounted in the housing of the tool. That is, the valves may be spring loaded by a spring to return to a closed or fully off position when they are not actuated.
• FIGS. 6A-6C,7A-7C,8,9 and10A-10B illustrate some of the various types of valves, various types of actuation means, and various types of automatic return means that may be used to control the flow of fluids through the robotic surgical instrument and into the surgical site. It is understood that other types of valves, actuation means, and automatic return means may be used to provide flow control for a flow control system of an IAB robotic surgical tool.
• Referring now toFIGS. 6A-6C, rotational actuators to actuate rotatable valves are illustrated for use with the irrigation/aspiration/blowing robotic surgical tool and the robotic surgical arm.
• InFIG. 6A, therotatable receiving element418A is directly coupled to therotatable valve604A. As therotatable receiving element418A is rotated, a shaft of the rotatable valve rotates to a different position in order to open or close the valve and control the flow of fluids. For actuation, therotatable receiving element418A couples to therotatable driver234 of theadapter228 in the robotic arm. Thepins422A-422B of therotatable receiving element418A couple into therespective openings240A-240B of theadapter228. Acoil spring606 may be used to return therotatable valve604A to a closed or shut off position when the roboticsurgical tool101A is dismounted from the robotic arm.
• InFIG. 6B, arotatable receiving element418B rotatably couples to therotatable valve604B through a gearing provided by the gears610-611. Therotatable receiving element418B similarly couples to therotatable driver234. Therotatable receiving element418B includes thegear610 which also may be referred to as adriving gear610.Valve604B includes thepinion gear611 coupled to ashaft602 of the rotatable valve in order to rotate the valve from one position to another. The gearing may be use to reduce or increase the rotation in thedriver gear610 to rotate the valve. Therotatable receiving element418B may further include thecoil spring606 to return the three-way fourposition valve604B to a shut off position. Therotatable valve604B is a three-way valve including three ports and has three positions.
• InFIG. 6C, therotatable receiving element418C is linked to therotatable valve604C by means of alinkage620. Therotatable receiving element418C includes a drive wheel with anotch622 to receive a distal end of thelinkage620. Therotatable valve604C is a three-way three position valve. Therotatable receiving element418C may move thevalve604C into one of three positions. Inposition620A, the valve may be shut off so that no fluid flows through the roboticsurgical tool101A,400. Inposition620B, a first fluid may flow between a first port and a second port. Inposition620C, a second fluid may flow between the first port and a third port.
• To change positions of the valve using thelinkage620, therotatable receiving element418C may be moved counter clockwise, while the valve rotates clockwise. If therotatable receiving element418C moves clockwise, thelinkage620 causes the valve to rotate counter clockwise. To actuate the rotatable valve, therotatable receiving element418C couples to therotatable driver234 by means of thepins422A-422B coupling into the opening240A-240B respectively.
• FIGS. 7A-7C illustrate the linear actuation of linear motion valves that may be used in theflow control system417 of IAB robotic surgical tools. The dashed lines shown inFIGS. 7A-7C illustrate a dividing line between the roboticsurgical tool400,101A and actuation in the roboticsurgical arm153.
• InFIG. 7A, apush rod702 is linearly actuated in therobotic arm153. One end of thepush rod702 pushes on abutton703 of a linearmotion trumpet valve704A to move aplunger705 therein. Thetrumpet valve704A is a two-way two-position valve. Theplunger705 in its closed position blocks the first and second ports of thetrumpet valve704A. When the valve is linearly pushed open, aspring706 is compressed and the plunger moves to aposition705′ such that the first and second ports are open to pass a fluid.
• Thepush rod702 may be linearly actuated in robotic arm in a number of ways including, but not limited to, pneumatically, hydraulically, electromechanically, or electrically. For example, asolenoid701 may be used to linearly actuate thepush rod702 to linearly move thevalve704A to an open position. When thepush rod702 is not actuated, the force of thespring706 may push back on thepush rod702 and return the plunger of the valve to aclosed plunger position705 to shut off the first and second ports and stop a flow of a fluid. Thespring706 may also retain the plunger of the valve in aclosed plunger position705 to shut off the first and second ports when the IAB robotic surgical tool is dismounted.
• InFIG. 7B, aspool valve704B linearly moves in response to a magnetic force generated by theelectromagnet710 in therobotic arm153. Theelectromagnet710 may be formed out of coil ofwire711 wrapped around amagnetic core712. When no electromagnetic field is generated by theelectromagnet710, aspring706 keeps thespool715 in a closed position blocking the first and second ports of thespool valve704B. To actuate the spool valve, theelectromagnet710 is actuated to pull thespool715 in a linear motion intoposition715′ so that the center hourglass portion of thespool715 is coincident with the first and second ports to allow fluid to flow through thevalve704B.Spring706 is compressed with the spool inposition715′ such that when the electromagnetic force of theelectromagnet710 is released thespring706 pushes back on thespool715 to close off thevalve704B.
• InFIG. 7C, a three-way spool valve704C is electrically actuated by therobotic arm153 to move thespool725 with a linear motion.Electrical contacts242 in therobotic arm153 couple to thepins424 of the roboticsurgical tool400,101A. The three-way valve704C includes thespool725, three ports, afirst spring706A at a first end, and asecond spring706B at a second end, a first wire coil710A at the first end, and a second wire coil710B at the second end. A current in thewires721A may flow through the coil710A to attract thespool725 towards the first end of the valve so that theports726 and728 of the valve are coincident with the center hourglass portion of the spool to allow fluid to flow there-between. To shut off the valve, the current flow in thewires721A is turned off and thespool725 is pushed back into the closed position by the force ofspring706A.Springs706A-706B maintain the spool in the center position shutting off the three ports in the valve from each other. By providing a current in thewires721B and thecoil720B, thespool725 is moved towards the second end and compresses thespring706B. This allows the center hourglass portion of thespool725 to coincide with thesecond port727 and thethird port728 to allow a fluid to flow there-between. To shut off the valve, the current flow in thewires721B is turned off and thespring706B pushes thespool725 back to its closed position.
• Referring now toFIG. 8, a linear actuation is transformed into a rotational actuation for a rotatable valve by a rack and pinion gear system. When activated, apush rod702 linearly pushes against abutton803 of therack801 in order to linearly move itsteeth810 and provide the initial linear actuation. Theteeth810 of therack801 are meshed with thepinion gear811 to transform the initial linear actuation of the push rod into a rotational actuation. The pinion gear is coupled to ashaft802 of therotatable valve804. As the teeth of therack801 linearly move, thepinion gear811 transforms the linear motion into a rotational motion in order to rotate therotatable valve804 between open and closed positions to control the fluid flow.
• A spring may be coupled between an end of therack801 and a stop in order to linearly push on the rack and rotate and maintain the valve in a closed position when the IAB robotic surgical tool is dismounted.
• In addition to being robotically controlled from themaster control console150, the valves of theflow control system417 of the IAB robotic surgical tools may also be manually controlled. Manual actuators may be provided that extend external to the housing so that a user's hand may open and/or close the valves.
• Referring now toFIGS. 9A-9B, a rotational actuation is transformed into linear actuation by a cam and cam follower system for actuation of a linearmotion trumpet valve704A.Trumpet valve704A illustrated inFIGS. 9A-9B operates similarly totrumpet valve704A ofFIG. 7A but with acam follower903 in place of thebutton703 to better couple to therotating cam902. Additionally, thecam follower903 ofFIG. 9A may further include amanual push arm913 that may extend for a top side of a housing of the IAB robotic surgical tools for manual operation of thetrumpet valve704A. Thecam follower903 ofFIG. 9B may further include a manualpush side arm923 that may extend for a side of a housing of the IAB robotic surgical tools for manual operation of thetrumpet valve704A.
• Therotatable receiving element418D of the IAB robotic surgical tools is coupled to thecam902. For robotic control from themaster control console150, therotatable receiving element418D couples to therotatable driver234 by means of thepins422A-422B within theopenings240A-240B, respectively.
• Thecam902 includes acam lobe904 that pushes on thecam follower903 to aposition903′ so that theplunger705 is moved to anopen position705′. In theopen position705′, the plunger allows the first and second ports to couple together and allow a fluid to flow there-between. As the cam rotates to move the cam lobe to a different position so that the cam follower can move back to itsoriginal position903, thespring706 pushes on theplunger705 to move it back into the closed position to close thevalve704A.
