minimally invasive surgical system and method

专利摘要:
surgeon interface turned to the patient's side for a minimally invasive teleoperated surgical instrument. the present invention relates to the surgeon interface facing the patient's side which provides greater capabilities to use a minimally invasive teleoperated surgical system. the surgeon interface facing the patient has components within the sterile surgical field of surgery. the components allow the surgeon to control teleoperated slave surgical instruments from within the sterile surgical field. the surgical interface facing the patient allows the surgeon to be in the sterile surgical field adjacent to the patient undergoing surgery. controlling minimally invasive slave surgical instruments from within the sterile field allows for minimally invasive surgery combined with direct visualization by the surgeon. proximity to the patient allows the surgeon to control a teleoperated slave surgical instrument coupled with the control of manually controlled instruments such as a laparoscopic instrument. also, the surgeon, from within the sterile surgical field, can use the surgeon interface facing the patient to control at least one visual proxy in the supervision of another surgeon.
公开号:BR112012011324B1
申请号:R112012011324
申请日:2010-11-11
公开日:2020-04-14
发明作者:D Itkowitz Brandon
申请人:Intuitive Surgical Operations；
IPC主号:

专利说明:

Descriptive Report of the Invention Patent for MINIMALLY INVASIVE SURGICAL SYSTEM AND METHOD.
Background
Field of the Invention [001] The present invention relates to minimally invasive teleoperated surgical systems, and more particularly to patient-oriented surgeon interfaces for minimally invasive teleoperated surgical systems.
Related Technique [002] The da Vinci® Surgical System, manufactured by Intuitive Surgical, Inc., Sunnyvale, California, is a teleoperated, minimally invasive robotic surgical system that offers patients many benefits, such as reduced trauma to the body, faster recovery and shorter hospital stay. The da Vinci® Surgical system provides intuitive and ergonomic control of minimally invasive slave surgical instruments, which provide telepresence to the surgeon. The system incorporates a dedicated surgeon console, which provides a three-dimensional stereo viewer, two main tool manipulators, pedals to control operating modes, and an ergonomic head and arm rest for extended sitting use.
[003] Although using the referred teleoperated robotic surgical system, the surgeon is typically physically separated from the sterile surgical field. Thus, the surgeon relies on assistants in the operating room to perform some tasks on the side facing the patient, which cannot be robotically controlled.
Summary [004] A surgeon interface aimed at the patient's side provides greater capabilities for using a minimally invasive teleoperated surgical system. The surgeon interface facing the
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2/56 the patient's side has at least one component within the sterile surgical field of surgery. The component allows the surgeon to control at least one teleoperated slave surgical instrument, sometimes referred to as a slave surgical instrument, from within the sterile surgical field. Thus, the surgeon interface facing the patient allows the surgeon to be in the sterile surgical field adjacent to the patient undergoing surgery.
[005] Controlling minimally invasive slave surgical instruments from within the sterile surgical field allows for minimally invasive surgery combined with direct visualization by the surgeon. The proximity of the patient allows the surgeon to control a teleoperated slave surgical instrument together with one or more manually operated instruments such as a laparoscopic instrument. Also, the surgeon, from within the sterile surgical field, can use the surgeon interface facing the patient to control a surgical instrument, and / or at least a visual proxy in the supervision of another surgeon.
[006] Thus, in one aspect, a minimally invasive surgical system includes a surgeon interface facing the patient. The surgeon interface facing the patient includes a display device mounted in an operating room and a main interface.
[007] The main interface includes a main tool handle mechanically ungrounded with respect to any object in an operating room. The main interface also includes a separate hand-held transmitter and removed from the main tool handle. The hand tracking transmitter is coupled to the main tool grip by a three-dimensional position tracking technology to generate the perceived position and perceived orientation of the gripPetition 870190120833, 11/21/2019, pg. 10/76
3/56 main tool.
[008] The minimally invasive surgical system also includes a teleoperated slave surgical instrument and a control system coupled to the hand tracking sensor, the display device, and the teleoperated slave surgical instrument. The control system sends control commands to the teleoperated slave surgical instrument in response to perceived information. The control system also updates an image generated by the display device as the teleoperated slave surgical instrument moves in response to control commands.
[009] In one aspect, the surgeon interface facing the patient also includes a stereoscopic image viewer. With the image display on the display device through the stereoscopic image viewer, a stereoscopic image is viewed.
[0010] In another aspect, the surgeon interface facing the patient also includes a mobile stabilization platform. The stabilization platform supports the surgeon's forearm while the surgeon takes the main tool handle. The stabilization platform can be moved independently from any movement of the display device. In one aspect, the mobile stabilization platform includes a plurality of wheels used to move the mobile stabilization platform with respect to an operating table position. In another aspect, the mobile stabilization platform is mounted on an operating table. In yet another aspect, the stabilization platform is mounted on an adjustable mechanical arm with brakes so that the forearm support can be adjusted and used while sitting or standing.
[0011] In yet another aspect, the minimally invasive surgical system also includes a surgeon's console, attached to the system
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4/56 control, including a stereoscopic display device and a powered main interface. The control system additionally comprises a visual proxy module coupled to the stereoscopic display device of the surgeon's console to provide a visual proxy, and coupled to the hand tracking sensor to receive the perceived information characterizing the movement of the main tool handle. The execution of the visual proxy module moves the visual proxy in response to the perceived information.
[0012] In one aspect, the position and perceived orientation information is generated by moving the handle of a mechanically ungrounded main tool located in a sterile surgical field. The perceived position and guidance information is in a frame of reference associated with a person working within the sterile surgical field, and operating the main tool handle mechanically ungrounded. In one aspect, the reference structure is a central body reference structure. The movement of an executing extremity of a minimally invasive teleoperated slave surgical instrument is controlled based on the perceived position and the orientation information. The performing end is also in the sterile surgical field. In addition, a manually operated surgical instrument is controlled by the person using a control rod of the manually operated surgical instrument. The control rod is within the sterile surgical field.
[0013] In another aspect, the position and orientation of a mechanically ungrounded main tool grip is perceived in the reference structure associated with a person operating the mechanically ungrounded main tool grip. In one aspect, the reference structure is a central body reference structure. Position and orientation are perceived when the main tool handle is not mechanically
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Grounded 5/56 is moved in a field from a hand held tracking transmitter, and is moved within a sterile surgical field. [0014] The perceived position and orientation are received by the control system. The control system generates a control command, using the perceived position and orientation, with respect to the reference structure associated with an image displayed on a display device. The control system sends the control command to a teleoperated slave surgical instrument.
Brief Description of the Drawings [0015] Figure 1A is a diagrammatic view of a minimally invasive surgical system, which includes the surgeon interface facing the patient.
[0016] Figure 1B is a diagrammatic view of a minimally invasive surgical system, which includes the surgeon interface facing the patient and a surgeon console.
[0017] Figure 2A is a more detailed diagram of an aspect of the main tool grip of figures 1A and 1B.
[0018] Figure 2B is a more detailed diagram of another aspect of the main tool grip of figures 1A and 1B.
[0019] Figure 2C is a more detailed diagram of yet another aspect of the main tool grip of figures 1A and 1B.
[0020] Figure 3A is a more detailed diagram of an aspect of the display device of figures 1A and 1B.
[0021] Figure 3B is a more detailed diagram of another aspect of the display device of figures 1A and 1B.
[0022] Figure 3C is a more detailed diagram of yet another aspect of the display device of figures 1A and 1B.
[0023] Figures 4A and 4B illustrate aspects of the mobile ergonomic support of figures 1A and 1B.
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6/56 [0024] Figure 4C illustrates an aspect of a foot console on the surgeon interface facing the patient.
[0025] Figure 5A is an illustration of the orientation of the handle that would be necessary if the display device were vertically oriented so as to reproduce the conventional configuration between the three-dimensional image and the main tool handles.
[0026] Figure 5B is an illustration of an improved wrist orientation obtained by using a fixed rotational deviation in the mapping of wrist orientation movements.
[0027] Figure 6A is an illustration of the endoscopic coordinate structure used in the system of figures 1A and 1B.
[0028] Figure 6B is an illustration of an aspect of a central body mapping used in the system of figures 1A and 1B.
[0029] Figure 7 is a block diagram of a control system that includes modules used to implement the various aspects of the control system.
[0030] Figure 8 is an illustration of an image, presented on a display device, of a teleoperated slave surgical instrument and a visual proxy, which in the mentioned example is a virtual phantom instrument.
[0031] Figure 9 is a process flow diagram for an aspect of the control system.
[0032] In the drawings, the first digit of a numerical figure indicates the figure in which the element with that numerical figure first appeared.
[0033] As used here, a sterile surgical drape means an area immediately around a patient that has been prepared for a surgical procedure. The sterile surgical field includes brushed team members, who are suitably dressed, and all furniture and accessories and facilities in the area.
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7/56 [0034] As used here, mechanically ungrounded main tool grip means a main tool grip that is not hindered with respect to possible position and orientation movement in a large workload. For the purpose of this definition, a large volume of work is a volume that allows the monitoring of position movements within the length of the user's arm and accompanies all orientations.
Detailed Description [0035] With general reference to figures 1A and 1B, aspects of the present invention include a surgeon interface facing the patient side 150 that provides greater capacity for using the minimally invasive, 100-operated surgical system. Unlike systems Conventional minimally invasive teleoperated surgeries, the surgeon interface facing the patient side 150 has at least one component within the sterile surgical field of surgery. Said component in combination with an image on the display device 160 allows the surgeon 101 to control the teleoperated slave surgical instruments 110, 111 from within the sterile surgical field. Thus, the surgeon interface facing the patient side 150 allows the surgeon 101 to work within the sterile surgical field adjacent to patient 102 undergoing surgery.
[0036] Controlling the minimally invasive slave surgical instruments 110, 111 from within the sterile surgical field allows a minimally invasive surgery combined with direct visualization of the patient 102, cart 105, any manually operated surgical instruments, other machines and / or instruments being used in surgery, etc., by the surgeon 101. The proximity to patient 102 allows the surgeon 101 to control an executing end of a teleoperated slave surgical instrument 110 along with one or more ins
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8/56 manually controlled instruments 115, such as a laparoscopic instrument or a stapler.
[0037] Also, as explained more fully below, surgeon 101, from within the sterile surgical field, can control at least one visual proxy to supervise surgeon 195 (figure 1B). The visual proxy is visible not only on the display device 160 but also on a display device seen on a surgeon's console 114, which is located outside the sterile surgical field (figure 1B). Using the main tool grip 170, surgeon 101 can manipulate the visual proxy to demonstrate control and use of teleoperated slave surgical instruments 110, 111. Alternatively, surgeon 195 can control the visual proxy using the main tool manipulator on surgeon console 114, to instruct surgeon 101.
[0038] The surgeon interface facing the patient side 150 reduces the floor requirements of the operating room for the teleoperated, minimally invasive surgical system 100. Surgeon interface facing the patient side 150 provides a low cost alternative to a surgeon console 114 (figure 1B) in a conventional, minimally invasive teleoperated surgical system.
[0039] In one aspect, the surgeon interface facing the patient side 150 includes (i) a display device 160, (ii) a main interface which in turn includes at least one main tool grip not driven and mechanically ungrounded 170 and typically two main tool wrenches not driven and mechanically ungrounded, and a hand-held transmitter 175 (iii) a foot console (see figure 4C), and optionally (iv) an ergonomic support 180. As explained more completely below, the display device 160 can provide either a two-dimensional image, or a three-dimensional image 161, for example
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9/56 example, of a slave surgical instrument 110 and the surgical field.
[0040] In one aspect, the display device 160 provides an output that the surgeon perceives as the three-dimensional image that includes an image 161 of an executing end of a slave surgical instrument 110 and the surgical field. The performing end is located within the sterile surgical field. The three-dimensional image provides three-dimensional depth markings to allow the surgeon 101 to access relative depths of instruments and the patient's anatomy. The three-dimensional depth markings, in turn, allow the surgeon 101 to use visual feedback to direct the executing end of the slave surgical instrument 110 using the main tool grip 170 to precisely target the characteristics with a millimeter of precision.
[0041] The display device 160 is mounted so that the surgeon 101, from a position that allows working within the sterile surgical field, can position the display device 160 for easy and comfortable viewing. However, the positioning of the display device 160 is typically limited to avoid interference with (i) the surgeon's ability 101 to see patient 102;
(ii) performance of the patient's lateral maneuvers with the main tool wield 170;
(iii) manual operation of any other surgical instruments;
(iv) visualization of other screens, or (v) functionality of other instrumentation used in surgery. Also, the movement of the display device 160 can be inhibited when it follows between the main tool grip movement 170 and the movement of the surgical instrument tip.
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10/56 slave is started and when tracking is in progress.
[0042] Surgeon 101 sits or stands comfortably next to patient 102 while working in the sterile surgical field and looks at the display device 160 during surgery. The surgeon 101 performs a medical procedure when handling at least the main tool handle 170 (figure 1A). In one aspect, surgeon 101 takes the main tool grip 170 between thumb and index finger so that targeting and gripping still involve intuitive pointing and grasping movements. The main tool grip 170 is either sterilized or covered so that the main tool grip 170 can be safely positioned and used within the sterile surgical field for surgery. In one aspect, an ergonomic forearm support 180, which may also be in the sterile surgical field, is provided to support the surgeon's forearm or elbows as the surgeon 101 manipulates the main tool grip 170 during surgery.
[0043] While working in the sterile surgical field, as the surgeon moves the main tool handle 170 in one aspect, the perceived spatial information and the perceived orientation information are provided to control the system 190 based on the movement of main tool grip 170. For example, a hand-held transmitter 175 generates a field, for example, an electromagnetic field, an optical field (for example, light beams), etc., and the main tool grip movement 170 in that field provides information on spatial position and orientation perceived in a three-dimensional coordinate system.
[0044] As explained more fully below, the control system 190 maps the perceived spatial motion data and the
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11/56 perceived orientation data to a common reference structure. The control system 190 processes the mapped data and generates commands to properly position an executing end, sometimes referred to as a tip, of a teleoperated slave surgical instrument 110 based on the main tool grip movement 170.
[0045] The control system 190 uses a teleoperation servo control system to translate and to transfer the perceived movement of the main tool 170 to an associated robotic arm through control commands so that the surgeon 101 can effectively manipulate the Slave surgical instrument tip 110. Thus, surgeon 101, working in the sterile surgical field, uses a main tool grip 170, which is in the sterile surgical field, to teleoperate a slave surgical instrument executing end 110.
[0046] The number of teleoperated slave surgical tools used at one time, and consequently, the number of robotic arms used in the 100 system generally depends on the medical procedure to be performed and space restrictions within the operating room, among other factors. If it is necessary to change one or more of the slave surgical instruments being used during a procedure, an auxiliary 103 can remove the slave surgical instrument that is no longer being used from his robot arm and replace that slave surgical instrument with another surgical instrument. slave from a tray in the operating room. During surgery, the distal end of at least one robotic slave surgical instrument is positioned within the sterile surgical field.
[0047] Although a teleoperated robotic surgical system that provides surgical telepresence offers many advantages over conventional open surgery and minimally invasive surgery performed
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12/56 performed manually, providing the surgeon with the ability to perform that telerobotic surgery while working from within the sterile surgical field offers additional benefits. For example, the surgeon interface facing the patient side 150 improves security by allowing the surgeon 101, who is performing the operation, to directly observe the patient 102 and the robotic cart on the patient side 105 while handling the slave surgical instruments 110 , 111.
[0048] The surgeon interface facing the patient side 150 also allows a single surgeon 101 to operate in the sterile surgical field and perform procedures, which require coordinated use of manual surgical instruments, such as surgical instrument 115, and one or more teleoperated slave surgical instruments 110,
111. This has advantages over conventional teleoperated surgical systems in which the surgeon operates remotely from the surgical field, and an assistant working within the sterile surgical field typically controls a manually operated minimally invasive surgical instrument, such as a stapler. The remote surgeon must then verbally coordinate with the assistant to properly dispose of the manual instrument and to coordinate actions between the instruments (for example, using the teleoperated instrument to feed tissue to the manually operated instrument).
[0049] As described here, however, the surgical workflow is increased because the single surgeon 101 can simultaneously and advantageously use both the slave surgical instrument 110 and a manually operated surgical instrument 115 (for example, a stapler instrument). For example, the manually operated surgical instrument 115 includes a control rod that is located within the sterile surgical field. The surgeon 101 uses the control rod to control the manually operated surgical instrument
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13/56
115.
[0050] Interface 150 also allows surgeon 101 to control imaging probes, targetable needles, etc. from not only inside but also outside the patient's body 102. Thus, the interface 150 allows the surgeon 101 to self-assist when using manually operated minimally invasive tools. Additionally, for example, in transoral, ear, nose, and throat procedures, the interface 150 allows the surgeon 101 to assist himself when using traditional open surgery instruments with teleoperated slave surgical instruments 110, 111.
[0051] Interface 150 promotes collaborative procedures without requiring additional large and independent surgical consoles for the teleoperated surgical system 100. Also, assistant 103 can share interface 150 to operate the other surgical instruments. In addition, multiple surgeons can collaborate using a common display device 160.
[0052] Additionally, to the aspects described above, the patient-side surgeon interface 150 also allows the surgeon 101 to guide or collaborate with the surgeon 195 (figure 1B) without needing an additional surgeon console. Surgeon 101 observes the same information on display device 160 as surgeon 195 observes with the conventional surgeon console 114. However, because surgeon 101 is working in the sterile surgical field, surgeon 101 may have access to additional information, such as as the patient's apparent general condition, which is not readily available to the surgeon 195.
[0053] Since surgeons 101 and 195 see the same information, surgeon 101 can demonstrate the proper technique and use teleoperated slave surgical instruments using interface 150. For example, surgeon 101 can use interface 150 to direct
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14/56 at least one visual proxy to visually indicate where to take the tissue, and to visually indicate in which direction to retract the tissue with an instrument. Likewise, the remotely located surgeon 195 can demonstrate techniques, either with the use of real or visual proxies, to the sterile surgical field surgeon 101, who can follow along using either real or visual proxies. Here, a visual real refers to an image of an executing end of a teleoperated slave surgical instrument.
[0054] Additionally, two surgeons can see the screen 160 and each has at least one main tool handle. One surgeon can control a visual proxy, while the other surgeon controls an executing end of a slave surgical instrument.
[0055] As indicated above, the patient-side surgeon interface 150 includes at least one main tool grip and tracking system, a screen, and optionally an ergonomic support. Also, several mapping and modifications to the conventional control system are implemented. Each of these aspects is described in more detail below.
Main Interface [0056] In said example, as shown in figure 2A, the surgeon interface facing the patient side 150 includes a first main tool grip 170A and a second main tool grip 170B. Main tool handles 170A and 170B are illustrative only and are not intended to limit main tool handles to said specific configuration. In view of the said description, a variety of main tool handles can be used from within the sterile surgical field to control teleoperated slave surgical instruments, such as instruments 110, 111 (figuPetition 870190120833, of 11/21/2019, pg. 22/76
15/56 ras 1A and 1B).
[0057] The selected main tool grip technology is attached to the hand of the surgeon 101. Each main tool grip 170A, 170B also includes presence detection. For example, a capacitance switch, a pressure switch, an infrared beam based presence switch, or some other type of presence detection mechanism is provided to determine whether the surgeon 101 is in proper contact with and therefore in the control of the main tool grip. Said presence detection mechanism is a safety feature that prevents accidental movement of the slave tool, as it should otherwise occur if the surgeon left the main tool handle, removed the main tool handle from the other surgeon. , moved the main tool handle while it is in a sterile tray, or performed some other action and therefore no longer has control over the main tool handle.
[0058] In one aspect, the main tool grip 170A, 170B includes at least one mode control key 201A, 201B. The mode control key 201A, 201B is used in conjunction with at least one of the following (which initiates the monitoring between the movements of a main tool handle and the associated teleoperated slave surgical instrument), main gear activation (which uncouples the master control of the slave instrument), endoscopic camera control (which allows the main control of the movement or characteristics of the endoscope, such as focus or electronic zoom), robotic arm exchange (which exchanges a particular main control between two slave instruments) , and swap tileprof, (fixing the auxiliary video window screen on the surgeon's screen). The number and function of the implemented mode control key
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16/56 used in the main tool handles 170A, 170B is complementary to the allied function associated with the pedal (s) in the foot tray, described more fully below.
[0059] When there are only two main tool handles 170A, 170B in system 100, and when surgeon 101 wants to control the movement of a slave surgical instrument other than the two slave surgical instruments coupled to the two main tool handles, surgeon 101 can lock one or both of the slave surgical instruments in place. The surgeon 101 then associates one or both of the main tool handles with other slave surgical instruments held by the other of the robotic arms by pressing the key on the main tool handle, which, in the present implementation, provides the main tool handle exchange association for another slave surgical instrument.
[0060] In one aspect, each main tool grip 170A, 170B provides a tactile perception of hardness (for example, particular shapes adapted, either for the left or right hand) so that a main tool grip is for the left hand of the surgeon 101 and the other main tool handle is for the right hand of the surgeon 101. In addition, the particular handle style of the main tool handle can be customized to accommodate the surgeon's preference using the main tool handle.
[0061] In the example in figure 2A, each main tool grip 170A, 170B includes two levers 231A, 231B, 232A, 232B, each with a finger grip 233A, 233B, 234A, 234B so that the surgeon 101 (figures 1A and 1B) you can typically pick up the pair of levers between your thumb and index finger. A palm rest 235, 236 adapts to the surgeon's palm and
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17/56 extends around the palm to the back of the hand, in the aforementioned example. Other examples of main tool wields include, but are not limited to, a glove device and a thimble device. Also, a main tool grip can be implemented as a pistol grip device or a pencil grip device. See also figures 2B and 2C, which are described below.
[0062] The main tool handles 170, 170A, 170B are mechanically ungrounded with respect to all equipment in the operating room. A cable 241, 242 connects the main tool grip 170A, 170B to control the system 190. In one aspect, the cable 241, 242 carries position and orientation information from sensors on the main tool grip 170A, 170B to control system 190 as well as sensor data for the closing grip and status data for key inputs on the main tool grip 170A, 170B.
[0063] The use of a cable to transmit the perceived position and orientation data to the control system 190 is only illustrative and is not intended to be limiting for this specific aspect. In view of the aforementioned description, one skilled in the art can select a mechanism to transmit the perceived position and orientation data from the main tool handle or main tool handle to the control system 190 (for example, by using a wireless connection) ).
[0064] The cables 241, 242 do not inhibit the movement of the main tool grip 170A, 170B. Since each main tool grip 170A, 170B is mechanically ungrounded, each main tool grip is effectively not impeded not only for position and orientation movements
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18/56 within the workspace reachable by the surgeon and the workspace of the hand-held transmitter (for example, swing, swing, pant, step, yaw, and roll in a Cartesian coordinate system). Since each main tool grip 170A, 170B also includes a grip handle mechanism, each main tool grip 170A, 170B has at least seven degrees of freedom.
[0065] The hand-held transmitter 175 may be an electromagnetic spatial tracking system, inertial spatial tracking system, optical spatial tracking system, or sonic spatial tracking system, for example. The device that provides the perceived information may vary depending on the particular spatial tracking system or combination of systems used. In each implementation, at least information of position and orientation perceived for a main tool grip is provided to the control system.
[0066] In some respects, a combination of an electromagnetic spatial tracking system and an inertial tracking system or a combination of an optical spatial tracking system and an inertial tracking system can be used. The inertial spatial tracking system has a high update frequency and high resolution, but it only provides differential tracking information, which is susceptible to absolute position deviation when integrated. The differential tracking information from the inertial spatial tracking can be merged with the absolute tracking information from the other spatial tracking system in a complementary mode to provide absolute position tracking free of deviation with high frequency.
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19/56 cia of update and high resolution for the main tool grip mechanically ungrounded.
[0067] In one respect, regardless of the particular implementation of spatial tracking and guidance, the tracking system provides reliable and continuous input data for the 190 control system. The high resolution reading of position and guidance provides at least better than one millimeter of position resolution and less than one degree of rotation resolution. The data provided for the 190 control system has low latency and high update frequency, for example, a latency of a maximum of fifteen milliseconds and an update coefficient of at least forty Hertz.
