CA2750053A1 - Method and apparatus for performing minimally invasive surgical procedures - Google Patents

Method and apparatus for performing minimally invasive surgical procedures Download PDF

Info

Publication number
CA2750053A1
CA2750053A1 CA2750053A CA2750053A CA2750053A1 CA 2750053 A1 CA2750053 A1 CA 2750053A1 CA 2750053 A CA2750053 A CA 2750053A CA 2750053 A CA2750053 A CA 2750053A CA 2750053 A1 CA2750053 A1 CA 2750053A1
Authority
CA
Canada
Prior art keywords
instrument
surgical instrument
coupled
handle
housing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA2750053A
Other languages
French (fr)
Inventor
Yulun Wang
Darrin Uecker
Keith Laby
Jeff Wilson
Charles Jordan
James Wright
Modjtaba Ghodoussi
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Computer Motion Inc
Original Assignee
Computer Motion Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Computer Motion Inc filed Critical Computer Motion Inc
Publication of CA2750053A1 publication Critical patent/CA2750053A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147Holding or positioning arrangements
    • A61B1/00149Holding or positioning arrangements using articulated arms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B34/35Surgical robots for telesurgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B34/37Master-slave robots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • A61B34/71Manipulators operated by drive cable mechanisms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • A61B34/75Manipulators having means for prevention or compensation of hand tremors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • A61B34/76Manipulators having means for providing feel, e.g. force or tactile feedback
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • A61B34/77Manipulators with motion or force scaling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062Needle manipulators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00203Electrical control of surgical instruments with speech control or speech recognition
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00243Type of minimally invasive operation cardiac
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135End-to-side connections, e.g. T- or Y-connections
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2927Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2927Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2945Curved jaws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1425Needle
    • A61B2018/1432Needle curved
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B2034/305Details of wrist mechanisms at distal ends of robotic arms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/064Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50Supports for surgical instruments, e.g. articulated arms
    • A61B2090/5025Supports for surgical instruments, e.g. articulated arms with a counter-balancing mechanism
    • A61B2090/504Supports for surgical instruments, e.g. articulated arms with a counter-balancing mechanism with a counterweight
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361Image-producing devices, e.g. surgical cameras

Abstract

This invention is a surgical system (10) that may include a remotely controlled surgical instrument. The surgical instrument may be coupled to a tool driver (1602) that can spin, and actuate the instrument. The instrument may include an actuator rod that is coupled to an end effector (1710), and detachably connected to a push rod (1654). The push rod (1836) can move relative to the handle to actuate the end effector. The end effector may include a fixture that conforms to the shape of a needle (1712). The handle (1812) can be secured to the tool driver by inserting pins into corresponding slots that are located on both the instrument and the tool driver. The instrument can be controlled by an operator through a pair of handles (1806). Each handle may be mechanically balanced by a counterweight. The surgical system may also include a touch pad (1808) that allows the operator to enter parameters of the system.

Description

Method and Apparatus for Performing Minimally Invasive Surgical Procedures RELATED APPLICATIONS

This application is a division of Canadian patent Application Serial No. 2,330,067 filed 28 February 2000 and which has been submitted as the Canadian national phase application of International Application No PCT/US2000/005351 filed 28 February 2000.

FIELD OF THE INVENTION

The present invention relates to a system and method for performing minimally invasive cardiac procedures. More particularly, the present invention relates to a robotic system and surgical instruments that may be removably attached thereto, wherein said system aids in performing minimally invasive surgical procedures.
-2-2. BACKGROUND INFORMATION

Blockage of a coronary artery may deprive the heart of the blood and oxygen required to sustain life.
The blockage may be removed with medication or by an angioplasty. For severe blockage a coronary artery bypass graft (CABG) is performed to bypass the blocked area of the artery. CABG procedures are typically performed by splitting the sternum and pulling open the chest cavity to provide access to the heart. An incision is made in the artery adjacent to the blocked area. The internal mammary artery (IMA) is then severed and attached to the artery at the point of incision. The IMA bypasses the blocked area of the artery to again provide a full flow of blood to the heart. Splitting the sternum and opening the chest cavity, commonly referred to as `open surgery', can create a tremendous trauma on the patient.
Additionally, the cracked sternum prolongs the recovery period of the patient.
There have been attempts to perform CABG
procedures without opening the chest cavity. Minimally invasive procedures are conducted by inserting surgical instruments and an endoscope through small incision in the skin of the patient. Manipulating such instruments can be awkward, particularly when suturing a graft to an artery. It has been found that a high level of dexterity is required to accurately control the instruments. Additionally, human hands typically have at least a minimal amount of tremor. The tremor
-3-further increases the difficulty of performing minimally invasive cardiac procedures.
To perform MIS, the surgeon uses special instruments. These instruments allow the surgeon to maneuver inside the patient. One type of instrument that is used in minimally invasive surgery is forceps, an instrument having a tip specifically configured to grasp objects, such as needles. Because forceps and other instruments designed for minimally invasive surgery are generally long and rigid, they fail to provide a surgeon the dexterity and precision necessary to effectively carry out many procedures in a minimally invasive fashion. For example, conventional MIS
forceps are not well suited for manipulating a needle during a minimally invasive procedure, such as during endoscopy. Therefore, many MIS procedures that might be performed, have, as of yet, not been accomplished.
In essence, during open surgeries, the tips of the various instruments may be positioned with six degrees of freedom. However, by inserting an instrument through a small aperture, such as one made in a patient to effectuate a minimally invasive procedure, two degrees of freedom are lost. It is this loss of freedom of movement within the surgical site that has substantially limited the types of MIS procedures that are performed.
Dexterity is lacking in MIS because the instruments that are used fail to provide the additional degrees of freedom that are lost when the instrument is inserted into a patient. One problem associated with this lack of dexterity is the inability
-4-to suture when the instruments are in certain positions. As a result, surgeries that require a great deal of suturing within the surgical site are almost impossible to perform because the surgical instruments to enable much of this work are not available.
Another problem associated with MIS is the lack of precision within the surgical site. For procedures such as the MICABG (Minimally Invasive Coronary Artery Bypass Graft), extremely small sutures must be emplaced in various locations proximate the heart. As such, precise motion of the tool at the tip of a surgical instrument is necessary. Currently, with hand positioned instruments, the precision necessary for such suturing is lacking.
As such, what is needed in the art is a tool and class of surgical instruments that may be articulated within the patient such that a surgeon has additional degrees of freedom available to more dexterously and precisely position the tool at the tip of the instrument, as is needed.
Additionally, what is needed in the art is a method and mechanism that provides simple handle, instrument and tool changing capabilities so that various tools may be easily and readily replaced to enable faster procedures to thus minimize operating room costs to the patient and to lessen the amount of time a patient is under anesthesia.
It is to the solution of the aforementioned problems to which the present invention is directed.
U.S. Patent No. 5,649,956 issued to Jensen et al.
and assigned to SRI International discloses a system
-5-for holding a surgical instrument. The system includes an instrument holder that can hold a surgical instrument. The instrument can be inserted into a collar assembly an instrument holder. The instrument has a pair of pins that are rotated into circumferential slots of the collar assembly. The collar assembly further contains a latch which secures one of the pins within a corresponding slot to prevent the instrument from being inadvertently detached from the holder. When installed into the collar assembly the surgical instrument can be rotated and actuated through the holder.
The surgical instrument can be detached from the holder by twisting and then pulling the instrument away from the collar. These steps may require valuable time during a surgical procedure. Additionally, it appears that a cover of the holder must be opened to pull the instrument out of the collar. Opening the cover exposes the mechanism that rotates and actuates the instrument. The exposed mechanism may introduce contaminants into the operating site. It would be desirable to provide an instrument and tool driver which allow an operator to quickly change instruments without introducing contaminates into the surgical site.

SUMMARY OF THE INVENTION

One embodiment of the present invention is a surgical instrument which has an actuator rod that is coupled to an end effector. The actuator rod is also
-6-detachably connected to a push rod that can move relative to a handle to actuate the end effector.

Accordingly, in one aspect, the present invention provides a surgical instrument, comprising: a handle; a push rod that is coupled to and movable relative to said handle, said push rod defining a locking cavity therein; an actuator rod detachably coupled to said push rod, said actuator rod including a locking barrel that is located within the locking cavity of said push rod when said actuator rod is coupled to said push rod; and an end effector that is coupled to said actuator rod.

In a further aspect, the present invention provides a surgical. instrument, comprising: a handle; a push rod that can move relative to said handle; an actuator rod that is coupled to said push rod; an end effector that is coupled to said actuator rod; and a plunger that is attached to said push rod and coupled to said handle, said plunger can be depressed so that said actuator rod can be detached from said push rod.

In a still further aspect, the present invention provides a surgical instrument, comprising: a handle having an inner channel; a push rod coupled to the inner channel of the handle; an end effector; and an actuator rod that is coupled to the end effector and is detachably coupled to the push rod without using a tool, wherein said push rod is movable relative to the handle to actuate the end effector.

In a further aspect, the present invention provides a tool driver that can actuate a surgical instrument, -6a-comprising: a housing; a sheath that is detachably connected to said housing and contains an inner channel that receives the surgical instrument, said sheath having a wiper that engages the surgical instrument and a valve that can be sealed against a valve seat; and an actuator that is coupled to said housing and which can actuate the surgical instrument.

In a still further aspect, the present invention provides a tool driver that can be coupled to a surgical instrument, comprising: a housing; a sleeve that is coupled to said housing and can be coupled to the surgical instrument; an actuator that is coupled to said housing and can move said sleeve to actuate the surgical instrument; a bellows that couples said actuator to said sleeve.

In a further aspect, the present invention provides a tool driver that can be coupled to a surgical instrument, comprising: a housing; a tube that is coupled to said housing and the surgical instrument; a first actuator that can move said sleeve and actuate the surgical instrument; a second actuator that can rotate said tube and the surgical instrument; and, a worm gear that couples to said second actuator to said tube.

In a still further aspect, the present invention provides a tool driver that can be coupled to a surgical instrument, comprising: a housing; an actuator that is attached to said housing and which can actuate the surgical instrument; a printed circuit board assembly that is coupled to said housing and said actuator; a wire assembly that is -6b-connected to said printed circuit board assembly and extends from said housing, said wire assembly includes an inner jacket that is within an outer jacket, and a wire that is within said inner jacket.

In another aspect, the present invention provides a surgical instrument that can be used to grasp a needle which has a curved profile, comprising: an end effector that includes an outer surface which has a curved shape that conforms to the curved profile of the needle; and, an actuator element that can actuate said end effector.

BRIEF DESCRIPTION OF THE DRAWINGS

Figure 1 is a perspective view of a minimally invasive surgical system in accordance with the present invention;
Figure 2 is a schematic of a master of the system;
Figure 3 is a schematic of a slave of the system;
Figure 4 is a schematic of a control system of the system;

Figure 5 is a schematic showing the instrument within a coordinate frame;

Figure 6 is a schematic of the instrument moving about a pivot point;

Figure 7 is an exploded view of an end effector in accordance with the system of the present invention;

Figure 8 is a side sectional view of a master handle of -6c-the system in accordance with the present invention;
Figure 8a is a side view of the master handle of the system in accordance with the present invention;

Figures 9-10A-I are illustrations showing an internal mammary artery being grafted to a coronary artery;

Figure 11 is a side view of a force feedback tool in accordance with one aspect of the present invention;
Figure 12 is a perspective view of a robotic arm including an additional joint;

Figure 13 is a side cross sectional view of an instrument in accordance with the present invention
-7-wherein said instrument includes irrigation and suction lines;
Figure 14 is an end sectional view of the instrument of Figure 13;
Figure 15 is a side view of a rear-loading tool driver in accordance with the system of the present invention;
Figure 16 is a plan view of the motor assembly of the back loading tool driver of Fig. 15;
Figure 17 is a side plan view of an articulable instrument in accordance with the present invention;
Figure 18 is a side plan view of an articulable instrument, where the instrument tip is articulated;
Figure 19 is an exploded view of the articulable portion of the articulable instrument in accordance with the present invention;
Figure 20 is a plan view of a pivot linkage in accordance with the articulate portion of the articulable surgical instrument of the present invention;
Figure 21. is a perspective view of an articulating tool driving assembly in accordance with the present invention;
Figure 22 is a view of a removable tool-tip in accordance with an articulable instrument of the present invention;
Figure 23 is a tool-tip receptacle in accordance with the present invention;
Figure 24 is a cross-sectional view of an articulable instrument attached to the articulate-translator of the present invention;
-8-Figure 25 is an enlarged cross-sectional view of the articulate-translator in accordance with the present invention;
Figure 26 is an end view of the articulate translator in accordance with the present invention;
Figure 27 is a cross-sectional view of the sterile section of the articulating tool driving assembly in accordance with the system of the present invention;
Figure 28 is a cross sectional view of the tool driver of the articulating too]. driving assembly in accordance with the system of the present invention;
Figure 29 is an schematic of a master of a system in accordance with the present invention that includes the articulating tool driving assembly;
Figure 30 is a plan view of a drape for use with the robotic arm in accordance with the present invention;
Figure 31 is a plan view of a surgical instrument having a stapling tool disposed at the end thereof and wherein the surgical instrument is attached to the robotic arm in accordance with the present invention;
Figure 32 is a plan view of a surgical instrument having a cutting blade disposed at the end thereof wherein the instrument is attached to the robotic arm in accordance with the present invention;
Figure 33 is a plan view of a surgical instrument having a coagulating/cutting device disposed at the end thereof, the instrument attached to a robotic arm in accordance with the present invention;

Figure 34 is a plan view of a surgical instrument having a suturing tool disposed at the end thereof and
-9-wherein the surgical instrument is attached to the robotic arm in accordance with the present invention;
Figure 35 is a plan view of an alternative master-handle console in accordance the present invention;
Figure 36 is a plan view of an alternative master-handle console in accordance with the present invention;
Figure 37 is a partial cut away cross-section of the master handle console in accordance with the present invention;
Figure 38 is a partial cut-away plan view of a handle in accordance with the present invention;
Figure 39 is a perspective view of an alternative embodiment of a handle in accordance with the present invention;
Figure 40 is a top plan cross-sectional view of the handle depicted in Figure 39;

Figure 40A is a top plan view which shows an interchange mechanism of the handle shown in Fig. 40;
Figure 41 is an alternative embodiment of a handle in accordance with the present invention;
Figure 42 is an alternative embodiment of a handle in accordance with the present invention;
Figure 43 is an alternative embodiment of a handle in accordance with the present invention.
Figure 44 is a perspective view of a tool driver and surgical instrument coupled to an articulate arm;
Figure 45 is a cross-sectional perspective view of an embodiment of a surgical instrument coupled to a tool driver;
-10-Figure 46 is a side cross-sectional view of a sheath of the tool driver;
Figure 47 is a cross-sectional view similar to Fig. 46 showing a surgical instrument inserted into the sheath;
Figure 48 is a cross-sectional view showing a surgical instrument coupled to a tool holder;
Figure 49 is an enlarged cross-sectional view of the holder without an instrument;
Figure 50 is a cross-sectional view of an embodiment of a surgical instrument;
Figure 51 is a cross-sectional view of an actuator pin assembly;
Figure 52 is a perspective view of a sleeve of the tool holder;
Figure 53 is an enlarged cross-sectional view showing a connector assembly of the instrument;
Figure 54 is a cross-sectional view of an alternate embodiment of a connector assembly;
Figure 55 is a perspective view of an embodiment of an effector;
Figure 56 is a cross-sectional view of a pin/slot interface of the tool driver and instrument;
Figure 57 is a perspective view of an embodiment of a console;
Figure 58 is a cross-sectional view of a grasper of a handle assembly;

Figure 59 is a cross-sectional view of a swing arm of the handle assembly;
Figure 60 is a side sectional view of the swing arm;
-11-Figure 61 is a schematic of an articulate arm of the system.

DETAILED DESCRIPTION

Referring to the drawings more particularly by reference numbers, Figure 1 shows a system 10 that can be used to perform minimally invasive surgery. In a preferred embodiment, the system 10 may be used to perform a minimally invasive coronary artery bypass graft, or Endoscopic coronary artery bypass graft (E-CABG) and other anastomostic procedures. Although a MI-CABG procedure is shown and described, it is to be understood that the system may be used for other surgical procedures. For example, the system'can be used to suture any pair of vessels as well as cauterizing, cutting, and radiating structures within a patient.
The system 10 is used to perform a procedure on a patient 12 that is typically lying on an operating table 14. Mounted to the operating table 14 is a first articulate arm 16, a second articulate arm 18 and a third articulate arm 20. The articulate arms 16-20 are preferably mounted to the table so that the arms are in a plane proximate the patient. It is to be appreciated that the arms may be mounted to a cart or some other device that places the arms proximate the plane of the patient as well. Although three articulate arms are shown and described, it is to be understood that the system may have any number of arms, such as one or more arms.
-12-The first and second articulate arms 16 and 18 each have a base housing 25 and a robotic arm assembly 26 extending from the base housing 25. Surgical instruments 22 and 24 are preferably removably coupled at the end of each robotic arm assembly 26 of the first and second articulate arms 16, 18. Each of the instruments 22, 24 may be coupled to a corresponding robotic arm assembly 26 in a variety of fashions which will be discussed in further detail hereinbelow.
The third articulate arm 20 additionally comprises a base housing 25 and a robotic arm assembly 26, and preferably has an endoscope 28 that is attached to the robotic arm assembly 26. The base housing 25 and robotic arm assemblies 26 of each of the articulate arms 16, 18, and 20 are substantially similar.
However, it is to be appreciated that the configuration of the third articulate arm 20, may be different as the purpose of the third articulate arm is to hold and position the endoscope 28 as opposed to hold and position a surgical instrument. Additionally, a fourth arm 29 may be included in the system 10. The fourth arm 29 may hold an additional instrument 31 for purposes set out hereinbelow.
The instruments 22, 24 and 29 and endoscope 28 are inserted through incisions cut into the skin of the patient 12. The endoscope 28 has a camera 30 that is coupled to a monitor 32 which displays images of the internal organs of the patient 12.
Each robotic arm assembly 26 has a base motor 34 which moves the arm assembly 26 in a linear fashion, relative to the base housing 25, as indicated by arrows
-13-Q. Each robotic arm assembly 26 also includes a first rotary motor 36 and a second rotary motor 38. Each of the robotic arm assemblies 26 also have a pair of passive joints 40 and 42. The passive joints 40, 42 are preferably disposed orthogonal to each other to provide pivotal movement of the instrument 22, 24 or endoscope 28 that is attached to a corresponding robotic arm assembly 26. The passive joints may be spring biased in any specific direction, however, they are not actively motor driven. The joint angle is controlled to a particular value using a feedback control loop. The robotic arm assemblies 26 also have a coupling mechanism 45 to couple the instruments 22 and 24, or endoscope 28 thereto. Additionally, each of the robotic arm assemblies 26 has a motor driven worm gear 44 to rotate the instrument 22, 24 or endoscope 28 attached thereto about its longitudinal axis. More particularly, the motor driven worm gear spins the instruments or endoscope.
The first, second, and third articulate arms 16, 18, 20 as well as the fourth arm 29 are coupled to a controller 46 which can control the movement of the arms. The arms are coupled to the controller 46 via wiring, cabling, or via a transmitter/receiver system such that control signals may be passed form the controller 46 to each of the articulate arms 16, 18, and 20. It is preferable, to ensure error free communication between each of the articulate arms 16, 18, 20 and 29 and the controller 46 that each arm 16, 18, 20 and 29 be electrically connected to the controller, and for the purposes of example, each arm
-14-16, 18, 20 and 29 is electrically connected to the controller 46 via electrical cabling 47. However, it is possible to control each of the arms 16, 18, 20 and 29 remotely utilizing well-known remote control systems as opposed to direct electrical connections. As such remote control systems are well-known in the art, they will not be further discussed herein.
The controller 46 is connected to an input device 48 such as a foot pedal, hand controller, or voice recognition unit. For purposes of example, a foot controller and voice recognition unit are disclosed herein. The input device 48 can be operated by a surgeon to move the location of the endoscope 28 and view a different portion of the patient by depressing a corresponding button(s) disposed on the input device 48. Alternatively, the endoscope 28 may be positioned via voice control. Essentially, a vocabulary of instructions to move the endoscope, such as up, down, back, and in may be recognized via a speech recognition system and the appropriate instructions are sent to the controller. The speech recognition system may be any well-known speech recognition software. Additionally, the controller 46 includes a vocabulary of appropriate words that may be used with the system 10. Including such a vocabulary in the controller 46 may be accomplished through the inclusion of the aforementioned speech recognition software. To effectuate the voice recognition a microphone 37 is included in the system 10. The microphone 37 may be part of a digital system such that integrity of the signal is ensure.
-15-The controller 46 receives the input signals from the input device 48 and moves the endoscope 28 and robotic arm assembly 26 of the third articulate arm 20 in accordance with the input commands of the surgeon.
Each of the robotic arm assemblies 26 may be devices that are sold by the assignee of the present invention, Computer Motion, Inc. of Goleta, California, under the trademark AESOP. The system is also described in U.S.
Patent Number 5,515,478. Although a foot pedal 49 is shown and described, it is to be understood that the system may have other input means such as a hand controller, or a speech recognition interface.