• Thecam902 may rotate clockwise or counterclockwise so that the cam follower transforms a rotational motion into a linear motion to open and close thevalve704A. In this manner, a rotational actuation within the roboticsurgical tool400,101A may be converted to linear actuation and actuate a linear motion valve, such as thetrumpet valve704A. A coil spring may be coupled around the shaft of the cam901 in order to rotate it so that the valve can close when the IAB robotic surgical tool is dismounted.
• With thecam902 rotated to a position so that thevalve704A is closed, the valve may be manually operated. To manually operatevalve704A, a user pushes on themanual push arms913,923 extending from the housing. With themanual push arms913,923 being coupled to thecam follower903, the force applied thereto manually forces open thevalve704A. This decouples thecam follower903 from thecam902. To close thevalve704A, a user releases the force applied to themanual push arms913,923 which allows thespring706 to push back out theplunger705 into a closed position and shut off the valve.
• Referring now toFIGS. 10A-10B,pinch valves1004A-1004B for use in the flow control system of IAB robotic surgical tools are illustrated. Thepinch valves1004A-1004B are used to pinch closed ahose1002,1002′ to control the flow of fluids.
• InFIG. 10A, arotary pinch valve1004A is illustrated to pinch closed ahose1002 and can be rotated to release and open thehose1002. Without thehose1002 pinched off, a fluid is allowed to flow therein and through the IAB robotic surgical tools. Therotary pinch valve1004A pinches thehose1002 closed against abackstop1005 to shut off the flow of fluids. Thehose1002 may be a silicon rubber hose that is flexible in order that it may be readily pinched off and stop the fluid flow therein and flex back when released.
• Therotary pinch valve1004A is coupled to a shaft of therotatable receiving element418E to receive a rotational actuation. Therotatable receiving element418E may couple to therotatable driver234 in a similar fashion as previously described withpins422A-422B inserted into therespective openings240A-240B.
• Therotary pinch valve1004A includes arotatable pinch arm1020 and apinch roller1022 coupled to the distal end of therotatable pinch arm1020. Therotary pinch valve1004A may further include aspring1006 coupled to therotatable receiving element418E in order to bias the pinch valve to a closed position and pinch off the hose when thesurgical tool101A,400 is dismounted.
• In the closed position, thepinch roller1022 pinches off thehose1002 against thebackstop1005. In rotating thepinch valve1004A and the rotatable pinch arm from the closed position to aposition1020′, the pressure against thehose1002 is released such that it flexes open and allows fluid to flow therein.
• InFIG. 10B, alinear pinch valve1004B is illustrated to pinch closed ahose1002′. Thelinear pinch valve1004B can be moved linearly to release and open thehose1002′. Without thehose1002′ pinched off, a fluid is allowed to flow therein and through the IAB robotic surgical tools. Thelinear pinch valve1004B pinches thehose1002′ closed against abackstop1015 to shut off the flow of fluids. Thehose1002′ may be a silicon rubber hose that is flexible in order that it may be readily pinched off and stop the fluid flow therein and flex back when released.
• Apush rod702 may be provided in therobotic arm153 to provide linear actuation of thelinear pinch valve1004B. Thepush rod702 pushes on abutton1013 to aposition1013″, compressing aspring1016, and linearly moving thelinear pinch valve1004B and alinear pinch arm1030 to position1030′ to release thehose1002 from thebackstop1015. With thelinear pinch arm1030 in theopen position1030′, the linear pinch valve is open and fluid can flow within thehose1002′. Upon releasing the linear force provided by thepush rod702 within therobotic arm153, thespring1016 forces back thelinear pinch arm1030 of thelinear pinch valve1030 to squeeze thehose1002 against thebackstop1015. In this manner, a linear actuating motion of thepush rod702 can activate alinear pinch valve1004B.
• FIGS. 11A-15B illustrate exemplary embodiments of IAB robotic surgical tools including varying types of flow control systems.
• Referring now toFIGS. 11A-11E, irrigation/aspiration/blowing robotic surgical tools having a flow control system with a solid valve body are now discussed.
• FIG. 11A illustrates a top perspective view of an IAB robotic surgical tool1100 with its cover removed to show theflow control system417 therein. The IAB robotic surgical tool1100 employs asolid valve body1101. Thesolid valve body1101 is a three-dimensional solid body that includes hollow passages with open ports therein and a pair of valve openings to receive a pair ofrotatable valves1104A-1104B. In one embodiment of the invention, thesolid valve body1101 is a polyhedron shaped solid body.
• With a solid valve body, theflow control system417 of the IAB robotic surgical tool1100 is relatively inexpensive to manufacture such that theflow control system417 may be discarded after use, instead of cleaned or sterilized. The remaining components of the tool1100 may be cleaned and re-sterilized. Alternatively, the IAB robotic surgical tool1100 is also relatively inexpensive to manufacture such that it may be discarded in its entirety after usage.
• A first port of thesolid valve body1101 couples to the proximal end of thehollow tube404. Second and third ports of thesolid valve body1101 may couple to thehose fittings410A-410B. Thehose fittings410A-410B may respectively couple tohoses106A-106B. Thesolid valve body1101 includes a three-way passage1106 coupled between the proximal end of thehollow tube404 and first ports ofrotatable valves1104A-1104B. Thesolid valve body1101 further includespassages1108A-1108B coupled between second ports of therotatable valves1104A-1104B and thehose fittings410A-410B, respectively. Therotatable valves1104A-1104B are two-way two-position valves and each have an open flow channel that can be rotated and switched open or closed between the ports to therespective passages1108A-1108B and the ports to the three-way passage1106.
• Although a third valve and a third set of passages are not illustrated inFIG. 11A, it is understood that it may be provided to provide flow control for a third type of fluid.
• Thehollow tube404 is mechanically supported in the mountable housing by having an end coupled into the first port of thesolid valve body1101. Thehollow tube404 maybe further supported mechanically by being inserted into a bushing that is supported within thecollar1102 of theinterface base412. As previously discussed, thehollow tube404 has anopening424 at itstip406. Thehollow tube404 may further have openings around its circumference near itstip406.
• Thesolid valve body1101 may be fitted to theinterface base412 so that it is readily replaceable. Thehollow tube404 may be fitted with a quick release fitting to thesolid valve body1101 so that it can be readily re-sterilized and reused.
• Referring now toFIG. 11B, a bottom exploded view of the IAB robotic surgical tool1100 is illustrated. As illustrated byFIG. 11B, thesolid valve body1101 includesvalve openings1109A-1109B to receive therotatable valves1104A-1104B, respectively. Thevalve openings1109A-1109B in the solid valve body may include threads or rings to allow therotatable valves1104A-1104B to rotate in a fixed axial position with respect to thepassages1106, and1108A-1108B.
• Coupled to one end of acylindrical shaft1105 of each of therotatable valves1104A-1104B is arotatable receiving element418 withpins422A-422B. Therotatable receiving element418 of therotatable valves1104A-1104B may further include atab1114 to abut against a stop within theinterface base412.
• Elements of therotatable valves1104A-1104B may be molded together as one piece to further lower the cost of manufacture of the flow control system. Asvalves1104A-1104B are substantially similar, a further detailed description ofvalve1104A is only provided withvalves1104A-1104B being collectively referred to asvalves1104.
• In thecylindrical shaft1105 of thevalves1104 is theflow channel1110. Theflow channel1110 of therotatable valves1104 may be a slanted opening through the cylindrical shaft. Theflow channel1110 of therotatable valves1104 may be a slanted opening through the cylindrical shaft. Wrapped around the cylindrical shaft are one ormore seals1112 to seal off theflow channel1110 within thevalve body1101. Aslanted seal1113 may be provided above the slanted opening of theflow channel1110. In an alternate embodiment of the invention, an additionalslanted seal1113 may be provided below the slanted opening of theflow channel1110. Thecylindrical shaft1105 has circumferential channels to respectively receive a portion of the one ormore seals1112. Thecylindrical shaft1105 has one or more slanted channels in its cylindrical surface to respectively receive a portion of the one or moreslanted seals1113. The channels in theshaft1105 keep the seals in position as the valve is moved.
• Referring now toFIG. 11C, a cross section of one of therotatable valves1104 is illustrated in a closed position. As discussed previously, therotatable valve1104 includes thecylindrical shaft1105 coupled at one end to therotatable receiving element418.
• Thecylindrical shaft1105 includes theflow channel1110. Theflow channel1110 has afirst port1110A at one end and asecond port1110B at a second end. As discussed previously, theflow channel1110 may be slanted from thefirst port1110A to thesecond port1110B. Asvalve1104 is in a closed position inFIG. 11C, neither thefirst port1110A nor thesecond port1110B of theflow channel1110 matches the ports into thepassages1106 or1108A,1108B. Thecylindrical shaft1105 further includes one ormore seals1112 near top and bottom portions to seal off theflow channel1110 in thesolid body1101. Thecylindrical shaft1105 further includes the slantedseal1113 between atop seal1112 and the slantedflow channel1110 to further seal the rotatable valve within thesolid body1101.