[0068] Figure 2B illustrates another embodiment of a main tool handle 220. Main tool handle 220 includes a handle 225 with a strip 227, the shaft 243 and a body 242. [0069] Handle 225 fits over the hand of the surgeon 101 so that the inner surface 225B is on the back of the surgeon's hand and the opposite inner surface 225A is on the surgeon's palm. Strip 226, which in one respect is a Velcro strip, attaches the handle 225 to the surgeon's hand.
[0070] The handle 225 is dimensioned to fit comfortably around the circumference of the surgeon's hand. In one aspect, handle 225 has a circumference of 15.3 cm (6 inches) and strip 227 is sized so that handle 225 can be used on hands with a circumference of about 17.3 cm to 23.1 cm (6.8 to about 9.1 inches).
[0071] In one aspect, when the strip 226 is in place and attached to both parts of the handle 225, the presence detection key is activated, but any of the presence detection techniques described above can be used.
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20/56 [0072] The 226 mode control key is positioned on an external surface of the handle 225. The 226 mode control key is positioned so that when a surgeon is grasping lever 241A and lever 24IB between the thumb and index finger, one of the other fingers of the surgeon can reach and press the 226 mode control key.
[0073] A main tool handle body 242 220 is slidably mounted on shaft 243. Axle 243 is attached to handle 225. In one aspect, body 242 moves along axis 243 up to 4.6 cm (1.8 inches) ) away from handle 225. Body 242 also rotates on axis 243.
[0074] Two levers 241A, 24IB are mounted on the body 242 at one end. The configurations of levers 241A, 24IB are similar and thus only lever 241A is considered in detail. [0075] Lever 241A has a contact plate 246A mounted on one end of the lever opposite the end mounted on body 242. Surgeon 101 (figures 1A and 1B) can typically pick up contact plates 246A and 246B between thumb and finger indicator and press contact plates 246A and 246B towards body 242 to increase the grip of the executing end of the teleoperated slave surgical instrument. Thus, levers 241A, 241B are mounted to body 242 in a mode that emulates gripping, or other operation, of the executing end. For example, variable resistance springs can be used so that contact plates 246A, 246B are closer to body 242, the resistance of moving contact plates 246A, 246B further in that direction increases.
[0076] Mounted on the lever 241, between the contact plate 246A and the attachment point to the body 242, it is a lock sensor 244A that includes a magnet and a Hall Effect sensor. Lock sensor 244A provides grip closure information
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21/56 as the lever 241A moves towards or away from the body 242 and control system 190 uses the grip closure information to control the closing of the executing end of the teleoperated slave surgical instrument. [0077] Mounted on the end of the body 242 distal to the handle 225 is an electromagnetic sensor 245 which is used in combination with the field from the hand-held transmitter 175 to generate the perceived position information and the perceived orientation information in the media wherein the main tool tracker 220 moves within the field from hand-held transmitter 175.
[0078] Figure 2C is an illustration of yet another main tool handle 260. In the said mode, instead of a glove with instrumented fingers, finger grip 261A, 261B are arranged on the surgeon's thumb and index finger.
[0079] Each 261A, 261B finger loop has a small electromagnetic sensor 262A, 262B mounted on it. A member 262 extends between the finger loop 261A and 261B. In one aspect, the member 262 emulates the closing of the executing end of the slave surgical tool and provides closing wield information.
[0080] As the finger handles 261A, 261B are moved apart, the executing end is opened. As the finger loops 261A, 261B are moved towards each other, the member 262 provides resistance to simulate the closing and gripping (if appropriate) of the executing end. To drive the scroll axis, surgeon 101 simply rubs his index finger and thumb together and the change in orientation of sensors 262A, 262B relative to each other corresponds to the amount of scroll.
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22/56 [0081] The different modalities described here of the main tool grip are only illustrative and are not intended to be limiting. In one aspect, each main tool grip includes a safe way to retain the main tool grip in the surgeon's hand, and still accommodate a variety of grip preferences. The main grip allows the surgeon to perform not only the coarse but also the fine movements with ease.
[0082] In one aspect, the main tool handle incorporates at least one mode control key. The main tool handle allows the surgeon to remove the finger and thumb from the main tool handle easily. In one aspect, the main handle incorporates a separately perceived scroll axis. The main handle detects the presence of the surgeon and accommodates a three-dimensional tracking sensor. The main tool handle also accommodates a sterile cover when the main handle cannot be sterilized. In some respects, the main tool handle maintains weight and mass distribution comparable to surgical instruments.
Display Device [0084] Figure 3A is a more detailed block diagram of an aspect of a system that provides an image on the display device 160, which is, for example, a liquid crystal display (LCD) device. A conventional stereoscopic endoscope 112 provides left and right channel images of patient tissue 102 and any executing ends of surgical instruments 110 and 111 in the field of view of stereoscopic endoscope 112.
[0085] Stereoscopic endoscope 112 includes two channels for transporting light from tissue (for example, channels for images)
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23/56 left and right genes). The light carried in each channel represents a different view of the fabric. The light can include one or more images. The light is captured by charge-coupled device cameras. The information from the load-coupled devices is processed by the video controller 391 in the control system 190, and appropriate updated information is provided to the display device 160 by the video controller 391. The particular information provided to the display device 160 by the controller video 391 depends on the characteristics of the display device 160, as discussed more fully below.
[0086] As described above, the display device 160 can provide images which, in some aspects, can be perceived by the surgeon 101 as two-dimensional images and in another aspect, can be perceived by the surgeon 101 as three-dimensional images. The ability to see in three dimensions and to perceive the relative depths of anatomy and instruments is advantageous in comparison to the typical two-dimensional images provided in conventional manually performed laparoscopic procedures. Accurate stereoscopic depth marks can reduce cognitive load and improve movement efficiency. However, accurate stereoscopic marks need to preserve eye separation and working distance relationships.
[0087] In one aspect, the display device 160 is mounted on a lance 310 to allow convenient placement and reorientation of the display device 160 with respect to patient 102 and at least surgeon 101. The display device 160 and / or the boom includes rods 311, 312 so that the display device 160 can be moved, as described above.
[0088] In one aspect, the stems 311,312 are covered so that stems 311, 312 are included in the sterile surgical field. This
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24/56 allows moving the display device 160 by a person working in the sterile surgical field.
[0089] The boom 310 includes, in one aspect, brakes so that the display device 160 cannot be moved while the system 100 is in a mode in which the slave surgical instruments follow the movements of the main tool handles (mode of follow). Alternatively, in one aspect, any movement of the display device 160, while the system 100 is in the tracking mode, interrupts the tracking mode. In some cases, the movement of the main tool handle is perceived with respect to the display device 160, so that the display device 160 is not allowed to move while the system is in tracking mode. Regardless of the implementation, in one aspect, the display device 160 includes a screen movement interlock coupled to the control system 190, and said interlock prevents screen movement in certain operating modes of the system where said movement would be inappropriate and / or disorienting to the surgeon 101.
[0090] Additionally, the display device 160 includes a surgeon presence key. When the surgeon 101 is facing the display device 160 and is within a range of the surgeon's presence key, the key provides a signal to control system 190 that allows control system 190 to enter and remain in control mode. follow. When the surgeon 101 is either not facing the display device 160 or is not within the range of the key, the surgeon's presence key provides a signal to the control system 190 that inhibits the control system 190 from being in follow. In one aspect, one or more sensors in the infrared (IR) range are used to read distances from the range close to the surgeon 101 from screen 160 or alternatively to parPetition 870190120833, of 11/21/2019, pg. 32/76
25/56 from the viewer of the surgeon 361.
[0091] The surgeon's presence key is a security feature that prevents the surgeon 101 from operating a slave surgical instrument when the surgeon 101 is not in a position to properly assess the visual depth markings on the three-dimensional image. The surgeon's presence key is an example of a screen-based presence interlock coupled to the 190 control system.
[0092] As indicated above, the information provided to the display device 160 by the screen controller 391 depends on the type of screen used. For a three-dimensional image on the display device 160, several different implementations can be used.
[0093] In a first implementation, the display device 160 provides a pair of polarized images and the surgeon 101 wears special glasses 361. The surgeon 101 observes the three-dimensional image when viewing the pair of polarized images with special glasses 361. The images polarized can be generated in multiple modes. In a first aspect, a screen includes features that automatically generate the pair of polarized images. In a second aspect, a film is applied to the screen of the liquid crystal display that generates the pair of polarized images. In both cases, passive glasses with polarized lenses are required to view the three-dimensional image.
[0094] In any of the above approaches, in one aspect, the polarization of the image on the LCD screen is changed on a line-by-line basis. For example, even-numbered lines in the displayed image are polarized in one mode and odd-numbered lines in the displayed image are polarized in another mode. Typically, the polarization for even numbered lines is perpendicular to the polarization
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26/56 for odd-numbered lines. The left eye image can be the polarized image from the even numbered lines and, for this example, the right eye image would be the polarized image from the odd numbered lines. Said aspect requires the control system 190 to provide a display device 160 with a composite image that contains both left eye and right eye information on a line-by-line basis. This approach requires the use of passive polarized glasses 361.
[0095] This approach provides high resolution images and is capable of multiple users due to a wide field of view. There is no dependence on update coefficients and no drizzle. Also, surgeon 101 is not limited to the specific location, as the screen can be seen from a distance in the range of 0.7 m to 3 m. However, this approach may suffer from ghostly artifacts and disturbing distortions from the lateral movement of the head.
[0096] An example of a screen with the features discussed above is the Miracube G240M provided by Pavonnine Korea, Inc., (406-130) Pavonne R & D Center # 7-42, Songdo, Yeonsu-gu, Incheon, Korea. Another example of a screen with such characteristics is the GD-463D10 provided by JVC U.S.A., 1700 Valley Road, Wayne, NJ 07470. Additionally, polarization films with said characteristics are commercially offered.
[0097] In another implementation, double images from the stereoscopic endoscope 112 can be displayed on the display device 160 by the control system 190, and a stereo viewer 361 is mounted on the boom so that the stereo viewer 361 is at a fixed distance from the display device 160. The stereo viewer 361 includes adjustable mirrors that reflect the stereo image pair from the display device 160 over the eyes
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27/56 of the surgeon 101, and in turn the surgeon's brain merges the images into a single, sharp, three-dimensional scene. In one example, stereo viewer 361 is a Wheatstone stereoscopic mirror.
[0098] Figure 3B is a more detailed illustration of a Wheatstone 361A stereoscopic mirror viewer with a 160A display device. In said aspect, the display device 160A is mounted on a mounting bracket 321 which provides rods 311A, 311B. The mounting clamp 321, in one aspect, is attached to the lance 310.
[0099] The left and right images 315, 316 from stereoscopic endoscope 112 are displayed, by the video controller 391, on the display device 160A. The viewer 361A is attached to the mounting bracket 321 by an extension boom 320. The extension boom 320 allows adjustment of the distance from display device 160A to viewer 361A, and adjustment of the vertical height of viewer 361A. Also, the extension boom 320 rotates so that the viewer 361A can be rotated out of the way to view the display device 160A directly.
[00100] In the aspect of figure 3B, attached to the mounting bracket 321 is a support set 330 for hand-held transmitter 175. Support set 330 includes a turntable 331 in which hand-held transmitter 175 is mounted. In one aspect, the 331 turntable is implemented as a Lazy Susan device.
[00101] Since said implementation of stereo viewer 361, 361A uses mirrors, full colors are supported. The three-dimensional image is not haunted by ghost images, and is completely free of drizzles on the screen, which allows for easy viewing. The image provides stereo depth markings
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28/56 accurate. The position of the stereo viewer 361, 361A is located at a good viewing distance from the display device. Also, the stereo viewer 361 supports a head sensor present for detecting the presence of the surgeon and maintains proper head alignment for motion mapping. The display device resolution 160 determines the resolution of the stereo image.
[00102] A stereo viewer that is capable of viewing stereo images located directly in front of the viewer is the Berezin Stereo Photography Products Adjustable LCD ScreenScope, 21686 Abedul, Mission Viejo, CA 92691 USA. However, in some ways, it is advantageous to be able to view stereo images that are colocalized with the hand movement workspace. This is achieved by using a set of mirrors such as a periscope with said stereo viewer. The incident mirrors, in the set of mirrors, for the eyes may have a different step angle than the mirrors that reflect the images from the display device 160. In one aspect, the angle of the incident mirrors to the eyes is adjustable via the parts of the eye viewer on which said mirrors are mounted. Sixty degrees down from the horizontal, it was observed to be a good working angle for colocalization.
[00103] The stereo viewer limits the options available to the surgeon with respect to selecting a position on the patient's side. However, the stereo viewer facilitates the implementations of the various locks described above and can be mounted on a boom of the patient's cart to reach many of the working positions desired by the surgeon 101. This implementation does not allow multiple users to simultaneously view the same three-dimensional image using the display device 160.
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29/56 [00104] In yet another aspect, active glasses 361 are used to view an image on the display device 160. Active glasses 361 are sometimes referred to as shutter glasses. Active glasses 361 turn off each eye at a time with an update coefficient of the display device 160. Each lens in the active glasses 361 is effectively a one-pixel LCD screen that is off (black) or on (clear) depending on which eye you should see the image displayed on the display device 160.
[00105] If the display device 160 is a 120 Hz LCD device, 120 frames per second of video are displayed so that 60 frames for each eye per second are displayed. This is sometimes referred to as a page flip.
[00106] A wireless connection or an infrared connection is used to synchronize the active glasses 361 with the display device 160. When the left eye frame is shown on the display device 160, the left lens is fully opened and during the moment when As the screen updates with the next frame for the right eye, the active glasses 361 must also change the opacity of the lenses. If display device 160 is the 120 Hz LCD display device, 120 frames per second of video are displayed so that 60 frames for each eye per second are provided by the 190 control system. A 120 Hz LCD screen that can be used is offered by Samsung.
[00107] In said aspect, the infrared (IR) shutter signal can be used as the surgeon's presence signal. The surgeon must face the display device 160 so that the IR shutter signal emitted by the display device 160 is detected by the active shutter glasses 361. Said detection can be based on the control system to confirm the presence as part of the safety interlock. While wearing filled glasses
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30/56 active res 361 provides good image quality and a large immersive screen, the surgeon 101 must remain within the line of sight of the display device 160 and avoid lateral movement of the head to minimize disturbing distortion.
[00108] In yet another aspect, the display device 160 is not mounted on the boom and is instead a head mounted screen unit. The head-mounted screen unit includes two small factor-forming LCD screens with the viewer's eye parts that display independent images for the left and right eyes. The eye pieces are adjustable for optimal alignment with the user's eye, including adjustment for inter-pupillary distance and direction of contemplation. The optics inside the eye pieces give the impression that the image is floating in front of the viewer within arm's length. The head-mounted screen provides accurate stereoscopic depth marks and has a good viewing distance. The head-mounted screen also supports colocalization of vision and a head sensor present as a presence sensor. A head-mounted screen suitable for use is the 3D-HD Personal Head Display offered by Vision Sistemas Group, A Division of Viking Sistemas, 134 Flanders Rd., Westborough, MA.
[00109] In yet another aspect, the head-mounted screen technology is also offered in a compact boom-mounted screen form factor. See figure 3C. In said aspect, the display device 160B is mounted on the boom 310A which is directly attached to the robotic cart facing the patient side 305 or an isolated cart. This technology supports most of the working positions desired by the surgeon in the cart facing the patient, and supports a head sensor present 371, and a head rest 372. Additionally, the angle of the eye pieces allows
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31/56 has the ideal colocalization of vision with a hand-held workspace. Arrow 373 represents the surgeon's line of sight using the 160B display device, which, in one embodiment, is angled down from the horizontal by sixty degrees. Also, in that aspect, the hand-held transmitter 175 is supported by the 310A boom.
[00110] In another aspect, the display device 160 is an auto-stereoscopic screen, which does not require special glasses or a stereo viewer and thus the surgeon viewer 361 is not used. The auto-stereoscopic screen sends separate images to each eye without the need for glasses. There are two main technologies used to generate an auto-stereoscopic screen: using a barrier to block the light destined for the contralateral eye, or using a lenticular lens to direct the light into the chosen eye.
[00111] A parallax barrier has thin vertical slits in an opaque medium. The barrier is arranged in front of an image on the display device 160 with the left and right images shown in the vertical slots. If the frequency of the image slots and barrier slits matches and the surgeon 101 is a necessary distance from the barrier, the left and right images can be seen by the left and right eyes, respectively, of the surgeon 101. There is no polarized glasses. However, there is a limited number of viewing positions, which in turn results in limited freedom in the choice of positions on the patient's side by the surgeon 101.
Mode Control [00112] The surgeon interface facing the patient side 150 includes an interface for the mode control system, such as: follow mode (slave surgical instruments follow the movements of the main tool handles), child
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32/56 main nage (disengaging slave drive from main movement), camera control mode (enabling endoscope movement), power tool mode (enabling surgical power tool control (for example, electrocautery tools) , camera focus mode (enabling camera focus control), arm swap (allowing various combinations of main and slave arm control), and tilepro swap mode (enabling control of various image displays on the surgeon's screen, for example, switching between a full-screen display and a screen where the surgeon sees two or more separate images or data screens.) An interface for controlling system modes is readily accessible by the surgeon 101 and supports not only activation on / off but also triggered activation of the various operating modes.
[00113] The interface for controlling system modes allows mode control inputs to be mapped and controlled by multiple users in a mutually exclusive mode. The interface also allows the user to have independent main gear. In one aspect, the interface is sterilizable. The interface for controlling system modes is easy to learn and remember. The interface for controlling system modes is configured to minimize unwanted activation modes.
[00114] The interface for controlling the system modes can be isolated or in combination with one or more keys, sensors and pedals. For example, the keys can be included in the main tool handles which when pressed activate the main clutch and camera control, as described above. A quick touch of the same keys triggers an arm swap or a tilepro swap. A particular feature for normal touch and a particular quick touch feature is assigned to each key.
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33/56 [00115] In one aspect, the interface for controlling system modes includes a 430 pedal console (figure 4C) that includes at least one 431. pedal. In one aspect, the 430 pedal console is a small pod that is similar to the right half of a conventional pedal console for controlling energy activation in a da Vinci® Surgical System Model IS3000 (see US patent application No. 12 / 400,726 (filed March 9, 2009), which is found incorporated herein by reference). However, in some ways, the full conventional pedal console can be used.
Ergonomic Support [00116] As illustrated in figures 1A and 1B, the surgeon interface facing the patient side 150 includes a mobile ergonomic forearm support 180 that functions as an armrest bench for the forearm (s) or elbow ( s) of the surgeon 101. The forearm support 180 provides stability for fine movement of the main tool handles 170, 170A, 170B. The 180 forearm support also maintains the proprioceptive relationship between the hands for coordinated tasks.
[00117] In the example in figure 4A, the forearm / elbow support 180A is attached to the operating table 405. As used here, the forearm / elbow support means that the support can be provided either for the forearm or for the elbow. The forearm / elbow support 180A is movable in multiple dimensions, for example, along the length of the operating table 405 as shown by arrow 404, closest to and away from the operating table as shown by arrow 401, and up and down with respect to the operating table surface 405 as shown by arrow 402. Also, in that example, the forearm / elbow support 180A can pivot over its center as shown by arrow 403. The forearm support / 180A elbow can be used or
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34/56 while surgeon 101 is standing or sitting. Alternatively, the 180A forearm / elbow support can be attached to the movable boom with brakes instead of to the 405 operating table. The movable boom can be adjusted for standing or seated use, and the movable boom structure is strong enough to withstand by the force of a surgeon leaning against the spear.
[00118] In another example, the forearm / elbow support 180B is mounted on a mobile platform such as a saddle seat 410. As shown in figure 4B, the saddle seat 410 includes a plurality of casters 415 to facilitate movement. A saddle seat with such support is offered as the Salli Saddle Stool with Elbow Rest offered by Back Designs, Inc. of Novato, CA, USA. The use of a saddle seat is only illustrative of a mobile platform and is not intended to be limiting to that specific seat. In view of said description, a suitable forearm / elbow support can be mounted on a variety of movable platforms on which the surgeon 101 can comfortably sit or otherwise be supported.
[00119] Said mobile platforms allow the surgeon 101 to sit on the platform and thus relax the body's muscles and preserve the ergonomic alignment of the spine during work. The mobile platform provides a neutral working position for the surgeon's forearms and a physical reference to return to an ergonomic pose in main gear mode. This physical reference reduces the cognitive load when using the main gear mode and helps to preserve ergonomic posture.
Control System [00120] As described above, the control system 190, 190A (figures 1A, IB, 3A, and 7) perform a variety of functions. The 190A control system (figure 7) receives not only the information that is associated
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35/56 linked to the operation in one of the operating modes but also the information that indicates a mode in which to operate. For example, using the main input / output interface module 702, the control system 190A receives the perceived spatial information 721, the perceived orientation information 722, and the closing grip information 723 as well as the status information of the keys. control 724, for example, the screen presence and main tool grip keys. The 190A control system also receives the 725 mode control commands from the patient-side surgeon interface (PSSI) 150. The actions taken by the 190A control system in response to status information from the various keys control and mode control commands have been described above and therefore will not be repeated here.
[00121] The 190A control system uses a teleoperation servo control system, which executes instructions on a 760 teleoperation control handle module on a processor in the 701 processor module, to translate and transfer the tool grip movement main 670 to an associated robotic arm through control commands so that the surgeon 601 can effectively manipulate the tip of the slave surgical instrument 110. In one aspect, the control commands include orientation motion commands 731 and spatial motion commands 732 The functions performed by the servo teleoperation control system are equivalent to conventional functions when considered in conjunction with the features described more fully below for the 190A control system.
[00122] In figure 6A, a conventional endoscopic coordinated view frame 610 for stereoscopic endoscope 612 is illustrated. In figure 6B, several coordinated frames 610, 620, and 630 are used
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36/56 dos in one aspect. As more fully described below, coordinated frames 610, 620, and 630 are used in an aspect of translating the main tool 670 grip movement into the tip of a teleoperated slave surgical instrument.
[00123] The 190A control system implements unique mappings and processing to translate the perceived spatial information 721, the perceived orientation information 722 into motion commands 731 and space motion commands 732 to move the tip of a teleoperated slave surgical instrument . In particular, the 190A control system, as described more fully below, includes a ratchet system module 730 which upon execution prevents the autonomous or unintentional movement of a slave surgical instrument. The control system 190A may also include a visual proxy module 750, as more fully described below, which is stored in memory 780 and run on a processor in processor module 701.
[00124] The following description of a 190A control system implementation is illustrative only and is not intended to be limiting. In view of the description, one skilled in the art can select and implement any desired combination of the features described to accommodate the needs of a minimally invasive teleoperated surgical system that includes the surgeon interface facing the patient 150.
[00125] The combination of the mechanically ungrounded 670 main tool handle in a sterile surgical field and a 660 three-dimensional display device provides a new ability to allow patient side control of teleoperated slave surgical instruments. As described above, in one aspect, the three-dimensional mobile screen 660 is mobile by the surgeon 601, who is working
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37/56 working in the sterile surgical field. The techniques used to map the hand tool movements 670 in the movement of an executing end of the slave surgical instrument 661 as seen on the three-dimensional display device 660 by the 190A control system are not directly transferable from the minimally teleoperated robotic surgical system conventional invasive.
[00126] To better understand the problem solved, it is useful to first consider the conventional mapping strategy used by the teleoperated robotic surgical system, minimally invasive conventional with respect to the surgeon's console 114 (figure 1B), which is not within the sterile surgical field . The movement mapping strategy for the surgeon console 114 is designed to be both intuitive and ergonomic. To accomplish this, motion mapping takes advantage of the colocalization of the sight and hand workspace. See, for example, US Patent No. 7,155,315 (filed December 12, 2005; which discloses Camera Referenced Control in a Minimally Invasive Surgical Apparatus), which is incorporated herein by reference in its entirety.
[00127] The surgeon 195 (figure 1B) sits on the surgeon's console 114 and looks inside a stereo viewer to see the three-dimensional image from the stereoscopic endoscope 112. The three-dimensional image is presented to the surgeon 195 in an immersion mode, so it looks like the 195 surgeon is looking at the surgical field directly with his own eyes. The stereo view is scaled so that it perceptually corresponds to the working space of the surgeon's eyes and hands. In addition, the stereo view is oriented so that the scene extends in depth along the viewing direction of the surgeon's head, where the head is angled down by sixty degrees.