The movement and positioning of instruments 22, 24 attached to the first and second articulate arms 16 and 18 is controlled by a surgeon at a pair of master handles 50 and 52. Each of the master handles 50, 52 which can be manipulated by the surgeon, has a master-slave relationship with a corresponding one of the articulate arms 16, 18 so that movement of a handle 50 or 52 produces a corresponding movement of the surgical instrument 22, 24 attached to the articulate arm 16, 18. Additionally, a switch 51 may be included in the system 10. The switch 51 may be used by the surgeon to allow positioning of the fourth arm 29. This is accomplished because the position of the switch 51 allows the surgeon to select which of the arms a specific handle 50 or 52 controls. In this way, a pair of handles 50 and 52 may be used to control a plurality of robotic arms. The switch 51 may be connected to a multiplexer to act as a selector so that output from
-16-the multiplexer is transmitted to the appropriate robotic arm. Alternatively, the switch may have several positions and may, therefore, direct its output to the appropriate input on the controller 46.
The handles 50 and 52 may be mounted to a portable cabinet 54. A second television monitor 56 may be placed onto the cabinet 54 and coupled to the endoscope 28 via well-known means so that the surgeon can readily view the internal organs of the patient 12. The handles 50 and 52 are also coupled to the controller 46. The controller 46 receives input signals from the handles 50 and 52, computes a corresponding movement of the surgical instruments, and provides output signals to move the robotic arm assemblies 26 and instruments 22, 24. Because the surgeon may control the movement and orientation of the instruments 22, 24 without actually holding the ends of the instruments, the surgeon may use the system 10 of the present invention both seated or standing. One advantage of the present system is that a surgeon may perform endoscopic surgeries in a sitting position. This helps reduce surgeon fatigue and may improve performance and outcomes in the operating room, especially during those procedures that are many hours in length. To accommodate a seated position, a chair 57 may be provided with the system.
Alternatively, and as depicted in Figures 35-37, the handles 50 and 52 may be mounted to a handle stand 900. The handle stand 900 essentially provides for adjustment of the height and tilt of the handles 50 and 52. The handle stand 900 includes a base 902, a neck
-17-904 and a handle portion 906. The base 902 may be adjusted so that the handle stand 900 is tilted. A
lever 908 connected to an elongated rod 910 may provide a means for tilting the handle stand 900. As such, the stand 900 may be tilted such that a surgeon using the system 10 can remain comfortable standing or sitting while manipulating the handles 50 and 52.
Additionally, the handle stand 900 may be heightened or shortened depending upon the position of the surgeon (i.e. standing or sitting). This is accomplished via a telescoping section 912. The telescoping section 912 includes an upper portion 914 telescopingly housed within a lower portion 916. A
spring biased detent 918 is attached to the upper portion 914 and a plurality of apertures 920 are provided in the lower portion 916 such that the detent 918 seats in an associated aperture 920. The upper portion 914 may be extended by depressing the detent 918 and pulling up on the stand 900. Alternatively, the stand 900 may be lowered by depressing the detent and pushing down on the stand 900. The telescoping section 912 and associated mechanisms serve as a means to raise and lower the stand 900.
Additionally, and as depicted in Figures 35-37, the handles 50 and 52 may be attached to the stand 900 via a plurality of rollers 930 and an elongated rod 932. Motion of the rod 932 is transmitted to a plurality of gears 934 disposed on the stand 900. The gears 934 may be housed within a housing 936 to protect them from the environment and to preclude access thereto. Additionally, potentiometers 938 are utilized
-18-to measure the position of the handles 50 and 52 relative to a starting position. This will be discussed in more detail hereinbelow. It is to be appreciated that the present invention may be accomplished either utilizing a cabinet 54 or a stand 900. As the handles 50 and 52 are connected to the controller 46 in either case.
Each handle has multiple degrees of freedom provided by the various joints Jml-Jm5 depicted in Figure 2. Joints Jm1 and Jm2 allow the handle to rotate about a pivot point in the cabinet 54 or on the stand 900. Joint Jm3 allows the surgeon to move the handle into and out of the cabinet 54 in a linear manner or in a similar manner an the stand 900. Joint Jm4 allows the surgeon to rotate the master handle about a longitudinal axis of the handle. The joint Jm5 allows a surgeon to open and close a gripper.
Each joint Jml-Jm5 has one or more position sensors which provides feedback signals that correspond to the relative position of the handle. The position sensors may be potentiometers, or any other feedback device such as rotary optical encoders that provides an electrical signal which corresponds to a change of position. Additionally, a plurality of position sensors may be emplaced at each joint to provide redundancy in the system which can be used to alert a surgeon of malfunctions or improper positioning of a corresponding robotic arm assembly 26.
In addition to position sensors, each joint may include tachometers, accelerometers, and force sensing load cells, each of which may provide electrical
-19-signals relating to velocity, acceleration and force being applied at a respective joint. Additionally, actuators may be included at each joint to reflect force feed back received at a robotic arm assembly 26.
This may be especially helpful at joint jm5 to indicate the force encountered inside a patient by the gripper disposed at the end of one of the tools 22, or 24. As such, a force reflective element must be included at the gripper of the instrument 22, 24 to effectuate such a force reflective feedback loop. Force reflective elements, such as a piezoelectric element in combination with a whetstone bridge are well-known in the art. However, it is not heretofore know to utilize such force reflection with such a system 10.
As such, a force reflective element must be included at the gripper of the instrument 22, 24 to effectuate such a force reflective feedback loop.
Force reflective elements, such as a piezoelectric element in combination with a whetstone bridge are well-known in the art. However, it is not heretofore know to utilize such force reflection with such a system 10. Additionally, and as depicted in Figure 11, a specialized tool 300 may be used in conjunction with the system 10. The tool 300 is attached to an articulate arm 26 as any other instrument used with the system. However, the instrument 300 includes force reflective elements at its tip or distal end 302. As such, the instrument may be dragged across an artery, vein or the like and provide feedback to the surgeon as to the rigidity of the vessel. A lead 303 extends the length of the instrument and connects to the controller
-20-46 to provide electrical signals indicative of the force encountered at the instrument tip. Such signals are then processed at the controller and transmitted to the corresponding handle which provides feedback indicative of the force. Force reflection and feedback are well known in the robotics art and as such will not be further discussed herein. In this fashion, the surgeon may determine whether there is plaque built up interior the vessel proximate the area that is palpated with the device. The force sensing portion 304 is electrically connected to a corresponding handle 51, 52 through the controller 46 and the switches disclosed herein earlier.
Figure 3 shows the various degrees of freedom of each articulate arm 16 and 18. The joints Jsl, Js2 and Js3 correspond to the axes of movement of the base motor 34 and rotary motors 36, 38 of the robotic arm assemblies 26, respectively. The joints Js4 and Js5 correspond to the passive joints 40 and 42 of the arms 26. The joint Js6 may be a motor which rotates the surgical instruments about the longitudinal axis of the instrument. The joint Js7 may be a pair of fingers that can open and close. The instruments 22 and 24 move about a pivot point P located at the incision of the patient.
Joint Js2(s) is a joint that is included directly after Joints Js2 and Js3 to provide for additional positionability of the arm 26, and more particularly an instruments disposed at the end thereof.
Joint Js2(a) is disposed orthogonal to both joints Js2 and Js3. Essentially, joint Js2(a) allows the arm
-21-26 to be offset an angle, theta, from the plane formed by segments 36 and 38. As such, the controller must account for this offset which is measured by a potentiometer or optical encoder emplaced at the joint Js2(a) and is depicted in figure 12.
Figure 12 shows a robotic arm including the additional joint, Js2(a). This joint is not motor drive, however the displacement of this joint from the plane formed by segments 36 and 38 must be accounted for to ensure proper functioning of the robotic arm.
As such, and as disclosed hereinbelow, the coordinate transforms necessary to provide for movement of surgical instruments disposed at the end of the arm 26 must include transformation at this joint. Coordinate frame transforms are well known in the robotic art and as such, they will not be further discussed herein. It is the inclusion of the additional joint itself that is unobvious over the prior art. More particularly, the inclusion of the additional joint provides additional maneuverability of the robotic arm making it easier to position for use with a patient.
The joints Js4 and Js5 correspond to the passive joints 40 and 42 of the arms 26. The joint Js6 may be a motor which rotates the surgical instruments about the longitudinal axis of the instrument. The joint Js7 may be a pair of fingers that can open and close. The instruments 22 and 24 move about a pivot point P
located at the incision of the patient.
Figure 4 shows a schematic of a control system that translates a movement of a master handle into a corresponding movement of a surgical instrument. In
-22-accordance with the control system shown in Fig. 4, the controller 46 computes output signals for the articulate arms so that the surgical instrument moves in conjunction with the movement of the handle. Each handle may have an input button 58 which enables the instrument to move with the handle. When the input button 58 is depressed the surgical instrument follows the movement of the handle. When the button 58 is released the instrument does not track the movement of the handle. In this manner the surgeon can adjust or "ratchet" the position of the handle without creating a corresponding undesirable movement of the instrument.
The "ratchet" feature allows the surgeon to continuously move the handles to more desirable positions without altering the positions of the arms.
Additionally, because the handles are constrained by a pivot point the ratchet feature allows the surgeon to move the instruments beyond the dimensional limitations of the handles. Although an input button 58 is shown and described, it is to be understood that the surgical instrument may be activated by other means such as voice recognition. Using the voice recognition would require a specifically vocabulary such as " AWAKE" and SLEEP" or some other two words having opposing meanings. Voice recognition is well known in general, and it is the specific use of voice recognition in this system 10 that has substantial novelty and utility.
The input button may alternatively be latched so that movement of the corresponding instrument toggles between active and inactive each time the button is depressed by the surgeon.
-23-When the surgeon moves a handle, the position sensors provide feedback signals M1-M5 that correspond to the movement of the joints Jml-JmS, respectively.
The controller 46 computes the difference between the new handle position and the original handle position in computation block 60 to generate incremental position values -Ml--M5.
The incremental position values Ml- MS are multiplied by scale factors Sl-S5, respectively in block 62. The scale factors are typically set at less than one so that the movement of the instrument is less than the movement of the handle. In this manner the surgeon can produce very fine movements of the instruments with relatively coarse movements of the handles. The scale factors S1-S5 are variable so that the surgeon can vary the resolution of instrument movement. Each scale factor is preferably individually variable so that the surgeon can more finely control the instrument in certain directions. By way of example, by setting one of the scale factors at zero the surgeon can prevent the instrument from moving in one direction. This may be advantageous if the surgeon does not want the surgical instrument to contact an organ or certain tissue located in a certain direction relative to the patient. Although scale factors smaller than a unit one are described, it is to be understood that a scale factor may be greater than one.
For example, it may be desirable to spin the instrument at a greater rate than a corresponding spin of the handle.
-24-The controller 46 adds the incremental values Ml-_M5 to the initial joint angles Mjl-Mj5 in adder element 64 to provide values Mrl-MrS. The controller 46 then computes desired slave vector calculations in computation block 66 in accordance with the following equations.

Rdx = Mr3=sin(Mr2)=cos(Mrl)+Px Rdy = Mr3=sin(Mr2)=sin(Mrl)+Py Rdz = Mr3=cos(Mr2)+Pz Sdr = Mr4 Sdg = MrS
where;
Rdx,y,z = the new desired position of the end effector of the instrument.
Sdr = the angular rotation of the instrument about the instrument longitudinal axis.
Sdg = the amount of movement of the instrument fingers.
Px,y,z = the position of the pivot point P.

The controller 46 then computes the movement of the robotic arm 26 in computational block 68 in accordance with the following equations.

Jsdl=Rdz Jsd3 = it - cos-1 Rdx2 + Rdy2 - L12 - L22 Jsd2=tan-1(Rdy/Rdx)+A for Jsd350 Jsd2=tan-1(Rdy/Rdx) -A for Jsd3>0 = os Rdx2 + Rdy2 + L12 - L22 c 2 = Ll Rdx2 + Rdy2 Jsd6=Mr4 Jsd7=Mr5
-25-where;

Jsdl = the movement of the linear motor.
Jsd2 = the movement of the first rotary motor.
Jsd3 = the movement of the second rotary motor.
Jsd6 = the movement of the rotational motor.
Jsd7 = the movement of the gripper.
L1 = the length of the linkage arm between the first rotary motor and the second rotary motor.
L2 = the length of the linkage arm between the second rotary motor and the passive joints.

The controller provides output signals to the motors to move the arm and instrument in the desired location in block 70. This process is repeated for each movement of the handle.
The master handle will have a different spatial position relative to the surgical instrument if the surgeon releases, or toggles, the input button and moves the handle. When the input button 58 is initially depressed, the controller 46 computes initial joint angles Mjl-Mj5 in computational block 72 with the following equations.

Mjl = tan-(ty/tx) Mj2 = tan_i (d/tz) Mj3 = D
Mj4 = Js6 Mj5 = Js7 d = tx2 +- ty2 tx = Rsx - Px ty = Rsy - Py tz Rsz - Pz D D D
D = )(RBX_PX)2 + (Rsy-Py)2 + (Rsz-Pz)2
-26-The forward kinematic values are computed in block 74 with the following equations.

Rsx=Ll=cos (Js2) +L2=cos (Js2+Js3) Rsy=Llsin(Js2)+L2=sin(Js2+Js3) Rsz=Jl The joint angles Mj are provided to adder 64. The pivot points Px, Py and Pz are computed in computational block 76 as follows. The pivot point is calculated by initially determining the original position of the intersection of the end effector and the instrument PO, and the unit vector Uo which has the same orientation as the instrument. The position P(x, y, z) values can be derived from various position sensors of the robotic arm. Referring to Figure 5 the instrument is within a first coordinate frame (x, y, z) which has the angles q4 and q5. The unit vector Uo is computed by the transformation matrix:

Cos 05 0 - sin 05 0 Uo Sin 04 Sin 05 COS 04 - sin 04 COS 05 0 cos 04 sin 05 sin 04 cos 04 - 1 After each movement of the end effector an angular movement of the instrument DQ is computed by taking the arcsin of the cross-product of the first and second unit vectors Uo and U1 of the instrument in accordance with the following line equations Lo and L1.
AO=aresin(ITI) T=UoooU1
-27-where;
T = a vector which is a cross-product of unit vectors Uo and U1.

The unit vector of the new instrument position U1 is again determined using the position sensors and the transformation matrix described above. If the angle A6 is greater than a threshold value, then a new pivot point is calculated and Uo is set to Ui. As shown in Figure 6, the first and second instrument orientations can be defined by the line equations Lo and L1:

Lo:

xo = MXO Zo + Cxo yo = Myo Zo + Cyo L1:

xl = Mxl Z1 + Cxl yl = Myl Z1 + Cy1 where;

Zo = a Z coordinate along the line Lo relative to the z axis of the first coordinate system.
Z1 = a Z coordinate along the line Li relative to the z axis of the first coordinate system.
Mxo = a slope of the line Lo as a function of Zo.
Myo = a slope of the line Lo as a function of Zo.
Mxl = a slope of the line L1 as a function of Zi.
Myl = a slope of the line Li as a function of Zi.
-28-Cxo = a constant which represents the intersection of the line Lo and the x axis of the first coordinate system.
Cyo = a constant which represents the intersection of the line Lo and the y axis of the first coordinate system.
Cxl = a constant which represents the intersection of the Ll and the x axis of the first coordinate system.
Cyl = a constant which represents the intersection of the line L1 and the y axis of the first coordinate system.

The slopes are computed using the following algorithms:
Mxo = Uxo/Uzo Myo = Uyo/Uzo Mxl = Uxl/Uzl Myl = Uyl/Uzl Cx0 = Pox - Mx1 Poz Cyo = Poy - Myl=Poz Cxl = Plx - Mxl=Plz Cyl = Ply - Myl=Plz where;

Uo(x, y and z) = the unit vectors of the instrument in the first position within the first coordinate system.
Ul(x, y and z) = the unit vectors of the instrument in the second position within the first coordinate system.
-29-Po(x, y and z) = the coordinates of the intersection of the end effector and the instrument in the first position within the first coordinate system.
P1(x, y and z) = the coordinates of the intersection of the end effector and the instrument in the second position within the first coordinate system.
To find an approximate pivot point location, the pivot points of the instrument in the first orientation Lo (pivot point Ro) and in the second orientation Ll (pivot point R1) are determined, and the distance half way between the two points Ro and Rl is computed and stored as the pivot point Rave of the instrument. The pivot point Rave is determined by using the cross-product vector T.
To find the points Ro and Ri the following equalities are set to define a line with the same orientation as the vector T that passes through both Lo and Li.

tx = Tx/Tz ty = Ty/Tz where;

tx = the slope of a line defined by vector T relative to the Z-x plane of the first coordinate system.
ty = the slope of a line defined by vector T relative to the Z-y plane of the first coordinate system.
Tx = the x component of the vector T.
Ty = the y component of the vector T.
Tz = the z component of the vector T.
-30-Picking two points to determine the slopes Tx, Ty and Tz (eq. Tx = xl-xo, Ty = yl-yo and Tz = z1-z0) and substituting the line equations Lo and Ll, provides a solution for the point coordinates for Ro (xo, yo, zo) and R1 (xl, yl, zi) as follows.

zo = ((Mx1 -tx )z1 + Cx 1 - Cxo)I (Mxo - tx ) z 1 = ((Cy 1 - Cyo ) ( Mxo - tx ) - (Cx 1 - Cxo) ( Myo - ty )) I
((Myo - ty ) ( Mx 1 - tx ) - (MY 1 - ty ) ( Mxo - tx ) ) yo = Myo ;-> zo + Cyo Y1 = My1 >_zl + Cyl xo = Mxo >-Zo + Cxo X1 = Mx1 >-zl + Cx1 The average distance between the pivot points Ro and R1 is computed with the following equation and stored as the pivot point of the instrument.

Rave = ((x 1 -f- xo) I 2, (y 1 + yo ) / 2, (z 1 + zo ) l 2) The pivot point can be continually updated with the above described algorithm routine. Any movement of the pivot point can be compared to a threshold value and a warning signal can be issued or the robotic system can become disengaged if the pivot point moves beyond a set limit. The comparison with a set limit may be useful in determining whether the patient is being moved, or the instrument is being manipulated outside of the patient, situations which may result in injury to the patient or the occupants of the operating room.
-31-While substantial real time movement of the robotic arms is provided, it may be appreciated that pre-planned movements may be incorporated into the present system 10. This is most advantageous with regard to movement of the endoscope. Any type of movement may be stored in am associated memory of the controller so that a surgeon may define his own favorite movements and then actuate such movement by pressing a button or via voice control. Because the movement is taught in the present application, no further disclosure of this concept is required.

To provide feedback to the surgeon, the system 10 may include a voice feedback unit. As such, it the robotic arms suffer any malfunction, the voice feedback may supply a message that such error has occurred.
Additionally, messages regarding instrument location, time-in-use, as well as a host of other data may be supplied to the surgeon through the voice feedback unit. If such a condition occurs that requires a message, the system has a set of messages stored in an associated memory, such message may be encoded and saved in the memory. A speech synthesis unit 89, as depicted in Fig. 1 can then vocalize the message to the surgeon. In this fashion, a surgeon can maintain sight of the operative environment as opposed to looking for messages displayed on a video screen or the like.
Speech synthesis is well known, although its inclusion in a master-slave robotic system for minimally invasive surgery is heretofore unknown and present novel and unobvious advantages.
-32-To provide feedback to the surgeon the fingers of the instruments may have pressure sensors that sense the reacting force provided by the object being grasped by the end effector. Referring to Fig. 4, the controller 46 receives the pressure sensor signals Fs and generates corresponding signals Cm in block 78 that are provided to an actuator located within the handle.
The actuator provides a corresponding pressure on the handle which is transmitted to the surgeon's hand. The pressure feedback allows the surgeon to sense the pressure being applied by the instrument. As an alternate embodiment, the handle may be coupled to the end effector fingers by a mechanical cable that directly transfers the grasping force of the fingers to the hands of the surgeon.
Figure 7 shows a preferred embodiment of an end effector 80 that may be used in the present invention.
The end effector 80 includes a surgical instrument 82, such as those disclosed hereinabove 22, 24, that is coupled to a front loading tool driver 84. The end effector 80 is mounted to one of the robotic arm assemblies 26 by coupling mechanism 45. The coupling mechanism 45 includes a collar 85 that removably attaches to a holder 86. The holder 86 includes a worm gear 87 that is driven by a motor in the robotic arm assembly 26 to rotate the collar 85 and in turn rotate the instrument 82 about its longitudinal axis. The holder 86 includes a shaft 88 that seats into a slot in the robotic arm assembly 26. The shaft 88 may be turned by the motor in the arm assembly, which then rotates the worm gear 87 thus rotating the collar 86
-33-and the instrument 82. A tightening tool 89 may be employed to tighten and loosen the collar about the instrument 82. Such a tool operates like a chuck key, to tighten and loosen the collar 86.
The surgical instrument 82 has a first finger 90 that is pivotally connected to a second finger 91. The fingers 90, 91 can be manipulated to hold objects such as tissue or a suturing needle. The inner surface of the fingers may have a texture to increase the friction and grasping ability of the instrument 82. The first finger. 90 is coupled to a rod 92 that extends through a center channel 94 of the instrument 82. The instrument 82 may have an outer sleeve 96 which cooperates with a spring biased ball quick disconnect fastener 98. The quick disconnect 98 allows instruments other than the finger grasper to be coupled to front loading tool driver 84. For example, the instrument 82 may be decoupled from the quick disconnect 98 and replaced by a cutting tool, a suturing tool, a stapling tool adapted for use in this system, such as the stapling apparatus disclosed in U.S. Patent No. 5,499,990 or 5,389,103 assigned to Karlsruhe, a cutting blade, or other surgical tools used in minimally invasive surgery. The quick disconnect 98 allows the surgical instruments to be interchanged without having to re-sterilize the front loading tool driver 84 each time an instrument is plugged into the tool driver 84. The operation of the front loading tool driver 84 shall be discussed in further detail hereinbelow.
The quick disconnect 98 has a slot 100 that receives a pin 102 of the front loading tool driver 84.
-34-The pin 102 locks the quick disconnect 98 to the front loading tool driver 100. The pin 102 can be released by depressing a spring biased lever 104. The quick disconnect 98 has a piston 106 that is attached to the tool rod 92 and in abutment with an output piston 108 of a load cell 110 located within the front loading tool driver 84.
The load cell 110 is mounted to a lead screw nut 112. The lead screw nut 112 is coupled to a lead screw 114 that extends from a gear box 116. The gear box 116 is driven by a reversible motor 118 that is coupled to an encoder 120. The entire end effector 80 is rotated by the motor driven worm gear 87.
In operation, the motor 118 of the front loading tool driver 84 receives input commands from the controller 46 via electrical wiring, or a transmitter/receiver system and activates, accordingly.
The motor 118 rotates the lead screw 114 which moves the lead screw nut 112 and load cell 110 in a linear manner. Movement of the load cell 110 drives the coupler piston 106 and tool rod 92, which rotate the first finger 88. The load cell 110 senses the counteractive force being applied to the fingers and provides a corresponding feedback signal to the controller 46.
The tool 82 and any tool included in the system may include an irrigation line 83 and a suction line 85. Each of the irrigation line 83 and suction line 85 extend down the center channel 94 and may be enclosed within a separate housing 89 disposed interior the tool 82. This is depicted in Figures 13 and 14. The
-35-irrigation line 83 is connected to a water source or saline source and may be used to irrigate the surgical site or to remove tissue from the instrument 82.
Irrigation systems are generally well known. It is not heretofore known, though, to include an irrigation line 83 into an endoscopic instrument for use with a robotic system 10.
Additionally, a suction line 85 may be enclosed within the housing 89 disposed interior the instrument 82. Suction is generally needed to remove blood, or other fluids from the surgical site. Again, it is not heretofore known to include a suction line 85 in an endoscopic instrument for use with a robotic system 10.
As such, the inclusion of either an irrigation line or a suction line present advances in the art that are novel and as of yet unknown.
Each of the suction and irrigation lines run to well-known suction and irrigation systems which are well known in the art. The activation of irrigation or suction is generally accomplished through the use of a foot controller or hand controller. However, it must be appreciated that the activation of such devices may be integrated into the present system by including a button at the surgeon input device or the cabinet.
Alternatively, the suction and irrigation may be voice activated and as such, additional vocabulary must be included in the voice recognition system of the present invention. More particularly, the voice recognition system should recognize the commands "suction" and "irrigate".
-36-The front loading tool driver 84 may be covered with a sterile drape 124 so that the tool driver 84 does not have to be sterilized after each surgical procedure. Additionally, the robotic arm assembly 26 is preferably covered with a sterile drape 125 so that it does not have to be sterilized either. The drapes 124, 125 serve substantially as a means for enclosing the front loading tool driver 84 and robotic arm assembly 26. The drape 125 used to enclose the robotic arm assembly 26 is depicted in further detail in Figure 26. The drape 125 has a substantially open end 300 wherein the robotic arm assembly 26 may be emplaced into the drape 125. The drape 125 additionally includes a substantially tapered enclosed end 302 that effectively separates the arm assembly 26 from the operating room environment. A washer 304 having a small aperture 306 formed therethrough allows an instrument to be coupled to the arm assembly 26 via the coupling mechanism 45. The washer 304 reinforces the drape 125 to ensure that the drape 125 does not tear as the arm assembly 26 moves about. Essentially, the instrument cannot be enclosed in the drape 125 because it is to be inserted into the patient 12. The drape 125 also includes a plurality of tape 308 having adhesive 310 disposed thereon. At least one piece of tape 308 is opposedly arranged the other pieces of tape 308 to effectuate the closing of the drape 125 about the arm assembly 26.
Figures 8 and 8a show a preferred embodiment of a master handle assembly 130. The master handle assembly 130 includes a master handle 132 that is coupled to an
-37-arm 134. The master handle 132 may be coupled to the arm 134 by a pin 136 that is inserted into a corresponding slot 138 in the handle 132. The handle 132 has a control button 140 that can be depressed by the surgeon. The control button 140 is coupled to a switch 142 by a shaft 144. The control button 140 corresponds to the input button 58 shown in Fig. 4, and activates the movement of the end effector.
The master handle 132 has a first gripper 146 that is pivotally connected to a second stationary gripper 148. Rotation of the first gripper 146 creates a corresponding linear movement of a handle shaft 150.
The handle shaft 150 moves a gripper shaft 152 that is coupled a load cell 154 by a bearing 156. The load cell 154 senses the amount of pressure being applied thereto and provides an input signal to the controller 46. The controller 46 then provides an output signal to move the fingers of the end effector.
The load cell 154 is mounted to a lead screw nut 158 that is coupled to a lead screw 160. The lead screw 160 extends from a reduction box 162 that is coupled to a motor 164 which has an encoder 166. The controller 46 of the system receives the feedback signal of the load cell 110 in the end effector and provides a corresponding command signal to the motor to move the lead screw 160 and apply a pressure on the gripper so that the surgeon receives feedback relating to the force being applied by the end effector. In this manner the surgeon has a "feel" for operating the end effector.
-38-The handle is attached to a swivel housing 168 that rotates about bearing 170. The swivel housing 168 is coupled to a position sensor 172 by a gear assembly 174. The position sensor 172 may be a potentiometer which provides feedback signals to the controller 46 that correspond to the relative position of the handle.
Additionally, an optical encoder may be employed for this purpose. Alternatively, both a potentiometer and an optical encoder may be used to provide redundancy in the system. The swivel movement is translated to a corresponding spin of the end effector by the controller and robotic arm assembly. This same type of assembly is employed in the stand 900.
The arm 134 may be coupled to a linear bearing 176 and corresponding position sensor 178 which allow and sense linear movement of the handle. The linear movement of the handle is translated into a corresponding linear movement of the end effector by the controller and robotic arm assembly- The arm can pivot about bearings 180, and be sensed by position sensor 182 located in a stand 184. The stand 184 can rotate about bearing 186 which has a corresponding position sensor 188. The arm rotation is translated into corresponding pivot movement of the end effector by the controller and robotic arm assembly.
A human hand will have a natural tremor typically resonating between 6-12 hertz. To eliminate tracking movement of the surgical instruments with the hand tremor, the system may have a filter that filters out any movement of the handles that occurs within the tremor frequency bandwidth. Referring to Figure 4, the
-39-filter 184 may filter analog signals provided by the potentiometers in a frequency range between 6-12 hertz.
Alternatively, an optical encoder and digital filter may be used for this purpose.
As shown in Figures 9 and lOA-J, the system is preferably used to perform a cardiac procedure such as a coronary artery bypass graft (CABG). The procedure is performed by initially cutting three incisions in the patient and inserting the surgical instruments 22 and 24, and the endoscope 26 through the incisions.
One of the surgical instruments 22 holds a suturing needle and accompanying thread when inserted into the chest cavity of the patient. If the artery is to be grafted with a secondary vessel, such as a saphenous vein, the other surgical instrument 24 may hold the vein while the end effector of the instrument is inserted into the patient.
The internal mammary artery (IMA) may be severed and moved by one of the instruments to a graft location of the coronary artery. The coronary artery is severed to create an opening in the artery wall of a size that corresponds to the diameter of the IMA. The incision(s) may be performed by a cutting tool that is coupled to one of the end effectors and remotely manipulated through a master handle. The arteries are clamped to prevent a blood flow from the severed mammary and coronary arteries. The surgeon manipulates the handle to move the IMA adjacent to the opening of the coronary artery. Although grafting of the IMA is shown and described, it is to be understood that
-40-another vessel such as a severed saphaneous vein may be grafted to bypass a blockage in the coronary artery.
Referring to Figs. l0A-J, the surgeon moves the handle to manipulate the instrument into driving the needle through the IMA and the coronary artery. The surgeon then moves the surgical instrument to grab and pull the needle through the coronary and graft artery as shown in Fig. 103. As shown in Fig. 10C, the surgical instruments are then manipulated to tie a suture at the heel of the graft artery. The needle can then be removed from the chest cavity. As shown in Figs. 1OD-F, a new needle and thread can be inserted into the chest cavity to suture the toe of the graft artery to the coronary artery. As shown in Fig. 1OH-J, new needles can be inserted and the surgeon manipulates the handles to create running sutures from the heel to the toe, and from the toe to the heel. The scaled motion of the surgical instrument allows the surgeon to accurately move the sutures about the chest cavity.
Although a specific graft sequence has been shown and described, it is to be understood that the arteries can be grafted with other techniques. In general the system of the present invention may be used to perform any minimally invasive anastomostic procedure.
Additionally, it may be advantageous to utilize a fourth robotic arm to hold a stabilizer 75. The stabilizer may be a tube or wire or some other medical device that may be emplaced within an artery, vein or similar structure to stabilize such structure. Using the switch 51 to interengage the fourth robotic arm, with a handle 50 or 52 a surgeon may position the
-41-stabilizer 75 into the vessel. This eases the task of placing a stitch through the vessel as the stabilizer 75 maintains the position of the vessel. Once the stabilizer 75 has been placed, the surgeon then flips the switch or like mechanism to activate the robotic arm that had been disconnected to allow for movement of the fourth robotic arm. The stabilizer 75 should be substantially rigid and hold its shape. Additionally, the stabilizer should be formed form a material that is steralizable. Such material are well known in the medical arts. However, this application and configuration is heretofore unknown.
As disclosed hereinabove, the system may include a front loading tool driver 84 which receives control signals from the controller 46 in response to movement of a master handle 50 or 52 and drives the tool disposed at the end of a surgical instrument.
Alternatively, a back loading tool driver 200 may be incorporated into the system 10 of the present invention, as depicted in Figures 15 and 16. The back loading tool driver 200 cooperates with a back loadable surgical instrument 202. The incorporation of such a back loading tool driver 200 and instrument 202 expedites tool changing during procedures, as tools may be withdrawn from the tool driver 200 and replaced with other tools in a very simple fashion.
The back loading tool driver 200 is attached to a robotic arm assembly 26 via a collar and holder as disclosed hereinabove. The back loading tool driver includes a sheath 204 having a proximal end 206 and a distal end 208. The sheath 204 may be formed of
-42-plastic or some other well-known material that is used in the construction of surgical instruments. The sheath 204 is essentially a hollow tube that fits through the collar 85 and is tightened in place by the tightening tool that is described in more detail hereinabove.
The back loadable surgical instrument 202 has a tool end 210 and a connecting end 212. A surgical tool 214, such as a grasper or some other tool that may be driven by a push/pull rod or cable system, or a surgical tool that does not require such a rod or cable, such as a coagulator, or harmonic scalpel is disposed at the tool end 210 of the instrument 202.
A housing 216 is disposed at the connecting end 212 of the instrument 202. The housing has a lever 218 disposed interiorly the housing 216. The lever 218 has a pivot point 220 that is established by utilizing a pin passing through an associated aperture 222 in the lever. The pin may be attached to the interior wall 224 of the housing. A push/pull cable or rod 226, that extends the length of the instrument 202 is attached to the lever 218, such that movement of the lever 218 about the pivot point 220 results in a linear movement of the cable or rod 226. Essentially the cable or rod 226 servers as a means 227 for actuating the tool 214 at the tool end 210 of the instrument 202. The cable or rod 226 may be attached to the lever via a connection pin as well. The lever 218 has a C-shape, wherein the ends of the lever 218 protrude through two apertures 228, 230 in the housing 216. The apertures 228, 230
-43-are preferably surrounded by O-rings 232 the purpose of which shall be described in more detail hereinbelow.
The tool end 210 of the back loadable surgical instrument 202 is emplaced in the hollow tube of the back loading tool driver 200. The tool 202 may be pushed through the tool driver until the tool end 210 extends beyond the sheath 204. The O-rings 232 seat in associated apertures 234, 236 in a housing 238 of the tool driver 200. The housing additionally has an aperture 240 centrally formed therethrough, the aperture being coaxial with the interior of the hollow tube. In this fashion, the surgical instrument 202 may be inserted into. and through the tool driver 200. Each of the O-rings 232 snugly seats in its associated aperture in the housing 238 of the tool driver 200.
The housing 238 additionally includes a motor assembly 242 which is depicted in Figure 16. The motor assembly 242 is attached to the housing 238 and is held firmly in place therein. The motor assembly generally includes a motor 244 attached to a reducer 246. The motor drives a leaf 248 attached at the end thereof.
The leaf 248 engages the ends of the lever 218 such that rotational movement of the motor results in the movement of the lever 218 about the pivot point 220.
This in turn results in the lateral movement of the means 227 for actuating the tool 214 at the tool end 210 of the instrument 202. The motor moves in response to movements at a control handle. Additionally, force sensors 248, 250 may be attached at the ends of the leaf 248. As such, a force feedback system may be incorporated to sense the amount of force necessary to
-44-actuate the tool 214 at the tool end 210 of the instrument 202. Alternatively, the motor 244 may have a force feedback device 252 attached thereto, which can be used in a similar fashion.
One advantage of utilizing the back loading tool driver 200 is that the sheath 204 always remains in the patient 12. As such, the tools do not have to be realigned, nor does the robotic arm assembly 26 when replacing or exchanging tools. The sheath 204 retains its position relative to the patient 12 whether or not a toll is placed therethrough.
The system 10 of the present invention may additionally be supplied with one or two additional degrees of freedom at the tip of an instrument. For the purposes of example, two additional degrees of freedom will be disclosed; however it is to be appreciated that only one degree of freedom may be included as well. To provide the additional degrees of freedom, and as depicted in Figures 17-20, an articulable surgical instrument 300 may be incorporated into the present. The instrument 300 may be coupled to the arm assembly 26 via a collar and holder as disclosed hereinabove. In order to articulate the tip of the articulable instrument 300 an articulating tool driver 500 must be employed. The articulating tool driver 500 shall be described in more detail hereinbelow. The master must have an additional two degrees of freedom added thereto to proved the controls for the articulation at the tip of the instrument 300.
Figure 29 depicts an alternative master schematic that includes the two additional degrees of freedom. As
-45-disclosed hereinbelow, the two additional degrees of freedom are mapped to the articulable portion of the instrument 300. The two additional axes at the master are referred to as Jm6 and Jm7.
By incorporating the articulable instrument 300 and the articulating tool driver 500 and the additional degrees of freedom at the master, difficult maneuvers may be carried out in an easier fashion.
With reference to figs. 17-20, the articulable instrument 300 generally includes an elongated rod 302, a sheath 304, and a tool 306. The tool can be a grasper, a cutting blade, a retractor, a stitching device, or some other well-known tool used in minimally invasive surgical procedures. Figures 27-30 show various tools that may be emplaced at the distal end of the articulable surgical instrument 300.