• The slantedseal1113 around thecylindrical shaft1105 allows for relaxed tolerances between therotatable valve1104 and thesolid valve body1101. In particular, the slantedseal1113 allows for a larger radial gap between thecylindrical shaft1105 of thevalve1104 and thesolid valve body1101 while maintaining a leak-less seal. While the top andbottom seals1112 seal the valve1404 with respect to the valve body, the slantedseal1113 seals the flow of fluids through thechannel1110. The slantedseal1113 seals the flow of fluids through thechannel1110 over the range of positions of thevalve1104, from a fully closed position to a fully open position. The slantedseal1113 particularly prevents leakage when thevalve1104 is in the closed position.
• In an alternate embodiment of the invention, thechannel1110 in thecylindrical shaft1105 is replaced by narrowing the center diameter portion of thecylindrical shaft1105 between theslanted seal1113 and thebottom seal1112, such as into an hour glass shape, to form a channel for fluid flow when thevalve1104 is moved from a closed position. In this case, the slantedseal1113 forms an end portion of the channel.
• Thehollow tube404 couples to a port of the three-way passage1106. Thehose fittings410A,410B couple to thepassages1108A,1108B, respectively. Thehose fittings410A,410B and thehollow tube404 may be press fitted into thesolid valve body1101 or have threads to be screwed into and mate with threads inpassages1106,1108A,1108B of thesolid valve body1101.
• Referring now toFIG. 11D, a cross section of one of therotatable valves1104 is illustrated in an open position. With therotatable valve1104 in an open position, a fluid can flow between thehollow tube404 and one of thehose fittings410A,410B by way of the passages in thesolid valve body1101 and theflow channel1110.
• In comparison withFIG. 11C, theflow channel1110 in thecylindrical shaft1105 is reoriented to a position where itsfirst port1110A matches a port of the three-way passage1106 and itssecond port1110B matches a port of thepassage1108A,1108B. In this manner, a fluid can flow from the hollow tube into the threeway passage1106, through theflow channel1110, into thepassage1108A,1108B and out of the hose fitting410A,410B. Alternatively, a fluid can flow from the hose fitting410A,410B, into thepassage1108A,1108B, through theflow channel1110, into the threeway passage1106 and out from thehollow tube404.
• FIGS. 11C-11D illustrate one ormore seals1112 near top and bottom portions of theshaft1105 and the slantedseal1113 in parallel with the slantedflow channel1110 to seal therotatable valves1004A-1104B in thesolid body1101.
• Therotatable valves1104A and1104B may operate in the same rotational direction or in opposite rotational directions. That is, each rotatable valve may operate to open in a clockwise direction or a counterclockwise direction. Alternatively,rotatable valve1104A may open using a counterclockwise rotation whilerotatable valve1104B opens using a clockwise rotation, for example.
• With asolid valve body1101 and one piecerotatable valves1104, theflow control system417 can be made relatively inexpensive such that it can be readily discarded with or without other components of the surgical tool1100.
• As discussed previously, the valves of theflow control system417 of the IAB robotic surgical tools may also be manually controlled with manual actuators. Additional manually controlled valves may also be provided in parallel with robotically controlled valves in the flow control system in order to both manually and robotically control the fluid flows through an IAB robotic surgical instrument. Manual actuators are coupled to the manually controlled valves to extend external to the housing of the IAB robotic surgical tools so that a user's hand may open and/or close the valves.
• Referring now toFIG. 11E, thesolid valve body1101 has been modified tosolid valve body1101′ that includes manually controlledvalves1124A-1124B in parallel with the respective robotically controlledvalves1104A-1104B in order that the fluid flows through the IAB roboticsurgical instrument1100B may be controlled manually by hand and robotically from amaster control console150. The manually controlledvalves1124A-1124B are trumpet valves, a type of valve such as illustrated inFIG. 7A and previously described. Thevalves1124A-1124B each include abutton1125 on top that extends out from thehousing401 through the cover414 (not illustrated inFIG. 11E), such as illustrated inFIG. 13B. However, thetrumpet valves1124A-1124B are two-way two position valves that are linearly actuated by a finger or hand pushing on the button to open the valve and allow fluid to flow. As invalve704A, each of the manually controlledvalves1124A-1124B includes aspring706 to return the valve to a closed position when the force is released from thebutton1125. (seeFIG. 7A). Thebutton1125 is similar to thebutton703 of thevalve704A illustrated inFIG. 7A.
• To support thevalves1124A-1124B, the twoway passages1108A-1108B and the threeway passage1106 in thesolid valve body1101 illustrated inFIG. 11A are modified respectively into threeway passages1108A′-1108B′ and a fiveway passage1106′ of thesolid valve body1101′ illustrated inFIG. 11E. The fiveway passage1106′ includes one or moreparallel passages1126 to a port of thevalves1124A-1124B. That is, the fiveway passage1106′ has a first port to couple to thetube404, a second port and a third port to respectively couple tovalves1104A,1104B, and a fourth port and a fifth port to respectively couple to thevalves1124A-1124B. The threeway passages1108A′-1108B′ each include aside passage1128 to a port of thevalves1124A-1124B. The threeway passage1108A′ has a first port to couple to thevalve1104A, a second port to couple to thevalve1124A, and a third port to couple to the hose fitting410A. The threeway passage1108B′ has a first port to couple to thevalve1104B, a second port to couple to thevalve1124B, and a third port to couple to the hose fitting4101B. Thesolid valve body1101′ further includes an additional pair of valve openings to receive thespring706 and theplunger705 of thetrumpet valve704A. Additional seals may be provided around the shaft between theplunger705 and thebuttons703,1125.
• Otherwise, the modifiedsolid valve body1101′, including the structure and function of thevalves1104A-1104B, is similar to that of thesolid valve body1101 illustrated byFIGS. 11A-11D and described previously.
• Referring now toFIG. 12, a top perspective view of an IAB roboticsurgical tool1200 is illustrated with its cover over the mountable housing removed. The IAB roboticsurgical tool1200 includes amodular valve subassembly1201. After being used once, themodular valve assembly1201 andcoupling hoses1208A-1208B are readily replaceable with new used components. The remaining portion of thetool1200 may be re-sterilized and then reused with a newmodular valve assembly1201 andcoupling hoses1208A-1028B. Themodular valve subassembly1201 is mountable to and dismountable from theinterface base412. Abase1211 of themodular valve subassembly1201 may press fit into place to mount the valve subassembly to theinterface base412. Thebase1211 of themodular valve subassembly1201 includes recesses for rigid attachment of the ports of thevalves1204A-1204B and the ports of thehose fittings410A-410B.Hoses106A-106B may be coupled to ends of thehose fittings410A-410B. The control and actuation of therotatable valves1204A-1204B was previously described with reference toFIG. 6A and therotatable valve604A.
• The modular valve subassembly includes a firstrotatable valve1204A and a secondrotatable valve1204B. Each of thevalves1204A-1204B are two-way, two-position valves having a pair of ports. Thevalves104A-104B may be trumpet valves, ball cock style valves, or other rotatable type of valve used to control the flow of gases or fluids. Coupled to the first ports of eachvalve1204A-1204B are thehose fittings410A-410B, respectively. Coupled to a second port of each of thevalves1204A-1204B are first ends of therespective coupling hoses1208A-1208B. Second ends of thehoses1208A-1208B respectively couple to a pair of ports of a three-way coupler1206. A third port of thecoupler1206 couples to thehollow tube404.
• Shafts of thevalves1204A-1204B can be coupled to and decoupled from a pair of rotatable receivingelements418. Themodular valve subassembly1201 is replaceable. After being used, themodular valve subassembly1201 is dismounted from the interface base with shafts of the usedvalves1204A-1204B being decoupled from therotatable receiving elements418. Similarly, shafts of newunused valves1204A-1204B may be coupled to therotatable receiving elements418 when mounting a new modular valve subassembly to the interface base.
• Coil springs may be wrapped around the shafts of thevalves1204A-1204B and coupled to the pair of rotatable receivingelements418 in order to spring load thevalves1204A-1204B to automatically close so that neither suction nor irrigation are activated when the instrument housing is not mounted onto the robotic arm, or modular valve subassembly is not mounted to theinterface base412 in themountable housing401.
• Thehollow tube404 is supported by the interface base. Abushing1202 may be inserted over thehollow tube404 and pressed into thecollar1102 of theinterface base412.
• The printedcircuit board425 may also be mounted to theinterface base412.Electrical pins424 may couple to the printedcircuit board425 to provide an electrical connection to theadaptor228. Theintegrated circuit426 is mounted to the printed circuit board may be reprogrammed to indicate that thetool1200 has been re-sterilized and its components replaced.
• In order to reuse the IAB roboticsurgical tool1200, themodular valve subassembly1201 and thecoupling hoses1208A-1208B are removed and discarded. Anew valve subassembly1201 andnew hoses1208A-1208B are installed and mounted in the robotic surgical tool. The remaining components including theinterface base412, the three-way coupler1206 and thehollow tube404 are re-sterilized prior to fitting a newmodular valve subassembly1201 andnew hoses1208A-1208B.
• After re-sterilization, theintegrated circuit426 may be programmed to indicate that thetool1200 has been re-sterilized and its components replaced.