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38/56 [00128] As a result of this configuration, the visual space of the surgeon perceptually overlaps with the space in which the surgeon moves the main tool manipulators. The referred architecture essentially gives the impression that the teleoperated slave surgical instruments are the surgeon's own hands.
[00129] Thus, the conventional system accommodates an ideal mapping of the hand - eye space to control teleoperated slave surgical instruments. As noted, when looking at the instruments in the endoscopic view, it is common for the surgeon to realize that the instruments are in fact their own hands.
Control System - Body - Central Mapping [00130] As described above, the surgeon interface facing the patient side 150 allows the display device 660 to be positioned and oriented in different ways in relation to the surgeon 601. The mapping of colocalization Conventional, described above, dictates that the surgeon 601 would have to move his hands along the viewing direction of the stereoscopic screen 660 to move the instruments along the Zs stereoscopic viewing direction. Such an approach may be acceptable for a stereoscopic display device such as that illustrated in Figure 3C, where the surgeon looks down into the display device 160B, but is unacceptable for screen devices where the surgeon's view is more horizontal.
[00131] Additionally, the surgeon 601 would have to move his hands upwards and parallel to the screen to move the instruments upwards in the Ys direction in the endoscopic view. However, this can lead to awkward and non-ergonomic movements when the display device 660 is not directly in front of the surgeon 601. This would be tiring for the surgeon 601 to have to continually raise his arms to move his hands up and on the display device. 660.
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39/56 [00132] To overcome the aforementioned problems associated with trying to use conventional visual space, a central body mapping is applied, which allows the 601 surgeon to record movements related to his own posture. In the example of figure 6B, a central body coordinate frame 610 includes a central body z-coordinate axis Zbc, a central body x-coordinate axis Xbc, and a central body y-axis coordinate Ybc.
[00133] In figure 6B, the central body z-coordinate axis Zbc is an axis along which the main tool 670 grip movement is offset from and towards the 601T surgeon's torso 601. The axis central body x-coordinate axis Xbc is an axis along which the main tool 670 grip movement is from left and right with respect to surgeon 601T's torso 601. The central body y-coordinate axis Ybc is an axis along which the main tool 670 grip movement is up and down with respect to the 601T torso of the surgeon 601.
[00134] In the image on the display device 660, the z-coordinate axis of endoscopic view Zs is an axis along the direction of endoscopic vision, which is in and out of the image on screen 660. The z-coordinate axis of endoscopic view Xs is an axis that extends from right to left in the image on screen 660. The y-coordinate axis of endoscopic view Ys is an axis that extends up and down in an image on screen 660. The coordinate frame 610 is illustrated on screen 660 for ease of discussion and is not normally included in the image on screen 660. In one aspect, the screen coordinate frame for the image on screen 660 is the same as the endoscopic view of the coordinate frame 610.
[00135] Also, in the image on the display device 660 is an executing end 661 of a slave surgical instrument
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40/56 teleoperated for which the end of the 630 coordinate frame is defined. The Zt-coordinate axis Zt of the executing end 661 is an axis along the longitudinal axis of the image of the slave surgical instrument teleoperated on screen 660. The axis of z-coordinate = xt of Xt and coordinate axis of Yt define a plane perpendicular to the Zt axis.
[00136] Note that for the sake of convenience the image of the executing end of the slave surgical instrument 661, sometimes referred to as the tip of the slave surgical instrument 661, is used in the present description, as this is what the surgeon observes if moving. The movement of the referred image corresponds directly to the movement of the tip of the teleoperated slave surgical instrument tip. One skilled in the art understands that the movement of the image is a direct result of the movement of the tip itself by the robot arm in response to a control command from the 190A control system, as described here.
[00137] Note that the 190A control system maps not only the data in the central coordinate frame of the body 620 and data in the edge coordinate frame of the surgical instrument 630 to the endoscopic view coordinate frame 610, which is sometimes referred to as a common coordinate table. Said mapping is used to translate the movement of the main tool tracker 660 into the movement of a surgical instrument tip 661 in the screen coordinate frame.
[00138] For example, when seated or standing, surgeon 601 can move main tool handle 670 away from his torso 601T along the zbc central body z-coordinate axis. Main tool handle 670, in that aspect, perceives the movement in the three-dimensional coordinate frame 610 and provides the perceived spatial information 721 and the
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41/56 perceived orientation information 722 for the 190A control system.
[00139] In control system 190, a hand tracking controller 704 receives the perceived information, for example, one or both of the perceived spatial information 721 and the perceived orientation information 722, and issues new spatial position data (Xbc, ybc , Zbc) and new orientation data (Step, Yaw, Roll). In one aspect, the hand tracking controller 704 is also coupled to a hand tracking transmitter 175 and controls the field transmitted by transmitter 175.
[00140] The spatial position data (Xbc, ybc, Zbc) and the orientation data (Step, Yaw, Roll) are mapped to the 610 endoscopic view coordinate table. Using the new mapped data and the current executing end position 661 in the endoscopic view coordinate frame 610, the information required to move the performing end 661 to the new position in the endoscopic view coordinate frame 610 is determined. This information is sent in a control command to the slave instrument. In response to the control command, the teleoperated slave surgical instrument moves the tip along the direction of stereoscopic vision to correspond to the 670 main tool handle movement along the Zbc central body Z-coordinate axis. Consequently, the image at the tip of the slave instrument 661 in the display device 660 moves along the z-coordinate Zs.
[00141] Similarly, moving the main tool handle 670 upward along the center body y-coordinate Ybc axis moves the slave instrument so that the image at the tip of the slave instrument 661 on the display device 660 moves upward along the y-coordinate axis of endoscopic view
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42/56 pica Ys, that is, the image moves upwards on the display device 660. Moving the main tool handle 670 to the left along the x-coordinate axis of the central body Xbe moves the slave instrument so that the image at the tip of the slave instrument 661 on the display device 660 moves left across the screen along the Xs endoscopic z-coordinate axis.
[00142] The referred mapping strategy relaxes the assumption that the head, body and arms of surgeon 601 are all aligned with the screen coordinate frame. The orientation of the central body coordinate frame can be directly managed by the surgeon 601. This allows the surgeon 601 to manage not only the mapping ergonomics but also to accommodate more flexibility in the arrangement of the surgeon, patient, endoscope and endoscopic screen.
[00143] One option is to allow the surgeon to orient the transmitter 175 used by the hand tracking system, for example, to rotate the transmitter 175 using the 331 turntable (figure 3B). Another related option is to attach a 175 light transmitter to the surgeon for use, so that the measured movements are always relative to the surgeon's torso. An alternative is to allow the surgeon to make an indication or gestural movement to define the orientation framework.
[00144] A magnetic hand tracking controller, sensors for use in the main tool grip, and a hand tracking transmitter suitable for use in a modality of the present invention are offered by Ascension Technology Corporation of Burlington, Vermont, USA as a 3D guidance trakSTAR ™ system with a Mid-Range transmitter. (trakSTAR ™ is a registered trademark of Ascension Technology Corporation). The transmitter generates pulsed DC magnetic fields for greater
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43/56 tracking accuracy over the medium ranges, which is specified as 78 centimeters (31 inches). This system provides dynamic monitoring with 240 to 420 updates / second for each sensor. Emissions from the miniaturized passive sensor are not affected by the noise sources of the power line. A clear line of sight between the transmitter and the sensors is not required. There is total attitude monitoring and no inertial deviation or optical interference. There is high metal immunity and no distortion from non-magnetic metals.
Control System - Ergonomic Handle Orientation Mapping [00145] With the surgeon's interface facing the patient side 150, the display device 160 is not always angled downward by sixty degrees like the stereo viewer console. If the display device 160 is oriented very vertically, (that is, the surgeon's view is normal to the screen and essentially horizontal) to reproduce a conventional configuration between the three-dimensional image and the main tool handles, the surgeon 101 would need to bend his hands. fists 515A, 515B backwards in an uncomfortable pose as illustrated in figure 5A, or otherwise keep the forearms in an uncomfortable pose. Although it is possible to operate the slave surgical instruments in said position, the surgeon 101 would find an unnatural position ergonomically undesirable.
[00146] Consequently, in one aspect, the fixed rotational deviation is used for mapping the wrist orientation movements in the central body coordinate frame. Specifically, the orientation data perceived from the main tool grip 170A, 170B that are received by the servo control handle within the 190A control system (figure 7) are rotated by
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44/56 a fixed displacement. This is re-presented in figure 6B by the fixed displacement of the 620R A coordinate frame in the range of -45 degrees to -30 degrees. It has been observed to work well in mitigating said ergonomic problem while still preserving intuitive control. The improved ergonomic pose 515A1, 515B1 allowed by the use of the said fixed rotational deviation is illustrated in 5B.
[00147] The anthropomorphic nature of the referred mapping aspect is that the wrist control is no longer mapped in an absolute mapping one by one that is based solely on the vision and mechanical components of the system configuration. The mapping is instead modified to accommodate a more comfortable wrist band of movement for a human user.
Control System - Ratchet System [00148] A teleoperated, minimally invasive conventional surgical system requires the surgeon to wait until the orientation of the main tool grip and the executing end of the slave surgical instrument are positioned so that the way to proceed can be triggered without causing an unwanted abrupt slave movement. However, in the 190A control system, a ratchet system module 730 (figure 7), within the teleoperation control handle module 760 is activated, for example, run on processor module 701, when surgeon 101 begins to move the main tool handle 170. The ratchet system module 730 as well as the module 760 are stored in memory 780. Regardless of the orientation error between the main tool handle 170 and the executing end of the slave surgical instrument 110, the teleoperation servo control handle enters the tracking mode between the main tool grip 170 and the surgical instrument executing end, sometimes called the surgical instrument tip esPetição 870190120833, of 11/21/2019, pg. 52/76
45/56 harpsichord 661.
[00149] The ratchet system module 730 smoothly and continuously improves the main tool grip orientation 170 with respect to the tip of the slave surgical instrument as the main tool grip 170 is moved. The ratchet system module 730 triggers the orientation of the slave surgical instrument tip to continuously and smoothly reduce any orientation error between the slave surgical instrument tip and the main tool handle 170. The main tool handle movements that are in Slave orientation directions are used to enhance the master / slave mapping, but the main tool handle movements that are offset from the slave orientation are not, and so the main / slave alignment is continuously leveraged towards a suitable ratio intuitive that the surgeon can experience. The execution of the ratchet system module 730 achieves the orientation alignment without autonomous movement or the main tool grip 170, or the tip of the slave surgical instrument.
[00150] The execution of the ratchet system module 730 results in intuitive orientation alignment between the main tool grip 170 and the tip of the slave surgical instrument as seen by surgeon 101 in the display device 160. Also, the module of the turnstile 730 provides a direct association between what the surgeon 101 is doing (manipulating the main tool handle 170) and what the surgeon 101 is seeing on the display device 160 (movement of the slave surgical instrument tip on the display device 160) . An example of such leverage is described in more detail in the copending and commonly assigned US Patent Application No. 12 / 495,213 (filed
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June 46/56, 2009; disclosing Ratcheting for Master Alignment of a Teleoperated Minimally-Invasive Surgical Instrument), which is hereby incorporated by reference in its entirety.
Control System - Visual Proxy System [00151] As described above, visual proxies can be used by one surgeon to supervise another surgeon. In said example, surgeon 195 (figure 1B) is supervised by surgeon 101 using the patient-side surgeon interface 150. However, said configuration is only illustrative. For example, surgeon 101 can use main tool grip 170A (figure 2) to control a visual proxy, while surgeon 195 uses main tool grip 170B to control the teleoperated slave surgical instrument 110. Any main tool grip can be assigned to a visual proxy and a surgeon can use that main tool handle to supervise another surgeon using a different main tool handle. The patient-side surgeon interface 150 facilitates said supervision without requiring a second surgeon console, or even a first surgeon console.
[00152] To facilitate supervision, a visual proxy module 750 is processed as part of the vision processing subsystem in one aspect. The module receives the position and orientation of the main tool handles and returns them as stereo images, which are composed with the images from the endoscopic camera in real time and displayed on the surgeon console, auxiliary screen, and the surgeon interface screen facing patient side 160. When surgeon 101 initiates supervision by taking a predefined action, a visual proxy system handle is activated, for example, module 750 is executed on processor module 701. The particular action used as the predefined action is not is essential since the control system
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47/56
190A is configured to recognize said action.
[00153] In one aspect, the visual proxy is an 811 virtual phantom instrument (figure 8) controlled by the main tool grip 170, while the teleoperated slave surgical instrument 810 is controlled by one of the surgeon's console 114 main tool manipulators. Surgeon 101 observes both instruments 810 and 811 on the display device 160, while surgeon 195 observes both instruments 810 and 811 on the stereoscopic screen on the surgeon's console 114. The use of virtual ghost instrument 811 as a visual proxy is only illustrative and is not intended to limit that particular image. In view of that description, other images can be used for the visual proxy, which facilitate the differentiation between the image representing the visual proxy and the current image of the executing end of the teleoperated slave surgical instrument.
[00154] The virtual ghost instrument 811 looks similar to the current instrument 810, except that the virtual ghost instrument 811 is displayed in a mode that clearly distinguishes the virtual ghost instrument 811 from the current instrument 810 (for example, a transparent ghost image or translucent, a distinctly colored image, etc.). The control and operation of the 811 virtual phantom instrument is the same as described above for a current teleoperated surgical instrument. Thus, the surgeon 101 can manipulate the virtual phantom instrument 811 using the main tool grip 170 to demonstrate the proper use of the teleoperated slave surgical instrument 810. The surgeon 195 can mimic the movement of the virtual phantom instrument 811 with the 810 instrument.
[00155] Virtual phantom instruments are described more fully in the commonly assigned US patent application publication No. US 2009/0192523 Al (filed March 31,
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48/56
2009; disclosing Synthetic Representation of a Surgical Instrument), which is hereby incorporated by reference in its entirety. Control System - Process Flow [00156] Figure 9 is a process flow diagram for an aspect of a method 900 implemented in a control system 190, 190A in a minimally invasive surgical system 100 including a mobile display device 160 , a main tool grip 170, a hand-held transmitter 175, and a teleoperated slave surgical instrument 110. In the RECEIVE NEW PERCEIVED MAIN MOVEMENT DATA 901 operation, new perceived spatial data, new perceived orientation data, or both are received control system 190. Operation 901 transfers processing to the safety interlock check operation 902.
[00157] The 902 safety interlock check operation determines whether the safety interlock states indicate that a tracking operation between at least one main tool handle and a slave surgical instrument is allowed. In addition to the various interlocks described above, another safety interlock is that the surgeon must guide the main handle to basically correspond to the perceived orientation of the tip of the instrument to be controlled before starting the follow-up mode. A 45 degree total misalignment tolerance was found to work well. Said tolerance adjustment is loose enough for the surgeon to correspond and reliably while still resulting in intuitive alignment when the next action is initiated. Residual misalignment is reduced while continuing to use the 730 ratchet system module. The closing grip must also be matched within a tolerance between the tip of the main instrument and the instrument
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49/56 slave before entering the follow mode.
[00158] If, for example, any of the presence keys, described above, indicate no presence, an indication is received that the display device 160 has been moved, or perhaps the interlocks in the follow mode are not true, the operation security interlock check 902 is false, which means that the way of following is not permissible. Thus, the check operation 902 transfers to the SAVE PERCEIVED DATA operation from MAIN TOOL HANDLING 903, which saves the new data received and the processing returns to operation 901, in that example.
[00159] If the states of the safety interlocks indicate that the system 100 including the surgeon 101 is in the state necessary for the follow-up operation, the SECURITY INTERLOCK check operation 902 transfers the processing to the CHECK MODE operation. FOLLOWING FROM SYSTEM 904. If system 100 is entering the follow mode or is in the follow mode, the check operation 904 transfers to the MAPPING COMMON REFERENCE STRUCTURE 905 and otherwise to the SAVE DATA operation PRINCIPALS OF PERCEIVED MAIN TOOL HOLDING 903.
[00160] The operation of MAPPING THE COMMON REFERENCE STRUCTURE 905 maps the new perceived data to the common reference structure. For example, if the central body coordinate frame is used, the perceived data that is in the central body coordinate frame is mapped to the endoscopic view coordinate frame as described above. Also, the fixed rotational deviation for the central body coordinate frame is implemented in operation 905 before mapping in one aspect. Adi
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50/56 a 4: 1 scale factor, in one aspect, is used between the movements in the m central body coordinate frame 620 and the movement in the 610 endoscopic coordinate frame. [00161] With the conclusion from operation 905, operation CATRACA 906 processes the new orientation data and the operation GENERATE NEW SPATIAL POSITION OF SLAVE DATA 910 processes the new position data. The CATRACA 906 operation uses the saved SLAVE ORIENTATION 907, which is the current slave orientation stored in the slave orientation storage element 770 in memory 780, and the new orientation data to generate a new relative rotation matrix and then transfer to the operation GENERATE NEW SLAVE ORIENTATION 908.
[00162] The GENERATE NEW SLAVE ORIENTATION 908 operation generates a new slave orientation using a new relative rotation matrix and transfers the processing to the SEND SLAVE ORIENTATION COMMAND operation. Using the new slave orientation, operation 909 sends a command including the slave orientation and the commanded angular speed, in the common frame of reference, through the slave input / output (I / O) module 703, which results in the tip of the slave surgical instrument being moved as directed by that command. With the completion of operation 909, in that example, it returns to operation 901.
[00163] When surgeon 101 moves the main tool handle 170 in a mode that reduces an orientation error between the main tool handle 170 and the slave surgical instrument tip 110, the ratchet orientation process uses the reduced orientation error in monitoring between the main tool grip 170 and the slave surgical instrument tip 110, while responding for how the surgeon picked up the main tool grip 170 and whether a scroll joint limit was found
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51/56 contracted. Conversely, when surgeon 101 moves the main tool handle 170 in a mode that increases an orientation error between the main tool handle 170 and the slave surgical instrument tip 110, the ratchet orientation process uses the current orientation, not increased orientation error, in the way of going between the main tool grip 170 and the tip point of the slave surgical instrument 110. [00164] Operations 906 to 909 are more fully described in the US patent application copedent and commonly assigned No. 12 / 495,213, which is hereby incorporated by reference. [00165] The ratchet orientation process smoothly and continuously improves the absolute orientation of the main tool grip 170 with respect to the slave surgical instrument tip 110. The ratchet orientation process achieves continuous improvement in absolute orientation without autonomous movement either the main tool grip 170 or the slave surgical instrument tip 110.
[00166] The operation to GENERATE NEW SPATIAL POSITION OF SLAVE DATA 910 uses the new spatial position data of main tool 670 in the common coordinate frame from operation 905 and a current saved spatial position of the slave surgical instrument 911 in the frame of common coordinate to determine a new slave spatial position for executing end 661 in the common reference structure. Using the new slave spatial position, the operation of sending SPACIAL SLAVE POSITION COMMAND 912 sends a command including the slave spatial position and the commanded speed, in the common frame of reference, through the slave input / output (I / O) module 703, which results in the tip of the slave surgical instrument being moved as directed by that command.
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52/56 [00167] Although described as a 190, 190A control system it should be appreciated that the 190, 190A control system can be implemented in practice by any combination of hardware, software that runs on a processor, and firmware. Also, its functions, as described here, can be performed by a unit, or divided between different components, each of which can be implemented in turn by any combination of hardware, software that runs on a processor, and firmware. When divided between different components, the components can be centralized in one place or distributed through the system 100 for the purpose of distributed processing.
[00168] The above description and the accompanying drawings that illustrate the aspects and modalities of the present invention should not be taken as limiting - the claims define the protected invention. The various mechanical, composition, structural, electrical, and operational changes can be made without departing from the spirit and scope of this description and the claims. In some examples, well-known circuits, structures, and techniques have not been shown or described in detail to avoid ambiguity of the invention.
[00169] Additionally, said terminology of the description is not intended to limit the invention. For example, spatially relative terms - such as bottom, bottom, bottom, top, top, proximal, distal, and the like - can be used to describe an element or feature relationship with another element or feature as illustrated in the figures. Said spatially relative terms are intended to encompass the different positions and orientations of the device in use or the operation in addition to the position and orientation shown in the figures. For example, if the device in the figures is rotated, the elements described as below
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53/56 x or under other elements or characteristics would then be above or over the other elements or characteristics. Thus, the example term below can encompass both the top and bottom positions and orientations. The device can be otherwise oriented (rotated 90 degrees or in other orientations) and the spatially related descriptions used herein are interpreted accordingly.
[00170] The singular forms o, a, um, um, intend to include plural forms too, unless the context indicates otherwise. The terms comprises, comprising, includes, and the like specify the presence of certain characteristics, steps, operations, elements, and / or components, but do not prevent the presence or addition of one or more other characteristics, steps, operations, elements, components, and / or groups.
[00171] All examples and illustrative references are not limiting and should not be used to limit claims to the specific implementations and modalities described here and their equivalents. Headings are for formatting only and should not be used to limit the subject in any way, because the text under a heading can be a cross-reference or apply to the text under one or more headings. Finally, in view of said description, particular features as described in relation to an aspect or embodiment can be applied to other aspects or embodiments described of the present invention, although not specifically shown in the drawings or described in the text.
[00172] Although memory 780 is illustrated as a unified structure, this should not be interpreted as requiring that all memory be in the same physical location. All or part of the memory can be in a different physical location than a processor. Memory refers to a volatile memory, a non-volatile memory, or any combination of the two.
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54/56 [00173] A processor is coupled to a memory containing instructions executed by the processor. This can be done inside a computer system, or alternatively by connecting to another computer using modems and analog lines, or digital interfaces and a digital carrier line.
[00174] Here, a computer program product comprises a computer-readable medium configured to store computer-readable code necessary for any part of or all of the 900 method, or in which code capable of being read by computer for any part of or all of the 900 method is stored. Some examples of computer program products are CD-ROM disks, DVD disks, flash memory, ROM cards, floppy disks, magnetic tapes, computer hard disks, servers on a network and signals transmitted over a network that represents program code able to be read by computer. A tangible computer program product comprises a computer-readable tangible medium configured to store instructions capable of being read by computer for any part of or all of the 900 method or where instructions capable of being read by computer for any part of or the entire 900 method is stored. Tangible computer program products are CD-ROM discs, DVD discs, flash memory, ROM cards, floppy disks, magnetic tapes, computer hard drives and other physical storage media.
[00175] In view of said description, the instructions used in any part of or all of the 900 method can be implemented in a wide variety of computer system configurations using an operating system and computer programming language of interest to the user.
[00176] Additionally, the different different systems and methods
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Minimally invasive 55/56 can be implemented in view of that description.
[00177] In one aspect, a minimally invasive surgical system includes:
a surgeon interface facing the patient side comprising:
a) a display device mounted in an operating room; and
b) the main interface including:
a mechanically ungrounded main tool handle positioned inside the operating room; and a separate hand-held transmitter removed from the mechanically ungrounded main tool handle in which the mechanically ungrounded main tool handle in combination with the hand-held transmitter provides perceived position and orientation information in the reference structure associated with a person operating the mechanically ungrounded main tool handle;
a teleoperated slave surgical instrument comprising a surgical performing end; and a control system coupled to the handle of a mechanically ungrounded main tool, the hand-held transmitter, the display device and the teleoperated slave surgical instrument, in which the said control system receives the position and orientation information perceived in the structure reference, generates a control command using the information of perceived position and orientation, and sends the control command to move the surgical executing end with respect to the reference structure associated with an image displayed on the display device 870190120833, of 11/21 / 2019, p. 63/76
56/56 tion.
[00178] Said minimally invasive surgical system also includes a manually operated surgical device including a control rod, in which the control rod is positioned so that the person operating the mechanically ungrounded main tool handle also operates the control rod of the manually operated surgical device.
[00179] In another aspect, a method of using said minimally invasive surgical system includes:
generate the perceived position and orientation information by moving the mechanically ungrounded main tool handle, where the perceived position and orientation information is in a reference structure associated with a person operating the mechanically ungrounded main tool handle;
to control the movement of an executing extremity of a teleoperated, minimally invasive slave surgical instrument based on the information of position and perceived orientation.