The instrument 300 includes an articulable portion 301 having a proximal portion 308, a pivot linkage 310 and a distal portion 212 each of which will be discussed in more detail hereinbelow. Additionally, the instrument 300 includes means 311 for articulating the articulable portion 301 of the instrument 300 with respect to the elongated rod 302. The inclusion of the articulable portion 301 provides two additional degrees of freedom at the instrument tip. It must also be appreciated that although the articulable portion 301 is described as including a proximal portion, a pivot linkage and a distal portion, there may be provided a plurality of intermediate portions each mounted to each other via a corresponding pivot linkage.
-46-Disposed between and mounted to each of the respective proximal portion and distal portion and any intervening intermediate portions are pivot linkages 310. The pivot linkage 310 interengages with the proximal and distal portions of the articulable portion to provide articulation at the instrument tip.
Essentially, the cooperation of the proximal portion, pivot linkage and distal portion serves as a universal joint.
The elongated rod 302 is preferably hollow and formed of stainless steel or plastic or some other well-know material that is steralizable. Because the rod 302 is hollow, it encompasses and defines an interior 314. The elongated rod 302 additionally has a proximal end 316 and a distal end 318. The distal end 318 of the elongated rod 302 should not be confused with the distal portion 312 of the articulable portion 301 of the instrument 300.
The proximal portion 308 of the articulable portion 301 may be integrally formed with the elongated rod 302 or it may be attached thereto vie welding, glue or some other means well-known to the skilled artisan.
It is preferable that the proximal portion 308 be integrally formed with the elongated rod 302 to ensure sufficient stability and durability of the instrument 300. The proximal portion 308 of the articulable portion 301 comprises two fingers 320, 322 each of which have an aperture 324, 326 formed therethrough.
A pivot linkage 310 is mounted to the proximal portion 308 via a plurality of pins 328 that each pass through an associated aperture in an adjoining finger.
-47-The pivot linkage 310 is a generally flat disk 330 having a central aperture 332 passing therethrough and four apertures 334, 336, 338, 340 evenly spaced at the periphery of the disk 330. Additionally pins 328 are attached to and extend from the edge 342. The pins 328 seat in the apertures of the associated fingers to provide the articulability of the instrument 300. Five leads 350, 352, 354, 356, 358 extend interiorly the hollow shaft. On lead 350 extends down the center and passes through the center aperture 332 in the pivot linkage 310. Two 352, 354 of the five leads extend down the hollow interior of the instrument and are attached to the pivot linkage such that linear tension on one of the leads results in rotational movement of the pivot portion 301. These two leads 352, 354 attach to the pivot linkage at two of the apertures formed.
therethrough. Additionally, they attach at those apertures that are adjacent to the pins that pass through the fingers of the proximal portion 308 of the articulable portion 301 of the instrument 300. The other two leads 356, 358 pass through the two other apertures in the pivot linkage and attach at the distal end of the articulable portion 301. Movement of these two leads results in movement of the articulable portion 301 that is orthogonal to the movement when the two other leads 352, 354 are moved.
To articulate the instrument as a part of the present system, and as depicted in Figures 21-28, there is provided an articulating mechanism 400. The articulating mechanism 400 generally comprises the
-48-articulating tool driver 500, a sterile coupler 600, a translator 700 and the articulable tool 300.
The translator is attached to the proximal end 316 of the instrument 300. The instrument 300 may additionally have a removable tool 420 as shown in Figs. 22-23. The removable tool 420 may be any tool, such as a cutter 422 that is attached to an elongated rod or cable 424. At the end of the rod 246 there is disposed a flat section 428 with an aperture 430 formed therethrough. The flat section 428 seats into a channel 432 disposed at the end of a second cable or rod 434 that travels down the elongated shaft of the instrument 300. The second cable 434 has a channel 432 formed in the end thereof such that the flat section 428 seats in the channel 432. At least one spring biased detent 436 seats in the aperture 430 disposed through the flat section 428. This connects the tool 420 to the rest of the instrument 300. As such, tools may be exchanged at the tip of the instrument without having to remove the instrument from the system 10 every time a new tool is required.
The tool 300 is attached to the translator 700 and essentially is integrally formed therewith. The articulating mechanism 400 is attached to the robotic arm assembly 26 via the collar 85 as is disclosed hereinabove. The collar 85 fits about the shaft 302 of the instrument 300.
The translator 700 has a proximal end 702 and a distal end 704. The distal end 704 of the translator 700 has a cross sectional shape that is substantially similar to the cross sectional shape of the elongated
-49-rod 302 of the instrument 300. Additionally, the translator 700 has a hollow interior 706. The center rod 350 extends through the hollow interior 706 of the translator 700 and emerges at the proximal end 702 thereof. Two of the leads 352, 354 terminate interiorly the translator at two shoulders 708, 710 that are attached to a first hollow tube 712 through which the center lead 350 extends. The first hollow tube 712 may be formed of some strong durable material such as stainless steel, steel, hard plastic or the like.
The first hollow tube 712 is mounted to a bearing 714 such that it may be rotated. Rotation of the first hollow tube 712 results in the linear motion of the leads 352, 254 and the articulation of the articulable portion 301 of the instrument 300 in one plane of motion.
A second hollow tube 716 has a pair of shoulders 718, 719 extending therefrom. Two leads 356, 358 attach to one each of the shoulders 718, 719. The hollow tube 716 is disposed within a bearing assembly 720 such that it may be rotated. Again, rotation of the second hollow tube 716 results in linear movement of the leads 356, 358 which articulates the articulable portion 301 of the instrument 300 in a plane orthogonal the plane of motion established through the rotation of the first hollow tube. It is to be appreciated that the second hollow tube 714 radially surrounds the first hollow tube 712. The translator 700 additionally includes a quick disconnect 722 comprising a pin 724 disposed at the end of a spring biased lever 726 which
-50-provides removable attachment of the translator 700 to the sterile coupler 600. Both of the hollow tubes 712 and 716 may have notches 750 formed therein at their ends. The notches serve as a means 752 for interconnecting each of the tubes to the sterile coupler 600 which will be discussed in further detail hereinbelow.
The translator 700 is removably attached to the sterile coupler 600 via the quick disconnect 722.
Because the articulable tool driver 500 is not easily sterilized, it is advantageous to include a sterile coupler 600 so that instruments may be exchanged without having to sterilize the articulable tool driver 500. Additionally, the coupler 600 provides a means by which the translator 700 may be attached to the tool driver 500 while the tool driver is enclosed in a drape 125 such as that depicted in figure 26. The translator 600 has a housing 610 . Preferably the housing and the components of the coupler 600 are formed of some easily steralizable mater such as stainless steel, plastics or other well-known sterilizable materials. The housing 610 has a substantially hollow interior 612 and open ends 614 and 616. Two hollow tubes 618 and 620 are rotatively disposed within the housing 610. To effectuate the rotation of each of the tubes 618 and 620, bearings 622 and 624 are disposed about each of the tubes. Each of the tubes has notches 626 formed in the ends thereof so effectuate the attachment of the translator 700 to the coupler 600 at one end. And to effectuate the attachment of the coupler 600 to the articulable tool driver 500 at the other end thereof.
-51-The pin 724 on the translator may seat in a notch 628 to attach the translator 700 to the coupler 600.
Additionally, the coupler 600 may include a pin 630 attached to a spring biased pivot 632 to effectuate attachment of the coupler to the driver 500. The coupler 600 additionally includes a center section 634 that slidably receives the end 351 of the center cable or rod 350. The end 351 may include a tip with a circumferential groove 353 disposed thereabout. The tip seats in a recess 636 formed in the center section 634 and is removably locked in place by at least one spring biased detent 638. A tip 640, which is substantially similar to the tip containing the circumferential groove 353 is disposed adjacent the recess 636 and serves to attach the cable center cable 350 to the articulable tool driver 500, which will be discussed in further detail hereinbelow.
The center section 634 is intended to laterally slide within the innermost tube 618. To effectuate such a sliding motion, a linear bearing may be disposed about the center section interiorly of the innermost tube, Alternatively, the center section 634 may be formed of a bearing material that provides smooth sliding within the innermost tube 618.
The coupler 600 is removably attached to the articulable tool driver 500. It is intended that the articulable tool driver be enclosed by a drape 125.
The articulable tool driver 500 includes a substantially hollow housing 502 having a closed first end 504 and a substantially open second end 504.
Securely disposed interiorly the housing 502 is a
-52-gripper motor 506, and a pair of wrist motors 508 and 510. Each of the motors are in electrical connection with the controller 46. Alternatively, the motors may receive signals from the controller via a transmitter/receiver system where such systems are well known. It is the application of such a transmitter/receiver system to the present invention that is new. The gripper motor 506 is attached to a load nut 510 that surrounds a load screw 512. The motor 506 receives the control signals and turns in response thereto. The load nut 510 turns which laterally moves the load screw 512. The load screw 512 is attached to a load cell 514 which may be employed to measure the force required to laterally move the cable 350 which is attached vie the coupler 600 to the gripper motor 506. This may be used in a force feedback system that may be incorporated in the system of the present invention. A rod 516 having a channel 518 formed at the end thereof is attached to the load cell 514. As such, the rod 516 moves in a linear fashion. The tip 640 of the coupler 600 seats in the channel 518 and is removably held in place by at least one spring biased detent or some other similar attachment mechanism 520. Therefore, if a surgeon at a master handle actuates the grippers, the gripper motor 506 turns, thus laterally moving the rod 516, and in turn the center cable 350 which opens and closes the grippers at the tool accordingly. Of course, the action at the tool will depend upon the type of tool disposed thereat. For example, if a stapling tool is
-53-disposed at the end of the surgical instrument 300 then a stapling action would take place.
If a master handle 50 or 52 is turned about axes J6 or J7 then one of the two wrist motors 510, 508 corresponding to the required motion turns. Each of the motors 508, 510 are attached to a corresponding gear 522, 524. Each of the gears 522, 524 engage a corresponding slotted section 530, 532 of an associated hollow tube 526, 528 to turn the associated tube radially about its longitudinal axis. Each of the tubes 526, 528 include notched ends 534, 536 to engage the notched ends of corresponding hollow tubes of the coupler 600. It is to be appreciated that each of the hollow tubes 526, 528, 618 and 620 are all coaxial.
Additionally, bearings may be emplaced intermediate each of the tubes 526 and 528 to provide easy independent rotatability of the individual tubes.
When the tubes 526, 528 are rotated, they rotate the tubes in the coupler which rotates the tubes in the translator. This results in the articulation at the tip of the surgical instrument 300. More particularly, this results in the articulation of the articulable portion of the surgical instrument 300. Additionally, whether the front loading tool driver, the back loading tool driver, or the articulable tool driver are employed, surgical instruments may be easily exchanged.
As such, a cutting blade 800 may be exchanged for a grasper, and a grasper may be exchanged for a stapler 810. Essentially, such a system simplifies the performance of minimally invasive surgical procedures where the procedures include the step of changing one
-54-tool for another. And because the system allows articulation at the tip of certain instruments, the articulation mechanism may be used to articulate such stapling, or cutting instruments that incorporate the articulable portion as disclosed hereinabove.
Additionally, the instrument may not be an articulable instrument, but the articulating mechanism can be used to control other functions, such as stapling. Figure 31 depicts a stapling instrument 810 attached to the robotic arm assembly via the collar 85 and holder 86. The lead that is generally use for the grasping tool, may be used to effectuate the stapling mechanism. Endoscopic staplers are generally well known in the art, however, it is heretofore to known to use a stapler that is attached to a robotic arm as is disclosed herein.
Additionally, a cutting blade, such as that depicted in Figure 32 may be employed in the system of the present invention. The cutting blade 800 is attached to the robotic arm assembly 26 via the collar 85 and holder 86. The cutting blade does not require a lead such as that required by the grasper or the stapler; however, the cutting tool, may be articulated via the articulating mechanism that has been disclosed hereinabove.
A cauterizer or coagulator may additionally be attached to the robotic arm assembly 26 via the collar 85 and holder. Cauterizers and coagulators are well known and the cauterizing tool may be attached at the end of an articulable instrument as disclosed hereinabove. By using a variety of tools in
-55-predetermined sequences, various procedures may be carried out. It is generally preferable to be able to change instruments because many procedures require such.
As disclosed hereinabove, the handles 50 and 52 allow a surgeon to control the movement of the tools attached to the robotic arms. As such, the configuration of the handles 50 and 52 should provide great ease of use for a surgeon. Figures 38-43 depict various handle configurations. Additionally, the handles 50 and 52 may be selected by a surgeon from a plurality of handles 960 that are available for use by the surgeon.
A proximally open handle 962 has a proximal end 963 and a distal end 965. The handle 962 has first finger portion 964 and a second finger portion 966 pivotally attached at the distal end 965 of the handle 962. A joint 968 disposed intermediate the finger portion 964 and 966 provides linear motion of an elongated rod 970 which is used to actuate the tool tip of an instrument attached to the robotic arm. This handle may serve as one or both of the two handles 50 and 52 of the system.
A distally open handle 972 has a proximal end 973 and a distal end 975. The handle 972 has first finger portion 974 and a second finger portion 976 pivotally attached at the proximal end 973 of the handle 972. A
joint 978 disposed intermediate the finger portion 964 and 966 provides linear motion of an elongated rod 980 which is used to actuate the tool tip of an instrument
-56-attached to the robotic arm. This handle may serve as one or both of the two handles 50 and 52 of the system.
Such handles 962 and 972 may be interchanged through the inclusion of an interchange mechanism 984.
The interchange mechanism 984 includes a biased detent latch 986 that engages an aperture in the elongated rod 932 such that the handle may be attached or removed from the rod 932.
Other handle configurations are depicted in Figures 41-43. And more particularly, each of the handles 1000, 1100, and 1200 have a pair of fingerseats 1020. The major difference between each of the handles 1000, 1100, and 1200 is the orientation of the fingerseats to a pivot point on the handle. The fingerseats may be parallel, or perpendicular to the axis S of the pivot point of the handle. Each of these configurations may be included as an attachable handle.
As such, a surgeon may exchange handles throughout a procedure depending upon the task to be accomplished.
A surgeon may prefer one handle for a set of tasks and another handle for a different set of tasks. As such, the surgeon may exchange handles during the performance of a surgical procedure to enable such tasks.
While certain exemplary embodiments have been described and shown in the accompanying drawings, it is to be understood that such embodiments are merely illustrative of and not restrictive on the broad invention, and that this invention not be limited to the specific constructions and arrangements shown and described, since various other modifications may occur to those ordinarily skilled in the art.
-57-Figure 44 shows an embodiment of a surgical instrument 1600 that is coupled to a tool driver 1602.
The instrument 1600 may have an end effector 1604 that is actuated by the tool driver 1602. The tool driver 1602 can be connected to a controller (not shown) by a wire assembly 1606. Additionally, the tool driver 1602 can be coupled to an articulate arm 1608. The articulate arm 1608 can both move the tool driver 1602 and spin the instrument 1600.
As shown in Figure 45, the tool driver 1602 may include a sheath 1610 that is attached to a tool housing 1612. The sheath 1610 may include a sleeve portion 1614 that extends from a collar 1616. The collar 1616 may have internal threads (not shown) that are screwed onto corresponding threads (not shown) of the housing 1612 so that the sheath can be detached from the housing 1612. The sheath 1610 may be constructed from a material that is both electrically non-conductive and transparent to x-rays.
The electrically non-conductive material may prevent electrical current from flowing to the patient from the surgical instrument. By way of example, if the instrument is an electro-cautery device the non-conductive sheath may prevent an electrical short through the sheath. As an alternate embodiment, the sheath 1610 may be constructed from a metal material that has an outer layer of non-conductive material.
Providing a sheath 1610 that is transparent to x-rays allows x-ray images of the patient to be taken without interference from the sheath.
-58-The sheath 1610 is typically inserted into an incision of a patient. The sheath 1610 and incision define a pivot point for the instrument 1600. The articulate arm 1608 may include passive joints which provide additional degrees of freedom for the arm (not shown). The sheath 1610 provides a structure that may hold the arm 1608 in place when a new instrument 1600 is being coupled to the tool driver 1602.
Figure 46 shows an embodiment of the sheath collar 1616. The collar 1616 may include a valve assembly 1620 that can move between an open position and a closed position. A gas is typically introduced into the patient when performing a procedure with the surgical instrument 1600. The valve 1620 prevents gas from escaping the patient and flowing through a sheath inner channel 1622 when the instrument 1600 is pulled out of the sheath 1610.
The valve assembly 1620 may include a valve 1624 that controls fluid communication between a valve port 1626 and the inner channel 1622. The valve 1624 may be coupled to a torsion spring 1628 that biases the valve 1624 into the closed position. In the closed position the valve 1624 may cooperate with a valve seat 1630 to prevent gas from flowing through the inner channel 1622 and into the port 1626. The valve 1624 may have a radial portion 1632 and an annular flat portion 1634 that presses against the seat 1630.
As shown in Figure 47, the instrument 1600 can be inserted through the port 1626 and into the inner channel 1622. The port 1626 may have a tapered surface 1636 to guide the instrument 1600 through the valve
-59-1624. Insertion of the instrument 1600 into the sheath 1610 pushes the valve 1624 into the open position. The seat 1630 may have a wiper 1638 that presses against the outside surface of the instrument 1600 and prevents gas from escaping the patient through the valve assembly 1620. The wiper 1638 may have an inner diameter that is approximately equal to the outer diameter of the surgical instrument 1600 so that there is a slip fit between the wiper 1638 and the instrument 1600. The valve 1624 may not make contact with the wiper 1638 even in the closed position.
As shown in Figures 48 and 49, the tool driver 1602 may include a tube 1640 that is coupled to the surgical instrument 1600. The tube 1640 may have gear teeth 1642 that are coupled to a mating gear 1644 of the articulate arm 1608 (also shown in Fig. 45). The mating gear 1644 can be rotated by a motor (not shown) in the arm 1608. Rotation of the gear 1644 rotates the worm gear 1642 and the tube 1640. Rotation of the tube 1640 rotates the instrument 1600 within the patient.