• Referring now toFIGS. 13A-13B, an IAB roboticsurgical tool1300 to control the flow of fluids into and out from a surgical site is illustrated.FIG. 13A illustrates the IAB roboticsurgical tool1300 with its cover removed to show that the IAB roboticsurgical tool1300 includes a flow control system that utilizesrotatable pinch valves1304A-1304B.
• To control the flow of fluids through the roboticsurgical tool1300, a pair offlexible coupling hoses1302A-1302B are coupled to a pair ofhose fittings410A-410B at a first end and a pair of ports of a three-way coupler1206 at a second end. The third port of the three-way coupler1206 is coupled to the proximal end of thehollow tubing404. To pinch offhoses1302A-1302B, thetool1300 includes arotatable pinch valves1304A-1304B rotatably mounted to theinterface base412. Each of thepinch valves1304A-1304B is coupled to arotatable receiving element418. As discussed previously, therotatable receiving element418 may couple to arotatable driver234.
• Each of therotatable pinch valves1304A-1304B may include acoil spring1306, arotatable pinch arm1320, apinch wheel1322 coupled to the end of therotatable pinch arm1320, atab1324, and a handle1330. InFIG. 13A, thepinch valve1304A is illustrated as being open and allowing the flow of fluid through thetool1300.Rotatable pinch valve1304B is illustrated as being closed to pinch offhose1302B at apinch point1302B′.
• At apinch point1302B′, apinch wheel1322 presses thehose1302B against thebackstop1315B ofbulkhead1310. Thehose1302B collapses to a diameter of zero so that no fluid can flow through it at thepinch point1302B′. Therotatable pinch valve1304A may utilize thebackstop1315A ofbulkhead1310 to close and pinch offhose1302A. The operation of a rotatable pinch valve is further discussed herein with reference toFIG. 10A. When being opened from the closed position, thetab1324 may be used to limit the rotation of eachrotatable pinch valve1304A-1304B to astop1325.
• In order to readily collapse and pinch off the flow of fluids, thehoses1302A-1302B may be silicon hoses that are flexible with the capability of expanding to an open non-collapsed diameter from a collapsed state at the pinch point in response to opening the rotatable pinch valves. Thepinch wheel1322 rotates along the hose as its being pinched off so as to avoid damaging the hose and cause leeks.
• Thecoil spring1306 wrapped around the shafts of thepinch valves1304A-1304B may be used to spring load thevalves1204A-1204B to automatically close and pinch off thehoses1302A-1302B when the instrument housing is dismounted from the robotic arm or otherwise not being actuated.
• While the IAB roboticsurgical tool1300 is typically under control of themaster control console150, thehandles1330A-1330B allow for manual use of the IAB robotsurgical tool1300 when it is not mounted to a robotic arm. Thehandles1330A-1330B are respectively coupled to theshafts1330A-1330B of therotatable pinch valves1304A-1304B in order to manually rotate them open and closed by hand. When the IAB robotsurgical tool1300 is not mounted to a robotic arm so that therotatable receiving elements418 are not engaged with therotatable drivers234, the assistant surgeon or nurse may manually operate the IAB roboticsurgical tool1300 to control the fluid flows by using thehandles1330A-1330B. Furthermore, thehandles1330A-1330B allow for cleaning the flow control system as is described further below.
• Referring now toFIG. 13B, the IAB roboticsurgical tool1300 is illustrated with itscover1350 coupled to theinterface base412. Thecover1350 provides protection to theflow control system417 including the rotatable pinch valves in the hoses. Thehandles1330A-1330B extend through thecover1350 so that they are accessible to manually control the pinch valves.
• Additionally, thehandle1330A includes aclip1332 that may be swung around and fitted into agroove1334 of thehandle1305B. With theclip1332 within thegroove1334, bothhandles1330A-1330B are open such that neitherhose1302A norhose1302B is pinched closed. The handles are clipped together in the open position during a cleaning of the flow control system of the roboticsurgical tool1300 and to ease replacement of the hoses.
• To clip the handles together, the handle is rotated to the open position and theclip1332 is swung toposition1332′. Thehandle1330B is rotated to position1330B′ so that theclip1332′ may be inserted into itsgroove1334. In this position, the pinch valves are both open and thehoses1302A-1302B are not pinched off but are open so that they can be cleaned.
• Referring now toFIG. 14, a top view of a IAB roboticsurgical tool1400 is illustrated with its cover removed to show the pinch valves and replaceable tubing. Thetool1400 is substantially similar totool1300 previously described but for use of thecoupling hoses1302A-1302B to control the flow of fluids within the tool.Tool1400 eliminates thehose fittings410A-410B and theshort coupling hoses1302A-1302B between thehose fittings410A-410B and the three-way coupler1206. Instead, thetool1400 includesreplaceable hoses106B-106A directly coupled to the ports of the three-way coupler1206, as is illustrated inFIG. 14. Thereplaceable hoses106B-106A extend beyond the robotic surgical tool in order to couple externally to sources of fluids.
• In contrast, thecoupling hoses1302A-1302B of thetool1300 require cleaning and sterilization after each use of thetool1300 in order for it to be reused. Intool1400, thehoses106A-106B are not cleaned, but replaced after each usage with new sterile hoses so that thetool1400 may be reused. With the rotatable pinch valves open, theinterface base412 is formed withbulkhead1410 to allow thehoses106A-106B to be readily replaceable and coupled to the three-way coupled1206.
• Thetool1400 includes therotatable pinch valves1304A-1304B with theirpinch arms1320 andpinch rollers1322 coupled thereto to pinch off thehoses106A-106B and stop the flow of fluids. The rotatable pinch valves are rotatably mounted to theinterface base412. The shaft of each rotatable valve is coupled to therotatable receiving element418.
• InFIG. 14,rotatable pinch valve1304A is open such thathose106A may allow a fluid to flow therein.Rotatable pinch valve1304B is closed to pinch offhose106B atpoint1402B. Thus, withpinch valve1304B closed, a fluid will not flow throughhose106B.Bulkhead1410 is provided so that thehoses106A-106B may be readily replaced when therotatable pinch valves1304A-1304B are held in their open positions. Thebulkhead1410 includesbackstops1415A and1415B against which therotatable pinch valves1304A-1304B may pinch off therespective hoses106A-106B.Hoses106A-106B may be formed of a silicon rubber compound so that they are flexible and can be readily collapsed and expanded in response to the opening and closing of the rotatable pinch valves.
• As discussed previously, thereplaceable hoses106B-106A are directly coupled to two of the three ports of the three-way coupler1206. The third port of the three-way coupler1206 is coupled to the proximal end of thehollow tube404. Thehollow tube404 may be further supported by theinterface base412 by inserting a the hollow tube into a bushing mounted in thecollar1102.
• The IAB robotic surgical tools, includingtool1400, may further include the printedcircuit board425 with one ormore pins424 and one or moreinterrelated circuits426 coupled thereto to indicate its tool type, whether its new or refurbished, and if refurbished, the number of prior uses.
• Referring now toFIGS. 15A-15B, IAB robotic surgical tools1500A-1500B are respectively illustrated without their covers. The tools1500A-1500B do not internally control the flow of fluids into and out of a surgical site. Instead, the control of the flow of fluids into and out of a surgical site is externally controlled away from the surgical tool. As previously discussed with reference toFIG. 1, the control of fluids may be provided at the respective fluid pumps by thecomputer system151 in the surgeonsmaster control console150 under the control of the operator O.
• Even though fluid flow is externally controlled, the IAB robotic surgical tools1500A-1500B are mounted to a robotic arm of the roboticsurgical manipulator152 and can facilitate the flow of fluids into and out of a surgical site through couplers and thehollow tube404.
• InFIG. 15A, the IAB robotic surgical tool1500A includes a three-way coupler1206 mounted to theinterface base412. A proximal end of thehollow tube404 couples to a first port of the three-way coupler1206.Replaceable hoses106A-106B respectively couple to a second and a third port of the three-way coupler1206. The tool1500A may further include the printedcircuit board425 with theelectrical pins424 in one or moreinterrelated circuits426 coupled thereto to indicate the tool type and that external fluid control is to be utilized.
• InFIG. 15B, the IAB roboticsurgical tool1500B includes a four-way coupler1506 with a first port coupled to thehollow tube404, a second port coupled to an end of afirst hose106A, a third port coupled to an end of asecond hose106B, and a fourth port coupled to an end of athird hose106C.Tool1500B may also include the printedcircuit board425 with theelectrical pins424 and the one or moreintegrated circuits426 coupled thereto to indicate the tool type and that external fluid control is to be utilized to control the flow of fluids flow in thehoses106A-106C.
• Cleaning and sterilization of the IAB robotic surgical tools1500A-1500B is fairly easy as there are no valves. To reuse the tools1500A-1500B, usedhoses106A-106C are removed. The remaining portions of thetools1500A and1500B, such as the couplers and thehollow tube404, are then sterilized and then fitted with newsterile hoses106A-106C so that they may be reused.