权利要求:
Claims (25)
[1]
1. Minimally invasive surgical system (100) characterized by the fact that it comprises:
a surgeon interface facing the patient (160) comprising a display device (160) and a main interface, where the display device (160) is configured to be mounted in an operating room to allow viewing by a person working in a sterile surgical field within the operating room, where the main interface comprises a mechanically ungrounded main tool handle (170) positioned within the sterile surgical field and a hand-held transmitter (175) configured for be separated and removed from the mechanically ungrounded main tool handle (170), and where the mechanically ungrounded main tool handle (170), in combination with the hand-held transmitter (175), is configured to generate position information and perceived orientation of the mechanically ungrounded main tool grip (170) in a central body reference structure (620) defined with respect to a person operating the mechanically ungrounded main tool grip (170);
a teleoperated slave surgical instrument (110) comprising the surgical performing end (661) positioned within the sterile surgical field; and a control system (190) coupled to the mechanically ungrounded main tool grip (170), the hand tracking transmitter (175), the display device
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[2]
2/8 (160) and the teleoperated slave surgical instrument (661), in which the control system (160) is configured to:
receive the position and orientation information perceived in the central body reference structure (620), generate a control command using the position and perceived orientation information, and send the control command to move the surgical performing end (661) with respect to the reference structure (610) associated with an image displayed on the display device (160).
2. Minimally invasive surgical system, according to claim 1, characterized by the fact that it additionally comprises:
a manually operated surgical device (115) including a control rod configured to control the manual operation of the manually operated surgical device (115) by a person, wherein the control rod is configured to be positioned within the sterile surgical field so that the person operating the mechanically ungrounded main tool handle (170) also operates the control rod of the manually operated surgical device (115) to control the manual operation of the manually operated surgical device (115).
[3]
3. Minimally invasive surgical system, according to claim 1, characterized by the fact that:
the surgeon interface facing the patient additionally comprises a stereoscopic image viewer (361) configured to be mounted on a lance at a fixed distance from the display device (160) in the operating room; and with the image display on the display device (160) through the stereoscopic image viewer, a stereoscopic image is seen.
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3/8
[4]
4. Minimally invasive surgical system, according to claim 1, characterized by the fact that:
the surgeon interface facing the patient (150) additionally comprises a screen movement interlocking device; and the screen movement interlock device prevents movement of the display device (160) with the receipt of a signal from the control system (190) movement of the teleoperated slave surgical instrument (110) follows the movement of the handle main tool (170).
[5]
5. Minimally invasive surgical system, according to claim 1, characterized by the fact that:
the surgeon interface facing the patient (150) additionally comprises a screen-based presence interlocking device; and the screen-based presence interlock device is configured to provide a signal to a control system (190) indicating the presence or absence of a surgeon.
[6]
6. Minimally invasive surgical system, according to claim 1, characterized by the fact that:
the surgeon interface facing the patient (150) additionally comprises a movable lance configured to have the display device (160) mounted thereon; and the movable boom is configured to allow the display device (160) to be positioned on an operating table (405) in the operating room.
[7]
7. Minimally invasive surgical system, according to claim 1, characterized by the fact that:
the surgeon interface facing the patient (150) additionally comprises a stabilization platform
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4/8 movable (180) configured to be movable with respect to a position of an operating table (405);
the mobile stabilization platform (180) is configured to support the surgeon's forearms while picking up the main tool handle (170); and the mobile stabilization platform is further configured to be moved independently from any movement of the display device (160).
[8]
8. Minimally invasive surgical system according to claim 7, characterized by the fact that the mobile stabilization platform (180) includes a plurality of wheels (415) configured to move the mobile stabilization platform (180) with respect to a operating table position (405).
[9]
9. Minimally invasive surgical system, according to claim 7, characterized by the fact that the mobile stabilization platform (180) is configured to be mounted on the operating table (405).
[10]
10. Minimally invasive surgical system, according to claim 7, characterized by the fact that the mobile stabilization platform (180) is configured to be mounted on a boom.
[11]
11. Minimally invasive surgical system, according to claim 1, characterized by the fact that the surgeon interface facing the patient side (150) additionally comprises a foot console (430) having at least one pedal (431) attached to the control system (190).
[12]
12. Minimally invasive surgical system, according to claim 1, characterized by the fact that the handle of a mechanically ungrounded main tool (170) additionally comprises at least one key (226) coupled to the control system (190).
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5/8
[13]
13. Minimally invasive surgical system, according to claim 12, characterized by the fact that at least one key (226) is configured to provide a signal to the control system (190) indicating the presence or absence of a surgeon.
[14]
14. Minimally invasive surgical system, according to claim 12, characterized by the fact that at least one key (226) is configured to provide a main clutch signal to the control system (190).
[15]
15. Minimally invasive surgical system, according to claim 12, characterized by the fact that at least one key (226) is configured to provide a camera control signal to the control system (190).
[16]
16. Minimally invasive surgical system, according to claim 1, characterized by the fact that the mechanically ungrounded main tool grip (170) additionally comprises a gripping sensor configured to provide closing grip information to the control system (190 ).
[17]
17. Minimally invasive surgical system according to claim 1, characterized by the fact that the control system (190) additionally comprises a ratchet system configured to continuously improve an orientation of the main tool handle (170) with respect to the end surgical executor (661) as the main tool handle (170) is moved.
[18]
18. Minimally invasive surgical system, according to claim 1, characterized by the fact that it additionally comprises:
a surgeon console (114), coupled to the control system (190), including a stereoscopic display device and a
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6/8 main interface activated.
[19]
19. Minimally invasive surgical system, according to claim 18, characterized by the fact that:
the control system (190) additionally comprises: a visual proxy module (750) coupled to the stereoscopic display device of the surgeon's console (114) and the display device (160);
the visual proxy module (750) is configured to provide a visual proxy; and the visual proxy is configured to be moved by moving one of the mechanically ungrounded main tool handle (170) or a surgeon console main tool manipulator (114).
[20]
20. Method, characterized by the fact that it comprises:
generate perceived position and orientation information when moving a mechanically ungrounded main tool handle (170) located in a sterile surgical field, where the perceived position and orientation information is in the central body reference structure (620) associated with a person;
operate the handle of a mechanically ungrounded main tool (170) within the sterile surgical field; and controlling movement of an executing extremity (661) of a minimally invasive teleoperated slave surgical instrument (110) based on the position and perceived orientation information in which at least a portion of the surgical instrument (110) is in the sterile surgical field.
[21]
21. Method, according to claim 20, characterized by the fact that it additionally comprises:
control a surgical instrument manually operated (115) by the person using a control rod of the surgical instrumentPetition 870190120833, of 11/21/2019, p. 70/76
7/8 manually operated logic (115);
where the control rod is within the sterile surgical field.
[22]
22. Minimally invasive surgical system characterized by the fact that it includes (a) a surgeon interface facing the patient side (150) additionally comprising a display device (160), a mechanically ungrounded main tool grip (170), a hand-held transmitter (175), (b) a teleoperated slave surgical instrument (110) and (c) a control system (190), a method comprising:
generate a control command to operate the teleoperated slave surgical instrument (110) based on the movement of the handle of the mechanically ungrounded main tool;
perceive, through the surgeon interface facing the patient (150), the position and orientation of the mechanically ungrounded main tool grip (170) in the central body reference structure (620) associated with a person operating the grip mechanically ungrounded main tool (170) when the mechanically ungrounded main tool handle (170) is moved in a field of said hand-held transmitter (175) and is moved within a sterile surgical field;
receive and use, through the control system (190), the position and orientation perceived in the central body reference structure (620) to generate the control command in relation to the reference structure (610) associated with an image displayed on the control device display (160); and send, through the control system (190), the control command generated to the teleoperated slave surgical instrument (110).
[23]
23. The method of claim 22, characterized
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8/8 by the fact that it additionally comprises:
generate, by the control system (190, a signal to prevent movement of the display device (160) in the control system (190) that enters the tracking mode between movement of the mechanically ungrounded main tool handle (170) and the teleoperated slave surgical instrument (110).
[24]
24. Method, according to claim 22, characterized by the fact that it additionally comprises: receiving, through the control system (190), a signal from the presence key (226) indicating the presence or absence of a surgeon.
[25]
25. Method, according to claim 24, characterized by the fact that the presence key (226) is included in the main tool grip mechanically ungrounded (170).