The driver 1602 may include an inner sleeve 1646 that is coupled to an actuator pin 1647 of the instrument 1600. The sleeve 1646 is attached to a plate 1648. The plate 1648 is coupled to a linear actuator 1650. The actuator 1650 can move the plate 1646 along the longitudinal axis of the tube 1640 as indicated by the arrow. Movement of the plate 1648 translates the sleeve 1646 and pin 1647 to actuate the end effector 1604 of the instrument 1600. The inner sleeve 1646 is coupled to the plate 1648 so that the sleeve 1646 can spin within the instrument 1600.
-60-The tool driver 1602 may include a bellows 1652 that couples the linear actuator 1650 to the plate 1648. The bellows 1652 seals the interface so that the actuator of the driver 1602 does not become contaminated. In one embodiment, the bellows 1652 is constructed from a stainless steel material which is particularly suitable for reuse when the tool driver 1604 is sterilized under elevated pressures and temperatures.
Figure 50 shows an embodiment of a surgical instrument 1600 that can be coupled to the tool driver 1602. The instrument 1600 may have a push rod 1654 that extends through the inner channel 1656 of a handle 1658. The push rod 1654 may be coupled to a detachable actuator rod 1660. The actuator rod 1660 extends through an instrument sleeve 1662 and terminates at the end effector 1604.
The actuator pin 1647 may be pressed into the push rod 1654. The pin 1647 is free to move along a slot 1666 of the handle 1658. As shown in Figure 51 the actuator pin 1647 may include a pair of caps 1668 that snap onto a barbed pin 1670. The caps 1668 secure the pin 1670 to the push rod 1654.
As shown in Figure 52, when the instrument 1600 is installed into the driver 1602 the pin assembly 1664 engages a corresponding groove 1672 of the sleeve 1646.
Movement of the sleeve 1646 by the linear actuator 1650 translates the pin 1647 and the attached actuator rod 1660 to provide a controlled movement of the end effector 1604.
-61-As shown in Figure 53, the actuator rod 1660 may have a proximal extension 1674 that engages a clamp portion 1676 of the push rod 1654. The extension 1674 and clamp 1676 allow the actuator rod 1654 and corresponding end effector to be detachably connected to the handle 1658. The clamp portion 1676 may include four barbed tips 1678 that essentially enclose a locking cavity 1680. The locking cavity 1680 may receive a locking barrel 1682 located at the end of the extension 1674.
The extension 1674 can be inserted through an opening 1684 of the handle 1658. The locking barrel 1682 engages chamfered surfaces 1686 of the barbed tips 1678 to deflect the tips 1678 in an outward direction and allow the barrel 1682 to be inserted into the locking cavity 1680. The locking cavity 1680 has a profile which prevents the barrel 1682 from becoming detached from the push rod 1654. A collar 1688 can be screwed onto a threaded portion 1690 to capture a collar of the instrument sleeve 1662 and secure the sleeve 1662 to the handle 1658.
The actuator rod 1660 can be removed by moving the push rod 1654 until the chamfered surfaces 1686 of the tips 1678 engage an annular lip 1692 of the handle 1658. The annular lip 1692 deflects the tips 1678 so that the actuator rod 1660 can be separated from the push rod 1654. The collar 1688 is typically initially removed to decouple the instrument sleeve 1662 from the handle 1654. The clamp arrangement allows different end effectors to be attached to the same handle 1654
-62-during a surgical procedure without having to decouple the entire instrument 1600 from the tool driver 1602.
Figure 54 shows an alternate embodiment wherein the actuator rod 1660' is screwed into a push rod 16541. The instrument sleeve 1662' may be connected to the handle 1658' by a set screw 1693.
Referring again to Fig. 50, the push rod 1654 may be attached to a plunger 1694 by a pin 1696. The plunger 1694 allows an operator to manually move the push rod 1654 into the annular lip 1692 shown in Fig.
53 so that the end effector 1604 can be replaced with another unit. The instrument 1600 may include a return spring 1698 that biases the plunger 1694 into a proximal position. The spring 1698 can also insure that the end effector 1604 is always closed or open, whatever is desired, when the end effector 1604 is removed from the patient.

The instrument 1600 may include a detachable electrode 1700 that is attached to the push rod 1654.
The electrode 1700 can be attached to an electrical power supply (not shown). The push rod 1654, actuator rod 1660 and electrode 1700 can all be constructed from an electrically conductive material which provides an electrical path between the power supply and a cauterizing element(s) on the tip of a cauterizing type instrument. The handle 1658 and plunger 1694 may be constructed from an expensive disposable non-conductive plastic material.
Figure 55 shows an embodiment of an end effector 1710 which can be used to grasp a needle 1712. The end effector 1710 may have a stationary finger 1714 and a
-63-clamp finger 1716 that is moved by the actuator rod 1660. The stationary finger 1714 may have an outer surface 1718 which has a radius of curvature that conforms to the shape of the needle 1712. The end effector 1710 can be manipulated so that the needle 1712 extends along the outer surface 1718. The needle 1712 is held in place by moving the clamp finger 1716 to a closed position. The outer surface 1718 is preferably oriented to be essentially perpendicular to the longitudinal axis of the push rod 1660 so that the needle 1712 can be moved in any direction in space.
Each finger 1714 and 1716 may have a tip 1720 can be used to grasp tissue.
Referring to Figures 48 and 56, show an interface which secures the handle 1658 to the sleeve 1662 and tube 1640 of the driver 1602. The tube 1640 may have a plurality of spring biased ball detents 1730 which can slide along corresponding alignment grooves 1732 of the handle 1658. The grooves 1732 may each have transverse portions 1734 which receive the detents 1730 when the handle 1658 is turned in a counter-clockwise direction.
The detents 1730 and grooves 1732 align the instrument 1600 with the driver 1602 so that the actuator pin 1647 is aligned with the grooves of the sleeve 1646.
Referring to Fig. 48 the tool driver 1602 may include a force sensor 1740 which senses the force exerted onto the end effector. The force sensor 1740 can be coupled to a controller (not shown) which can utilize the feedback as part of an algorithm to control the instrument.
-64-The mechanical advantage may vary for different surgical instruments. For example, the force ratio between the handle and tip of a hand-held tweezer may be 2/5, while the ratio for a needle grasper may be 5/1. It may be desirable to provide the following variable force transformation algorithm to allow an operator to vary the force ratio between the handle held by the hand of the surgeon and the tip of the instrument. This provides the surgeon with a more realistic "feel" of an instrument that is normally held by the surgeon. The force algorithm may be as follows.
Ft = R.(Fh - K
O~
where;

Ft = force at the instrument tip.
R = variable force ratio.
Fh = force applied by the opeartor on the handle.
K = spring constant for instrument jaw.
8 = angle of instrument jaw.
The ratio R may be defined by;

R - Ftm 9 where;
Fhm K

Ftm = nominal maximum tip force.
Fhm = nominal maximum handle force.

Each instrument coupled to the tool driver may have a corresponding R value that is utilized by the
-65-controller to provide a tip force which corresponds to a handle force that is similar to the ratio of a corresponding instrument that is normally held in the hand of a surgeon.
By way of example, if the instrument coupled to the driver corresponds to a tweezer, an appropriate R
value can be loaded into the controller so that two pounds of force exerted onto the handle will translate into 5 pounds of force at the tip of the end effector.
Likewise, 5 pounds of forces sensed by the force sensor will translate into 2 pounds of feedback to the handle.
The R value can be entered through an input device such as a keypad, voice recognition system, etc., or automatically called up from an electronically stored look-up table when the instrument 1600 is coupled to the driver 1602.
Referring to Fig. 49, the driver 1602 may include a printed circuit board assembly 1750 that is connected to the linear actuator 1650 and the force sensor 1740.
The printed circuit board assembly 1750 may be coupled to the controller by a wire assembly 1752. The wire assembly 1752 is introduced to the driver 1602 through a connector port 1754.
The wire assembly 1752 may include an outer jacket 1756 that encloses an inner jacket 1758. The inner jacket 1758 may enclose electrical wires 1760. The inner jacket 1758 may be constructed from a non-porous material such as TEFLON. The outer jacket 1756 may be constructed from a flexible material such as silicon.
The outer jacket 1758 may extend through an inner channel 1762 of a sleeve 1764 that is screwed into the
-66-driver housing 1612. The sleeve 1764 may be sealed against the housing by an 0-ring 1766. The assembly 1752 may further include a sealant 1768 that seals the inner jacket 1758 to the outer jacket 1756 within the sleeve 1764. The dual jackets and seals insure that moisture does not enter the tool driver through the wire assembly when the driver is sterilized.
The printed circuit board assembly 1750 may include a temperature sensor 1770. By way of example, the tool driver 1602 may be sterilized after each surgical procedure under elevated temperatures and pressures. During sterilization the sensor 1770 may be connected to an instrument (not shown) through the wire assembly 1752. The instrument may provide a readout of the temperature within the tool driver 1602 to allow an operator to determine whether the driver temperature exceeds a threshold value that may damage the driver.
Alternatively, or in addition to, the instrument may provide an indicator, such as the illumination of light, when the temperature exceeds a threshold value.
Figure 57 shows an embodiment of a console 1800 for the system. The console 1800 may include a video monitor 1802, an input device 1804 and a pair of handle assemblies 1806. The handles 1806 can be manipulated to control the surgical instrument (not shown). The input device 1804 may include a touchpad screen 1808 which displays a menu(s), commands and other information which allow an operator to vary different operating parameters of the systems by pressing the screen 1808.
-67-By way of example, the touchpad 1808 may allow the operator to vary the force ratio value R, or a scale factor that correlates the amount of spacial movement between the handles and the instrument. The operator may also select between a pull type surgical instrument and a push type instrument. A push type instrument may require a distal movement of the actuator rod to close the end effector. A pull type instrument may require an opposite proximal movement of the actuator rod to close the end effector. Selecting push or pull insures that the tool driver will properly actuate the instrument. The operator may also control the maximum jaw angle of the instrument and a jaw locking option wherein the instrument jaw remains locked even when the operator releases the handle.
Each handle assembly 1806 may include a grasper 1810 that can spin relative to a handle 1812 as indicated by arrow 1814. Rotation of the grasper 1810 can be translated into a corresponding spinning movement of the instrument about the instrument longitudinal axis. The grasper 1810 may contain a pair of pressure plates 1816 that can be depressed by the operator. The depression of the plates 1816 can cause a corresponding movement of the actuator rod and the end effector of the instrument.
The handle 1812 can be pivoted and translated relative to a swing arm 1818 as indicated by the arrows 1820 and 1822, respectively. Pivoting the handle 1812 may provide a corresponding rotational movement of the instrument within the patient. Likewise, translational movement of the handle 1812 may induce a movement of
-68-the instrument into and out of the patient. The handle 1812 may have a release button 1823 which can be depressed to decouple the handle assembly 1806 from the instrument, such that movement of the assembly 1806 will not create a corresponding movement of the instrument.
Figure 58 shows an embodiment of the grasper 1810.
The pressure plates 1816 can be pivotally connected together by a pin 1824 and bushing 1826. The plates 1816 are also connected to a push ring 1828 by a pair of rocker arms 1830. The rocker arms 1830 are pivotally connected to a grasper housing 1832 by pins 1834. The push ring 1828 is connected to a push rod 1836.

The push rod 1836 is connected to an actuator/sensor assembly 1838 that can translate the rod 1836 and ring 1828 as indicated by the arrow 1840.
The actuator/sensor assembly 1838 can either induce or sense the translational movement of the rod 1836.
Movement of the rod 1836 can either induce, or be responsive to, deflection of the plates 1816. The plates 1816, ring 1828, rod 1836 and actuator/sensor assembly 1838 allow the system to both sense the force being applied by the operator and apply a feedback force to the operator.
The push rod 1836 may be coaxial aligned with a connector rod 1839 that is used to couple the grasper 1810 to the handle 1812. The connector rod 1839 is locked in place by a connecting pin 1842 that sits within a corresponding groove 1844 of the rod 1840.
The pin 1842 is attached to a threaded collar 1846 and
-69-a handle 1848. The handle 1848 can be rotated to move the pin 1842 into engagement with the connector rod 1836 to "frictionally" lock the rod 1836 to the grasper 1810. The grasper 1810 may also have a spring biased ball detent 1849 which mates with a corresponding feature of the rod 1840 to properly orient the grasper 1810 with the handle 1812.
Referring to Fig. 57, the swing arm 1818 can pivot about a forearm 1850 as indicated by arrow 1852.
Pivotal movement of the swing arm 1818 may induce a corresponding movement of the instrument. The forearm may be adjusted to a desirable position by the operator.
Figure 59 shows an embodiment of the swing arm 1818. The swing arm handle 1812 may include a sliding bearing assembly 1860 which allows an operator to slide the handle 1812 relative to the arm 1818. The handle 1812 may have cables (not shown) that are coupled to a roller 1862. The roller 1862 rotates in conjunction with any linear displacement of the handle 1812.
Rotation of the roller 1862 can be detected by a rotational sensor 1864 that is connected to the controller of the system. The sensor 1864 can provide output signals that are processed to induce a corresponding movement of the instrument.
Translation of the handle 1812 may move the center of gravity of the assembly 1806. The assembly 1806 may include a counterweight assembly 1866 that counteracts the movement of the handle 1812 so that the handle assembly 1806 is mechanically balanced.
-70-The counterweight assembly 1866 may include a counterweight 1868 that is coupled to a translator 1870. The translator 1870 causes the counterweight 1868 to move in a direction opposite from the movement of the handle 1812 to counteract the shifting weight of the handle 1812.
The counterweight 1868 may be connected to a roller 1872 that is coupled to a variable torque assembly 1874. The variable torque assembly may include an actuator 1876 that is connected to a linkage mechanism 1878. The linkage mechanism 1878 includes a finger plate 1880 that exerts a force on the roller 1872 and the counterweight 1868.
As shown in Figure 60 the roller 1872 can move along the finger plate 1880. Movement of the roller 1872 varies the effective lever arm and corresponding torque exerted by the counterweight to counteract an opposite movement of the handle 1812. The output of the actuator 1876 can be varied to change the force exerted by the plate 1880 and torque applied by the counterweight 1868.
Figure 61 shows a schematic of an articulate arm that corresponds to the arm shown in Fig. 3. When performing a cardiac surgical procedure it may be desirable to insert a surgical instrument into a patient and then move the tip of the instrument up toward the patient's sternum. The active actuator Js4 will allow the instrument to move in such a manner.
The articulate arm can be located within nine different Cartesian coordinate systems designated by subscripts 0, 1, 2, 3, 4, 5, 6, 7 and t. The zero
-71-coordinate system is a fixed world system. The first coordinate system has an origin at the center of the first rotary motor Js2. The origin can move along a z direction a distance dl. The x and y unit vectors of the first coordinate system do not vary regardless of the position of the first linkage arm Ll.

The second coordinate system has an origin at the center of the first rotary motor J52 but has x and y unit vectors that rotate with rotation of the first linkage arm Ll. The third, fourth, fifth, sixth and seventh coordinate systems correspond to the centers of joints J53, Js4 Js5 and JS6 and JS7, respectively.
Joints Js3, Js4 and Js7 may all be active. Joints Js5 and Js6 may be passive.

The tip of the instrument may be located within a tip coordinate system Xt, Yt and Zt. A movement of the tip in a desired direction may be translated back into the world coordinate system X0, Y0 and Z0 utilizing the following forward transformation matrices. The transformation matrix To transforms world coordinates Ti into the coordinates of the first coordinate system, transforms the first coordinates into the second coordinate system and so forth and so on.

TO =
0 0 1 dl
-72-cos 02 - sin 02 0 0 2 sin 02 cos 02 0 0 T1 =

cos 03 - sin 03 0 Ll T3 - sin 03 cos 03 0 0 - cos 04 - sin 04 0 L2 T3 =
sin 04 cos 04 0 0 t 0 0 1 0 T4 =

T5 sin 05 cos 05 0 0 t - cos 05 sin 06 0 0 - sin 06 - cos 06 0 0 T5 =
cos 06 - sin 06 0 0
-73-cos 07 - sin 97 0 L3 T6 =
sin 07 - cos 07 0 0 The inverse of the above listed transformation matrices can be used to provide the following equations which define the amount of movement for each actuator for a desired movement of the instrument tip.
While certain exemplary embodiments have been described and shown in the accompanying drawings, it is to be understood that such embodiments are merely illustrative of and not restrictive on the broad invention, and that this invention not be limited to the specific constructions and arrangements shown and described, since various other modifications may occur to those ordinarily skilled in the art.

Claims (18)

Claims:
1. A tool driver that can actuate a surgical instrument, comprising:

a housing;

a sheath that is detachably connected to said housing and contains an inner channel that receives the surgical instrument, said sheath having a wiper that engages the surgical instrument and a valve that can be sealed against a valve seat; and an actuator that is coupled to said housing and which can actuate the surgical instrument.
2. The tool driver of claim 1, wherein at least a portion of said sheath is non-conductive.
3. The tool driver of claim 1, wherein at least a portion of said sheath is transparent to x-rays.
4. A tool driver that can be coupled to a surgical instrument, comprising:

a housing;

a sleeve that is coupled to said housing and can be coupled to the surgical instrument;

an actuator that is coupled to said housing and can move said sleeve to actuate the surgical instrument;

a bellows that couples said actuator to said sleeve.
5. The tool driver of claim 4, further comprising a plate that is coupled to said bellows and said sleeve.
6. The tool driver of claim 4, further comprising a worm gear that is coupled to said sleeve.
7. A tool driver that can be coupled to a surgical instrument which has an alignment groove, comprising:

a housing;

a tube that is coupled to said housing;

a detent that is coupled to said housing and can be inserted into the alignment groove to couple the surgical instrument with said tube; and an actuator that can rotate said tube and the surgical instrument.
8. The tool driver of claim 7, further comprising a sleeve that is coupled to said housing and the surgical instrument and an actuator that can move said sleeve and actuate the surgical instrument.
9. The tool driver of claim 8, wherein said sleeve includes a slot that can receive a pin of the surgical instrument.
10. The tool driver of claim 8, further comprising a bellows that couples said sleeve to said actuator.
11. The tool driver of claim 7, further comprising a worm gear that couples said actuator to said tube.
12. A tool driver that can be coupled to a surgical instrument, comprising: a housing; a tube that is coupled to said housing and the surgical instrument; a first actuator that can move said sleeve and actuate the surgical instrument; a second actuator that can rotate said tube and the surgical instrument; and, a worm gear that couples to said second actuator to said tube.
13. The tool driver of claim 9, wherein said sleeve includes a slot that can receive a pin of the surgical instrument.
14. A tool driver that can be coupled to a surgical instrument, comprising:

a housing;

an actuator that is attached to said housing and which can actuate the surgical instrument;

a printed circuit board assembly that is coupled to said housing and said actuator;

a wire assembly that is connected to said printed circuit board assembly and extends from said housing, said wire assembly includes an inner jacket that is within an outer jacket, and a wire that is within said inner jacket.
15. The tool driver of claim 14, further comprising a seal that is located between said inner and outer jackets.
16. The tool driver of claim 14, wherein said printed circuit board assembly includes a temperature sensor.
17. A tool driver that can be coupled to a surgical instrument, comprising:

a housing;

an actuator that is attached to said housing and which can actuate the surgical instrument;

and, a temperature sensor located within said housing.
18. The tool driver of claim 17, further comprising a wire assembly that is coupled to said temperature sensor and extends from said housing.
CA2750053A 1999-03-03 2000-02-28 Method and apparatus for performing minimally invasive surgical procedures Abandoned CA2750053A1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/262,134 US6436107B1 (en) 1996-02-20 1999-03-03 Method and apparatus for performing minimally invasive surgical procedures
US09/262,134 1999-03-03
CA2330674A CA2330674C (en) 1999-03-03 2000-02-28 Method and apparatus for performing minimally invasive surgical procedures

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
CA2330674A Division CA2330674C (en) 1999-03-03 2000-02-28 Method and apparatus for performing minimally invasive surgical procedures

Publications (1)

Publication Number Publication Date
CA2750053A1 true CA2750053A1 (en) 2000-09-08

Family

ID=22996292

Family Applications (2)

Application Number Title Priority Date Filing Date
CA2750053A Abandoned CA2750053A1 (en) 1999-03-03 2000-02-28 Method and apparatus for performing minimally invasive surgical procedures
CA2330674A Expired - Lifetime CA2330674C (en) 1999-03-03 2000-02-28 Method and apparatus for performing minimally invasive surgical procedures

Family Applications After (1)

Application Number Title Priority Date Filing Date
CA2330674A Expired - Lifetime CA2330674C (en) 1999-03-03 2000-02-28 Method and apparatus for performing minimally invasive surgical procedures

Country Status (6)

Country Link
US (3) US6436107B1 (en)
EP (2) EP1076507A4 (en)
JP (1) JP2002537884A (en)
AU (1) AU3613300A (en)
CA (2) CA2750053A1 (en)
WO (1) WO2000051486A1 (en)