• While IAB robotic surgical tools1500A-1500B have been shown and described to includecouplers1206,1506, respectively, the couplers can be removed and provided externally to the surgical tools1500A-1500B. In which case, a single hose would be routed from the external coupler to the IAB robotic surgical tool. The single hose may couple to a hose fitting, that in turn would be coupled to thehollow tube404. Alternatively, the proximal end of the hollow tube could be formed as a hose fitting and directly couple to an end of the hose. In this manner, reuse of the IAB robotic surgical tool may further simplified with fewer components to sterilize and a single hose to replace.
User Control
• Typically, irrigation and aspiration of a surgical site are manually controlled by an assisting surgeon or nurse using manual surgical tools. By allowing tele-operated or remote control and actuation of an IA or IAB robotic surgical instrument, the primary surgeon can now control irrigation and aspiration of a surgical site.
• The flow control system of the IAB robotic surgical instrument may be controlled by the operator O seated at the robotic surgicalmaster control console150 in a number of ways. For example, master axes of movement in a control handle that is normally used for controlling a wristed robotic surgical instrument may be used to activate irrigation, aspiration, and or blowing through an IAB robotic surgical instrument over a surgical site. As previously discussed, one or a combination of both the rotational motion of the touchsensitive handle325 and the squeezing motion of thegrips350A,350B may be used to control the flow of fluids through the IAB robotic surgical tools. For example, the rotational motion of the touchsensitive handle325 may be used for the control of irrigation while the squeezing motion of thegrips350A,350B may be used for controlling suction in a surgical site.
• FIG. 16A is a side view of the touchsensitive handle325 of the robotic surgicalmaster control console150. The touchsensitive handle325 may be used by the operator O to control the fluid flow in IAB robotic surgical instruments. In one embodiment of the invention, a rotational motion R (“roll”) of the touch sensitive handle may control the irrigation, aspiration, and/or blowing through IABsurgical instruments101A,400. For example, the handle may rotated clockwise to open a first valve to have a fluid flow through the IAB surgical instrument into or out of a surgical site. The handle may then be rotated counter-clockwise to close the first valve and stop the flow of fluid through the IAB surgical instrument and into or out of the surgical site. A center detent point D of rotation in the touchsensitive handle325 may be used to switch over from one type of fluid flow to another. In which case, the handle may rotated counter-clockwise to open a second valve or switch open the first valve to a different position to have a second fluid flow through the IAB surgical instrument and into or out of a surgical site. Thehandle325 may then be rotated clockwise to the center detent point D to close the second valve and stop the flow of fluid through the IAB surgical instrument and into or out of the surgical site.
• The rotational motion of thehandle325 may typically control wrist motors in the roboticsurgical manipulator152 to control a wrist motion of a robotic surgical tool. In this case, the wrist motors in the roboticsurgical manipulator152 may be adapted for use to control one or move valves in the IAB robotic surgical instruments in response to the rotational motion of thehandle325.
• In another embodiment of the invention, a gripping or squeezing motion (“master grip”) on thegrips350A-350B of the touchsensitive handle325 may be used to control the flow of fluids through IAB robotic surgical instruments. For example, squeezing the grip of touch sensitive handle may be used to turn on the suction of the I/A/B surgical instrument and the grip released to turn off the suction. In which case, the touch sensitive handle may include one ormore springs306A-306C to provide differing spring constants or a single spring306 with a progressive rate spring constant as the positions of thegrips350A-350B change. An explanation as to how the touchsensitive handle325 functions was previously describe with reference toFIG. 3C. By using the grip of the touchsensitive handle325 to control the IAB robotic surgical instrument, the rotational motion of the handle may be used for further movement or control of the instrument.
• The position of thegrips350A-350B can vary over a range of positions in order to control suction, blowing and irrigation of a surgical site such as from a fully released or fully open position to a fully squeezed or fully closed position.
• FIGS. 16B-16D illustrate different positions of thegrips350A-350B of the touchsensitive handle325 when squeezed by a hand H of the operator O to control the IAB robotic surgical tool at a surgical site.FIG. 16B illustrates a fully open grip position without any squeezing by the hand H.FIG. 16C illustrates the hand H squeezing thegrips350A-350B to a half-way closed position. To provide force feedback to a user, a first spring rate may be used over a range of positions, such as from the fully open to the half-way closed position.FIG. 16D illustrates the hand H squeezing thegrips350A-350B to a fully closed position. To provide force feedback to a user, a second spring rate somewhat greater than the first may be used over a range of positions, such as from the half-way closed position to the fully closed position.
• FIG. 17 is a graph showing exemplary control of irrigation and aspiration using the grip control of the touchsensitive handle325. The open, half, and closed positions along the X-axis of the graph correspond to the different positions of thegrips350A-350B of the touchsensitive handle325 illustrated inFIGS. 16B-16D.Curve1701 illustrates a flow of vacuum or a percentage of suction.Curve1710 illustrates a flow of irrigation fluid through the tool and into a surgical site.
• With thegrips350A-350B in the fully released or fully open position, both suction and irrigation are turned off. As the grip is initially squeezed, suction is turned on and irrigation remains turned off. As the grip position changes from fully-open to half-way closed,curve1701 illustrates the flow of vacuum change from zero to one hundred percent. As the grip reaches half way, suction may be fully turned on with a negligible amount of irrigation. As the operator O squeezes further still, past the half-way closed position, the vacuum flow tapers off toward zero and the irrigation begins from zero around the three-fourths closed position, as is illustrated bycurves1701 and1710.
• In another embodiment of the invention, both the rotational motion of the touchsensitive handle325 and the squeezing motion of thegrips350A,350B may be used to control the flow of fluids through the IAB robotic surgical tools.
• In addition to the touchsensitive handle325 and itsgrips350A-350B, foot pedals18 of the surgeonsmaster control console150, as illustrated inFIG. 3A, may be used to further control the IAB robotic surgical tools. For example, one of the foot pedals18 may be used to switch from suction control to blow control in order to blow a pressurized gas over the surgical site. In which case, a gripping squeezing motion of the touch sensitive handle can also control the blowing provided by the I/A/B surgical instrument.
• Alternatively, the touchsensitive handle325 may be modified to include buttons to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the roboticsurgical manipulator152
• To avoid using a touch sensitive handle, the foot pedals18 of the surgeonsmaster control console150 may be used to fully control the suction and irrigation provided by an IAB robotic surgical tool. In one embodiment of the invention, a first foot pedal18A may be used to control suction and a second foot pedal18B may be used to control the irrigation provided by an IA or IAB surgical instrument.
• With knowledge of other surgical instruments that are to be controlled by some of the foot pedals, foot pedals on the right side of the footrest may be used, for example. Two pedals and a toggle switch on the master control console or the control handle may be used to control a variety of actuations in a plurality of surgical instruments knowing the context of the robotic surgical system in advance. Additionally, foot pedals normally used for cautery (or another energy device) may be switched to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the roboticsurgical manipulator152.
• To avoid any use of hands or feet in controlling the I/A surgical instrument, voice activation may be used to activate irrigation, aspiration, and or blowing when an IAB robotic surgical tool is mounted to the roboticsurgical manipulator152. In this case, an operator's voice or speech may be used to control the suction, irrigation, and or blowing provided by an IA or IAB surgical instrument. For example, spoken voice commands such as “suction ON”, “suction OFF”, “suction lightly”, “irrigation ON”, “irrigation OFF”, and “irrigate lightly” may be used to control the suction and irrigation provided by the IA or IAB surgical instrument.
• To recognize the voice commands, themaster control console150 includes amicrophone315 and aspeech recognizer317. Thespeech recognizer317 may generate the control signals that are provided to the IA or IAB surgical instrument.
• While various control means have been individually described here, two or more of these control means may be combined in order to control the flow of fluids through an IAB robotic surgical tool. For example, the rotational motion of the touchsensitive handle325 may be used for the control of irrigation while the squeezing motion of thegrips350A,350B may be used for controlling suction in a surgical site.
User Feedback
• Within a surgical site it may be difficult to determine if a valve is open and providing suction, blowing, or irrigation. User feedback may be provided to the surgeon at the console to provide information to him/her such as suction is on and at what level—high, medium, low, or otherwise off. User feedback information may also be provided regarding blowing and irrigation—whether its off or on, and if on at what level—high, medium, or low. However, it typically is easier to visually determine when a liquid is flowing for irrigation than when suction is provided for aspiration or a pressurized gas for blowing.