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引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

FR2416094A1|1978-02-01|1979-08-31|Zarudiansky Alain|REMOTE HANDLING DEVICE|

---

US4988981B1|1987-03-17|1999-05-18|Vpl Newco Inc|Computer data entry and manipulation apparatus and method|

---

US6701296B1|1988-10-14|2004-03-02|James F. Kramer|Strain-sensing goniometers, systems, and recognition algorithms|

---

JP2561561B2|1990-11-30|1996-12-11|株式会社フジタ|Robot hand remote control system|

---

US6963792B1|1992-01-21|2005-11-08|Sri International|Surgical method|

---

DE4306786C1|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|

---

US5791231A|1993-05-17|1998-08-11|Endorobotics Corporation|Surgical robotic system and hydraulic actuator therefor|

---

US6463361B1|1994-09-22|2002-10-08|Computer Motion, Inc.|Speech interface for an automated endoscopic system|

---

US5808219A|1995-11-02|1998-09-15|Yamaha Corporation|Motion discrimination method and device using a hidden markov model|

---

JP2776477B2|1996-02-13|1998-07-16|川崎重工業株式会社|Robot 3D position and orientation teaching system|

---

US5762458A|1996-02-20|1998-06-09|Computer Motion, Inc.|Method and apparatus for performing minimally invasive cardiac procedures|

---

US5855583A|1996-02-20|1999-01-05|Computer Motion, Inc.|Method and apparatus for performing minimally invasive cardiac procedures|

---

US6436107B1|1996-02-20|2002-08-20|Computer Motion, Inc.|Method and apparatus for performing minimally invasive surgical procedures|

---

US7699855B2|1996-12-12|2010-04-20|Intuitive Surgical Operations, Inc.|Sterile surgical adaptor|

---

US6110130A|1997-04-21|2000-08-29|Virtual Technologies, Inc.|Exoskeleton device for directly measuring fingertip position and inferring finger joint angle|

---

US7472047B2|1997-05-12|2008-12-30|Immersion Corporation|System and method for constraining a graphical hand from penetrating simulated graphical objects|

---

WO1998051451A2|1997-05-12|1998-11-19|Virtual Technologies, Inc.|Force-feedback interface device for the hand|

---

US6126373A|1997-12-19|2000-10-03|Fanuc Usa Corporation|Method and apparatus for realtime remote robotics command|

---

US20030135204A1|2001-02-15|2003-07-17|Endo Via Medical, Inc.|Robotically controlled medical instrument with a flexible section|

---

JP2000132305A|1998-10-23|2000-05-12|Olympus Optical Co Ltd|Operation input device|

---

US6799065B1|1998-12-08|2004-09-28|Intuitive Surgical, Inc.|Image shifting apparatus and method for a telerobotic system|

---

US6331181B1|1998-12-08|2001-12-18|Intuitive Surgical, Inc.|Surgical robotic tools, data architecture, and use|

---

US6424885B1|1999-04-07|2002-07-23|Intuitive Surgical, Inc.|Camera referenced control in a minimally invasive surgical apparatus|

---

US6565554B1|1999-04-07|2003-05-20|Intuitive Surgical, Inc.|Friction compensation in a minimally invasive surgical apparatus|

---

US6809462B2|2000-04-05|2004-10-26|Sri International|Electroactive polymer sensors|

---

JP2002059380A|2000-08-22|2002-02-26|Olympus Optical Co Ltd|Master-slave device|

---

US9002518B2|2003-06-30|2015-04-07|Intuitive Surgical Operations, Inc.|Maximum torque driving of robotic surgical tools in robotic surgical systems|

---

US6785358B2|2001-10-09|2004-08-31|General Electric Company|Voice activated diagnostic imaging control user interface|

---

US20040087989A1|2001-10-23|2004-05-06|Theracardia, Inc.|Scalpel sheath and methods for use|

---

US7203911B2|2002-05-13|2007-04-10|Microsoft Corporation|Altering a display on a viewing device based upon a user proximity to the viewing device|

---

EP1550024A2|2002-06-21|2005-07-06|Cedara Software Corp.|Computer assisted system and method for minimal invasive hip, uni knee and total knee replacement|

---

US7155316B2|2002-08-13|2006-12-26|Microbotics Corporation|Microsurgical robot system|

---

US7410483B2|2003-05-23|2008-08-12|Novare Surgical Systems, Inc.|Hand-actuated device for remote manipulation of a grasping tool|

---

JP2005224528A|2004-02-16|2005-08-25|Olympus Corp|Endoscope|

---

US7386365B2|2004-05-04|2008-06-10|Intuitive Surgical, Inc.|Tool grip calibration for robotic surgery|

---

US7976559B2|2004-11-04|2011-07-12|Dynamic Surgical Inventions, Llc|Articulated surgical probe and method for use|

---

EP1669038B1|2004-12-09|2008-02-20|The University of Dundee|Device for supporting at least one arm of an operating person during a surgical operation|

---

US8398541B2|2006-06-06|2013-03-19|Intuitive Surgical Operations, Inc.|Interactive user interfaces for robotic minimally invasive surgical systems|

---

US7834847B2|2005-12-01|2010-11-16|Navisense|Method and system for activating a touchless control|

---

US7907166B2|2005-12-30|2011-03-15|Intuitive Surgical Operations, Inc.|Stereo telestration for robotic surgery|

---

US20070167702A1|2005-12-30|2007-07-19|Intuitive Surgical Inc.|Medical robotic system providing three-dimensional telestration|

---

US7845537B2|2006-01-31|2010-12-07|Ethicon Endo-Surgery, Inc.|Surgical instrument having recording capabilities|

---

EP1815949A1|2006-02-03|2007-08-08|The European Atomic Energy Community , represented by the European Commission|Medical robotic system with manipulator arm of the cylindrical coordinate type|

---

US7433024B2|2006-02-27|2008-10-07|Prime Sense Ltd.|Range mapping using speckle decorrelation|