Families Citing this family (971)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6963792B1 (en) * 1992-01-21 2005-11-08 Sri International Surgical method
US6436107B1 (en) * 1996-02-20 2002-08-20 Computer Motion, Inc. Method and apparatus for performing minimally invasive surgical procedures
US6132441A (en) 1996-11-22 2000-10-17 Computer Motion, Inc. Rigidly-linked articulating wrist with decoupled motion transmission
US6231565B1 (en) * 1997-06-18 2001-05-15 United States Surgical Corporation Robotic arm DLUs for performing surgical tasks
US7371210B2 (en) 1998-02-24 2008-05-13 Hansen Medical, Inc. Flexible instrument
US7789875B2 (en) 1998-02-24 2010-09-07 Hansen Medical, Inc. Surgical instruments
US7758569B2 (en) 1998-02-24 2010-07-20 Hansen Medical, Inc. Interchangeable surgical instrument
US8414598B2 (en) 1998-02-24 2013-04-09 Hansen Medical, Inc. Flexible instrument
US7775972B2 (en) 1998-02-24 2010-08-17 Hansen Medical, Inc. Flexible instrument
US8303576B2 (en) 1998-02-24 2012-11-06 Hansen Medical, Inc. Interchangeable surgical instrument
US7297142B2 (en) * 1998-02-24 2007-11-20 Hansen Medical, Inc. Interchangeable surgical instrument
US20020095175A1 (en) * 1998-02-24 2002-07-18 Brock David L. Flexible instrument
US6860878B2 (en) 1998-02-24 2005-03-01 Endovia Medical Inc. Interchangeable instrument
US7713190B2 (en) 1998-02-24 2010-05-11 Hansen Medical, Inc. Flexible instrument
US7901399B2 (en) 1998-02-24 2011-03-08 Hansen Medical, Inc. Interchangeable surgical instrument
US8527094B2 (en) 1998-11-20 2013-09-03 Intuitive Surgical Operations, Inc. Multi-user medical robotic system for collaboration or training in minimally invasive surgical procedures
US6659939B2 (en) 1998-11-20 2003-12-09 Intuitive Surgical, Inc. Cooperative minimally invasive telesurgical system
US6852107B2 (en) 2002-01-16 2005-02-08 Computer Motion, Inc. Minimally invasive surgical training using robotics and tele-collaboration
US6398726B1 (en) 1998-11-20 2002-06-04 Intuitive Surgical, Inc. Stabilizer for robotic beating-heart surgery
US8944070B2 (en) 1999-04-07 2015-02-03 Intuitive Surgical Operations, Inc. Non-force reflecting method for providing tool force information to a user of a telesurgical system
EP1176921B1 (en) 1999-05-10 2011-02-23 Hansen Medical, Inc. Surgical instrument
JP4014792B2 (en) * 2000-09-29 2007-11-28 株式会社東芝 manipulator
EP2932884B1 (en) 2000-11-28 2020-09-09 Intuitive Surgical Operations, Inc. Endoscopic beating-heart stabilizer and vessel occlusion fastener
US7105005B2 (en) * 2001-01-29 2006-09-12 Scanlan International, Inc. Arteriotomy scissors for minimally invasive surgical procedures
US20030135204A1 (en) 2001-02-15 2003-07-17 Endo Via Medical, Inc. Robotically controlled medical instrument with a flexible section
US7699835B2 (en) 2001-02-15 2010-04-20 Hansen Medical, Inc. Robotically controlled surgical instruments
US8414505B1 (en) 2001-02-15 2013-04-09 Hansen Medical, Inc. Catheter driver system
US20090182226A1 (en) * 2001-02-15 2009-07-16 Barry Weitzner Catheter tracking system
US7766894B2 (en) 2001-02-15 2010-08-03 Hansen Medical, Inc. Coaxial catheter system
US7367973B2 (en) * 2003-06-30 2008-05-06 Intuitive Surgical, Inc. Electro-surgical instrument with replaceable end-effectors and inhibited surface conduction
US8398634B2 (en) * 2002-04-18 2013-03-19 Intuitive Surgical Operations, Inc. Wristed robotic surgical tool for pluggable end-effectors
US7824401B2 (en) * 2004-10-08 2010-11-02 Intuitive Surgical Operations, Inc. Robotic tool with wristed monopolar electrosurgical end effectors
US6994708B2 (en) * 2001-04-19 2006-02-07 Intuitive Surgical Robotic tool with monopolar electro-surgical scissors
US6817974B2 (en) 2001-06-29 2004-11-16 Intuitive Surgical, Inc. Surgical tool having positively positionable tendon-actuated multi-disk wrist joint
US20060178556A1 (en) 2001-06-29 2006-08-10 Intuitive Surgical, Inc. Articulate and swapable endoscope for a surgical robot
NL1018874C2 (en) * 2001-09-03 2003-03-05 Michel Petronella Hub Vleugels Surgical instrument.
US6728599B2 (en) * 2001-09-07 2004-04-27 Computer Motion, Inc. Modularity system for computer assisted surgery
US7464847B2 (en) 2005-06-03 2008-12-16 Tyco Healthcare Group Lp Surgical stapler with timer and feedback display
US10285694B2 (en) 2001-10-20 2019-05-14 Covidien Lp Surgical stapler with timer and feedback display
US7819875B2 (en) * 2002-02-08 2010-10-26 Gursharan Singh Chana Surgical devices and methods of use
EP1482841B1 (en) 2002-03-14 2005-12-07 Yeung, Jeffery E. Suture anchor and approximating device
US9155544B2 (en) 2002-03-20 2015-10-13 P Tech, Llc Robotic systems and methods
US7164968B2 (en) * 2002-04-05 2007-01-16 The Trustees Of Columbia University In The City Of New York Robotic scrub nurse
AU2003245246B2 (en) * 2002-04-25 2009-01-08 Covidien Lp Surgical instruments including micro-electromechanical systems (MEMS)
KR100965538B1 (en) * 2002-04-30 2010-06-23 그레이트베치 메디칼 에스에이 Reamer spindle for minimally invasive joint surgery
EP2070487B1 (en) 2002-08-13 2014-03-05 NeuroArm Surgical, Ltd. Microsurgical robot system
US20040176751A1 (en) * 2002-08-14 2004-09-09 Endovia Medical, Inc. Robotic medical instrument system
US7259906B1 (en) 2002-09-03 2007-08-21 Cheetah Omni, Llc System and method for voice control of medical devices
US7331967B2 (en) * 2002-09-09 2008-02-19 Hansen Medical, Inc. Surgical instrument coupling mechanism
JP2004154877A (en) * 2002-11-05 2004-06-03 Japan Science & Technology Agency Bending mechanism formed of multi-joint slider link
US7386365B2 (en) * 2004-05-04 2008-06-10 Intuitive Surgical, Inc. Tool grip calibration for robotic surgery
CN100389730C (en) 2002-12-06 2008-05-28 直观外科手术公司 Flexible wrist for surgical tool
US7083615B2 (en) * 2003-02-24 2006-08-01 Intuitive Surgical Inc Surgical tool having electrocautery energy supply conductor with inhibited current leakage
US7736300B2 (en) * 2003-04-14 2010-06-15 Softscope Medical Technologies, Inc. Self-propellable apparatus and method
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US8007511B2 (en) * 2003-06-06 2011-08-30 Hansen Medical, Inc. Surgical instrument design
US7960935B2 (en) 2003-07-08 2011-06-14 The Board Of Regents Of The University Of Nebraska Robotic devices with agent delivery components and related methods
US7042184B2 (en) 2003-07-08 2006-05-09 Board Of Regents Of The University Of Nebraska Microrobot for surgical applications
US7672741B2 (en) * 2003-07-24 2010-03-02 Keio University Position/force control device
US10105140B2 (en) * 2009-11-20 2018-10-23 Covidien Lp Surgical console and hand-held surgical device
EP1562099A1 (en) * 2004-02-09 2005-08-10 SAP Aktiengesellschaft Method and computer system for document encryption
US8046049B2 (en) 2004-02-23 2011-10-25 Biosense Webster, Inc. Robotically guided catheter
US7974681B2 (en) * 2004-03-05 2011-07-05 Hansen Medical, Inc. Robotic catheter system
US7632265B2 (en) 2004-05-28 2009-12-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Radio frequency ablation servo catheter and method
US7974674B2 (en) 2004-05-28 2011-07-05 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for surface modeling
US8755864B2 (en) 2004-05-28 2014-06-17 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for diagnostic data mapping
US10863945B2 (en) 2004-05-28 2020-12-15 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system with contact sensing feature
US10258285B2 (en) 2004-05-28 2019-04-16 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for automated creation of ablation lesions
US9782130B2 (en) 2004-05-28 2017-10-10 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system
US8528565B2 (en) 2004-05-28 2013-09-10 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic surgical system and method for automated therapy delivery
JP2006000538A (en) * 2004-06-21 2006-01-05 Olympus Corp Operating theater controlling system
US7874839B2 (en) * 2004-07-13 2011-01-25 Westport Medical, Inc. Powered surgical instruments
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US11890012B2 (en) 2004-07-28 2024-02-06 Cilag Gmbh International Staple cartridge comprising cartridge body and attached support
FR2875282B1 (en) * 2004-09-15 2006-11-24 Centre Nat Rech Scient Cnrse AXIALLY ORIENTABLE AND RIGID TORSION MECHANICAL TRANSMISSION
EP1845861B1 (en) 2005-01-21 2011-06-22 Mayo Foundation for Medical Education and Research Thorascopic heart valve repair apparatus
US9789608B2 (en) 2006-06-29 2017-10-17 Intuitive Surgical Operations, Inc. Synthetic representation of a surgical robot
US8668705B2 (en) 2005-05-20 2014-03-11 Neotract, Inc. Latching anchor device
US8945152B2 (en) 2005-05-20 2015-02-03 Neotract, Inc. Multi-actuating trigger anchor delivery system
US9504461B2 (en) 2005-05-20 2016-11-29 Neotract, Inc. Anchor delivery system
US8333776B2 (en) 2005-05-20 2012-12-18 Neotract, Inc. Anchor delivery system
US10195014B2 (en) 2005-05-20 2019-02-05 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US9364212B2 (en) 2005-05-20 2016-06-14 Neotract, Inc. Suture anchoring devices and methods for use
US8529584B2 (en) 2005-05-20 2013-09-10 Neotract, Inc. Median lobe band implant apparatus and method
US7909836B2 (en) 2005-05-20 2011-03-22 Neotract, Inc. Multi-actuating trigger anchor delivery system
US9149266B2 (en) 2005-05-20 2015-10-06 Neotract, Inc. Deforming anchor device
US7758594B2 (en) 2005-05-20 2010-07-20 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US7896891B2 (en) 2005-05-20 2011-03-01 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US8394113B2 (en) 2005-05-20 2013-03-12 Neotract, Inc. Coiled anchor device
US8157815B2 (en) 2005-05-20 2012-04-17 Neotract, Inc. Integrated handle assembly for anchor delivery system
US8628542B2 (en) 2005-05-20 2014-01-14 Neotract, Inc. Median lobe destruction apparatus and method
US8834492B2 (en) 2005-05-20 2014-09-16 Neotract, Inc. Continuous indentation lateral lobe apparatus and method
US8491606B2 (en) 2005-05-20 2013-07-23 Neotract, Inc. Median lobe retraction apparatus and method
US8425535B2 (en) 2005-05-20 2013-04-23 Neotract, Inc. Multi-actuating trigger anchor delivery system
US9549739B2 (en) 2005-05-20 2017-01-24 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US8603106B2 (en) 2005-05-20 2013-12-10 Neotract, Inc. Integrated handle assembly for anchor delivery system
US10925587B2 (en) 2005-05-20 2021-02-23 Neotract, Inc. Anchor delivery system
US7645286B2 (en) 2005-05-20 2010-01-12 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US8083664B2 (en) 2005-05-25 2011-12-27 Maquet Cardiovascular Llc Surgical stabilizers and methods for use in reduced-access surgical sites
US8155910B2 (en) 2005-05-27 2012-04-10 St. Jude Medical, Atrial Fibrillation Divison, Inc. Robotically controlled catheter and method of its calibration
US7717312B2 (en) 2005-06-03 2010-05-18 Tyco Healthcare Group Lp Surgical instruments employing sensors
US11291443B2 (en) 2005-06-03 2022-04-05 Covidien Lp Surgical stapler with timer and feedback display
CA2609970C (en) 2005-06-03 2014-08-12 Tyco Healthcare Group Lp Battery powered surgical instrument
US7833236B2 (en) * 2005-06-13 2010-11-16 Ethicon Endo-Surgery, Inc. Surgical suturing apparatus with collapsible vacuum chamber
WO2007002180A2 (en) * 2005-06-28 2007-01-04 Stryker Corporation Powered surgical tool with control module that contains a sensor for remotely monitoring the tool power generating unit
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US7673781B2 (en) 2005-08-31 2010-03-09 Ethicon Endo-Surgery, Inc. Surgical stapling device with staple driver that supports multiple wire diameter staples
US8800838B2 (en) 2005-08-31 2014-08-12 Ethicon Endo-Surgery, Inc. Robotically-controlled cable-based surgical end effectors
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US7799039B2 (en) 2005-11-09 2010-09-21 Ethicon Endo-Surgery, Inc. Surgical instrument having a hydraulically actuated end effector
US7519253B2 (en) 2005-11-18 2009-04-14 Omni Sciences, Inc. Broadband or mid-infrared fiber light sources
US7930065B2 (en) 2005-12-30 2011-04-19 Intuitive Surgical Operations, Inc. Robotic surgery system including position sensors using fiber bragg gratings
US9962066B2 (en) 2005-12-30 2018-05-08 Intuitive Surgical Operations, Inc. Methods and apparatus to shape flexible entry guides for minimally invasive surgery
US9308049B2 (en) * 2006-01-13 2016-04-12 Olympus Corporation Medical treatment endoscope
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US8161977B2 (en) 2006-01-31 2012-04-24 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US8763879B2 (en) 2006-01-31 2014-07-01 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of surgical instrument
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US7770775B2 (en) 2006-01-31 2010-08-10 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with adaptive user feedback
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US7766210B2 (en) 2006-01-31 2010-08-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with user feedback system
US7568603B2 (en) 2006-01-31 2009-08-04 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with articulatable end effector
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
EP1815950A1 (en) 2006-02-03 2007-08-08 The European Atomic Energy Community (EURATOM), represented by the European Commission Robotic surgical system for performing minimally invasive medical procedures
EP1815949A1 (en) * 2006-02-03 2007-08-08 The European Atomic Energy Community (EURATOM), represented by the European Commission Medical robotic system with manipulator arm of the cylindrical coordinate type
US8992422B2 (en) * 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US8236010B2 (en) 2006-03-23 2012-08-07 Ethicon Endo-Surgery, Inc. Surgical fastener and cutter with mimicking end effector
US8986196B2 (en) 2006-06-13 2015-03-24 Intuitive Surgical Operations, Inc. Minimally invasive surgery instrument assembly with reduced cross section
JP2009539509A (en) * 2006-06-14 2009-11-19 マクドナルド デットワイラー アンド アソシエイツ インコーポレーテッド Surgical manipulator with right angle pulley drive mechanism
CA3068216C (en) 2006-06-22 2023-03-07 Board Of Regents Of The University Of Nebraska Magnetically coupleable robotic devices and related methods
US8974440B2 (en) 2007-08-15 2015-03-10 Board Of Regents Of The University Of Nebraska Modular and cooperative medical devices and related systems and methods
US8679096B2 (en) 2007-06-21 2014-03-25 Board Of Regents Of The University Of Nebraska Multifunctional operational component for robotic devices
US9579088B2 (en) 2007-02-20 2017-02-28 Board Of Regents Of The University Of Nebraska Methods, systems, and devices for surgical visualization and device manipulation
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US10008017B2 (en) 2006-06-29 2018-06-26 Intuitive Surgical Operations, Inc. Rendering tool information as graphic overlays on displayed images of tools
US10258425B2 (en) * 2008-06-27 2019-04-16 Intuitive Surgical Operations, Inc. Medical robotic system providing an auxiliary view of articulatable instruments extending out of a distal end of an entry guide
US9718190B2 (en) 2006-06-29 2017-08-01 Intuitive Surgical Operations, Inc. Tool position and identification indicator displayed in a boundary area of a computer display screen
US20090192523A1 (en) 2006-06-29 2009-07-30 Intuitive Surgical, Inc. Synthetic representation of a surgical instrument
US7740159B2 (en) 2006-08-02 2010-06-22 Ethicon Endo-Surgery, Inc. Pneumatically powered surgical cutting and fastening instrument with a variable control of the actuating rate of firing with mechanical power assist
US20080053962A1 (en) * 2006-09-06 2008-03-06 Applied Robotics, Inc. Methods and devices for handling a work piece for a machining process
JP2010504127A (en) * 2006-09-25 2010-02-12 コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ Medical scanning method and apparatus using haptic feedback
US7506791B2 (en) 2006-09-29 2009-03-24 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical mechanism for limiting maximum tissue compression
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
EP1915963A1 (en) 2006-10-25 2008-04-30 The European Atomic Energy Community (EURATOM), represented by the European Commission Force estimation for a minimally invasive robotic surgery system
US7935130B2 (en) * 2006-11-16 2011-05-03 Intuitive Surgical Operations, Inc. Two-piece end-effectors for robotic surgical tools
US8556807B2 (en) * 2006-12-21 2013-10-15 Intuitive Surgical Operations, Inc. Hermetically sealed distal sensor endoscope
US8814779B2 (en) 2006-12-21 2014-08-26 Intuitive Surgical Operations, Inc. Stereoscopic endoscope
US9232959B2 (en) 2007-01-02 2016-01-12 Aquabeam, Llc Multi fluid tissue resection methods and devices
US8459520B2 (en) 2007-01-10 2013-06-11 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US7721936B2 (en) * 2007-01-10 2010-05-25 Ethicon Endo-Surgery, Inc. Interlock and surgical instrument including same
US7738971B2 (en) 2007-01-10 2010-06-15 Ethicon Endo-Surgery, Inc. Post-sterilization programming of surgical instruments
US7900805B2 (en) 2007-01-10 2011-03-08 Ethicon Endo-Surgery, Inc. Surgical instrument with enhanced battery performance
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US7721931B2 (en) * 2007-01-10 2010-05-25 Ethicon Endo-Surgery, Inc. Prevention of cartridge reuse in a surgical instrument
US7954682B2 (en) 2007-01-10 2011-06-07 Ethicon Endo-Surgery, Inc. Surgical instrument with elements to communicate between control unit and end effector
US8684253B2 (en) * 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US20080169332A1 (en) 2007-01-11 2008-07-17 Shelton Frederick E Surgical stapling device with a curved cutting member
WO2008097853A2 (en) * 2007-02-02 2008-08-14 Hansen Medical, Inc. Mounting support assembly for suspending a medical instrument driver above an operating table
US7655004B2 (en) 2007-02-15 2010-02-02 Ethicon Endo-Surgery, Inc. Electroporation ablation apparatus, system, and method
US20090001130A1 (en) 2007-03-15 2009-01-01 Hess Christopher J Surgical procedure using a cutting and stapling instrument having releasable staple-forming pockets
US7431188B1 (en) 2007-03-15 2008-10-07 Tyco Healthcare Group Lp Surgical stapling apparatus with powered articulation
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US8056787B2 (en) * 2007-03-28 2011-11-15 Ethicon Endo-Surgery, Inc. Surgical stapling and cutting instrument with travel-indicating retraction member
US8308746B2 (en) * 2007-04-12 2012-11-13 Applied Medical Resources Corporation Method and apparatus for tissue morcellation
US11259801B2 (en) 2007-04-13 2022-03-01 Covidien Lp Powered surgical instrument
US20080255413A1 (en) 2007-04-13 2008-10-16 Michael Zemlok Powered surgical instrument
US8800837B2 (en) 2007-04-13 2014-08-12 Covidien Lp Powered surgical instrument
US7950560B2 (en) 2007-04-13 2011-05-31 Tyco Healthcare Group Lp Powered surgical instrument
US8560118B2 (en) 2007-04-16 2013-10-15 Neuroarm Surgical Ltd. Methods, devices, and systems for non-mechanically restricting and/or programming movement of a tool of a manipulator along a single axis
CA2684459C (en) * 2007-04-16 2016-10-04 Neuroarm Surgical Ltd. Methods, devices, and systems for non-mechanically restricting and/or programming movement of a tool of a manipulator along a single axis
US7823760B2 (en) 2007-05-01 2010-11-02 Tyco Healthcare Group Lp Powered surgical stapling device platform
US7931660B2 (en) 2007-05-10 2011-04-26 Tyco Healthcare Group Lp Powered tacker instrument
US7922064B2 (en) 2007-05-16 2011-04-12 The Invention Science Fund, I, LLC Surgical fastening device with cutter
US7810691B2 (en) * 2007-05-16 2010-10-12 The Invention Science Fund I, Llc Gentle touch surgical stapler
US8485411B2 (en) 2007-05-16 2013-07-16 The Invention Science Fund I, Llc Gentle touch surgical stapler
US7823761B2 (en) * 2007-05-16 2010-11-02 The Invention Science Fund I, Llc Maneuverable surgical stapler
US7798385B2 (en) * 2007-05-16 2010-09-21 The Invention Science Fund I, Llc Surgical stapling instrument with chemical sealant
US7832611B2 (en) * 2007-05-16 2010-11-16 The Invention Science Fund I, Llc Steerable surgical stapler
US7798386B2 (en) 2007-05-30 2010-09-21 Ethicon Endo-Surgery, Inc. Surgical instrument articulation joint cover
US7810693B2 (en) 2007-05-30 2010-10-12 Ethicon Endo-Surgery, Inc. Surgical stapling and cutting instrument with articulatable end effector
US8157145B2 (en) 2007-05-31 2012-04-17 Ethicon Endo-Surgery, Inc. Pneumatically powered surgical cutting and fastening instrument with electrical feedback
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US11857181B2 (en) 2007-06-04 2024-01-02 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US7905380B2 (en) 2007-06-04 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US8534528B2 (en) 2007-06-04 2013-09-17 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US7832408B2 (en) 2007-06-04 2010-11-16 Ethicon Endo-Surgery, Inc. Surgical instrument having a directional switching mechanism
US8620473B2 (en) 2007-06-13 2013-12-31 Intuitive Surgical Operations, Inc. Medical robotic system with coupled control modes
US9469034B2 (en) 2007-06-13 2016-10-18 Intuitive Surgical Operations, Inc. Method and system for switching modes of a robotic system
US9138129B2 (en) 2007-06-13 2015-09-22 Intuitive Surgical Operations, Inc. Method and system for moving a plurality of articulated instruments in tandem back towards an entry guide
US9084623B2 (en) 2009-08-15 2015-07-21 Intuitive Surgical Operations, Inc. Controller assisted reconfiguration of an articulated instrument during movement into and out of an entry guide
US9089256B2 (en) 2008-06-27 2015-07-28 Intuitive Surgical Operations, Inc. Medical robotic system providing an auxiliary view including range of motion limitations for articulatable instruments extending out of a distal end of an entry guide
US8444631B2 (en) 2007-06-14 2013-05-21 Macdonald Dettwiler & Associates Inc Surgical manipulator
US7510107B2 (en) 2007-06-18 2009-03-31 Ethicon Endo-Surgery, Inc. Cable driven surgical stapling and cutting instrument with apparatus for preventing inadvertent cable disengagement
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US8308040B2 (en) 2007-06-22 2012-11-13 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US7658311B2 (en) 2007-06-22 2010-02-09 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with a geared return mechanism
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US20110046659A1 (en) * 2007-07-09 2011-02-24 Immersion Corporation Minimally Invasive Surgical Tools With Haptic Feedback
US8758366B2 (en) 2007-07-09 2014-06-24 Neotract, Inc. Multi-actuating trigger anchor delivery system
US8343171B2 (en) 2007-07-12 2013-01-01 Board Of Regents Of The University Of Nebraska Methods and systems of actuation in robotic devices
JP2010536435A (en) 2007-08-15 2010-12-02 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Medical inflation, attachment and delivery devices and associated methods
US8579897B2 (en) 2007-11-21 2013-11-12 Ethicon Endo-Surgery, Inc. Bipolar forceps
CA2703129C (en) * 2007-10-18 2016-02-16 Neochord Inc. Minimially invasive repair of a valve leaflet in a beating heart
US7922063B2 (en) 2007-10-31 2011-04-12 Tyco Healthcare Group, Lp Powered surgical instrument
US8480657B2 (en) 2007-10-31 2013-07-09 Ethicon Endo-Surgery, Inc. Detachable distal overtube section and methods for forming a sealable opening in the wall of an organ
US20090112059A1 (en) 2007-10-31 2009-04-30 Nobis Rudolph H Apparatus and methods for closing a gastrotomy
JP5017065B2 (en) * 2007-11-21 2012-09-05 日野自動車株式会社 Exhaust purification device
WO2009079781A1 (en) * 2007-12-21 2009-07-02 Macdonald Dettwiler & Associates Inc. Surgical manipulator
GB0801419D0 (en) * 2008-01-25 2008-03-05 Prosurgics Ltd Albation device
US7766209B2 (en) 2008-02-13 2010-08-03 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
US7905381B2 (en) 2008-09-19 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with cutting member arrangement
US8540133B2 (en) 2008-09-19 2013-09-24 Ethicon Endo-Surgery, Inc. Staple cartridge
US8561870B2 (en) 2008-02-13 2013-10-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US8453908B2 (en) 2008-02-13 2013-06-04 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
US7861906B2 (en) 2008-02-14 2011-01-04 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with articulatable components
JP5410110B2 (en) 2008-02-14 2014-02-05 エシコン・エンド−サージェリィ・インコーポレイテッド Surgical cutting / fixing instrument with RF electrode
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US7810692B2 (en) 2008-02-14 2010-10-12 Ethicon Endo-Surgery, Inc. Disposable loading unit with firing indicator
US8584919B2 (en) 2008-02-14 2013-11-19 Ethicon Endo-Sugery, Inc. Surgical stapling apparatus with load-sensitive firing mechanism
US7819296B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with retractable firing systems
US7819297B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with reprocessible handle assembly
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US8459525B2 (en) 2008-02-14 2013-06-11 Ethicon Endo-Sugery, Inc. Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US7857185B2 (en) 2008-02-14 2010-12-28 Ethicon Endo-Surgery, Inc. Disposable loading unit for surgical stapling apparatus
US8622274B2 (en) 2008-02-14 2014-01-07 Ethicon Endo-Surgery, Inc. Motorized cutting and fastening instrument having control circuit for optimizing battery usage
US7793812B2 (en) 2008-02-14 2010-09-14 Ethicon Endo-Surgery, Inc. Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus
US8752749B2 (en) 2008-02-14 2014-06-17 Ethicon Endo-Surgery, Inc. Robotically-controlled disposable motor-driven loading unit
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US7913891B2 (en) 2008-02-14 2011-03-29 Ethicon Endo-Surgery, Inc. Disposable loading unit with user feedback features and surgical instrument for use therewith
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US7980443B2 (en) 2008-02-15 2011-07-19 Ethicon Endo-Surgery, Inc. End effectors for a surgical cutting and stapling instrument
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
EP3622910A1 (en) 2008-03-06 2020-03-18 AquaBeam LLC Tissue ablation and cautery with optical energy carried in fluid stream
US8343096B2 (en) 2008-03-27 2013-01-01 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter system
US8317744B2 (en) * 2008-03-27 2012-11-27 St. Jude Medical, Atrial Fibrillation Division, Inc. Robotic catheter manipulator assembly
US8808164B2 (en) 2008-03-28 2014-08-19 Intuitive Surgical Operations, Inc. Controlling a robotic surgical tool with a display monitor
US8155479B2 (en) 2008-03-28 2012-04-10 Intuitive Surgical Operations Inc. Automated panning and digital zooming for robotic surgical systems
US10406026B2 (en) * 2008-05-16 2019-09-10 The Johns Hopkins University System and method for macro-micro distal dexterity enhancement in micro-surgery of the eye
US8679003B2 (en) 2008-05-30 2014-03-25 Ethicon Endo-Surgery, Inc. Surgical device and endoscope including same
US8771260B2 (en) 2008-05-30 2014-07-08 Ethicon Endo-Surgery, Inc. Actuating and articulating surgical device
US8906035B2 (en) 2008-06-04 2014-12-09 Ethicon Endo-Surgery, Inc. Endoscopic drop off bag
US8403926B2 (en) 2008-06-05 2013-03-26 Ethicon Endo-Surgery, Inc. Manually articulating devices
US8864652B2 (en) 2008-06-27 2014-10-21 Intuitive Surgical Operations, Inc. Medical robotic system providing computer generated auxiliary views of a camera instrument for controlling the positioning and orienting of its tip
US8361112B2 (en) * 2008-06-27 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical suture arrangement
US8888792B2 (en) 2008-07-14 2014-11-18 Ethicon Endo-Surgery, Inc. Tissue apposition clip application devices and methods
FR2934486B1 (en) * 2008-07-29 2012-08-17 Univ Joseph Fourier Grenoble I MODULAR SURGICAL TOOL
EP2345374B1 (en) 2008-07-30 2020-05-20 Neotract, Inc. Anchor delivery system with replaceable cartridge
WO2010014825A1 (en) 2008-07-30 2010-02-04 Neotract, Inc. Slotted anchor device
US8409200B2 (en) 2008-09-03 2013-04-02 Ethicon Endo-Surgery, Inc. Surgical grasping device
US9679499B2 (en) * 2008-09-15 2017-06-13 Immersion Medical, Inc. Systems and methods for sensing hand motion by measuring remote displacement
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US9050083B2 (en) 2008-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8157834B2 (en) 2008-11-25 2012-04-17 Ethicon Endo-Surgery, Inc. Rotational coupling device for surgical instrument with flexible actuators
US8939963B2 (en) 2008-12-30 2015-01-27 Intuitive Surgical Operations, Inc. Surgical instruments with sheathed tendons
US8361066B2 (en) 2009-01-12 2013-01-29 Ethicon Endo-Surgery, Inc. Electrical ablation devices
US8216212B2 (en) 2009-01-15 2012-07-10 Immersion Corporation Providing haptic feedback to the handle of a tool
US20100198248A1 (en) * 2009-02-02 2010-08-05 Ethicon Endo-Surgery, Inc. Surgical dissector
US8397971B2 (en) 2009-02-05 2013-03-19 Ethicon Endo-Surgery, Inc. Sterilizable surgical instrument
US8414577B2 (en) 2009-02-05 2013-04-09 Ethicon Endo-Surgery, Inc. Surgical instruments and components for use in sterile environments
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
US8453907B2 (en) 2009-02-06 2013-06-04 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with cutting member reversing mechanism
CN102341048A (en) 2009-02-06 2012-02-01 伊西康内外科公司 Driven surgical stapler improvements
US20100268249A1 (en) * 2009-04-17 2010-10-21 Microdexterity Systems, Inc. Surgical system with medical manipulator and sterile barrier
US20100268250A1 (en) * 2009-04-17 2010-10-21 Microdexterity Systems, Inc. Surgical system with medical manipulator and sterile barrier
US9254123B2 (en) 2009-04-29 2016-02-09 Hansen Medical, Inc. Flexible and steerable elongate instruments with shape control and support elements
US9138207B2 (en) 2009-05-19 2015-09-22 Teleflex Medical Incorporated Methods and devices for laparoscopic surgery
ES2388029B1 (en) * 2009-05-22 2013-08-13 Universitat Politècnica De Catalunya ROBOTIC SYSTEM FOR LAPAROSCOPIC SURGERY.
US8821514B2 (en) 2009-06-08 2014-09-02 Covidien Lp Powered tack applier
CN101584594B (en) * 2009-06-18 2010-12-29 天津大学 Metamorphic tool hand for abdominal cavity minimal invasive surgery robot
US9492927B2 (en) 2009-08-15 2016-11-15 Intuitive Surgical Operations, Inc. Application of force feedback on an input device to urge its operator to command an articulated instrument to a preferred pose
US8918211B2 (en) 2010-02-12 2014-12-23 Intuitive Surgical Operations, Inc. Medical robotic system providing sensory feedback indicating a difference between a commanded state and a preferred pose of an articulated instrument
US8733612B2 (en) 2009-08-17 2014-05-27 Covidien Lp Safety method for powered surgical instruments
EP2477531A1 (en) * 2009-09-17 2012-07-25 FUJIFILM Corporation Propellable apparatus with active size changing ability
US8141762B2 (en) 2009-10-09 2012-03-27 Ethicon Endo-Surgery, Inc. Surgical stapler comprising a staple pocket
US20110098704A1 (en) 2009-10-28 2011-04-28 Ethicon Endo-Surgery, Inc. Electrical ablation devices
US8608652B2 (en) 2009-11-05 2013-12-17 Ethicon Endo-Surgery, Inc. Vaginal entry surgical devices, kit, system, and method
US8996173B2 (en) 2010-09-21 2015-03-31 Intuitive Surgical Operations, Inc. Method and apparatus for hand gesture control in a minimally invasive surgical system
US8935003B2 (en) 2010-09-21 2015-01-13 Intuitive Surgical Operations Method and system for hand presence detection in a minimally invasive surgical system
CN102596058B (en) * 2009-11-13 2015-10-21 直观外科手术操作公司 There is the end effector of the close mechanism established again
EP2489323B1 (en) 2009-11-13 2018-05-16 Intuitive Surgical Operations, Inc. Surgical tool with a compact wrist
US8543240B2 (en) * 2009-11-13 2013-09-24 Intuitive Surgical Operations, Inc. Master finger tracking device and method of use in a minimally invasive surgical system
US9259275B2 (en) * 2009-11-13 2016-02-16 Intuitive Surgical Operations, Inc. Wrist articulation by linked tension members
US8521331B2 (en) * 2009-11-13 2013-08-27 Intuitive Surgical Operations, Inc. Patient-side surgeon interface for a minimally invasive, teleoperated surgical instrument
CN102596087B (en) 2009-11-13 2015-07-22 直观外科手术操作公司 Motor interface for parallel drive shafts within an independently rotating member
US8353439B2 (en) 2009-11-19 2013-01-15 Ethicon Endo-Surgery, Inc. Circular stapler introducer with radially-openable distal end portion
WO2011075693A1 (en) 2009-12-17 2011-06-23 Board Of Regents Of The University Of Nebraska Modular and cooperative medical devices and related systems and methods
US8496574B2 (en) 2009-12-17 2013-07-30 Ethicon Endo-Surgery, Inc. Selectively positionable camera for surgical guide tube assembly
US8353487B2 (en) 2009-12-17 2013-01-15 Ethicon Endo-Surgery, Inc. User interface support devices for endoscopic surgical instruments
US8506564B2 (en) 2009-12-18 2013-08-13 Ethicon Endo-Surgery, Inc. Surgical instrument comprising an electrode
US9028483B2 (en) 2009-12-18 2015-05-12 Ethicon Endo-Surgery, Inc. Surgical instrument comprising an electrode
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8267300B2 (en) 2009-12-30 2012-09-18 Ethicon Endo-Surgery, Inc. Dampening device for endoscopic surgical stapler
WO2011084863A2 (en) 2010-01-07 2011-07-14 Cheetah Omni, Llc Fiber lasers and mid-infrared light sources in methods and systems for selective biological tissue processing and spectroscopy
US8721539B2 (en) 2010-01-20 2014-05-13 EON Surgical Ltd. Rapid laparoscopy exchange system and method of use thereof
EP2525720A1 (en) 2010-01-20 2012-11-28 EON Surgical Ltd. System of deploying an elongate unit in a body cavity
CA2786480C (en) 2010-01-26 2018-01-16 Novolap Medical Ltd. Articulating medical instrument
US9005198B2 (en) 2010-01-29 2015-04-14 Ethicon Endo-Surgery, Inc. Surgical instrument comprising an electrode
US20110282357A1 (en) 2010-05-14 2011-11-17 Intuitive Surgical Operations, Inc. Surgical system architecture
DE102010026305A1 (en) 2010-07-06 2012-01-12 Deutsches Zentrum für Luft- und Raumfahrt e.V. robot structure
US8789740B2 (en) 2010-07-30 2014-07-29 Ethicon Endo-Surgery, Inc. Linear cutting and stapling device with selectively disengageable cutting member
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8968267B2 (en) 2010-08-06 2015-03-03 Board Of Regents Of The University Of Nebraska Methods and systems for handling or delivering materials for natural orifice surgery
EP2417925B1 (en) 2010-08-12 2016-12-07 Immersion Corporation Electrosurgical tool having tactile feedback
US8360296B2 (en) 2010-09-09 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
KR20120030174A (en) * 2010-09-17 2012-03-28 삼성전자주식회사 Surgery robot system and surgery apparatus and method for providing tactile feedback
US9314306B2 (en) 2010-09-17 2016-04-19 Hansen Medical, Inc. Systems and methods for manipulating an elongate member
CA2811730C (en) 2010-09-19 2017-12-05 EON Surgical Ltd. Micro laparoscopy devices and deployments thereof
US9877720B2 (en) 2010-09-24 2018-01-30 Ethicon Llc Control features for articulating surgical device
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US8777004B2 (en) 2010-09-30 2014-07-15 Ethicon Endo-Surgery, Inc. Compressible staple cartridge comprising alignment members
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
AU2011308701B2 (en) 2010-09-30 2013-11-14 Ethicon Endo-Surgery, Inc. Fastener system comprising a retention matrix and an alignment matrix
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US9044228B2 (en) 2010-09-30 2015-06-02 Ethicon Endo-Surgery, Inc. Fastener system comprising a plurality of fastener cartridges
US11925354B2 (en) 2010-09-30 2024-03-12 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9301752B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising a plurality of capsules
US9055941B2 (en) 2011-09-23 2015-06-16 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9301753B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Expandable tissue thickness compensator
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9220500B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising structure to produce a resilient load
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
WO2012049623A1 (en) 2010-10-11 2012-04-19 Ecole Polytechnique Federale De Lausanne (Epfl) Mechanical manipulator for surgical instruments
US9486189B2 (en) 2010-12-02 2016-11-08 Hitachi Aloka Medical, Ltd. Assembly for use with surgery system
US8801710B2 (en) 2010-12-07 2014-08-12 Immersion Corporation Electrosurgical sealing tool having haptic feedback
US8523043B2 (en) 2010-12-07 2013-09-03 Immersion Corporation Surgical stapler having haptic feedback
WO2012088471A1 (en) 2010-12-22 2012-06-28 Veebot, Llc Systems and methods for autonomous intravenous needle insertion
US9119655B2 (en) 2012-08-03 2015-09-01 Stryker Corporation Surgical manipulator capable of controlling a surgical instrument in multiple modes
EP2658480B1 (en) 2010-12-29 2017-11-01 Neochord Inc. Exchangeable system for minimally invasive beating heart repair of heart valve leaflets
US9921712B2 (en) 2010-12-29 2018-03-20 Mako Surgical Corp. System and method for providing substantially stable control of a surgical tool
KR101177777B1 (en) 2011-01-24 2012-08-30 인하대학교 산학협력단 A net-type tactile sensation embodiment apparatus using magneto-rheological fluid and shape memory alloy
KR101228019B1 (en) 2011-01-24 2013-02-01 인하대학교 산학협력단 An array-type tactile sensation embodiment apparatus using magneto-rheological fluid and shape memory alloy
US10092291B2 (en) 2011-01-25 2018-10-09 Ethicon Endo-Surgery, Inc. Surgical instrument with selectively rigidizable features
US9314620B2 (en) 2011-02-28 2016-04-19 Ethicon Endo-Surgery, Inc. Electrical ablation devices and methods
US9254169B2 (en) 2011-02-28 2016-02-09 Ethicon Endo-Surgery, Inc. Electrical ablation devices and methods
US9233241B2 (en) 2011-02-28 2016-01-12 Ethicon Endo-Surgery, Inc. Electrical ablation devices and methods
US8858590B2 (en) 2011-03-14 2014-10-14 Ethicon Endo-Surgery, Inc. Tissue manipulation devices
US9049987B2 (en) 2011-03-17 2015-06-09 Ethicon Endo-Surgery, Inc. Hand held surgical device for manipulating an internal magnet assembly within a patient
US9161749B2 (en) 2011-04-14 2015-10-20 Neotract, Inc. Method and apparatus for treating sexual dysfunction
BR112013027794B1 (en) 2011-04-29 2020-12-15 Ethicon Endo-Surgery, Inc CLAMP CARTRIDGE SET
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
WO2012167120A2 (en) 2011-06-01 2012-12-06 Neochord, Inc. Minimally invasive repair of heart valve leaflets
JP6174017B2 (en) 2011-06-10 2017-08-02 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ In vivo vascular seal end effector and in vivo robotic device
EP2732344B1 (en) 2011-07-11 2019-06-05 Board of Regents of the University of Nebraska Robotic surgical system
US8845667B2 (en) 2011-07-18 2014-09-30 Immersion Corporation Surgical tool having a programmable rotary module for providing haptic feedback
JP5715304B2 (en) 2011-07-27 2015-05-07 エコール ポリテクニーク フェデラル デ ローザンヌ (イーピーエフエル) Mechanical remote control device for remote control
US9138166B2 (en) 2011-07-29 2015-09-22 Hansen Medical, Inc. Apparatus and methods for fiber integration and registration
JP6005950B2 (en) 2011-08-04 2016-10-12 オリンパス株式会社 Surgery support apparatus and control method thereof