• Referring now toFIGS. 18A-18G, various types of user feedback may be provided to the IAB robotic surgical tools.
• InFIG. 18A, the irrigation/aspiration/blowing roboticsurgical tool400A includes a pair of light emitting diodes (LEDs)1801-1802 near thetip406 of thehollow tube404 in order provide visible feedback to an operator O that a fluid is flowing through the tool. One ormore wires1804 may couple between the light emitting diodes1801-1802 and the printedcircuit board425 within themountable housing401. Electrical signals can be transmitted towards the light emitting diodes from the printed circuit board to turn them on during the flow of fluids and off when no fluid flow occurs. Theintegrated circuit426 may generate the electrical signals to control the light emitting diodes. In this manner, the light emitting diode1801-1802 may be activated by control signals received over the one ormore wires1804 from themaster control console150. Additional light emitting diodes may be provided near thetip406 of thehollow tube404 in order provide additional visible feedback for additional fluid flows. Moreover, the light emitting diodes1801-1802, including any additional LEDs, may emit photons of different wavelengths in order that different colors can be provided corresponding to different types of fluid flow (e.g., suction, irrigation, gas pressure).
• InFIG. 18B, the IAB roboticsurgical tool400B includes alight pipe1812 mounted externally to thehollow tube404 to provide visible user feedback to the operator O that fluids are flowing into or out of the surgical site. Thelight pipe1812 maybe a side lighting fiber optic cable with one end optically coupled to one or morelight emitting diodes1811 to receive photons. Thelight emitting diodes1811 may emit photons of different wavelengths in order that different colors can be provided corresponding to different types of fluid flow (e.g., suction, irrigation, gas pressure). One ormore wires1814 may couple between the one or morelight emitting diodes1811 and the printedcircuit board425 mounted within thehousing401. An integrated circuit, such asintegrated circuit426, may be used to drive the one or morelight emitting diodes1811 to turn them on or off. Alternatively when fluids flow, the one or morelight emitting diodes1811 may be activated directly by control signals received over the one ormore wires1814 from themaster control console150 or from theintegrated circuit426. More than onelight pipe1812 may be provide along the circumference of thehollow tube404 so that the side light may be visible at different viewing angles and positions of the IAB robotic surgical instrument.
• In comparison with the light emitting diodes1801-1802 at the tip, thelight pipe1812 provides a light that maybe visible along the entire length of thehollow tube404 so that it can be seen, regardless of the position of the tip. Additionally, thelight emitting diode1811 is protected under the cover of themountable housing401.
• Referring now toFIG. 18C, an IAB roboticsurgical tool400C is illustrated. Intools400A-400B previously described, user feedback was provided by electro-optic means. In contrast, the user feedback provided by thetool400C is provided mechanically. The IAB roboticsurgical tool400C includes a slidingsleeve1820 and avisible scale1824 coupled to thehollow tube404. The slidingsleeve1820 is coaxial with thehollow tube404 and covers over thescale1824 when no fluid is flowing through the tool. The slidingsleeve1820 can be slid along thehollow tube404 and into thehousing401 to reveal thevisible scale1824 as fluids flow through thetool400C. Thevisible scale1824 maybe different colored bands to indicate the level of fluid flow within thetool400C. Alternatively, thevisible scale1824 maybe bands of different thickness to reveal the amount of fluid flow within thetool400C. The slidingsleeve1820 can be gradually received into the hosing401 to reveal the appropriate scale in proportion to the amount of fluid flow in thetool400C.
• Without any flow of fluids within thetool400C, atip1822 of the slidingsleeve1820 may completely cover over thevisible scale1824. With maximum fluid flow in thetool400C, the slidingsleeve1820 may be slid into thehousing401 such that its tip moves to aposition1822′ to fully reveal thevisible scale1824. Theopposite end1823 of the slidingsleeve1820 moves inward toposition1823′. In this manner, the level of fluid flow in thetool400C maybe provided to a user by mechanical means.
• The slidingsleeve1820 may be pulled into thehousing401 and pushed back out in a variety of ways. A spring may used to apply a force against the retraction of the slidingsleeve1820 into the housing so that it can push it back out after the pulling force is released. A cable with one end coupled to and wrapped around a take up drum may be coupled to thesleeve1820 through a pulley in order to pull the sleeve into thehousing401. A gearing system may alternatively be used. A pinion gear may couple to arotatable receiving element418 and to a rack coupled to thesleeve1820. Alternatively, a ball screw and a lead screw may be used. A slider with a crank or lever arm may be used. An electrical means may also be used, such as a solenoid to pull in on the slidingsleeve1820.
• Referring now toFIGS. 18D-18G, an IAB roboticsurgical tool400D includes another mechanical structure to provide user feedback. However instead of a sliding sleeve, the IAB roboticsurgical tool400D includes arotating sleeve1820′ coaxial with thehollow tube404.FIGS. 18E-18G illustrate various types oftips406 andsleeves1820A′-1820C′ that may be used to provide user feedback.
• InFIG. 18D, the IAB roboticsurgical tool400D includes the hollow tube coupled to thesolid valve body1101,1101′ mounted to theinterface base412. Thetool400D further includes the hollowrotatable sleeve1820′ coaxial around thehollow tube404. Therotatable sleeve1820′ couples to abearing assembly1852 mounted to thecollar1102 to rotatably mount to theinterface base412.
• For rotational purposes, therotatable sleeve1820′ includes adrum1854 that extends from thebearing assembly1852 into thehousing401. There are a number of ways to couple a rotational movement from the surgical manipulator to therotatable sleeve1820′. In one embodiment of the invention, thetool400D is backward compatible and includes aspool1830 rotatably mounted to theinterface base412. Arotatable receiving element418 of the IAB robotic surgical tool is coupled to thespool1830. For robotic control from themaster control console150, therotatable receiving element418 couples to therotatable driver234 by means of thepins422A-422B within theopenings240A-240B, respectively.
• Coupled between thespool1830 and thedrum1854 of the rotatable sleeve are a top cable1832 and abottom cable1834. One end of each cable couples to thespool1830. The opposite end of each cable couples to the drum2854. Alternatively, a single cable may be used by appropriately wrapping it around the drum2834 and thespool1830. The top cable and the bottom cable wrap different from each other around the spool. They also wrap different from each other around thedrum1854. In this manner, one cable is being let out while the other cable is being taken in by the rotation of the spool.1854. If thespool1854 is turning clockwise as indicated by arrow F2, the cable1832 is taken in, thecable1834 is let out, and thesleeve1820′ rotates counter clockwise as illustrated by the letter G2. If thespool1854 is turning counter-clockwise as indicated by arrow F1, the cable1832 is let out, thecable1834 is let out, and thesleeve1820′ rotates clockwise as illustrated by the letter G1.
• There rotational movement of the receivingelement418 may be transmitted by other means to therotatable sleeve1820′. For example, a gear system may be used. In which case, a first worm gear may be used in place of thespool1830 and a second worm gear coupling to the first may be used in place of thedrum1854.
• The flow control system provided by thesolid valve bodies1101,1101′ and their valves was previously described with reference toFIGS. 11A-11E and is incorporated here by reference.
• Referring now toFIG. 18E, the hollowrotatable sleeve1820A′ includes a plurality of narrow openings1840 located around a circumference of a distal end of thesleeve1820A′. This way, the scale may be seen from different angles. The narrow window openings1840 may be oval shaped as illustrated or rectangularly shaped. Thehollow tube404 includes a plurality ofcurved color stripes1842 around its circumference that may be rectangularly shaped as illustrated by the dashed lines inFIG. 18E. As thesleeve1820A′ rotates, thestripes1842 are positioned on thehollow tube404 to be substantially aligned with the window openings1840.
• In one position of thesleeve1820A′, no color stripe or a color stripe representative of fluid flow being completely shut off is located within a window opening1840. This corresponds to all the valves being closed to shut off the fluid flow through the IAB robotic surgical tool. Rotating thesleeve1820A′ from a shut off position, a first or second color stripe may begin to be revealed, such as illustrated inFIGS. 18E-18G, representative of a first fluid flow in an IAB robotic surgical instrument. The level of fluid flow can be indicated by the amount ofcolor stripe1842 that is exposed in the window opening1840. With thecolor stripe1842 being completely exposed by the window opening1840, the corresponding valve of the flow control system may be fully open. With thesleeve1820A′ being rotated still further, a second or third color stripe may begin to be exposed by the window opening1840. In which case, the prior fluid flow may be substantially shut off and another valve opened to allow another fluid to flow through the IAB robotic surgical tool.