---

US20070225562A1|2006-03-23|2007-09-27|Ethicon Endo-Surgery, Inc.|Articulating endoscopic accessory channel|

---

US20090192523A1|2006-06-29|2009-07-30|Intuitive Surgical, Inc.|Synthetic representation of a surgical instrument|

---

KR101494283B1|2006-06-13|2015-02-23|인튜어티브 서지컬 인코포레이티드|Minimally invasive surgical system|

---

US8792688B2|2007-03-01|2014-07-29|Titan Medical Inc.|Methods, systems and devices for three dimensional input and control methods and systems based thereon|

---

US8682502B2|2007-03-28|2014-03-25|Irobot Corporation|Remote vehicle control system and method|

---

US20090012533A1|2007-04-23|2009-01-08|Hansen Medical, Inc.|Robotic instrument control system|

---

US20090138025A1|2007-05-04|2009-05-28|Hansen Medical, Inc.|Apparatus systems and methods for forming a working platform of a robotic instrument system by manipulation of components having controllably rigidity|

---

US9881520B2|2008-01-08|2018-01-30|Immersion Medical, Inc.|Virtual tool manipulation system|

---

US8282653B2|2008-03-24|2012-10-09|Board Of Regents Of The University Of Nebraska|System and methods for controlling surgical tool elements|

---

US8808164B2|2008-03-28|2014-08-19|Intuitive Surgical Operations, Inc.|Controlling a robotic surgical tool with a display monitor|

---

US7843158B2|2008-03-31|2010-11-30|Intuitive Surgical Operations, Inc.|Medical robotic system adapted to inhibit motions resulting in excessive end effector forces|

---

US8803955B2|2008-04-26|2014-08-12|Intuitive Surgical Operations, Inc.|Augmented stereoscopic visualization for a surgical robot using a camera unit with a modified prism|

---

US20100013910A1|2008-07-21|2010-01-21|Vivid Medical|Stereo viewer|

---

US20100082368A1|2008-09-29|2010-04-01|Corquality Systems, Inc.|Wrong site surgery prevention system|

---

US8830224B2|2008-12-31|2014-09-09|Intuitive Surgical Operations, Inc.|Efficient 3-D telestration for local robotic proctoring|

---

US9492240B2|2009-06-16|2016-11-15|Intuitive Surgical Operations, Inc.|Virtual measurement tool for minimally invasive surgery|

---

US9155592B2|2009-06-16|2015-10-13|Intuitive Surgical Operations, Inc.|Virtual measurement tool for minimally invasive surgery|

---

US8521331B2|2009-11-13|2013-08-27|Intuitive Surgical Operations, Inc.|Patient-side surgeon interface for a minimally invasive, teleoperated surgical instrument|

---

US8543240B2|2009-11-13|2013-09-24|Intuitive Surgical Operations, Inc.|Master finger tracking device and method of use in a minimally invasive surgical system|

---

US8682489B2|2009-11-13|2014-03-25|Intuitive Sugical Operations, Inc.|Method and system for hand control of a teleoperated minimally invasive slave surgical instrument|

---

US8520027B2|2010-05-14|2013-08-27|Intuitive Surgical Operations, Inc.|Method and system of see-through console overlay|

---

US8996173B2|2010-09-21|2015-03-31|Intuitive Surgical Operations, Inc.|Method and apparatus for hand gesture control in a minimally invasive surgical system|

---

US8935003B2|2010-09-21|2015-01-13|Intuitive Surgical Operations|Method and system for hand presence detection in a minimally invasive surgical system|US8527094B2|1998-11-20|2013-09-03|Intuitive Surgical Operations, Inc.|Multi-user medical robotic system for collaboration or training in minimally invasive surgical procedures|

---

US6852107B2|2002-01-16|2005-02-08|Computer Motion, Inc.|Minimally invasive surgical training using robotics and tele-collaboration|

---

US9943372B2|2005-04-18|2018-04-17|M.S.T. Medical Surgery Technologies Ltd.|Device having a wearable interface for improving laparoscopic surgery and methods for use thereof|

---

US11253327B2|2012-06-21|2022-02-22|Globus Medical, Inc.|Systems and methods for automatically changing an end-effector on a surgical robot|

---

US10231791B2|2012-06-21|2019-03-19|Globus Medical, Inc.|Infrared signal based position recognition system for use with a robot-assisted surgery|

---

US10893912B2|2006-02-16|2021-01-19|Globus Medical Inc.|Surgical tool systems and methods|

---

US11045267B2|2012-06-21|2021-06-29|Globus Medical, Inc.|Surgical robotic automation with tracking markers|

---

US10136954B2|2012-06-21|2018-11-27|Globus Medical, Inc.|Surgical tool systems and method|

---

US8219178B2|2007-02-16|2012-07-10|Catholic Healthcare West|Method and system for performing invasive medical procedures using a surgical robot|

---

US10350013B2|2012-06-21|2019-07-16|Globus Medical, Inc.|Surgical tool systems and methods|

---

US10357184B2|2012-06-21|2019-07-23|Globus Medical, Inc.|Surgical tool systems and method|

---

US11116576B2|2012-06-21|2021-09-14|Globus Medical Inc.|Dynamic reference arrays and methods of use|

---

US20090173846A1|2008-01-09|2009-07-09|Allan Katz|Medical boom|

---

US10875182B2|2008-03-20|2020-12-29|Teladoc Health, Inc.|Remote presence system mounted to operating room hardware|

---

US9089360B2|2008-08-06|2015-07-28|Ethicon Endo-Surgery, Inc.|Devices and techniques for cutting and coagulating tissue|

---

US8332072B1|2008-08-22|2012-12-11|Titan Medical Inc.|Robotic hand controller|

---

US9679499B2|2008-09-15|2017-06-13|Immersion Medical, Inc.|Systems and methods for sensing hand motion by measuring remote displacement|

---

US9439736B2|2009-07-22|2016-09-13|St. Jude Medical, Atrial Fibrillation Division, Inc.|System and method for controlling a remote medical device guidance system in three-dimensions using gestures|

---

FR2937854B1|2008-10-31|2010-12-03|Aripa Services Innovations Ind|DEVICE FOR POSITIONING A PATIENT IN RELATION TO RADIATION.|

---

US8423182B2|2009-03-09|2013-04-16|Intuitive Surgical Operations, Inc.|Adaptable integrated energy control system for electrosurgical tools in robotic surgical systems|

---

US8423186B2|2009-06-30|2013-04-16|Intuitive Surgical Operations, Inc.|Ratcheting for master alignment of a teleoperated minimally-invasive surgical instrument|

---

US8663220B2|2009-07-15|2014-03-04|Ethicon Endo-Surgery, Inc.|Ultrasonic surgical instruments|

---

US8384755B2|2009-08-26|2013-02-26|Intouch Technologies, Inc.|Portable remote presence robot|

---

US8986302B2|2009-10-09|2015-03-24|Ethicon Endo-Surgery, Inc.|Surgical generator for ultrasonic and electrosurgical devices|

---

US11090104B2|2009-10-09|2021-08-17|Cilag Gmbh International|Surgical generator for ultrasonic and electrosurgical devices|

---

US10441345B2|2009-10-09|2019-10-15|Ethicon Llc|Surgical generator for ultrasonic and electrosurgical devices|

---

US8521331B2|2009-11-13|2013-08-27|Intuitive Surgical Operations, Inc.|Patient-side surgeon interface for a minimally invasive, teleoperated surgical instrument|

---

KR101313106B1|2009-12-17|2013-09-30|한국전자통신연구원|Thimble-type mediated device and method for recognizing thimble gesture using the device|

---

US8469981B2|2010-02-11|2013-06-25|Ethicon Endo-Surgery, Inc.|Rotatable cutting implement arrangements for ultrasonic surgical instruments|

---

US8670017B2|2010-03-04|2014-03-11|Intouch Technologies, Inc.|Remote presence system including a cart that supports a robot face and an overhead camera|

---

IT1401669B1|2010-04-07|2013-08-02|Sofar Spa|ROBOTIC SURGERY SYSTEM WITH PERFECT CONTROL.|

---

FR2962063B1|2010-07-02|2012-07-20|Commissariat Energie Atomique|ROBOTIC HANDLING ASSISTANCE DEVICE WITH VARIABLE EFFORT INCREASE RATIO|

---

US20120010475A1|2010-07-06|2012-01-12|Markus Rossmeier|Integrated display and control for multiple modalities|

---

US8795327B2|2010-07-22|2014-08-05|Ethicon Endo-Surgery, Inc.|Electrosurgical instrument with separate closure and cutting members|

---

US9192431B2|2010-07-23|2015-11-24|Ethicon Endo-Surgery, Inc.|Electrosurgical cutting and sealing instrument|

---

US8996173B2|2010-09-21|2015-03-31|Intuitive Surgical Operations, Inc.|Method and apparatus for hand gesture control in a minimally invasive surgical system|

---

US8935003B2|2010-09-21|2015-01-13|Intuitive Surgical Operations|Method and system for hand presence detection in a minimally invasive surgical system|

---

EP2627278B1|2010-10-11|2015-03-25|Ecole Polytechnique Fédérale de Lausanne |Mechanical manipulator for surgical instruments|

---

US10456209B2|2010-10-13|2019-10-29|Gholam A. Peyman|Remote laser treatment system with dynamic imaging|

---

US9931171B1|2010-10-13|2018-04-03|Gholam A. Peyman|Laser treatment of an eye structure or a body surface from a remote location|

---

EP2637594A4|2010-11-11|2015-05-06|Univ Johns Hopkins|Human-machine collaborative robotic systems|

---

JP5905031B2|2011-01-28|2016-04-20|インタッチ テクノロジーズ インコーポレイテッド|Interfacing with mobile telepresence robot|

---

WO2012131660A1|2011-04-01|2012-10-04|Ecole Polytechnique Federale De Lausanne |Robotic system for spinal and other surgeries|

---

BR112013030210A2|2011-06-02|2016-11-29|Medrobotics Corp|robotic systems, robotic system user interfaces, human interface devices for robotic system control, and robotic system control methods|

---

JP5800616B2|2011-07-15|2015-10-28|オリンパス株式会社|Manipulator system|

---

US9259265B2|2011-07-22|2016-02-16|Ethicon Endo-Surgery, Llc|Surgical instruments for tensioning tissue|

---

JP5715304B2|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|

---

JP6021353B2|2011-08-04|2016-11-09|オリンパス株式会社|Surgery support device|

---

JP5936914B2|2011-08-04|2016-06-22|オリンパス株式会社|Operation input device and manipulator system including the same|

---

EP2740433B1|2011-08-04|2016-04-27|Olympus Corporation|Surgical implement and medical treatment manipulator|

---

JP6000641B2|2011-08-04|2016-10-05|オリンパス株式会社|Manipulator system|

---

JP5953058B2|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|

---

JP5931497B2|2011-08-04|2016-06-08|オリンパス株式会社|Surgery support apparatus and assembly method thereof|

---

JP6005950B2|2011-08-04|2016-10-12|オリンパス株式会社|Surgery support apparatus and control method thereof|

---

WO2013018861A1|2011-08-04|2013-02-07|オリンパス株式会社|Medical manipulator and method for controlling same|

---

JP6009840B2|2011-08-04|2016-10-19|オリンパス株式会社|Medical equipment|

---

JP6021484B2|2011-08-04|2016-11-09|オリンパス株式会社|Medical manipulator|

---

US9519341B2|2011-08-04|2016-12-13|Olympus Corporation|Medical manipulator and surgical support apparatus|

---

JP6081061B2|2011-08-04|2017-02-15|オリンパス株式会社|Surgery support device|

---

JP5841451B2|2011-08-04|2016-01-13|オリンパス株式会社|Surgical instrument and control method thereof|

---

US9757206B2|2011-08-21|2017-09-12|M.S.T. Medical Surgery Technologies Ltd|Device and method for assisting laparoscopic surgery—rule based approach|

---

EP2744388B1|2011-08-21|2020-04-01|TransEnterix Europe Sàrl|Wearable user interface|

---

US10866783B2|2011-08-21|2020-12-15|Transenterix Europe S.A.R.L.|Vocally activated surgical control system|

---

US9204939B2|2011-08-21|2015-12-08|M.S.T. Medical Surgery Technologies Ltd.|Device and method for assisting laparoscopic surgery—rule based approach|

---

US9795282B2|2011-09-20|2017-10-24|M.S.T. Medical Surgery Technologies Ltd|Device and method for maneuvering endoscope|

---

US9241770B2|2011-09-30|2016-01-26|Ethicon Endo-Surgery, Inc.|Methods and devices for remotely controlling movement of surgical tools|

---

JP6141289B2|2011-10-21|2017-06-07|インテュイティブ サージカル オペレーションズ， インコーポレイテッド|Gripping force control for robotic surgical instrument end effector|

---

US8836751B2|2011-11-08|2014-09-16|Intouch Technologies, Inc.|Tele-presence system with a user interface that displays different communication links|

---

DE102011119608B4|2011-11-29|2021-07-29|Karl Storz Se & Co. Kg|Device and method for endoscopic 3D data acquisition|

---

KR101828452B1|2012-01-05|2018-02-12|삼성전자주식회사|Servo control apparatus and method for controlling the same|

---

WO2013119545A1|2012-02-10|2013-08-15|Ethicon-Endo Surgery, Inc.|Robotically controlled surgical instrument|

---

CN104105577B|2012-02-15|2017-06-27|直观外科手术操作公司|Use pattern distinguishes user's selection of the robot system operator scheme of Operator action|

---

TR201202175A2|2012-02-27|2012-09-21|Tami̇ş Otogaz Sanayi̇ Ti̇c. Ve Müh. Hi̇z. İth. İhr. Ltd. Şti̇.|A fixing robot for bone fractures.|

---

EP2819609B1|2012-02-29|2020-10-21|TransEnterix Europe Sàrl|Manual control system for maneuvering an endoscope|

---

WO2013132501A1|2012-03-07|2013-09-12|M.S.T. Medical Surgery Technologies Ltd.|Overall endoscopic control system|

---

US9439668B2|2012-04-09|2016-09-13|Ethicon Endo-Surgery, Llc|Switch arrangements for ultrasonic surgical instruments|

---

EP2863827A4|2012-06-21|2016-04-20|Globus Medical Inc|Surgical robot platform|

---

US9629523B2|2012-06-27|2017-04-25|Camplex, Inc.|Binocular viewing assembly for a surgical visualization system|

---

US9642606B2|2012-06-27|2017-05-09|Camplex, Inc.|Surgical visualization system|

---

US9326788B2|2012-06-29|2016-05-03|Ethicon Endo-Surgery, Llc|Lockout mechanism for use with robotic electrosurgical device|

---

US20140005702A1|2012-06-29|2014-01-02|Ethicon Endo-Surgery, Inc.|Ultrasonic surgical instruments with distally positioned transducers|

---

US9408622B2|2012-06-29|2016-08-09|Ethicon Endo-Surgery, Llc|Surgical instruments with articulating shafts|

---

US9198714B2|2012-06-29|2015-12-01|Ethicon Endo-Surgery, Inc.|Haptic feedback devices for surgical robot|

---

US9351754B2|2012-06-29|2016-05-31|Ethicon Endo-Surgery, Llc|Ultrasonic surgical instruments with distally positioned jaw assemblies|

---

US9393037B2|2012-06-29|2016-07-19|Ethicon Endo-Surgery, Llc|Surgical instruments with articulating shafts|

---

US20140005705A1|2012-06-29|2014-01-02|Ethicon Endo-Surgery, Inc.|Surgical instruments with articulating shafts|

---

US9226767B2|2012-06-29|2016-01-05|Ethicon Endo-Surgery, Inc.|Closed feedback control for electrosurgical device|

---

US9566173B2|2012-08-02|2017-02-14|Korea University Of Technology And Education Industry-University Cooperation Foundation|Motion control device based on winding string|

---

JP6173678B2|2012-08-09|2017-08-02|日本電産サンキョー株式会社|Industrial robot and control method for industrial robot|

---

EP2895098A4|2012-09-17|2016-05-25|Intuitive Surgical Operations|Methods and systems for assigning input devices to teleoperated surgical instrument functions|

---

BR112015007010A2|2012-09-28|2017-07-04|Ethicon Endo Surgery Inc|multifunctional bipolar forceps|

---

DE102012218213B4|2012-10-05|2016-03-03|Deutsches Zentrum für Luft- und Raumfahrt e.V.|Method for controlling a telemanipulation robot|

---

US10201365B2|2012-10-22|2019-02-12|Ethicon Llc|Surgeon feedback sensing and display methods|

---

US9095367B2|2012-10-22|2015-08-04|Ethicon Endo-Surgery, Inc.|Flexible harmonic waveguides/blades for surgical instruments|

---

US10864048B2|2012-11-02|2020-12-15|Intuitive Surgical Operations, Inc.|Flux disambiguation for teleoperated surgical systems|

---

US10631939B2|2012-11-02|2020-04-28|Intuitive Surgical Operations, Inc.|Systems and methods for mapping flux supply paths|

---

CN113397655A|2012-11-14|2021-09-17|直观外科手术操作公司|System and method for dual control surgical instrument|

---

US9566414B2|2013-03-13|2017-02-14|Hansen Medical, Inc.|Integrated catheter and guide wire controller|

---

EP3900641A4|2013-03-14|2021-10-27|Sri int inc|Wrist and grasper system for a robotic tool|

---

WO2014151621A1|2013-03-15|2014-09-25|Sri International|Hyperdexterous surgical system|