JP5931497B2 (en) 2011-08-04 2016-06-08 オリンパス株式会社 Surgery support apparatus and assembly method thereof
JP6021353B2 (en) 2011-08-04 2016-11-09 オリンパス株式会社 Surgery support device
JP6000641B2 (en) 2011-08-04 2016-10-05 オリンパス株式会社 Manipulator system
JP6009840B2 (en) 2011-08-04 2016-10-19 オリンパス株式会社 Medical equipment
JP5936914B2 (en) 2011-08-04 2016-06-22 オリンパス株式会社 Operation input device and manipulator system including the same
JP5953058B2 (en) * 2011-08-04 2016-07-13 オリンパス株式会社 Surgery support device and method for attaching and detaching the same
WO2013018897A1 (en) 2011-08-04 2013-02-07 オリンパス株式会社 Surgical implement and medical treatment manipulator
JP5841451B2 (en) 2011-08-04 2016-01-13 オリンパス株式会社 Surgical instrument and control method thereof
EP2740435B8 (en) 2011-08-04 2018-12-19 Olympus Corporation Surgical support apparatus
JP6021484B2 (en) 2011-08-04 2016-11-09 オリンパス株式会社 Medical manipulator
EP2740434A4 (en) 2011-08-04 2015-03-18 Olympus Corp Medical manipulator and method for controlling same
JP6081061B2 (en) * 2011-08-04 2017-02-15 オリンパス株式会社 Surgery support device
US11561762B2 (en) * 2011-08-21 2023-01-24 Asensus Surgical Europe S.A.R.L. Vocally actuated surgical control system
US10866783B2 (en) * 2011-08-21 2020-12-15 Transenterix Europe S.A.R.L. Vocally activated surgical control system
EP3213697B1 (en) 2011-09-02 2020-03-11 Stryker Corporation Surgical instrument including a housing, a cutting accessory that extends from the housing and actuators that establish the position of the cutting accessory relative to the housing
US9198661B2 (en) 2011-09-06 2015-12-01 Ethicon Endo-Surgery, Inc. Stapling instrument comprising a plurality of staple cartridges stored therein
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US20130303944A1 (en) 2012-05-14 2013-11-14 Intuitive Surgical Operations, Inc. Off-axis electromagnetic sensor
US10238837B2 (en) 2011-10-14 2019-03-26 Intuitive Surgical Operations, Inc. Catheters with control modes for interchangeable probes
US9387048B2 (en) 2011-10-14 2016-07-12 Intuitive Surgical Operations, Inc. Catheter sensor systems
US9452276B2 (en) 2011-10-14 2016-09-27 Intuitive Surgical Operations, Inc. Catheter with removable vision probe
US8968312B2 (en) 2011-11-16 2015-03-03 Covidien Lp Surgical device with powered articulation wrist rotation
US9504604B2 (en) 2011-12-16 2016-11-29 Auris Surgical Robotics, Inc. Lithotripsy eye treatment
KR101901580B1 (en) * 2011-12-23 2018-09-28 삼성전자주식회사 Surgical robot and control method thereof
EP2806941B1 (en) 2012-01-10 2021-10-27 Board of Regents of the University of Nebraska Systems and devices for surgical access and insertion
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
EP3351196A1 (en) 2012-02-29 2018-07-25 Procept Biorobotics Corporation Automated image-guided tissue resection and treatment
RU2014143258A (en) 2012-03-28 2016-05-20 Этикон Эндо-Серджери, Инк. FABRIC THICKNESS COMPENSATOR CONTAINING MANY LAYERS
CN104334098B (en) 2012-03-28 2017-03-22 伊西康内外科公司 Tissue thickness compensator comprising capsules defining a low pressure environment
MX353040B (en) 2012-03-28 2017-12-18 Ethicon Endo Surgery Inc Retainer assembly including a tissue thickness compensator.
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
US10292801B2 (en) 2012-03-29 2019-05-21 Neotract, Inc. System for delivering anchors for treating incontinence
US10383765B2 (en) 2012-04-24 2019-08-20 Auris Health, Inc. Apparatus and method for a global coordinate system for use in robotic surgery
EP2881069B1 (en) * 2012-04-27 2020-03-11 KUKA Deutschland GmbH Surgical robot system and surgical instrument
CA2871149C (en) 2012-05-01 2020-08-25 Board Of Regents Of The University Of Nebraska Single site robotic device and related systems and methods
US9427255B2 (en) 2012-05-14 2016-08-30 Ethicon Endo-Surgery, Inc. Apparatus for introducing a steerable camera assembly into a patient
US20130317519A1 (en) 2012-05-25 2013-11-28 Hansen Medical, Inc. Low friction instrument driver interface for robotic systems
JP2013255966A (en) * 2012-06-13 2013-12-26 Olympus Corp Linear motion mechanism with own weight compensation, operation input device, and surgical operation support system
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
EP3680071B1 (en) 2012-06-22 2021-09-01 Board of Regents of the University of Nebraska Local control robotic surgical devices
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
US8747238B2 (en) 2012-06-28 2014-06-10 Ethicon Endo-Surgery, Inc. Rotary drive shaft assemblies for surgical instruments with articulatable end effectors
US20140005718A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Multi-functional powered surgical device with external dissection features
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US11202631B2 (en) 2012-06-28 2021-12-21 Cilag Gmbh International Stapling assembly comprising a firing lockout
BR112014032776B1 (en) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
JP6290201B2 (en) 2012-06-28 2018-03-07 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Lockout for empty clip cartridge
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US10130353B2 (en) 2012-06-29 2018-11-20 Neotract, Inc. Flexible system for delivering an anchor
US9078662B2 (en) 2012-07-03 2015-07-14 Ethicon Endo-Surgery, Inc. Endoscopic cap electrode and method for using the same
US9545290B2 (en) 2012-07-30 2017-01-17 Ethicon Endo-Surgery, Inc. Needle probe guide
US10314649B2 (en) 2012-08-02 2019-06-11 Ethicon Endo-Surgery, Inc. Flexible expandable electrode and method of intraluminal delivery of pulsed power
US9572623B2 (en) 2012-08-02 2017-02-21 Ethicon Endo-Surgery, Inc. Reusable electrode and disposable sheath
US9820818B2 (en) 2012-08-03 2017-11-21 Stryker Corporation System and method for controlling a surgical manipulator based on implant parameters
US9226796B2 (en) 2012-08-03 2016-01-05 Stryker Corporation Method for detecting a disturbance as an energy applicator of a surgical instrument traverses a cutting path
CN112932672A (en) 2012-08-03 2021-06-11 史赛克公司 Systems and methods for robotic surgery
US9770305B2 (en) 2012-08-08 2017-09-26 Board Of Regents Of The University Of Nebraska Robotic surgical devices, systems, and related methods
EP2882331A4 (en) 2012-08-08 2016-03-23 Univ Nebraska Robotic surgical devices, systems, and related methods
US9277957B2 (en) 2012-08-15 2016-03-08 Ethicon Endo-Surgery, Inc. Electrosurgical devices and methods
US9700310B2 (en) 2013-08-23 2017-07-11 Ethicon Llc Firing member retraction devices for powered surgical instruments
EP2925249A4 (en) 2012-11-29 2016-12-07 Olympus Corp Instrument, manipulator system, and control method of instrument
US9993159B2 (en) 2012-12-31 2018-06-12 Omni Medsci, Inc. Near-infrared super-continuum lasers for early detection of breast and other cancers
WO2014105521A1 (en) 2012-12-31 2014-07-03 Omni Medsci, Inc. Short-wave infrared super-continuum lasers for early detection of dental caries
US9164032B2 (en) 2012-12-31 2015-10-20 Omni Medsci, Inc. Short-wave infrared super-continuum lasers for detecting counterfeit or illicit drugs and pharmaceutical process control
EP2938259A4 (en) 2012-12-31 2016-08-17 Omni Medsci Inc Near-infrared lasers for non-invasive monitoring of glucose, ketones, hba1c, and other blood constituents
WO2014143276A2 (en) 2012-12-31 2014-09-18 Omni Medsci, Inc. Short-wave infrared super-continuum lasers for natural gas leak detection, exploration, and other active remote sensing applications
US10660526B2 (en) 2012-12-31 2020-05-26 Omni Medsci, Inc. Near-infrared time-of-flight imaging using laser diodes with Bragg reflectors
US10231867B2 (en) 2013-01-18 2019-03-19 Auris Health, Inc. Method, apparatus and system for a water jet
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US10507066B2 (en) 2013-02-15 2019-12-17 Intuitive Surgical Operations, Inc. Providing information of tools by filtering image areas adjacent to or on displayed images of the tools
US10098527B2 (en) 2013-02-27 2018-10-16 Ethidcon Endo-Surgery, Inc. System for performing a minimally invasive surgical procedure
US10092292B2 (en) 2013-02-28 2018-10-09 Ethicon Llc Staple forming features for surgical stapling instrument
US9326767B2 (en) 2013-03-01 2016-05-03 Ethicon Endo-Surgery, Llc Joystick switch assemblies for surgical instruments
JP6345707B2 (en) 2013-03-01 2018-06-20 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Surgical instrument with soft stop
JP6382235B2 (en) 2013-03-01 2018-08-29 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Articulatable surgical instrument with a conductive path for signal communication
US9668814B2 (en) 2013-03-07 2017-06-06 Hansen Medical, Inc. Infinitely rotatable tool with finite rotating drive shafts
US10149720B2 (en) 2013-03-08 2018-12-11 Auris Health, Inc. Method, apparatus, and a system for facilitating bending of an instrument in a surgical or medical robotic environment
US10080576B2 (en) 2013-03-08 2018-09-25 Auris Health, Inc. Method, apparatus, and a system for facilitating bending of an instrument in a surgical or medical robotic environment
US9867635B2 (en) 2013-03-08 2018-01-16 Auris Surgical Robotics, Inc. Method, apparatus and system for a water jet
EP2996611B1 (en) 2013-03-13 2019-06-26 Stryker Corporation Systems and software for establishing virtual constraint boundaries
US9345481B2 (en) 2013-03-13 2016-05-24 Ethicon Endo-Surgery, Llc Staple cartridge tissue thickness sensor system
KR102274277B1 (en) 2013-03-13 2021-07-08 스트리커 코포레이션 System for arranging objects in an operating room in preparation for surgical procedures
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9173713B2 (en) * 2013-03-14 2015-11-03 Hansen Medical, Inc. Torque-based catheter articulation
US9687230B2 (en) 2013-03-14 2017-06-27 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US9545288B2 (en) 2013-03-14 2017-01-17 Think Surgical, Inc. Systems and devices for a counter balanced surgical robot
US9326822B2 (en) 2013-03-14 2016-05-03 Hansen Medical, Inc. Active drives for robotic catheter manipulators
US11213363B2 (en) 2013-03-14 2022-01-04 Auris Health, Inc. Catheter tension sensing
US9888966B2 (en) 2013-03-14 2018-02-13 Board Of Regents Of The University Of Nebraska Methods, systems, and devices relating to force control surgical systems
US9743987B2 (en) 2013-03-14 2017-08-29 Board Of Regents Of The University Of Nebraska Methods, systems, and devices relating to robotic surgical devices, end effectors, and controllers
US9498601B2 (en) * 2013-03-14 2016-11-22 Hansen Medical, Inc. Catheter tension sensing
US20140277334A1 (en) 2013-03-14 2014-09-18 Hansen Medical, Inc. Active drives for robotic catheter manipulators
US10376672B2 (en) 2013-03-15 2019-08-13 Auris Health, Inc. Catheter insertion system and method of fabrication
US20140276647A1 (en) 2013-03-15 2014-09-18 Hansen Medical, Inc. Vascular remote catheter manipulator
US9408669B2 (en) 2013-03-15 2016-08-09 Hansen Medical, Inc. Active drive mechanism with finite range of motion
KR102505589B1 (en) 2013-03-15 2023-03-03 스트리커 코포레이션 End effector of a surgical robotic manipulator
US9452018B2 (en) 2013-03-15 2016-09-27 Hansen Medical, Inc. Rotational support for an elongate member
US20140276936A1 (en) 2013-03-15 2014-09-18 Hansen Medical, Inc. Active drive mechanism for simultaneous rotation and translation
EP3970604A1 (en) 2013-03-15 2022-03-23 Board of Regents of the University of Nebraska Robotic surgical devices and systems
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US9700318B2 (en) 2013-04-09 2017-07-11 Covidien Lp Apparatus for endoscopic procedures
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
BR112015026109B1 (en) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc surgical instrument
JP6296236B2 (en) * 2013-05-27 2018-03-20 パナソニックIpマネジメント株式会社 Master device for master-slave device, control method therefor, and master-slave device
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
WO2014201165A1 (en) 2013-06-11 2014-12-18 Auris Surgical Robotics, Inc. System for robotic assisted cataract surgery
US20140367445A1 (en) 2013-06-18 2014-12-18 Covidien Lp Emergency retraction for electro-mechanical surgical devices and systems
US10117654B2 (en) 2013-06-18 2018-11-06 Covidien Lp Method of emergency retraction for electro-mechanical surgical devices and systems
CA2918531A1 (en) 2013-07-17 2015-01-22 Board Of Regents Of The University Of Nebraska Robotic surgical devices, systems and related methods
CA2918879A1 (en) 2013-07-24 2015-01-29 Centre For Surgical Invention & Innovation Multi-function mounting interface for an image-guided robotic system and quick release interventional toolset
US10426661B2 (en) 2013-08-13 2019-10-01 Auris Health, Inc. Method and apparatus for laser assisted cataract surgery
US9636112B2 (en) * 2013-08-16 2017-05-02 Covidien Lp Chip assembly for reusable surgical instruments
MX369362B (en) 2013-08-23 2019-11-06 Ethicon Endo Surgery Llc Firing member retraction devices for powered surgical instruments.
US20140171986A1 (en) 2013-09-13 2014-06-19 Ethicon Endo-Surgery, Inc. Surgical Clip Having Comliant Portion
US9980785B2 (en) 2013-10-24 2018-05-29 Auris Health, Inc. Instrument device manipulator with surgical tool de-articulation
EP3060157B1 (en) * 2013-10-24 2019-12-11 Auris Health, Inc. System for robotic-assisted endolumenal surgery
JP6358463B2 (en) * 2013-11-13 2018-07-18 パナソニックIpマネジメント株式会社 Master device for master-slave device, control method therefor, and master-slave device
US20150173756A1 (en) 2013-12-23 2015-06-25 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling methods
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US9968354B2 (en) 2013-12-23 2018-05-15 Ethicon Llc Surgical staples and methods for making the same
FR3016512B1 (en) * 2014-01-23 2018-03-02 Universite De Strasbourg MASTER INTERFACE DEVICE FOR MOTORIZED ENDOSCOPIC SYSTEM AND INSTALLATION COMPRISING SUCH A DEVICE
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US20140166725A1 (en) 2014-02-24 2014-06-19 Ethicon Endo-Surgery, Inc. Staple cartridge including a barbed staple.
JP6462004B2 (en) 2014-02-24 2019-01-30 エシコン エルエルシー Fastening system with launcher lockout
AU2015222873B2 (en) 2014-02-27 2018-09-13 University Surgical Associates, Inc. Interactive display for surgery
US20150272571A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Surgical instrument utilizing sensor adaptation
BR112016021943B1 (en) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US20150272557A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Modular surgical instrument system
BR112016021832B1 (en) * 2014-03-26 2022-10-11 Ethicon Endo-Surgery, Llc SURGICAL INSTRUMENT CONTROL CIRCUIT
JP6636452B2 (en) 2014-04-16 2020-01-29 エシコン エルエルシーEthicon LLC Fastener cartridge including extension having different configurations
CN106456158B (en) 2014-04-16 2019-02-05 伊西康内外科有限责任公司 Fastener cartridge including non-uniform fastener
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
US10327764B2 (en) 2014-09-26 2019-06-25 Ethicon Llc Method for creating a flexible staple line
BR112016023807B1 (en) 2014-04-16 2022-07-12 Ethicon Endo-Surgery, Llc CARTRIDGE SET OF FASTENERS FOR USE WITH A SURGICAL INSTRUMENT
US10299792B2 (en) 2014-04-16 2019-05-28 Ethicon Llc Fastener cartridge comprising non-uniform fasteners
US10046140B2 (en) 2014-04-21 2018-08-14 Hansen Medical, Inc. Devices, systems, and methods for controlling active drive systems
US10569052B2 (en) 2014-05-15 2020-02-25 Auris Health, Inc. Anti-buckling mechanisms for catheters
AU2015201323B2 (en) 2014-05-16 2019-12-19 Covidien Lp Apparatus for endoscopic procedures
CN104000637B (en) * 2014-05-29 2016-06-15 清华大学 A kind of in-vivo tissue is directly repaired and the medical system shaped
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
US9788910B2 (en) 2014-07-01 2017-10-17 Auris Surgical Robotics, Inc. Instrument-mounted tension sensing mechanism for robotically-driven medical instruments
US10792464B2 (en) 2014-07-01 2020-10-06 Auris Health, Inc. Tool and method for using surgical endoscope with spiral lumens
US9744335B2 (en) 2014-07-01 2017-08-29 Auris Surgical Robotics, Inc. Apparatuses and methods for monitoring tendons of steerable catheters
US9561083B2 (en) 2014-07-01 2017-02-07 Auris Surgical Robotics, Inc. Articulating flexible endoscopic tool with roll capabilities
WO2016030767A1 (en) * 2014-08-27 2016-03-03 Distalmotion Sa Surgical system for microsurgical techniques
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
BR112017004361B1 (en) 2014-09-05 2023-04-11 Ethicon Llc ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT
US10111679B2 (en) 2014-09-05 2018-10-30 Ethicon Llc Circuitry and sensors for powered medical device
EP3868322A1 (en) 2014-09-12 2021-08-25 Board of Regents of the University of Nebraska Quick-release effectors and related systems
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
MX2017003960A (en) 2014-09-26 2017-12-04 Ethicon Llc Surgical stapling buttresses and adjunct materials.
EP3202362A4 (en) * 2014-09-30 2018-06-27 Riverfield Inc. Adapter component
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
CN104287798B (en) * 2014-10-22 2017-07-14 广州新诚生物科技有限公司 Adjustable endoscope-assistant surgery needle holder
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
GB201419645D0 (en) * 2014-11-04 2014-12-17 Cambridge Medical Robotics Ltd Characterising motion constraints
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
JP6608928B2 (en) 2014-11-11 2019-11-20 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ Robotic device with miniature joint design and related systems and methods
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US10117649B2 (en) 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
BR112017012996B1 (en) 2014-12-18 2022-11-08 Ethicon Llc SURGICAL INSTRUMENT WITH AN ANvil WHICH IS SELECTIVELY MOVABLE ABOUT AN IMMOVABLE GEOMETRIC AXIS DIFFERENT FROM A STAPLE CARTRIDGE
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US11039820B2 (en) 2014-12-19 2021-06-22 Distalmotion Sa Sterile interface for articulated surgical instruments
GB2534558B (en) * 2015-01-21 2020-12-30 Cmr Surgical Ltd Robot tool retraction
KR102602379B1 (en) 2015-02-20 2023-11-16 스트리커 코포레이션 Sterile barrier assembly, mounting system, and method for coupling surgical components
US20160249910A1 (en) 2015-02-27 2016-09-01 Ethicon Endo-Surgery, Llc Surgical charging system that charges and/or conditions one or more batteries
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US10226250B2 (en) 2015-02-27 2019-03-12 Ethicon Llc Modular stapling assembly
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
JP2020121162A (en) 2015-03-06 2020-08-13 エシコン エルエルシーEthicon LLC Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
CA2977413A1 (en) 2015-03-10 2016-09-15 Covidien Lp Measuring health of a connector member of a robotic surgical system
WO2016160272A1 (en) 2015-03-27 2016-10-06 Sonitrack Systems, Inc. Rapidly repositionable powered support arm
US11819636B2 (en) 2015-03-30 2023-11-21 Auris Health, Inc. Endoscope pull wire electrical circuit
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
WO2016196238A1 (en) 2015-06-03 2016-12-08 Covidien Lp Offset instrument drive unit
US10335149B2 (en) 2015-06-18 2019-07-02 Ethicon Llc Articulatable surgical instruments with composite firing beam structures with center firing support member for articulation support
EP3313317A4 (en) * 2015-06-23 2019-02-20 Covidien LP Robotic surgical assemblies
WO2017015167A1 (en) * 2015-07-17 2017-01-26 Deka Products Limited Partnership Robotic surgery system, mithod, and appratus
EP3326565A4 (en) * 2015-07-23 2019-03-27 Olympus Corporation Input mechanism and medical system
JP6177488B2 (en) 2015-07-23 2017-08-09 オリンパス株式会社 Manipulator and medical system
CA2994823A1 (en) 2015-08-03 2017-02-09 Board Of Regents Of The University Of Nebraska Robotic surgical devices, systems and related methods
US10835249B2 (en) 2015-08-17 2020-11-17 Ethicon Llc Implantable layers for a surgical instrument
CN108348233B (en) 2015-08-26 2021-05-07 伊西康有限责任公司 Surgical staple strip for allowing changing staple characteristics and achieving easy cartridge loading
US10213203B2 (en) 2015-08-26 2019-02-26 Ethicon Llc Staple cartridge assembly without a bottom cover
WO2017037532A1 (en) 2015-08-28 2017-03-09 Distalmotion Sa Surgical instrument with increased actuation force
US10238390B2 (en) 2015-09-02 2019-03-26 Ethicon Llc Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns
MX2022006191A (en) 2015-09-02 2022-06-16 Ethicon Llc Surgical staple configurations with camming surfaces located between portions supporting surgical staples.
CN108348133B (en) 2015-09-09 2020-11-13 奥瑞斯健康公司 Instrument device manipulator for surgical robotic system
WO2017043583A1 (en) * 2015-09-11 2017-03-16 ライフロボティクス株式会社 Robot apparatus
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US10478188B2 (en) 2015-09-30 2019-11-19 Ethicon Llc Implantable layer comprising a constricted configuration
US10736633B2 (en) 2015-09-30 2020-08-11 Ethicon Llc Compressible adjunct with looping members
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
WO2017059406A1 (en) 2015-10-01 2017-04-06 Neochord, Inc. Ringless web for repair of heart valves
US10058393B2 (en) 2015-10-21 2018-08-28 P Tech, Llc Systems and methods for navigation and visualization
US9955986B2 (en) 2015-10-30 2018-05-01 Auris Surgical Robotics, Inc. Basket apparatus
US10639108B2 (en) 2015-10-30 2020-05-05 Auris Health, Inc. Process for percutaneous operations
US9949749B2 (en) 2015-10-30 2018-04-24 Auris Surgical Robotics, Inc. Object capture with a basket
JP6673684B2 (en) 2015-12-11 2020-03-25 株式会社メディカロイド Remote control device and remote operation system
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
JP6944939B2 (en) 2015-12-31 2021-10-06 ストライカー・コーポレイション Systems and methods for performing surgery on a patient's target site as defined by a virtual object
JP6911054B2 (en) 2016-02-09 2021-07-28 エシコン エルエルシーEthicon LLC Surgical instruments with asymmetric joint composition
US10588625B2 (en) 2016-02-09 2020-03-17 Ethicon Llc Articulatable surgical instruments with off-axis firing beam arrangements
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10350016B2 (en) * 2016-03-17 2019-07-16 Intuitive Surgical Operations, Inc. Stapler with cable-driven advanceable clamping element and dual distal pulleys
US11045191B2 (en) 2016-04-01 2021-06-29 Cilag Gmbh International Method for operating a surgical stapling system
US11064997B2 (en) 2016-04-01 2021-07-20 Cilag Gmbh International Surgical stapling instrument
US11284890B2 (en) 2016-04-01 2022-03-29 Cilag Gmbh International Circular stapling system comprising an incisable tissue support
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10531874B2 (en) 2016-04-01 2020-01-14 Ethicon Llc Surgical cutting and stapling end effector with anvil concentric drive member
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
JP6831642B2 (en) * 2016-04-15 2021-02-17 川崎重工業株式会社 Surgical system
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US10433840B2 (en) 2016-04-18 2019-10-08 Ethicon Llc Surgical instrument comprising a replaceable cartridge jaw
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US10454347B2 (en) 2016-04-29 2019-10-22 Auris Health, Inc. Compact height torque sensing articulation axis assembly
CA3024623A1 (en) 2016-05-18 2017-11-23 Virtual Incision Corporation Robotic surgical devices, systems and related methods
WO2017208395A1 (en) * 2016-06-01 2017-12-07 オリンパス株式会社 Manipulator system
USD850617S1 (en) 2016-06-24 2019-06-04 Ethicon Llc Surgical fastener cartridge
US10675024B2 (en) 2016-06-24 2020-06-09 Ethicon Llc Staple cartridge comprising overdriven staples
JP6957532B2 (en) 2016-06-24 2021-11-02 エシコン エルエルシーEthicon LLC Staple cartridges including wire staples and punched staples
USD826405S1 (en) 2016-06-24 2018-08-21 Ethicon Llc Surgical fastener
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
CN109475267B (en) * 2016-07-19 2021-07-20 奥林巴斯株式会社 Medical instrument holding device
JP6474366B2 (en) * 2016-08-05 2019-02-27 株式会社メディカロイド Manipulator arm, patient side system, and surgical system
US11173617B2 (en) 2016-08-25 2021-11-16 Board Of Regents Of The University Of Nebraska Quick-release end effector tool interface
US10463439B2 (en) 2016-08-26 2019-11-05 Auris Health, Inc. Steerable catheter with shaft load distributions
US11241559B2 (en) 2016-08-29 2022-02-08 Auris Health, Inc. Active drive for guidewire manipulation
US10702347B2 (en) 2016-08-30 2020-07-07 The Regents Of The University Of California Robotic device with compact joint design and an additional degree of freedom and related systems and methods
KR102555546B1 (en) 2016-08-31 2023-07-19 아우리스 헬스, 인코포레이티드 length-preserving surgical instruments
US20200008890A1 (en) * 2016-10-04 2020-01-09 Imperial Innovations Limited Coupling for a robotic surgical instrument
US11642126B2 (en) * 2016-11-04 2023-05-09 Covidien Lp Surgical stapling apparatus with tissue pockets
WO2018098319A1 (en) 2016-11-22 2018-05-31 Board Of Regents Of The University Of Nebraska Improved gross positioning device and related systems and methods
JP7099728B2 (en) 2016-11-29 2022-07-12 バーチャル インシジョン コーポレイション User controller with user presence detection, related systems and methods
WO2018112199A1 (en) 2016-12-14 2018-06-21 Virtual Incision Corporation Releasable attachment device for coupling to medical devices and related systems and methods
US11202682B2 (en) 2016-12-16 2021-12-21 Mako Surgical Corp. Techniques for modifying tool operation in a surgical robotic system based on comparing actual and commanded states of the tool relative to a surgical site
US10028794B2 (en) * 2016-12-19 2018-07-24 Ethicon Llc Surgical system with voice control
US10888322B2 (en) 2016-12-21 2021-01-12 Ethicon Llc Surgical instrument comprising a cutting member
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US10687810B2 (en) 2016-12-21 2020-06-23 Ethicon Llc Stepped staple cartridge with tissue retention and gap setting features
US20180168598A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Staple forming pocket arrangements comprising zoned forming surface grooves
US11684367B2 (en) 2016-12-21 2023-06-27 Cilag Gmbh International Stepped assembly having and end-of-life indicator
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US10675025B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Shaft assembly comprising separately actuatable and retractable systems
US10980536B2 (en) 2016-12-21 2021-04-20 Ethicon Llc No-cartridge and spent cartridge lockout arrangements for surgical staplers
US20180168625A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments with smart staple cartridges
US20180168647A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments having end effectors with positive opening features
US10588631B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical instruments with positive jaw opening features
JP6983893B2 (en) 2016-12-21 2021-12-17 エシコン エルエルシーEthicon LLC Lockout configuration for surgical end effectors and replaceable tool assemblies
US10835246B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Staple cartridges and arrangements of staples and staple cavities therein
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10524789B2 (en) 2016-12-21 2020-01-07 Ethicon Llc Laterally actuatable articulation lock arrangements for locking an end effector of a surgical instrument in an articulated configuration
US10993715B2 (en) 2016-12-21 2021-05-04 Ethicon Llc Staple cartridge comprising staples with different clamping breadths
JP7010956B2 (en) 2016-12-21 2022-01-26 エシコン エルエルシー How to staple tissue
US10945727B2 (en) 2016-12-21 2021-03-16 Ethicon Llc Staple cartridge with deformable driver retention features
JP2020501779A (en) 2016-12-21 2020-01-23 エシコン エルエルシーEthicon LLC Surgical stapling system
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US10675026B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Methods of stapling tissue
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US20180168608A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical instrument system comprising an end effector lockout and a firing assembly lockout
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US10543048B2 (en) 2016-12-28 2020-01-28 Auris Health, Inc. Flexible instrument insertion using an adaptive insertion force threshold
US10244926B2 (en) 2016-12-28 2019-04-02 Auris Health, Inc. Detecting endolumenal buckling of flexible instruments
CA3028792A1 (en) * 2017-02-15 2017-04-14 Synaptive Medical (Barbados) Inc. Sensored surgical tool and surgical intraoperative tracking and imaging system incorporating same
EP3363401A1 (en) * 2017-02-16 2018-08-22 Microsure B.V. Robotic manipulator interface for hinged surgical tools
US10213306B2 (en) 2017-03-31 2019-02-26 Neochord, Inc. Minimally invasive heart valve repair in a beating heart
US11058503B2 (en) 2017-05-11 2021-07-13 Distalmotion Sa Translational instrument interface for surgical robot and surgical robot systems comprising the same
US11311295B2 (en) 2017-05-15 2022-04-26 Covidien Lp Adaptive powered stapling algorithm with calibration factor
CN110769736B (en) 2017-05-17 2023-01-13 奥瑞斯健康公司 Replaceable working channel
WO2018225818A1 (en) * 2017-06-08 2018-12-13 株式会社メディカロイド Remote operation device, display device, remote operation system, surgery assistance system, and method for exchanging display device of remote operation device
JP6792074B2 (en) * 2017-06-08 2020-11-25 株式会社メディカロイド Remote control device and remote control system
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11141154B2 (en) 2017-06-27 2021-10-12 Cilag Gmbh International Surgical end effectors and anvils
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US20190000461A1 (en) 2017-06-28 2019-01-03 Ethicon Llc Surgical cutting and fastening devices with pivotable anvil with a tissue locating arrangement in close proximity to an anvil pivot axis
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US11026758B2 (en) 2017-06-28 2021-06-08 Auris Health, Inc. Medical robotics systems implementing axis constraints during actuation of one or more motorized joints
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
US11058424B2 (en) 2017-06-28 2021-07-13 Cilag Gmbh International Surgical instrument comprising an offset articulation joint
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
EP4070740A1 (en) 2017-06-28 2022-10-12 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
CN111163723A (en) 2017-08-16 2020-05-15 柯惠Lp公司 Preventative maintenance of robotic surgical systems
JP7405432B2 (en) 2017-09-27 2023-12-26 バーチャル インシジョン コーポレイション Robotic surgical device with tracking camera technology and related systems and methods
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US11096754B2 (en) 2017-10-04 2021-08-24 Mako Surgical Corp. Sterile drape assembly for surgical robot
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11207066B2 (en) 2017-10-30 2021-12-28 Covidien Lp Apparatus for endoscopic procedures
US10987104B2 (en) 2017-10-30 2021-04-27 Covidien Lp Apparatus for endoscopic procedures
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
JP2021503998A (en) 2017-11-29 2021-02-15 コヴィディエン リミテッド パートナーシップ Robotic surgery system, instrument drive assembly, and drive assembly
US10987175B2 (en) 2017-12-06 2021-04-27 Medtech S.A. Robotic shoulder repair and reconstruction
WO2019118368A1 (en) 2017-12-11 2019-06-20 Auris Health, Inc. Systems and methods for instrument based insertion architectures
KR20200100613A (en) 2017-12-14 2020-08-26 아우리스 헬스, 인코포레이티드 System and method for estimating instrument position
JP6654180B2 (en) * 2017-12-14 2020-02-26 株式会社メディカロイド Remote control device and remote operation system
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US10682134B2 (en) 2017-12-21 2020-06-16 Ethicon Llc Continuous use self-propelled stapling instrument
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
WO2019126718A1 (en) 2017-12-23 2019-06-27 Neotract, Inc. Expandable tissue engagement apparatus and method
EP3735341A4 (en) 2018-01-05 2021-10-06 Board of Regents of the University of Nebraska Single-arm robotic device with compact joint design and related systems and methods
WO2019143458A1 (en) 2018-01-17 2019-07-25 Auris Health, Inc. Surgical robotics systems with improved robotic arms
EP3743003A1 (en) * 2018-01-26 2020-12-02 Mako Surgical Corp. End effectors and methods for driving tools guided by surgical robotic systems
AU2019218707A1 (en) 2018-02-07 2020-08-13 Distalmotion Sa Surgical robot systems comprising robotic telemanipulators and integrated laparoscopy
US10772704B2 (en) 2018-03-12 2020-09-15 Zimmer Biomet CMF and Thoracic, LLC End effector coupler for surgical arm
US10687792B2 (en) 2018-03-12 2020-06-23 Zimmer Biomet CMF and Thoracic, LLC End effector coupler for surgical arm
US10835345B2 (en) 2018-03-12 2020-11-17 Zimmer Biomet CMF and Thoracic, LLC End effector coupler for surgical arm
USD878585S1 (en) 2018-03-12 2020-03-17 Zimmer Biomet CMF and Thoracic, LLC End effector coupler stem
CN110269692B (en) * 2018-03-14 2021-01-05 深圳市精锋医疗科技有限公司 Connecting assembly, operating arm, slave operating equipment and surgical robot
EP3768176B1 (en) 2018-03-23 2024-03-20 NeoChord, Inc. Device for suture attachment for minimally invasive heart valve repair
EP3773135B1 (en) 2018-03-28 2024-02-14 Auris Health, Inc. Medical instruments with variable bending stiffness profiles
US11253360B2 (en) 2018-05-09 2022-02-22 Neochord, Inc. Low profile tissue anchor for minimally invasive heart valve repair
US11173030B2 (en) 2018-05-09 2021-11-16 Neochord, Inc. Suture length adjustment for minimally invasive heart valve repair
EP3793780A4 (en) * 2018-05-18 2022-10-05 Corindus, Inc. Remote communications and control system for robotic interventional procedures
KR20210024472A (en) 2018-06-27 2021-03-05 아우리스 헬스, 인코포레이티드 Alignment and attachment system for medical devices
RU185415U1 (en) * 2018-07-05 2018-12-04 Федеральное государственное бюджетное образовательное учреждение высшего образования "Поволжский государственный технологический университет" DEVICE FOR LAPAROSCOPIC OPERATIONS
US11497490B2 (en) 2018-07-09 2022-11-15 Covidien Lp Powered surgical devices including predictive motor control
US10898276B2 (en) 2018-08-07 2021-01-26 Auris Health, Inc. Combining strain-based shape sensing with catheter control
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
JP6777694B2 (en) * 2018-08-28 2020-10-28 株式会社メディカロイド Endoscope adapter
US10966709B2 (en) 2018-09-07 2021-04-06 Neochord, Inc. Device for suture attachment for minimally invasive heart valve repair
US11179212B2 (en) 2018-09-26 2021-11-23 Auris Health, Inc. Articulating medical instruments
CN112752534A (en) 2018-09-28 2021-05-04 奥瑞斯健康公司 Apparatus, system and method for manual and robotic driving of medical instruments
AU2019232836A1 (en) 2018-10-12 2020-04-30 Covidien Lp Apparatus for endoscopic procedures
US11197734B2 (en) 2018-10-30 2021-12-14 Covidien Lp Load sensing devices for use in surgical instruments
US11369372B2 (en) 2018-11-28 2022-06-28 Covidien Lp Surgical stapler adapter with flexible cable assembly, flexible fingers, and contact clips
EP3890643A2 (en) 2018-12-04 2021-10-13 Mako Surgical Corporation Mounting system with sterile barrier assembly for use in coupling surgical components
US11730556B2 (en) * 2018-12-31 2023-08-22 Asensus Surgical Us, Inc. Compact actuation configuration and expandable instrument receiver for robotically controlled surgical instruments
US11690688B2 (en) * 2018-12-31 2023-07-04 Asensus Surgical Us, Inc. Compact actuation configuration and expandable instrument receiver for robotically controlled surgical instruments
US11628028B2 (en) 2018-12-31 2023-04-18 Asensus Surgical Us, Inc. Articulating surgical instrument
JP2022516937A (en) 2019-01-07 2022-03-03 バーチャル インシジョン コーポレイション Equipment and methods related to robot-assisted surgery systems
US11202635B2 (en) 2019-02-04 2021-12-21 Covidien Lp Programmable distal tilt position of end effector for powered surgical devices
US11376006B2 (en) 2019-02-06 2022-07-05 Covidien Lp End effector force measurement with digital drive circuit
US11219461B2 (en) 2019-03-08 2022-01-11 Covidien Lp Strain gauge stabilization in a surgical device
EP3908224A4 (en) 2019-03-22 2022-10-19 Auris Health, Inc. Systems and methods for aligning inputs on medical instruments
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11617627B2 (en) 2019-03-29 2023-04-04 Auris Health, Inc. Systems and methods for optical strain sensing in medical instruments
WO2020214818A1 (en) 2019-04-16 2020-10-22 Neochord, Inc. Transverse helical cardiac anchor for minimally invasive heart valve repair
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
CN114554930A (en) 2019-08-15 2022-05-27 奥瑞斯健康公司 Medical device with multiple curved segments
US11896330B2 (en) 2019-08-15 2024-02-13 Auris Health, Inc. Robotic medical system having multiple medical instruments
WO2021064536A1 (en) 2019-09-30 2021-04-08 Auris Health, Inc. Medical instrument with capstan
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
JP2020049300A (en) * 2019-12-25 2020-04-02 株式会社メディカロイド Remote handling equipment and remote surgery system
CN114901200A (en) 2019-12-31 2022-08-12 奥瑞斯健康公司 Advanced basket drive mode
CN111134847B (en) * 2020-01-23 2021-10-22 诺创智能医疗科技(杭州)有限公司 Operation assembly and surgical robot
CN111329581B (en) * 2020-01-23 2022-03-15 诺创智能医疗科技(杭州)有限公司 Force feedback measuring method of surgical mechanical arm and surgical mechanical arm
US11596467B2 (en) * 2020-02-04 2023-03-07 Covidien Lp Articulating tip for bipolar pencil
US11458244B2 (en) 2020-02-07 2022-10-04 Covidien Lp Irrigating surgical apparatus with positive pressure fluid
US11553913B2 (en) 2020-02-11 2023-01-17 Covidien Lp Electrically-determining tissue cut with surgical stapling apparatus
JP7171647B2 (en) * 2020-04-28 2022-11-15 川崎重工業株式会社 Surgery support robot, pivot positioning method and surgical operation system
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
US11622768B2 (en) 2020-07-13 2023-04-11 Covidien Lp Methods and structure for confirming proper assembly of powered surgical stapling systems
US20220031351A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with differential articulation joint arrangements for accommodating flexible actuators
CN114286646B (en) 2020-08-03 2024-03-08 泰利福生命科学有限公司 Handle and cassette system for medical intervention
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11653919B2 (en) 2020-11-24 2023-05-23 Covidien Lp Stapler line reinforcement continuity
US11744580B2 (en) 2020-11-24 2023-09-05 Covidien Lp Long stapler reloads with continuous cartridge
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US20220378424A1 (en) 2021-05-28 2022-12-01 Cilag Gmbh International Stapling instrument comprising a firing lockout
US11684362B2 (en) 2021-06-07 2023-06-27 Covidien Lp Handheld electromechanical surgical system
US11771432B2 (en) 2021-06-29 2023-10-03 Covidien Lp Stapling and cutting to default values in the event of strain gauge data integrity loss
US11627243B2 (en) * 2021-07-23 2023-04-11 Phaox LLC Handheld wireless endoscope image streaming apparatus
US11903669B2 (en) 2021-07-30 2024-02-20 Corindus, Inc Sterile drape for robotic drive
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11832823B2 (en) 2022-02-08 2023-12-05 Covidien Lp Determination of anvil release during anastomosis
US11844585B1 (en) * 2023-02-10 2023-12-19 Distalmotion Sa Surgical robotics systems and devices having a sterile restart, and methods thereof