• Thedifferent color stripes1842 indicate the flow of different fluids through the IAB robotic surgical. For example, a red color stripe may indicate that all fluid flows are fully shut off. A green color stripe may indicate pressurized gas flow. A blue color stripe may indicate irrigation, An orange color stripe may indicate suction or aspiration.
• Referring now toFIG. 18F, thetool400D includes therotatable sleeve1820B′ that is similar to therotatable sleeve1820A′ but has triangular shapedwindow openings1850 instead. Thehollow tube404 includes the plurality ofcolor stripes1842. But for the shape of the window openings, thesleeve1820′B operates substantially similar to that ofsleeve1820A′ described previously.
• Referring now toFIG. 18G, the hollowrotatable sleeve1820C′ includes a plurality of narrowrectangular openings1860 located around a circumference of a distal end. With the plurality ofopenings1860, the scale may be seen from different angles and positions of the tool. Thenarrow window openings1860 are rectangularly shaped. However, thehollow tube404 includes a plurality oftriangle stripes1842 curving around its circumference as illustrated by the dashed lines inFIG. 18G. Thecolored triangle stripes1862 are positioned on thehollow tube404 to be substantially aligned with the window openings186, as thesleeve1820C′ rotates,
• As thesleeve1820C′ rotates, the level of fluid flow can be indicated by the amount of colortriangular stripe1862 that is exposed in thewindow opening1860. As discussed previously, the type of fluid flow may be indicated by the different colors.
• The type of user feedback previously disclosed was implemented by the IAB robotic surgical tool. Alternatively, user feedback may be provided by themaster control console150, such as through an electronic visual display of a graphical icon or image.
• Referring now toFIG. 19, a simulated 3D image of a surgical site in aviewer312 of themaster control console150 is illustrated when the operators eyes are in theviewer312. As illustrated inFIGS. 20A-20B, stereo optic images of aleft image1900L and aright image1900R are provided at theviewer312, in order to provide a three-dimensional image when viewed by the operator O. In the left and right views, the IAB roboticsurgical tool400 is located within the surgical site. To provide user feedback as to the fluid flow in thetool400, icons1902 are overlaid onto the images displayed in one or both of thedisplays1900L,1900R. The icons may use different colors overlaid on the image in order to display the function of thetool400. A scale maybe provided in the viewer to display the level of the fluid flow in thetool400. Alternatively abbreviated letters maybe used to indicate the type of fluid flow (e.g., S—suction or A—aspiration, I—irrigation, B—blowing) in thetool400 as well as its level, such as L, M, and H.
• Referring now toFIG. 20A, aviewer312A of themaster control console150 is illustrated. To provide a three-dimensional perspective, theviewer312A includes stereo images for each eye includingleft image400L of thetool400 and surgical site and aright image400R of thetool400 and surgical site. One ormore icons2010R may be overlaid onto the images in theright viewfinder2001R to indicate the functionality and the level of fluid flow in the IAB roboticsurgical tool400. Theimages400R and400L in the viewfinders maybe provided by a rightliquid crystal display2002R and a leftliquid crystal display2002L, respectively.
• As the one ormore icons2010R in theviewer312A are provided in a single viewfinder of the stereo viewer, they are displayed as two-dimensional icons. However, three dimensional images of the icons maybe provided and overlaid onto stereo left and right images of the surgical site.
• InFIG. 20B, one or more icons to provide user feedback of the control of the IAB robotic surgical tool are overlaid onto both theleft image400L and right image40R of the surgical site. In theright viewfinder2001R, aright icon image2010R is overlaid onto theright image400R being displayed by theliquid crystal display2002R. In theleft viewfinder2001L, aleft icon image2010L is overlaid onto theleft image400L of the surgical site provided by theliquid crystal display2002L. In this manner, a stereo image of the icons may be used to provide user feedback of the control of the IAB robotic surgical tool maybe provided in theviewer312B.
Exemplary Operation of the IAB Robotic Surgical Instruments
• In order to use the IAB robotic surgical tools, it is first undergoes an initial setup prior to surgery. The IAB robotic surgical instrument is mounted to arobotic arm153 of the roboticsurgical manipulator152. One or more hoses160A-160C are coupled from the IAB robotic surgical instrument to one ormore pumps102A-102C. The roboticsurgical manipulator152 is oriented with the patient P so that the tip of the hollow tube of the irrigation-aspiration robotic surgical instrument may be inserted into the patient near the desired surgical site. During the surgery, the operator O may control the flow of fluids between the surgical site and the IAB robotic surgical instrument from themaster control console150 using theflow control system417 of the IAB robotic surgical tool. Alternatively or conjunctively, the operator may also control the flow of fluids between the IAB robotic surgical instrument and the one or more pumps. To control the flow of fluids, the operator O at themaster control console150 may generate one or more control signals to control the IAB robotic surgical instrument. The one or more control signals may be directly or indirectly coupled into the IAB robotic surgical instrument. For example, the one or more control signals may be electrical signals that are directly coupled into the IAB robotic surgical instrument to electrically control one or more valves. Alternatively, the one or more control signals may be electrical signals that are translated into a mechanical motion. In this case, the mechanical motion may be directly coupled into IAB robotic surgical instrument while the electrical control signals are indirectly coupled into the IAB robotic surgical instrument. In any case, one or more valves in the IAB robotic surgical instrument may be opened to flow one or more fluids over a surgical site in response to the control signals. Similarly, one or more valves in the IAB robotic surgical instrument may be closed to reduce the flow of the one or more fluids over the surgical site in response to the control signals.
• In alternative embodiments of the invention, the control of the flow of fluids between the surgical site and the IAB robotic surgical instrument is provided by controlling the one or more pumps. In which case, the control signals are coupled to the pumps and/or flow control valves located external to the IAB robotic surgical instrument. The IAB robotic surgical instrument may include a coupler to couple between the hoses from the one or more pumps and the hollow tube that is inserted into a patient.
• The one or more control signals may be generated in various ways including in response to movement of a touch sensitive handle of a master control console, squeezing of a grip of the touch sensitive handle, rotation of the touch sensitive handle, movement of a foot pedal, or a spoken command at the master control console.
• The level of flow of the fluids and the control thereof may be monitored between the surgical site and the IAB robotic surgical instrument through the user-feedback means previously described. One user-feedback means is one or more light emitting diodes coupled near the tip of the hollow tube of the IAB robotic surgical instrument. The one or more light emitting diodes generate a visible light in response to the control of a flow of a fluid through the IAB robotic surgical instrument. Another user-feedback means is a light pipe coupled along the length of the hollow tube of the irrigation-aspiration robotic surgical instrument with a light emitting diode. The light emitting diode couples photons into the light pipe and generates a visible side light in response to the control of a flow of a fluid through the irrigation-aspiration robotic surgical instrument. Still another user-feedback means is a sliding sleeve coaxial with the hollow tube and a scale coupled to the irrigation-aspiration robotic surgical instrument. The sliding sleeve slides along the hollow tube and reveals the scale in response to the control of a flow of a fluid through the irrigation-aspiration robotic surgical instrument.
• After the using the IAB robotic surgical instrument, it is removed from the patient and can then be dismounted from the robotic arm of the roboticsurgical manipulator152. If the IAB robotic surgical instrument is to be reused, a modular valve assembly and one or more hoses of the irrigation-aspiration robotic surgical instrument may be discarded and the remaining components of the IAB robotic surgical instrument sterilized for reuse. In the case that the IAB robotic surgical instrument includes a flow control system with an inexpensive valve subassembly, the irrigation-aspiration robotic surgical instrument can be removed from the patient; dismounted from the robotic arm; and then discarded.
• While certain exemplary embodiments of the invention 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 the embodiments of the 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, while an irrigation/aspiration/blowing robotic surgical instrument has been shown and described in a number of embodiments of the invention, it may be modified into an irrigation robotic surgical instrument with a single valve to provide irrigation only or it may be modified into an aspiration robotic surgical instrument with a single valve to provide aspiration only. Furthermore, while aspiration or suction has been described as being provided by a vacuum pump, one would recognize that a pressurized gas maybe provided instead, such as air by an air pump. The pressurized gas may be used to blow debris or cut tissue, if sufficient pressure is provided. Rather, the embodiments of the invention should be construed according to the claims that follow below.