---

US9283046B2|2013-03-15|2016-03-15|Hansen Medical, Inc.|User interface for active drive apparatus with finite range of motion|

---

CN108143497B|2013-03-15|2020-06-26|直观外科手术操作公司|System and method for tracking a path using null space|

---

US10849702B2|2013-03-15|2020-12-01|Auris Health, Inc.|User input devices for controlling manipulation of guidewires and catheters|

---

KR20140121581A|2013-04-08|2014-10-16|삼성전자주식회사|Surgical robot system|

---

US9265581B2|2013-04-21|2016-02-23|Gyrus Acmi, Inc.|Relay based tool control|

---

CN104139389B|2013-05-06|2016-04-27|鸿富锦精密工业（深圳）有限公司|Driving mechanism|

---

EP2999414B1|2013-05-21|2018-08-08|Camplex, Inc.|Surgical visualization systems|

---

US11020016B2|2013-05-30|2021-06-01|Auris Health, Inc.|System and method for displaying anatomy and devices on a movable display|

---

EP3038542B1|2013-09-01|2018-12-26|Human Extensions Ltd|Control unit for a medical device|

---

US9814514B2|2013-09-13|2017-11-14|Ethicon Llc|Electrosurgicalmedical instruments for cutting and coagulating tissue|

---

US10881286B2|2013-09-20|2021-01-05|Camplex, Inc.|Medical apparatus for use with a surgical tubular retractor|

---

JP6521982B2|2013-09-20|2019-05-29|キャンプレックス インコーポレイテッド|Surgical visualization system and display|

---

US9283048B2|2013-10-04|2016-03-15|KB Medical SA|Apparatus and systems for precise guidance of surgical tools|

---

EP3052042B1|2013-10-04|2019-11-27|Stryker Corporation|System for interacting with an object|

---

TWI515643B|2013-10-15|2016-01-01|緯創資通股份有限公司|Operation method for electronic apparatus|

---

US9265926B2|2013-11-08|2016-02-23|Ethicon Endo-Surgery, Llc|Electrosurgical devices|

---

US9505133B2|2013-12-13|2016-11-29|Canon Kabushiki Kaisha|Robot apparatus, robot controlling method, program and recording medium|

---

GB2521228A|2013-12-16|2015-06-17|Ethicon Endo Surgery Inc|Medical device|

---

US9795436B2|2014-01-07|2017-10-24|Ethicon Llc|Harvesting energy from a surgical generator|

---

US10039605B2|2014-02-11|2018-08-07|Globus Medical, Inc.|Sterile handle for controlling a robotic surgical system from a sterile field|

---

US9259844B2|2014-02-12|2016-02-16|General Electric Company|Vision-guided electromagnetic robotic system|

---

JP6619748B2|2014-03-17|2019-12-11|インテュイティブ サージカル オペレーションズ， インコーポレイテッド|Method and apparatus for telesurgical table alignment|

---

US10166061B2|2014-03-17|2019-01-01|Intuitive Surgical Operations, Inc.|Teleoperated surgical system equipment with user interface|

---

USD767129S1|2014-03-17|2016-09-20|Intuitive Surgical Operations, Inc.|Surgical instrument end portion|

---

USD768295S1|2014-03-17|2016-10-04|Intuitive Surgical Operations, Inc.|Surgical instrument end portion|

---

EP3119317B1|2014-03-17|2020-02-26|Intuitive Surgical Operations, Inc.|Restoring instrument control input position/orientation during midprocedure restart|

---

USD767130S1|2014-03-17|2016-09-20|Intuitive Surgical Operations, Inc.|Surgical instrument end portion|

---

USD760387S1|2014-03-17|2016-06-28|Intuitive Surgical Operations, Inc.|Surgical instrument end portion|

---

KR102311986B1|2014-03-17|2021-10-14|인튜어티브 서지컬 오퍼레이션즈 인코포레이티드|System and method for recentering imaging devices and input controls|

---

US9554854B2|2014-03-18|2017-01-31|Ethicon Endo-Surgery, Llc|Detecting short circuits in electrosurgical medical devices|

---

CN106456148B|2014-03-19|2020-06-12|直观外科手术操作公司|Medical devices, systems, and methods using eye gaze tracking|

---

CN106659541B|2014-03-19|2019-08-16|直观外科手术操作公司|Integrated eyeball stares medical device, the system and method that tracking is used for stereoscopic viewer|

---

EP3243476B1|2014-03-24|2019-11-06|Auris Health, Inc.|Systems and devices for catheter driving instinctiveness|

---

US10463421B2|2014-03-27|2019-11-05|Ethicon Llc|Two stage trigger, clamp and cut bipolar vessel sealer|

---

US9737355B2|2014-03-31|2017-08-22|Ethicon Llc|Controlling impedance rise in electrosurgical medical devices|

---

CN106659537B|2014-04-24|2019-06-11|Kb医疗公司|The surgical instrument holder used in conjunction with robotic surgical system|

---

CN106232048B|2014-04-24|2019-05-03|柯惠Lp公司|Robot interface's positioning determining system and method|

---

WO2016008880A1|2014-07-14|2016-01-21|KB Medical SA|Anti-skid surgical instrument for use in preparing holes in bone tissue|

---

US10285724B2|2014-07-31|2019-05-14|Ethicon Llc|Actuation mechanisms and load adjustment assemblies for surgical instruments|

---

KR20170041698A|2014-08-12|2017-04-17|인튜어티브 서지컬 오퍼레이션즈 인코포레이티드|Detecting uncontrolled movement|

---

CN104127209B|2014-08-12|2016-03-23|梁迪|Chamber mirror holographic imaging surgery systems|

---

LT3188645T|2014-09-04|2020-07-10|Memic Innovative Surgery Ltd.|Device and system including mechanical arms|

---

CA2957362A1|2015-09-04|2017-03-04|Memic Innovative Surgery Ltd.|Actuation of a device comprising mechanical arms|

---

US9815206B2|2014-09-25|2017-11-14|The Johns Hopkins University|Surgical system user interface using cooperatively-controlled robot|

---

JP6682512B2|2014-10-27|2020-04-15|インテュイティブ サージカル オペレーションズ， インコーポレイテッド|Integrated operating table system and method|

---

US10702353B2|2014-12-05|2020-07-07|Camplex, Inc.|Surgical visualizations systems and displays|

---

US10639092B2|2014-12-08|2020-05-05|Ethicon Llc|Electrode configurations for surgical instruments|

---

US10864049B2|2014-12-19|2020-12-15|Distalmotion Sa|Docking system for mechanical telemanipulator|

---

US11039820B2|2014-12-19|2021-06-22|Distalmotion Sa|Sterile interface for articulated surgical instruments|

---

US10864052B2|2014-12-19|2020-12-15|Distalmotion Sa|Surgical instrument with articulated end-effector|

---

US9739674B2|2015-01-09|2017-08-22|Stryker Corporation|Isolated force/torque sensor assembly for force controlled robot|

---

US9541998B2|2015-01-29|2017-01-10|Samsung Electronics Co., Ltd.|Electronic system with gaze alignment mechanism and method of operation thereof|

---

US10013808B2|2015-02-03|2018-07-03|Globus Medical, Inc.|Surgeon head-mounted display apparatuses|

---

US10555782B2|2015-02-18|2020-02-11|Globus Medical, Inc.|Systems and methods for performing minimally invasive spinal surgery with a robotic surgical system using a percutaneous technique|

---

WO2016137527A1|2015-02-24|2016-09-01|Sri International|Hyperdexterous system user interface|

---

CN107073704A|2015-02-25|2017-08-18|奥林巴斯株式会社|Arm-and-hand system and medical system|

---

JP6766062B2|2015-03-17|2020-10-07|インテュイティブ サージカル オペレーションズ， インコーポレイテッド|Systems and methods for on-screen identification of instruments in remote-controlled medical systems|

---

US10342602B2|2015-03-17|2019-07-09|Ethicon Llc|Managing tissue treatment|

---

US10321950B2|2015-03-17|2019-06-18|Ethicon Llc|Managing tissue treatment|

---

US10595929B2|2015-03-24|2020-03-24|Ethicon Llc|Surgical instruments with firing system overload protection mechanisms|

---

WO2016154589A1|2015-03-25|2016-09-29|Camplex, Inc.|Surgical visualization systems and displays|

---

TWI610250B|2015-06-02|2018-01-01|鈺立微電子股份有限公司|Monitor system and operation method thereof|

---

JP6552642B2|2015-06-10|2019-07-31|インテュイティブ サージカル オペレーションズ， インコーポレイテッド|Orientation mapping between master and slave at misalignment|

---

EP3310290B1|2015-06-16|2021-08-18|Titan Medical Inc.|Hand grip apparatus for receiving operator input in a robotic surgery system|

---

US11129669B2|2015-06-30|2021-09-28|Cilag Gmbh International|Surgical system with user adaptable techniques based on tissue type|

---

US11051873B2|2015-06-30|2021-07-06|Cilag Gmbh International|Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters|

---

US11141213B2|2015-06-30|2021-10-12|Cilag Gmbh International|Surgical instrument with user adaptable techniques|

---

US10898256B2|2015-06-30|2021-01-26|Ethicon Llc|Surgical system with user adaptable techniques based on tissue impedance|

---

US10034704B2|2015-06-30|2018-07-31|Ethicon Llc|Surgical instrument with user adaptable algorithms|

---

JP6772185B2|2015-07-07|2020-10-21|インテュイティブ サージカル オペレーションズ， インコーポレイテッド|Control of multiple devices|

---

US10828115B2|2015-07-23|2020-11-10|Sri International|Robotic arm and robotic surgical system|

---

US10058394B2|2015-07-31|2018-08-28|Globus Medical, Inc.|Robot arm and methods of use|

---

US10080615B2|2015-08-12|2018-09-25|Globus Medical, Inc.|Devices and methods for temporary mounting of parts to bone|

---

WO2017031132A1|2015-08-17|2017-02-23|Intuitive Surgical Operations, Inc.|Unground master control devices and methods of use|

---

US10136949B2|2015-08-17|2018-11-27|Ethicon Llc|Gathering and analyzing data for robotic surgical systems|

---

EP3342553A4|2015-08-25|2019-08-07|Kawasaki Jukogyo Kabushiki Kaisha|Information sharing system and information sharing method for sharing information between multiple robot systems|

---

US10617481B2|2016-03-09|2020-04-14|Memic Innovative Surgey Ltd.|Modular device comprising mechanical arms|

---

US10034716B2|2015-09-14|2018-07-31|Globus Medical, Inc.|Surgical robotic systems and methods thereof|

---

JP6652292B2|2015-09-24|2020-02-19|キヤノン株式会社|Control method, control program, robot system, control method of rotary drive device, and robot device|

---

US10485616B2|2015-09-25|2019-11-26|Ethicon Llc|Hybrid robotic surgery with power assisted motion|

---

US10111721B2|2015-09-25|2018-10-30|Ethicon Llc|Hybrid robotic surgery with mirrored and mimicked motion|

---

US10194906B2|2015-09-25|2019-02-05|Ethicon Llc|Hybrid robotic surgery with manual and robotic modes|

---

US10258419B2|2015-09-25|2019-04-16|Ethicon Llc|Methods for hybrid robotic laparoscopic surgery|

---

US10130432B2|2015-09-25|2018-11-20|Ethicon Llc|Hybrid robotic surgery with locking mode|

---

US10687884B2|2015-09-30|2020-06-23|Ethicon Llc|Circuits for supplying isolated direct currentvoltage to surgical instruments|

---

US9771092B2|2015-10-13|2017-09-26|Globus Medical, Inc.|Stabilizer wheel assembly and methods of use|

---

ITUB20155057A1|2015-10-16|2017-04-16|Medical Microinstruments S R L|Robotic surgery set|

---

US10595930B2|2015-10-16|2020-03-24|Ethicon Llc|Electrode wiping surgical device|

---

ITUB20154977A1|2015-10-16|2017-04-16|Medical Microinstruments S R L|Medical instrument and method of manufacture of said medical instrument|

---

AU2016341284A1|2015-10-22|2018-04-12|Covidien Lp|Variable sweeping for input devices|

---

CA3005083A1|2015-11-11|2017-05-18|Johnson & Johnson Surgical Vision, Inc.|Systems and methods for providing virtual access to a surgical console|

---

US10500739B2|2015-11-13|2019-12-10|Ethicon Llc|Robotic surgical system|

---

WO2017091704A1|2015-11-25|2017-06-01|Camplex, Inc.|Surgical visualization systems and displays|

---

US9888975B2|2015-12-04|2018-02-13|Ethicon Endo-Surgery, Llc|Methods, systems, and devices for control of surgical tools in a robotic surgical system|

---

US10179022B2|2015-12-30|2019-01-15|Ethicon Llc|Jaw position impedance limiter for electrosurgical instrument|

---

US10575892B2|2015-12-31|2020-03-03|Ethicon Llc|Adapter for electrical surgical instruments|

---

US9931170B2|2016-01-06|2018-04-03|Ethicon Endo-Surgery, Llc|Methods, systems, and devices for moving a surgical instrument coupled to a robotic surgical system|

---

US10154886B2|2016-01-06|2018-12-18|Ethicon Llc|Methods, systems, and devices for controlling movement of a robotic surgical system|

---

US9949798B2|2016-01-06|2018-04-24|Ethicon Endo-Surgery, Llc|Methods, systems, and devices for controlling movement of a robotic surgical system|

---

US10219868B2|2016-01-06|2019-03-05|Ethicon Llc|Methods, systems, and devices for controlling movement of a robotic surgical system|

---

US10130429B1|2016-01-06|2018-11-20|Ethicon Llc|Methods, systems, and devices for controlling movement of a robotic surgical system|

---

US9872738B2|2016-01-06|2018-01-23|Ethicon Endo-Surgery, Llc|Methods, systems, and devices for control of surgical tools in a robotic surgical system|

---

US11129670B2|2016-01-15|2021-09-28|Cilag Gmbh International|Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization|

---

US11229471B2|2016-01-15|2022-01-25|Cilag Gmbh International|Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization|

---

US11051840B2|2016-01-15|2021-07-06|Ethicon Llc|Modular battery powered handheld surgical instrument with reusable asymmetric handle housing|

---

US10835307B2|2016-01-15|2020-11-17|Ethicon Llc|Modular battery powered handheld surgical instrument containing elongated multi-layered shaft|

---

US10716615B2|2016-01-15|2020-07-21|Ethicon Llc|Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade|

---

US11229472B2|2016-01-15|2022-01-25|Cilag Gmbh International|Modular battery powered handheld surgical instrument with multiple magnetic position sensors|

---

US10448910B2|2016-02-03|2019-10-22|Globus Medical, Inc.|Portable medical imaging system|

---

US11058378B2|2016-02-03|2021-07-13|Globus Medical, Inc.|Portable medical imaging system|

---

US10842453B2|2016-02-03|2020-11-24|Globus Medical, Inc.|Portable medical imaging system|

---

US10117632B2|2016-02-03|2018-11-06|Globus Medical, Inc.|Portable medical imaging system with beam scanning collimator|

---

US10555769B2|2016-02-22|2020-02-11|Ethicon Llc|Flexible circuits for electrosurgical instrument|

---

US10973592B2|2017-03-09|2021-04-13|Memie Innovative Surgery Ltd.|Control console for surgical device with mechanical arms|

---

US10993734B2|2016-03-10|2021-05-04|Hsiman Extensions Ltd.|Control unit for a medical device|

---

US10866119B2|2016-03-14|2020-12-15|Globus Medical, Inc.|Metal detector for detecting insertion of a surgical device into a hollow tube|

---

US10646269B2|2016-04-29|2020-05-12|Ethicon Llc|Non-linear jaw gap for electrosurgical instruments|

---

US10485607B2|2016-04-29|2019-11-26|Ethicon Llc|Jaw structure with distal closure for electrosurgical instruments|

---

US10702329B2|2016-04-29|2020-07-07|Ethicon Llc|Jaw structure with distal post for electrosurgical instruments|

---

US10456193B2|2016-05-03|2019-10-29|Ethicon Llc|Medical device with a bilateral jaw configuration for nerve stimulation|

---

JP6959264B2|2016-06-03|2021-11-02|コヴィディエン リミテッド パートナーシップ|Control arm assembly for robotic surgery system|

---

US10149726B2|2016-07-01|2018-12-11|Ethicon Endo-Surgery, Llc|Methods, systems, and devices for initializing a surgical tool|

---

EP3484402A4|2016-07-14|2020-03-25|Intuitive Surgical Operations Inc.|Secondary instrument control in a computer-assisted teleoperated system|

---

USD865163S1|2016-07-14|2019-10-29|Intuitive Surgical Operations, Inc.|Surgical instrument actuator end portion|

---

USD864386S1|2016-07-14|2019-10-22|Intuitive Surgical Operations, Inc.|Surgical instrument actuator end portion|

---

EP3484400A4|2016-07-14|2020-04-01|Intuitive Surgical Operations Inc.|Systems and methods for onscreen menus in a teleoperational medical system|

---

USD865164S1|2016-07-14|2019-10-29|Intuitive Surgical Operations, Inc.|Surgical instrument actuator end portion|

---

US11037464B2|2016-07-21|2021-06-15|Auris Health, Inc.|System with emulator movement tracking for controlling medical devices|

---

US10376305B2|2016-08-05|2019-08-13|Ethicon Llc|Methods and systems for advanced harmonic energy|