Family Cites Families (204)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US776738A (en) * 1904-04-27 1904-12-06 Regis Guenette Convertible trunk.
US977825A (en) 1910-01-08 1910-12-06 George N Murphy Surgical instrument.
US1327577A (en) * 1919-03-11 1920-01-06 Joseph S Turner Surgical-needle holder
GB955005A (en) 1961-07-21 1964-04-08 Molins Machine Co Ltd Apparatus for gripping and lifting articles
US3280991A (en) 1964-04-28 1966-10-25 Programmed & Remote Syst Corp Position control manipulator
US3628535A (en) * 1969-11-12 1971-12-21 Nibot Corp Surgical instrument for implanting a prosthetic heart valve or the like
US5196688A (en) 1975-02-04 1993-03-23 Telefunken Systemtechnik Gmbh Apparatus for recognizing and following a target
US4128880A (en) 1976-06-30 1978-12-05 Cray Research, Inc. Computer vector register processing
US4058001A (en) 1976-08-02 1977-11-15 G. D. Searle & Co. Ultrasound imaging system with improved scan conversion
US4221997A (en) 1978-12-18 1980-09-09 Western Electric Company, Incorporated Articulated robot arm and method of moving same
DE3045295A1 (en) 1979-05-21 1982-02-18 American Cystoscope Makers Inc Surgical instrument for an endoscope
US4367998A (en) 1979-09-13 1983-01-11 United Kingdom Atomic Energy Authority Manipulators
FR2482508A1 (en) 1980-05-14 1981-11-20 Commissariat Energie Atomique MANIPULATOR AND MOTORIZED ORIENTATION BRACKET FOR SUCH A MANIPULATOR
FR2492304A1 (en) 1980-10-17 1982-04-23 Commissariat Energie Atomique TELEMANIPULATION ASSEMBLY MOUNTED ON A MOBILE PLATFORM AND COMPRISING A RETRACTABLE TELESCOPIC CARRIER ASSEMBLY WITHIN A SEALED HOOD, AND METHOD FOR SETTING UP ON AN ENCLOSURE
JPS57118299A (en) 1981-01-14 1982-07-23 Nissan Motor Voice load driver
JPS58130393A (en) 1982-01-29 1983-08-03 株式会社東芝 Voice recognition equipment
JPS58134357A (en) 1982-02-03 1983-08-10 Hitachi Ltd Array processor
US4456961A (en) 1982-03-05 1984-06-26 Texas Instruments Incorporated Apparatus for teaching and transforming noncoincident coordinate systems
US4491135A (en) 1982-11-03 1985-01-01 Klein Harvey A Surgical needle holder
US4517963A (en) 1983-01-04 1985-05-21 Harold Unger Image-erecting barrel rotator for articulated optical arm
US4503854A (en) 1983-06-16 1985-03-12 Jako Geza J Laser surgery
US4641292A (en) 1983-06-20 1987-02-03 George Tunnell Voice controlled welding system
US4604016A (en) 1983-08-03 1986-08-05 Joyce Stephen A Multi-dimensional force-torque hand controller having force feedback
US4586398A (en) 1983-09-29 1986-05-06 Hamilton Industries Foot control assembly for power-operated tables and the like
US4635292A (en) 1983-12-19 1987-01-06 Matsushita Electric Industrial Co., Ltd. Image processor
US4616637A (en) 1984-09-14 1986-10-14 Precision Surgical Instruments, Inc. Shoulder traction apparatus
US4676243A (en) 1984-10-31 1987-06-30 Aldebaran Xiii Consulting Company Automated anterior capsulectomy instrument
JPH055529Y2 (en) 1985-03-25 1993-02-15
JPS61279491A (en) 1985-05-31 1986-12-10 株式会社安川電機 Visual apparatus holder
US4672963A (en) 1985-06-07 1987-06-16 Israel Barken Apparatus and method for computer controlled laser surgery
US4945479A (en) 1985-07-31 1990-07-31 Unisys Corporation Tightly coupled scientific processing system
JPH085018B2 (en) 1986-02-26 1996-01-24 株式会社日立製作所 Remote manipulation method and apparatus
EP0239409A1 (en) 1986-03-28 1987-09-30 Life Technology Research Foundation Robot for surgical operation
US5078140A (en) 1986-05-08 1992-01-07 Kwoh Yik S Imaging device - aided robotic stereotaxis system
US4791934A (en) 1986-08-07 1988-12-20 Picker International, Inc. Computer tomography assisted stereotactic surgery system and method
SE464855B (en) 1986-09-29 1991-06-24 Asea Ab PROCEDURE OF AN INDUSTRIAL BOTTOM FOR CALIBRATION OF A SENSOR
US5157603A (en) 1986-11-06 1992-10-20 Storz Instrument Company Control system for ophthalmic surgical instruments
US4854301A (en) 1986-11-13 1989-08-08 Olympus Optical Co., Ltd. Endoscope apparatus having a chair with a switch
JPH0829509B2 (en) 1986-12-12 1996-03-27 株式会社日立製作所 Control device for manipulator
US4791940A (en) 1987-02-02 1988-12-20 Florida Probe Corporation Electronic periodontal probe with a constant force applier
EP0549569B1 (en) 1987-02-09 1995-01-25 Sumitomo Electric Industries Limited Mechanism for bending elongated body
US4860215A (en) 1987-04-06 1989-08-22 California Institute Of Technology Method and apparatus for adaptive force and position control of manipulators
US5065741A (en) 1987-04-16 1991-11-19 Olympus Optical Co. Ltd. Extracoporeal ultrasonic lithotripter with a variable focus
US4863133A (en) 1987-05-26 1989-09-05 Leonard Medical Arm device for adjustable positioning of a medical instrument or the like
US4762455A (en) 1987-06-01 1988-08-09 Remote Technology Corporation Remote manipulator
US4852083A (en) 1987-06-22 1989-07-25 Texas Instruments Incorporated Digital crossbar switch
JPH088933B2 (en) 1987-07-10 1996-01-31 日本ゼオン株式会社 Catheter
US4794912A (en) 1987-08-17 1989-01-03 Welch Allyn, Inc. Borescope or endoscope with fluid dynamic muscle
JP2602240B2 (en) 1987-08-28 1997-04-23 株式会社日立製作所 Multi-processor system
US4991579A (en) 1987-11-10 1991-02-12 Allen George S Method and apparatus for providing related images over time of a portion of the anatomy using fiducial implants
US5303148A (en) 1987-11-27 1994-04-12 Picker International, Inc. Voice actuated volume image controller and display controller
US5251127A (en) 1988-02-01 1993-10-05 Faro Medical Technologies Inc. Computer-aided surgery apparatus
US4815450A (en) 1988-02-01 1989-03-28 Patel Jayendra I Endoscope having variable flexibility
EP0326768A3 (en) 1988-02-01 1991-01-23 Faro Medical Technologies Inc. Computer-aided surgery apparatus
US4964062A (en) 1988-02-16 1990-10-16 Ubhayakar Shivadev K Robotic arm systems
US4930494A (en) 1988-03-09 1990-06-05 Olympus Optical Co., Ltd. Apparatus for bending an insertion section of an endoscope using a shape memory alloy
US4949717A (en) 1988-03-17 1990-08-21 Shaw Edward L Surgical instrument with suture cutter
FR2628670B1 (en) * 1988-03-21 1990-08-17 Inst Nat Rech Inf Automat ARTICULATED DEVICE, IN PARTICULAR FOR USE IN THE FIELD OF ROBOTICS
US5019968A (en) 1988-03-29 1991-05-28 Yulan Wang Three-dimensional vector processor
US4989253A (en) 1988-04-15 1991-01-29 The Montefiore Hospital Association Of Western Pennsylvania Voice activated microscope
US4979949A (en) 1988-04-26 1990-12-25 The Board Of Regents Of The University Of Washington Robot-aided system for surgery
US4979933A (en) 1988-04-27 1990-12-25 Kraft, Inc. Reclosable bag
US5142484A (en) 1988-05-12 1992-08-25 Health Tech Services Corporation An interactive patient assistance device for storing and dispensing prescribed medication and physical device
US4883400A (en) 1988-08-24 1989-11-28 Martin Marietta Energy Systems, Inc. Dual arm master controller for a bilateral servo-manipulator
JPH079606B2 (en) 1988-09-19 1995-02-01 豊田工機株式会社 Robot controller
CA2000818C (en) 1988-10-19 1994-02-01 Akira Tsuchihashi Master slave manipulator system
US5123095A (en) 1989-01-17 1992-06-16 Ergo Computing, Inc. Integrated scalar and vector processors with vector addressing by the scalar processor
US5098426A (en) 1989-02-06 1992-03-24 Phoenix Laser Systems, Inc. Method and apparatus for precision laser surgery
US4965417A (en) 1989-03-27 1990-10-23 Massie Philip E Foot-operated control
JPH034831A (en) 1989-06-01 1991-01-10 Toshiba Corp Endoscope device
US4980626A (en) 1989-08-10 1990-12-25 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Method and apparatus for positioning a robotic end effector
US5271384A (en) 1989-09-01 1993-12-21 Mcewen James A Powered surgical retractor
US5201325A (en) 1989-09-01 1993-04-13 Andronic Devices Ltd. Advanced surgical retractor
US5182557A (en) 1989-09-20 1993-01-26 Semborg Recrob, Corp. Motorized joystick
US5181823A (en) 1989-10-27 1993-01-26 Grumman Aerospace Corporation Apparatus and method for producing a video display
US5249121A (en) 1989-10-27 1993-09-28 American Cyanamid Company Remote control console for surgical control system
US5091656A (en) 1989-10-27 1992-02-25 Storz Instrument Company Footswitch assembly with electrically engaged detents
ES2085885T3 (en) 1989-11-08 1996-06-16 George S Allen MECHANICAL ARM FOR INTERACTIVE SURGERY SYSTEM DIRECTED BY IMAGES.
DE4102196C2 (en) 1990-01-26 2002-08-01 Olympus Optical Co Imaging device for tracking an object
US5175694A (en) 1990-02-08 1992-12-29 The United States Of America As Represented By The Secretary Of The Navy Centroid target tracking system utilizing parallel processing of digital data patterns
US5097829A (en) 1990-03-19 1992-03-24 Tony Quisenberry Temperature controlled cooling system
US5343391A (en) 1990-04-10 1994-08-30 Mushabac David R Device for obtaining three dimensional contour data and for operating on a patient and related method
FR2660852A1 (en) 1990-04-17 1991-10-18 Cheval Freres Sa LASER BEAM DENTAL INSTRUMENT.
EP0455852B1 (en) 1990-05-09 1994-08-10 Siemens Aktiengesellschaft Medical and, in particular, dental device
US5431645A (en) 1990-05-10 1995-07-11 Symbiosis Corporation Remotely activated endoscopic tools such as endoscopic biopsy forceps
US5086401A (en) 1990-05-11 1992-02-04 International Business Machines Corporation Image-directed robotic system for precise robotic surgery including redundant consistency checking
JPH0771288B2 (en) 1990-08-24 1995-07-31 神田通信工業株式会社 Automatic view adjustment method and device
US5489292A (en) * 1990-10-05 1996-02-06 United States Surgical Corporation Endoscopic surgical instrument with grip enhancing means
JPH04157889A (en) 1990-10-20 1992-05-29 Fujitsu Ltd Automatic adjusting method for person image pickup position
US5131105A (en) 1990-11-21 1992-07-21 Diasonics, Inc. Patient support table
US5145227A (en) 1990-12-31 1992-09-08 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Electromagnetic attachment mechanism
US5228429A (en) 1991-01-14 1993-07-20 Tadashi Hatano Position measuring device for endoscope
US5217453A (en) 1991-03-18 1993-06-08 Wilk Peter J Automated surgical system and apparatus
US5217003A (en) 1991-03-18 1993-06-08 Wilk Peter J Automated surgical system and apparatus
US5339799A (en) 1991-04-23 1994-08-23 Olympus Optical Co., Ltd. Medical system for reproducing a state of contact of the treatment section in the operation unit
US5166513A (en) 1991-05-06 1992-11-24 Coherent, Inc. Dual actuation photoelectric foot switch
US5313306A (en) 1991-05-13 1994-05-17 Telerobotics International, Inc. Omniview motionless camera endoscopy system
JP3173042B2 (en) 1991-05-21 2001-06-04 ソニー株式会社 Robot numerical controller
US5279309A (en) 1991-06-13 1994-01-18 International Business Machines Corporation Signaling device and method for monitoring positions in a surgical operation
US5417210A (en) 1992-05-27 1995-05-23 International Business Machines Corporation System and method for augmentation of endoscopic surgery
US5182641A (en) 1991-06-17 1993-01-26 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Composite video and graphics display for camera viewing systems in robotics and teleoperation
US5458574A (en) 1994-03-16 1995-10-17 Heartport, Inc. System for performing a cardiac procedure
US5735290A (en) 1993-02-22 1998-04-07 Heartport, Inc. Methods and systems for performing thoracoscopic coronary bypass and other procedures
WO1993001750A1 (en) 1991-07-23 1993-02-04 Kernforschungszentrum Karlsruhe Gmbh Surgical stitching instrument
US5184601A (en) 1991-08-05 1993-02-09 Putman John M Endoscope stabilizer
US5239883A (en) * 1991-09-26 1993-08-31 Rosheim Mark E Modular robot wrist
US5275608A (en) 1991-10-16 1994-01-04 Implemed, Inc. Generic endoscopic instrument
US5230623A (en) 1991-12-10 1993-07-27 Radionics, Inc. Operating pointer with interactive computergraphics
US5289365A (en) 1991-12-23 1994-02-22 Donnelly Corporation Modular network control system
US5631973A (en) 1994-05-05 1997-05-20 Sri International Method for telemanipulation with telepresence
ATE238140T1 (en) 1992-01-21 2003-05-15 Stanford Res Inst Int SURGICAL SYSTEM
US5345538A (en) 1992-01-27 1994-09-06 Krishna Narayannan Voice activated control apparatus
US5357962A (en) 1992-01-27 1994-10-25 Sri International Ultrasonic imaging system and method wtih focusing correction
US5626595A (en) 1992-02-14 1997-05-06 Automated Medical Instruments, Inc. Automated surgical instrument
US5282806A (en) * 1992-08-21 1994-02-01 Habley Medical Technology Corporation Endoscopic surgical instrument having a removable, rotatable, end effector assembly
US5201743A (en) 1992-05-05 1993-04-13 Habley Medical Technology Corp. Axially extendable endoscopic surgical instrument
US5282826A (en) 1992-03-05 1994-02-01 Quadtello Corporation Dissector for endoscopic and laparoscopic use
JP3199130B2 (en) 1992-03-31 2001-08-13 パイオニア株式会社 3D coordinate input device
US5221283A (en) 1992-05-15 1993-06-22 General Electric Company Apparatus and method for stereotactic surgery
DE4217202C2 (en) 1992-05-23 1994-06-23 Kernforschungsz Karlsruhe Surgical sewing instrument
US5257999A (en) 1992-06-04 1993-11-02 Slanetz Jr Charles A Self-oriented laparoscopic needle holder for curved needles
US5478351A (en) * 1992-06-24 1995-12-26 Microsurge, Inc. Endoscopic surgical tool with handle and detachable tool assembly
AU4771893A (en) 1992-07-14 1994-01-31 Sierra Matrix, Inc. Hands-free ultrasonic test view (hf-utv)
US5458547A (en) 1992-07-17 1995-10-17 Tochigifujisangyo Kabushiki Kaisha Differential apparatus with speed and torque sensitive differential limiting forces
US5515478A (en) 1992-08-10 1996-05-07 Computer Motion, Inc. Automated endoscope system for optimal positioning
US5754741A (en) 1992-08-10 1998-05-19 Computer Motion, Inc. Automated endoscope for optimal positioning
US5657429A (en) 1992-08-10 1997-08-12 Computer Motion, Inc. Automated endoscope system optimal positioning
US5762458A (en) 1996-02-20 1998-06-09 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5609560A (en) 1992-08-19 1997-03-11 Olympus Optical Co., Ltd. Medical operation device control system for controlling a operation devices accessed respectively by ID codes
US5337732A (en) 1992-09-16 1994-08-16 Cedars-Sinai Medical Center Robotic endoscopy
US5397323A (en) 1992-10-30 1995-03-14 International Business Machines Corporation Remote center-of-motion robot for surgery
US5304185A (en) 1992-11-04 1994-04-19 Unisurge, Inc. Needle holder
US5629594A (en) 1992-12-02 1997-05-13 Cybernet Systems Corporation Force feedback system
US5451924A (en) 1993-01-14 1995-09-19 Massachusetts Institute Of Technology Apparatus for providing sensory substitution of force feedback
US5320630A (en) 1993-02-23 1994-06-14 Munir Ahmed Endoscopic ligating instrument for applying elastic bands
DE9302650U1 (en) * 1993-02-24 1993-04-15 Karl Storz Gmbh & Co, 7200 Tuttlingen, De
DE4306786C1 (en) 1993-03-04 1994-02-10 Wolfgang Daum Hand-type surgical manipulator for areas hard to reach - has distal components actuated by fingers via Bowden cables
US5309717A (en) 1993-03-22 1994-05-10 Minch Richard B Rapid shape memory effect micro-actuators
JP3477781B2 (en) 1993-03-23 2003-12-10 セイコーエプソン株式会社 IC card
US5417701A (en) 1993-03-30 1995-05-23 Holmed Corporation Surgical instrument with magnetic needle holder
DE4310842C2 (en) 1993-04-02 1996-01-25 Viktor Dr Med Grablowitz Device for performing minimally invasive operations
US5410638A (en) 1993-05-03 1995-04-25 Northwestern University System for positioning a medical instrument within a biotic structure using a micromanipulator
WO1994026167A1 (en) 1993-05-14 1994-11-24 Sri International Remote center positioner
US5395369A (en) 1993-06-10 1995-03-07 Symbiosis Corporation Endoscopic bipolar electrocautery instruments
WO1995002426A1 (en) 1993-07-13 1995-01-26 Sims Deltec, Inc. Medical pump and method of programming
US5434457A (en) 1993-07-30 1995-07-18 Josephs; Harold Foot pedal safety switch and safety circuit
US5382885A (en) 1993-08-09 1995-01-17 The University Of British Columbia Motion scaling tele-operating system with force feedback suitable for microsurgery
US5343385A (en) 1993-08-17 1994-08-30 International Business Machines Corporation Interference-free insertion of a solid body into a cavity
US5776126A (en) 1993-09-23 1998-07-07 Wilk; Peter J. Laparoscopic surgical apparatus and associated method
US5779623A (en) 1993-10-08 1998-07-14 Leonard Medical, Inc. Positioner for medical instruments
US5876325A (en) 1993-11-02 1999-03-02 Olympus Optical Co., Ltd. Surgical manipulation system
US5422521A (en) 1993-11-18 1995-06-06 Liebel-Flarsheim Co. Foot operated control system for a multi-function device
WO1995016396A1 (en) 1993-12-15 1995-06-22 Computer Motion, Inc. Automated endoscope system for optimal positioning
US5454827A (en) * 1994-05-24 1995-10-03 Aust; Gilbert M. Surgical instrument
US5645077A (en) 1994-06-16 1997-07-08 Massachusetts Institute Of Technology Inertial orientation tracker apparatus having automatic drift compensation for tracking human head and other similarly sized body
DE9409979U1 (en) * 1994-06-21 1994-09-22 Aesculap Ag Surgical tubular shaft instrument
US6120433A (en) 1994-09-01 2000-09-19 Olympus Optical Co., Ltd. Surgical manipulator system
US5803089A (en) 1994-09-15 1998-09-08 Visualization Technology, Inc. Position tracking and imaging system for use in medical applications
US5737711A (en) 1994-11-09 1998-04-07 Fuji Jukogyo Kabuishiki Kaisha Diagnosis system for motor vehicle
JP3640087B2 (en) * 1994-11-29 2005-04-20 豊田工機株式会社 Machine Tools
US5562503A (en) 1994-12-05 1996-10-08 Ellman; Alan G. Bipolar adaptor for electrosurgical instrument
US5836869A (en) 1994-12-13 1998-11-17 Olympus Optical Co., Ltd. Image tracking endoscope system
US5530622A (en) 1994-12-23 1996-06-25 National Semiconductor Corporation Electronic assembly for connecting to an electronic system and method of manufacture thereof
US5882206A (en) 1995-03-29 1999-03-16 Gillio; Robert G. Virtual surgery system
US5740699A (en) * 1995-04-06 1998-04-21 Spar Aerospace Limited Wrist joint which is longitudinally extendible
US5887121A (en) 1995-04-21 1999-03-23 International Business Machines Corporation Method of constrained Cartesian control of robotic mechanisms with active and passive joints
US5636259A (en) 1995-05-18 1997-06-03 Continental X-Ray Corporation Universal radiographic/fluoroscopic digital room
US5544654A (en) 1995-06-06 1996-08-13 Acuson Corporation Voice control of a medical ultrasound scanning machine
US5649956A (en) 1995-06-07 1997-07-22 Sri International System and method for releasably holding a surgical instrument
US5814038A (en) 1995-06-07 1998-09-29 Sri International Surgical manipulator for a telerobotic system
GB9518402D0 (en) 1995-09-08 1995-11-08 Armstrong Projects Ltd Improvements in or relating to a robotic apparatus
US5825982A (en) 1995-09-15 1998-10-20 Wright; James Head cursor control interface for an automated endoscope system for optimal positioning
US5860995A (en) 1995-09-22 1999-01-19 Misener Medical Co. Inc. Laparoscopic endoscopic surgical instrument
JPH09114543A (en) 1995-10-02 1997-05-02 Xybernaut Corp Handfree computer system
US5717480A (en) 1995-10-27 1998-02-10 Reliance Medical Products, Inc. Ophthalmic instrument support and lighting system
US5693071A (en) * 1996-01-23 1997-12-02 United States Surgical Corporation Tapered surgical needles and surgical incision members
US6436107B1 (en) 1996-02-20 2002-08-20 Computer Motion, Inc. Method and apparatus for performing minimally invasive surgical procedures
US5855583A (en) 1996-02-20 1999-01-05 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5727569A (en) 1996-02-20 1998-03-17 Cardiothoracic Systems, Inc. Surgical devices for imposing a negative pressure to fix the position of cardiac tissue during surgery
US5792135A (en) 1996-05-20 1998-08-11 Intuitive Surgical, Inc. Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5797900A (en) 1996-05-20 1998-08-25 Intuitive Surgical, Inc. Wrist mechanism for surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5807377A (en) 1996-05-20 1998-09-15 Intuitive Surgical, Inc. Force-reflecting surgical instrument and positioning mechanism for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5792178A (en) 1996-06-11 1998-08-11 Ethicon Endo Surgery, Inc. Handle latching mechanism with release trigger
BR9714740A (en) * 1996-11-18 2002-01-02 Univ Massachusetts Systems, methods and instruments for minimized penetration surgery
US5984932A (en) 1996-11-27 1999-11-16 Yoon; Inbae Suturing instrument with one or more spreadable needle holders mounted for arcuate movement
US6132368A (en) * 1996-12-12 2000-10-17 Intuitive Surgical, Inc. Multi-component telepresence system and method
US5893874A (en) * 1997-02-07 1999-04-13 Smith & Nephew, Inc. Surgical instrument
US5810879A (en) * 1997-02-27 1998-09-22 Microline, Inc. Laparoscopic instrument
US5980782A (en) 1997-04-25 1999-11-09 Exxon Research And Engineering Co. Face-mixing fluid bed process and apparatus for producing synthesis gas
US5938678A (en) * 1997-06-11 1999-08-17 Endius Incorporated Surgical instrument
US5947996A (en) * 1997-06-23 1999-09-07 Medicor Corporation Yoke for surgical instrument
US5954731A (en) 1997-07-29 1999-09-21 Yoon; Inbae Surgical instrument with multiple rotatably mounted spreadable end effectors
US5904702A (en) 1997-08-14 1999-05-18 University Of Massachusetts Instrument for thoracic surgical procedures
WO1999010137A1 (en) * 1997-08-28 1999-03-04 Microdexterity Systems Parallel mechanism
US6002184A (en) * 1997-09-17 1999-12-14 Coactive Drive Corporation Actuator with opposing repulsive magnetic forces
US5951475A (en) 1997-09-25 1999-09-14 International Business Machines Corporation Methods and apparatus for registering CT-scan data to multiple fluoroscopic images
US5951587A (en) 1997-10-09 1999-09-14 Ethicon-Endo-Surgery, Inc. Needle holder with suture filament grasping abilities
WO1999038646A1 (en) * 1998-02-03 1999-08-05 Hexel Corporation Systems and methods employing a rotary track for machining and manufacturing
DE29803734U1 (en) * 1998-03-04 1998-04-23 Aesculap Ag & Co Kg Surgical tubular shaft instrument
US5906630A (en) 1998-06-30 1999-05-25 Boston Scientific Limited Eccentric surgical forceps
JP2000193893A (en) * 1998-12-28 2000-07-14 Suzuki Motor Corp Bending device of insertion tube for inspection
US6312435B1 (en) * 1999-10-08 2001-11-06 Intuitive Surgical, Inc. Surgical instrument with extended reach for use in minimally invasive surgery
EP1408846B1 (en) * 2001-06-29 2012-03-07 Intuitive Surgical Operations, Inc. Platform link wrist mechanism
JP3646163B2 (en) * 2001-07-31 2005-05-11 国立大学法人 東京大学 Active forceps