Claims (26)

1. A robotic surgical system comprising:

a master control console to generate control signals to cause one or more fluids to flow into or out of a surgical site;

a surgical manipulator coupled to the master control console to receive the control signals, the surgical manipulator including

at least one robotic arm to manipulate at least one surgical instrument, and

a surgical instrument coupled to the robotic arm, the surgical manipulator to control the surgical instrument in response to the control signals to control the flow of the one or more fluids into or out of the surgical site, the surgical instrument having

a first robotically controlled valve responsive to the surgical manipulator, the first robotically controlled valve having a first port and a second port, and

a hollow tube having a first end coupled to the second port of the first robotically controlled valve, the hollow tube having an opening at a second end to direct the flow of one or more fluids into or out of the surgical site;

a first pump having a pump port, the first pump to pump a first fluid into or out of the surgical site; and

a first hose having a first end coupled to the first port of the first robotically controlled valve and a second end coupled to the pump port of the pump, the first hose to transport a first fluid between the first robotically controlled valve and the pump.

2. The system ofclaim 1, wherein

the first pump is a suction pump to create a vacuum in the first hose as the first fluid to aspirate the surgical site in response to opening the first robotically controlled valve.

3. The system ofclaim 1, wherein

the first pump is a fluid pump to pressurize a liquid in the first hose as the first fluid to irrigate the surgical site in response to opening the first robotically controlled valve.

4. The system ofclaim 1, wherein

the first pump is a compressor to pressurize a gas in the first hose as the first fluid to blow a pressurized gas in the surgical site in response to opening the first robotically controlled valve.

5. The system ofclaim 1, wherein

the first robotically controlled valve is responsive to the control signals from the master control console, and

the master control console includes at least one foot pedal to generate the control signals to control the first robotically controlled valve.

6. The system ofclaim 1, wherein

the first robotically controlled valve is responsive to the control signals from the master control console, and

the master control console includes a touch sensing handle to generate the control signals to control the first robotically controlled valve.

7. The system ofclaim 1, wherein

the first robotically controlled valve is responsive to the control signals from the master control console, and

the master control console includes a voice recognition system to recognize commands to generate the control signals to control the first robotically controlled valve.

8. The system ofclaim 1, wherein

the first robotically controlled valve is a three-way valve having a third port;

and,

the system further comprises

a second hose having a first end coupled to the third port of the first robotically controlled valve;

and

a second pump having a port coupled to a second end of the second hose.

9. The system ofclaim 8, wherein

the first pump is a suction pump to create a vacuum in the first hose and to aspirate the surgical site in response to opening the first robotically controlled valve to couple the first port and the second port together, and

the second pump is a fluid pump to pressurize a fluid in the second hose to irrigate the surgical site in response to opening the first robotically controlled valve to couple the first port and the third port together.

10. The system ofclaim 8, wherein

the first pump is a gas compressor to create a gas pressure in the first hose and to blow a pressurized gas in the surgical site in response to opening the first robotically controlled valve to couple the first port and the second port together, and

the second pump is a fluid pump to pressurize a fluid in the second hose to irrigate the surgical site in response to opening the first robotically controlled valve to couple the first port and the third port together.

11. The system ofclaim 1, wherein

the first robotically controlled valve is a four-way valve having a third port and a fourth port;

and,

the system further comprises

a second hose having a first end coupled to the third port of the first robotically controlled valve;

a third hose having a first end coupled to the fourth port of the first robotically controlled valve;

a second pump having a port coupled to a second end of the second hose;

and

a third pump having a port coupled to a second end of the third hose.

12. The system ofclaim 11, wherein

the first pump is a suction pump to create a vacuum in the first hose and to aspirate the surgical site in response to opening the first robotically controlled valve to couple the first port and the second port together,

the second pump is a fluid pump to pressurize a fluid in the second hose to irrigate the surgical site in response to opening the first robotically controlled valve to couple the first port and the third port together, and

the third pump is a gas compressor to create a gas pressure in the first hose and to blow a pressurized gas in the surgical site in response to opening the first robotically controlled valve to couple the first port and the fourth port together.

13. The system ofclaim 1, wherein

the surgical instrument further has

a second robotically controlled valve having a first port and a second port,

a third robotically controlled valve having a first port and a second port, and

a four-way coupler coupled between the second ports of the first, second, and third robotically controlled valves and the first end of the hollow tube;

and,

the system further comprises

a second hose having a first end coupled to the first port of the second robotically controlled valve;

a third hose having a first end coupled to the first port of the third robotically controlled valve;

a second pump having a port coupled to a second end of the second hose; and

a third pump having a port coupled to a second end of the third hose.

14. The system ofclaim 13, wherein

the first pump is a suction pump to create a vacuum in the first hose and to aspirate the surgical site in response to opening the first robotically controlled valve to couple the first port and the second port together,

the second pump is a fluid pump to pressurize a fluid in the second hose to irrigate the surgical site in response to opening the first robotically controlled valve to couple the first port and the third port together, and

the third pump is a gas compressor to create a gas pressure in the first hose and to blow a pressurized gas in the surgical site in response to opening the first robotically controlled valve to couple the first port and the fourth port together.

15. A robotic surgical system comprising:

a master control console to generate control signals to cause one or more fluids to flow into or out of a surgical site;

a surgical manipulator coupled to the master control console to receive the control signals, the surgical manipulator including

at least one robotic arm to manipulate at least one surgical instrument, and

a surgical instrument coupled to the robotic arm, the surgical manipulator to control the surgical instrument in response to the control signals to control the flow of one or more fluids into or out of the surgical site, the surgical instrument having

a first robotically controlled valve having a first port and a second port, the first robotically controlled valve responsive to the surgical manipulator to control the flow of a first fluid,

a second robotically controlled valve having a first port and a second port, the second robotically controlled valve responsive to the surgical manipulator to control the flow of a second fluid,

a hollow tube having a first end and a second end with an opening to direct the flow of a plurality of fluids into or out of the surgical site, and

a three-way coupler coupled between the second ports of the first and second robotically controlled valves and the first end of the hollow tube, the three way coupler to couple a plurality of fluids between the hollow tube and the first and second robotically controlled valves.

16. The system ofclaim 15, further comprising:

a first pump having a first pump port, the first pump to pump the first fluid into or out of the surgical site;

a second pump having a second pump port, the second pump to pump the second fluid into or out of the surgical site;

a first hose having a first end coupled to the first port of the first robotically controlled valve and a second end coupled to the first pump port of the first pump, the first hose to transport the first fluid between the first robotically controlled valve and the first pump; and

a second hose having a first end coupled to the first port of the second robotically controlled valve and a second end coupled to the second pump port of the second pump;

the second hose to transport the second fluid between the second robotically controlled valve and the second pump.

17. The system ofclaim 16, wherein

the first pump is a suction pump to create a vacuum in the first hose and to aspirate the surgical site in response to opening the first robotically controlled valve, and

the second pump is a fluid pump to pressurize a fluid in the second hose to irrigate the surgical site in response to opening the second robotically controlled valve.

18. The system ofclaim 15, wherein

the first robotically controlled valve and the second robotically controlled valve are responsive to the control signals from the master control console, and

the master control console includes at least one foot pedal to generate the control signals to control the first robotically controlled valve and the second robotically controlled valve.

19. The system ofclaim 15, wherein

the first robotically controlled valve and the second robotically controlled valve are responsive to the control signals from the master control console, and

the master control console includes at least one touch sensing handle to generate the control signals to control the first robotically controlled valve and the second robotically controlled valve.

20. The system ofclaim 15, wherein

the first robotically controlled valve and the second robotically controlled valve are responsive to the control signals from the master control console, and

the master control console includes a voice recognition system to recognize commands to generate the control signals to control the first robotically controlled valve and the second robotically controlled valve.

21. A robotic surgical system comprising:

a master control console to generate control signals to cause a fluid to flow into or out of a surgical site;

a surgical manipulator coupled to the master control console to receive the control signals, the surgical manipulator including

at least one robotic arm to manipulate at least one surgical instrument, and

a surgical instrument coupled to the robotic arm, the surgical instrument to control the flow of the fluid into or out of the surgical site, the surgical instrument having

a first hose having a first end and a second end, the first hose being flexible;

a first robotically controlled pinch valve to receive the first hose, the first robotically controlled pinch valve to squeeze and pinch closed the first hose and to release and open the first hose, and

a hollow tube having a first end to couple to the first end of the first hose;

and

a first pump having a port coupled to the second end of the first hose.

22. The system ofclaim 21, wherein

the first pump is a suction pump to create a vacuum in the first hose and to aspirate the surgical site at a second end of the hollow tube in response to releasing the first robotically controlled pinch valve.

23. The system ofclaim 21, wherein

the first pump is a fluid pump to pressurize a fluid in the first hose to irrigate the surgical site at a second end of the hollow tube in response to releasing the first robotically controlled pinch valve.

24. The system ofclaim 21, wherein

the first pump is a compressor to pressurize a gas in the first hose to blow a pressurized gas in the surgical site in response to opening the robotically controlled pinch valve.

25. The system ofclaim 21, wherein

the surgical instrument further has

a second robotically controlled pinch valve having a first port and a second port, and

a three-way coupler coupled between the second ports of the first and second robotically controlled pinch valves and the first end of the hollow tube; and,

the system further comprises

a second hose having a first end coupled to the first port of the second robotically controlled pinch valve;

and

a second pump having a port coupled to a second end of the second hose.

26. The system ofclaim 25, wherein

the first pump is a suction pump to create a vacuum in the first hose and to aspirate the surgical site in response to opening the first robotically controlled pinch valve, and

the second pump is a fluid pump to pressurize a fluid in the second hose to irrigate the surgical site in response to opening the second robotically controlled pinch valve.

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