---

EP3512449A4|2016-09-16|2020-05-20|Verb Surgical Inc.|Table adapters for mounting robotic arms to a surgical table|

---

US10568703B2|2016-09-21|2020-02-25|Verb Surgical Inc.|User arm support for use in a robotic surgical system|

---

BR112019004139A2|2016-10-03|2019-05-28|Verb Surgical Inc|robotic surgery immersive three-dimensional screen|

---

WO2018098444A1|2016-11-28|2018-05-31|Verb Surgical Inc.|Robotic surgical system to reduce unwanted vibration|

---

US11266430B2|2016-11-29|2022-03-08|Cilag Gmbh International|End effector control and calibration|

---

US10743948B2|2016-12-07|2020-08-18|Ethicon Llc|Surgical tool wrists|

---

EP3554415A4|2016-12-15|2020-08-05|Intuitive Surgical Operations Inc.|Detection of user touch on controller handle|

---

WO2018112227A2|2016-12-15|2018-06-21|Intuitive Surgical Operations, Inc.|Actuated grips for controller|

---

US10813713B2|2016-12-16|2020-10-27|Ethicon Llc|Methods and systems for coupling a surgical tool to a tool driver of a robotic surgical system|

---

US10143524B2|2016-12-16|2018-12-04|Ethicon Llc|Methods and systems for coupling a surgical tool to a tool driver of a robotic surgical system|

---

CA3053233A1|2017-02-23|2018-08-30|Human Xtensions Ltd.|Controller for surgical tools|

---

US10918455B2|2017-05-08|2021-02-16|Camplex, Inc.|Variable light source|

---

US11058503B2|2017-05-11|2021-07-13|Distalmotion Sa|Translational instrument interface for surgical robot and surgical robot systems comprising the same|

---

US10856948B2|2017-05-31|2020-12-08|Verb Surgical Inc.|Cart for robotic arms and method and apparatus for registering cart to surgical table|

---

US10485623B2|2017-06-01|2019-11-26|Verb Surgical Inc.|Robotic arm cart with fine position adjustment features and uses therefor|

---

JP2018202032A|2017-06-08|2018-12-27|株式会社メディカロイド|Remote control apparatus for medical equipment|

---

WO2018225818A1|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|

---

WO2018225819A1|2017-06-08|2018-12-13|株式会社メディカロイド|Remote operation device and remote operation system|

---

US10913145B2|2017-06-20|2021-02-09|Verb Surgical Inc.|Cart for robotic arms and method and apparatus for cartridge or magazine loading of arms|

---

US11270601B2|2017-06-29|2022-03-08|Verb Surgical Inc.|Virtual reality system for simulating a robotic surgical environment|

---

US10610303B2|2017-06-29|2020-04-07|Verb Surgical Inc.|Virtual reality laparoscopic tools|

---

US11011077B2|2017-06-29|2021-05-18|Verb Surgical Inc.|Virtual reality training, simulation, and collaboration in a robotic surgical system|

---

CN110996825A|2017-07-13|2020-04-10|直观外科手术操作公司|System and method for switching control authority between multiple instrument arms|

---

US10675094B2|2017-07-21|2020-06-09|Globus Medical Inc.|Robot surgical platform|

---

WO2019026654A1|2017-07-31|2019-02-07|株式会社メディカロイド|Master operation input device and master-slave manipulator|

---

CN107334531A|2017-07-31|2017-11-10|成都中科博恩思医学机器人有限公司|A kind of robotic surgery equipment and robotic surgery equipment safety control method|

---

US10973600B2|2017-09-29|2021-04-13|Ethicon Llc|Power axle wrist for robotic surgical tool|

---

US10820898B2|2017-10-05|2020-11-03|Ethicon Llc|Surgical tools with occluded blade|

---

US10639116B2|2017-10-23|2020-05-05|Ethicon Llc|Distally replaceable cable systems in surgical tools|

---

US10881476B2|2017-10-26|2021-01-05|Ethicon Llc|Drive cable capstans for robotic surgical tools|

---

US10828117B2|2017-10-26|2020-11-10|Ethicon Llc|Constant force spring assemblies for robotic surgical tools|

---

US10704624B2|2017-10-26|2020-07-07|Ethicon Llc|Drive cable brake assembly for robotic surgical tool|

---

US10624708B2|2017-10-26|2020-04-21|Ethicon Llc|Auto cable tensioning system|

---

US10786320B2|2017-10-26|2020-09-29|Ethicon Llc|Cable driven motion systems for robotic surgical tools|

---

US10624709B2|2017-10-26|2020-04-21|Ethicon Llc|Robotic surgical tool with manual release lever|

---

US11141160B2|2017-10-30|2021-10-12|Cilag Gmbh International|Clip applier comprising a motor controller|

---

US11103268B2|2017-10-30|2021-08-31|Cilag Gmbh International|Surgical clip applier comprising adaptive firing control|

---

US11229436B2|2017-10-30|2022-01-25|Cilag Gmbh International|Surgical system comprising a surgical tool and a surgical hub|

---

JP6780882B2|2017-11-07|2020-11-04|リバーフィールド株式会社|Medical operation unit|

---

JP6778242B2|2017-11-09|2020-10-28|グローバス メディカル インコーポレイティッド|Surgical robot systems for bending surgical rods, and related methods and equipment|

---

US11134862B2|2017-11-10|2021-10-05|Globus Medical, Inc.|Methods of selecting surgical implants and related devices|

---

US11191596B2|2017-11-15|2021-12-07|Intuitive Surgical Operations, Inc.|Foot controller|

---

WO2019099504A1|2017-11-15|2019-05-23|Intuitive Surgical Operations, Inc.|Master control device with multi-finger grip and methods therefor|

---

EP3709924A4|2017-11-15|2021-12-15|Intuitive Surgical Operations, Inc.|Master control device and methods therefor|

---

US10786316B2|2017-11-28|2020-09-29|Ethicon Llc|Robotic surgical tools with latching mechanism|

---

WO2019113391A1|2017-12-08|2019-06-13|Auris Health, Inc.|System and method for medical instrument navigation and targeting|

---

US11179208B2|2017-12-28|2021-11-23|Cilag Gmbh International|Cloud-based medical analytics for security and authentication trends and reactive measures|

---

US11056244B2|2017-12-28|2021-07-06|Cilag Gmbh International|Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks|

---

US11109866B2|2017-12-28|2021-09-07|Cilag Gmbh International|Method for circular stapler control algorithm adjustment based on situational awareness|

---

US11160605B2|2017-12-28|2021-11-02|Cilag Gmbh International|Surgical evacuation sensing and motor control|

---

US20190274716A1|2017-12-28|2019-09-12|Ethicon Llc|Determining the state of an ultrasonic end effector|

---

US11257589B2|2017-12-28|2022-02-22|Cilag Gmbh International|Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes|

---

US11253315B2|2017-12-28|2022-02-22|Cilag Gmbh International|Increasing radio frequency to create pad-less monopolar loop|

---

US11166772B2|2017-12-28|2021-11-09|Cilag Gmbh International|Surgical hub coordination of control and communication of operating room devices|

---

US11234756B2|2017-12-28|2022-02-01|Cilag Gmbh International|Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter|

---

US10944728B2|2017-12-28|2021-03-09|Ethicon Llc|Interactive surgical systems with encrypted communication capabilities|

---

US10943454B2|2017-12-28|2021-03-09|Ethicon Llc|Detection and escalation of security responses of surgical instruments to increasing severity threats|

---

US11100631B2|2017-12-28|2021-08-24|Cilag Gmbh International|Use of laser light and red-green-blue coloration to determine properties of back scattered light|

---

US20190205001A1|2017-12-28|2019-07-04|Ethicon Llc|Sterile field interactive control displays|

---

US11202570B2|2017-12-28|2021-12-21|Cilag Gmbh International|Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems|

---

US11045591B2|2017-12-28|2021-06-29|Cilag Gmbh International|Dual in-series large and small droplet filters|

---

US11096693B2|2017-12-28|2021-08-24|Cilag Gmbh International|Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing|

---

US11013563B2|2017-12-28|2021-05-25|Ethicon Llc|Drive arrangements for robot-assisted surgical platforms|

---

US10966791B2|2017-12-28|2021-04-06|Ethicon Llc|Cloud-based medical analytics for medical facility segmented individualization of instrument function|

---

US11147607B2|2017-12-28|2021-10-19|Cilag Gmbh International|Bipolar combination device that automatically adjusts pressure based on energy modality|

---

US11266468B2|2017-12-28|2022-03-08|Cilag Gmbh International|Cooperative utilization of data derived from secondary sources by intelligent surgical hubs|

---

US10932872B2|2017-12-28|2021-03-02|Ethicon Llc|Cloud-based medical analytics for linking of local usage trends with the resource acquisition behaviors of larger data set|

---

US11076921B2|2017-12-28|2021-08-03|Cilag Gmbh International|Adaptive control program updates for surgical hubs|

---

US20190206551A1|2017-12-28|2019-07-04|Ethicon Llc|Spatial awareness of surgical hubs in operating rooms|

---

US11213359B2|2017-12-28|2022-01-04|Cilag Gmbh International|Controllers for robot-assisted surgical platforms|

---

US10758310B2|2017-12-28|2020-09-01|Ethicon Llc|Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices|

---

US10987178B2|2017-12-28|2021-04-27|Ethicon Llc|Surgical hub control arrangements|

---

US11051876B2|2017-12-28|2021-07-06|Cilag Gmbh International|Surgical evacuation flow paths|

---

US11132462B2|2017-12-28|2021-09-28|Cilag Gmbh International|Data stripping method to interrogate patient records and create anonymized record|

---

US11069012B2|2017-12-28|2021-07-20|Cilag Gmbh International|Interactive surgical systems with condition handling of devices and data capabilities|

---

JP6757340B2|2018-01-25|2020-09-16|株式会社メディカロイド|Remote control device for medical equipment|

---

CA3125391A1|2019-01-05|2020-07-09|Distalmotion Sa|Surgical robot systems comprising robotic telemanipulators and integrated laparoscopy|

---

US20190254753A1|2018-02-19|2019-08-22|Globus Medical, Inc.|Augmented reality navigation systems for use with robotic surgical systems and methods of their use|

---

US10856942B2|2018-03-02|2020-12-08|Ethicon Llc|System and method for closed-loop surgical tool homing|

---

US11259830B2|2018-03-08|2022-03-01|Cilag Gmbh International|Methods for controlling temperature in ultrasonic device|

---

US11219453B2|2018-03-28|2022-01-11|Cilag Gmbh International|Surgical stapling devices with cartridge compatible closure and firing lockout arrangements|

---

US11096688B2|2018-03-28|2021-08-24|Cilag Gmbh International|Rotary driven firing members with different anvil and channel engagement features|

---

US10973520B2|2018-03-28|2021-04-13|Ethicon Llc|Surgical staple cartridge with firing member driven camming assembly that has an onboard tissue cutting feature|

---

US11166716B2|2018-03-28|2021-11-09|Cilag Gmbh International|Stapling instrument comprising a deactivatable lockout|

---

US20190298350A1|2018-03-28|2019-10-03|Ethicon Llc|Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems|

---

US11090047B2|2018-03-28|2021-08-17|Cilag Gmbh International|Surgical instrument comprising an adaptive control system|

---

US11207067B2|2018-03-28|2021-12-28|Cilag Gmbh International|Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing|

---

US11213294B2|2018-03-28|2022-01-04|Cilag Gmbh International|Surgical instrument comprising co-operating lockout features|

---

US11197668B2|2018-03-28|2021-12-14|Cilag Gmbh International|Surgical stapling assembly comprising a lockout and an exterior access orifice to permit artificial unlocking of the lockout|

---

US10573023B2|2018-04-09|2020-02-25|Globus Medical, Inc.|Predictive visualization of medical imaging scanner component movement|

---

USD884892S1|2018-04-20|2020-05-19|Intuitive Surgical Operations, Inc.|Surgical instrument backend housing|

---

US20210298855A1|2018-05-11|2021-09-30|Intuitive Surgical Operations, Inc.|Master control device with finger grip sensing and methods therefor|

---

IT201800005471A1|2018-05-17|2019-11-17|Robotic system for surgery, particularly microsurgery|

---

JP2021522894A|2018-05-18|2021-09-02|オーリス ヘルス インコーポレイテッド|Controller for robot-enabled remote control system|

---

JP2021529014A|2018-06-15|2021-10-28|バーブ サージカル インコーポレイテッドＶｅｒｂ Ｓｕｒｇｉｃａｌ Ｉｎｃ．|User interface device with grip link|

---

US11135031B2|2018-06-15|2021-10-05|Verb Surgical Inc.|User interface device having grip linkages|

---

CN112218747A|2018-06-15|2021-01-12|威博外科公司|User interface device with finger clutch|

---

US11135030B2|2018-06-15|2021-10-05|Verb Surgical Inc.|User interface device having finger clutch|

---

US20190380791A1|2018-06-15|2019-12-19|Verb Surgical Inc.|User input device for use in robotic surgery|

---

US20210251707A1|2018-08-22|2021-08-19|Intuitive Surgical Operations, Inc.|Control switch position sensing across a rotational joint|

---

KR102202030B1|2018-09-12|2021-01-12|미래컴퍼니|Handling device of surgical robot system|

---

EP3852673A1|2018-09-17|2021-07-28|Surgibox Inc.|Data analytics and interface platform for portable surgical enclosure|

---

US11166769B2|2018-10-30|2021-11-09|Titan Medical Inc.|Hand controller apparatus with feedback responsive to function change in a robotic surgery system|

---

US11116591B2|2018-10-30|2021-09-14|Titan Medical Inc.|Hand controller apparatus including ergonomic features for a robotic surgery system|

---

US10426561B1|2018-10-30|2019-10-01|Titan Medical Inc.|Hand controller apparatus for detecting input position in a robotic surgery system|

---

US10758311B2|2018-10-30|2020-09-01|Titan Medical Inc.|Hand controller apparatus for gesture control and shared input control in a robotic surgery system|

---

EP3671305A1|2018-12-18|2020-06-24|Eberhard Karls Universität Tübingen|Exoscope system and use of such an exoscope system|

---

US20200237467A1|2019-01-24|2020-07-30|Verb Surgical Inc.|Wearable user interface device|

---

CN109758234B|2019-02-15|2020-07-31|哈尔滨工业大学|Automatic control system and control method for mobile laparoscope for minimally invasive surgery|

---

US11259807B2|2019-02-19|2022-03-01|Cilag Gmbh International|Staple cartridges with cam surfaces configured to engage primary and secondary portions of a lockout of a surgical stapling device|

---

US11204640B2|2019-05-17|2021-12-21|Verb Surgical Inc.|Methods for determining if teleoperation should be disengaged based on the user's gaze|

---

US11045179B2|2019-05-20|2021-06-29|Global Medical Inc|Robot-mounted retractor system|

---

WO2021041253A1|2019-08-23|2021-03-04|Intuitive Surgical Operations, Inc.|Moveable display unit on track|

---

WO2021041249A1|2019-08-23|2021-03-04|Intuitive Surgical Operations, Inc.|Moveable display system|

---

WO2021071933A1|2019-10-08|2021-04-15|Intuitive Surgical Operations, Inc.|Hand presence sensing at control input device|

---

CN110720924A|2019-11-27|2020-01-24|河北省中医院|Uterine orifice measuring and displaying instrument for lying-in woman|

---

WO2021161177A1|2020-02-10|2021-08-19|Medical Microinstruments S.p.A.|Master workstation for robotic surgery, sterile operatory field, surgical robotic system and method|

---

WO2021161158A1|2020-02-10|2021-08-19|Medical Microinstruments S.p.A.|Sterile master input handle assembly for a robotic surgery system and surgical drape for a sterile master input handle|

---

US11207150B2|2020-02-19|2021-12-28|Globus Medical, Inc.|Displaying a virtual model of a planned instrument attachment to ensure correct selection of physical instrument attachment|

---

WO2021191693A1|2020-03-27|2021-09-30|Auris Health, Inc.|Hand-manipulated input device for robotic system|

---

US11253216B2|2020-04-28|2022-02-22|Globus Medical Inc.|Fixtures for fluoroscopic imaging systems and related navigation systems and methods|

---

US11153555B1|2020-05-08|2021-10-19|Globus Medical Inc.|Extended reality headset camera system for computer assisted navigation in surgery|

---

US11166765B1|2020-05-08|2021-11-09|Verb Surgical Inc.|Feedback for surgical robotic system with virtual reality|

---

WO2021252930A1|2020-06-12|2021-12-16|Digital Surgery Systems, Inc.|System, method, and apparatus for hand-centric controller for the robotic digital surgical microscope|

---

WO2022009355A1|2020-07-08|2022-01-13|リバーフィールド株式会社|Medical operation apparatus|

---

CN113208734B|2021-05-13|2022-02-22|德智鸿机器人有限责任公司|Surgical robot and positioning method|

法律状态:
2018-03-27| B15K| Others concerning applications: alteration of classification|Ipc: A61B 17/00 (2006.01) |

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2019-01-08| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2019-08-27| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2020-02-27| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2020-04-14| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 11/11/2010, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US12/617,937|US8521331B2|2009-11-13|2009-11-13|Patient-side surgeon interface for a minimally invasive, teleoperated surgical instrument|

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PCT/US2010/056345|WO2011060139A2|2009-11-13|2010-11-11|Patient-side surgeon interface for a minimally invasive, teleoperated surgical instrument|

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