Also Published As

Publication number Publication date
US20080312668A1 (en) 2008-12-18
EP2143372A2 (en) 2010-01-13
WO2000051486A1 (en) 2000-09-08
US8241306B2 (en) 2012-08-14
EP1076507A1 (en) 2001-02-21
US6436107B1 (en) 2002-08-20
CA2330674A1 (en) 2000-09-08
US20100217284A1 (en) 2010-08-26
JP2002537884A (en) 2002-11-12
CA2330674C (en) 2011-11-15
EP2143372B1 (en) 2014-12-17
EP2143372A3 (en) 2012-07-11
AU3613300A (en) 2000-09-21
EP1076507A4 (en) 2009-04-08

Similar Documents

Publication Publication Date Title
CA2330674C (en) Method and apparatus for performing minimally invasive surgical procedures
US7914521B2 (en) Method and apparatus for performing minimally invasive cardiac procedures
US6905460B2 (en) Method and apparatus for performing minimally invasive surgical procedures
US6699177B1 (en) Method and apparatus for performing minimally invasive surgical procedures
US6063095A (en) Method and apparatus for performing minimally invasive surgical procedures
JP4176126B2 (en) Method and apparatus for performing cardiac surgery with minimal invasion
US20040236352A1 (en) Method and apparatus for performing minimally invasive cardiac procedures
US20030065311A1 (en) Method and apparatus for performing minimally invasive cardiac procedures
AU754882B2 (en) A method and apparatus for performing minimally invasive cardiac procedures

Legal Events

Date Code Title Description
EEER Examination request
FZDE Discontinued

Effective date: 20160519