STERILE BARRIER BETWEEN SURGICAL INSTRUMENT AND TELEOPERATED ACTUATOR
20200069389 ยท 2020-03-05
Inventors
- Tyler J. Morrissette (Old Lyme, CT, US)
- Gregory W. Dachs, II (San Mateo, CA, US)
- Bruce Michael Schena (Menlo Park, CA, US)
Cpc classification
F16H1/20
MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
A61B46/40
HUMAN NECESSITIES
Y10T403/59
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
A61B46/10
HUMAN NECESSITIES
Y10T29/49817
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
A61B2090/0813
HUMAN NECESSITIES
A61B46/23
HUMAN NECESSITIES
A61B1/00142
HUMAN NECESSITIES
A61B34/70
HUMAN NECESSITIES
A61B90/08
HUMAN NECESSITIES
International classification
A61B46/10
HUMAN NECESSITIES
A61B1/00
HUMAN NECESSITIES
A61B90/00
HUMAN NECESSITIES
Abstract
An instrument sterile drape includes a plastic sheet and a pouch sealed to a first opening in the plastic sheet. The pouch is shaped to fit around a carriage that includes actuators and may be shaped to provide a loose form fit around the carriage. A stiffener is coupled to the pouch around a second opening in the pouch to provide an area that is less elastic than the remainder of the pouch. An instrument sterile adapter (ISA) may be coupled to the second opening in the pouch. The ISA may include a bottom plate and a top plate located on opposite sides of the pouch and joined together. Portions of the bottom plate may project through the top plate to provide a datum plane to receive a surgical instrument. The ISA may contain loose pins that depress sensing pins in the carriage when a surgical instrument is mounted.
Claims
1. An instrument sterile drape comprising: a plastic sheet; a pouch sealed to a first opening in the plastic sheet, the pouch shaped to fit around a carriage that includes actuators; and a stiffener coupled to the pouch around a second opening in the pouch to provide an area that is less elastic than the remainder of the pouch.
2. The instrument sterile drape of claim 1 wherein: the plastic sheet is a single layer of thermoplastic polyurethane about 100 micrometers (0.004 inch) thick in the form of a tube; and the plastic sheet includes a lubricant.
3. The instrument sterile drape of claim 1 wherein the pouch is shaped to provide a loose form fit around the carriage.
4. The instrument sterile drape of claim 1 wherein the pouch is made from a polyurethane.
5. The instrument sterile drape of claim 1 wherein the stiffener is cut from a sheet that includes a layer of thermoplastic urethane (TPU) and a layer of polyethylene terephthalate glycol-modified (PETG).
6. The instrument sterile drape of claim 1 further comprising an instrument sterile adapter (ISA) coupled to the second opening in the pouch, the ISA including a bottom plate located on a first side of the pouch and a top plate located on an opposing second side of the pouch and joined to the bottom plate.
7. The instrument sterile drape of claim 6 wherein the top plate is joined to the bottom plate by passing pins between the top and bottom plates and through the pouch and the stiffener.
8. The instrument sterile drape of claim 6 wherein: the bottom plate includes a pocket with a third opening in a first surface of the bottom plate furthest from the top plate, the top plate includes a fourth opening in a second surface of the top plate furthest from the bottom plate; and the ISA further includes a presence pin loosely retained in the pocket, a portion of the presence pin extending through the fourth opening.
9. The instrument sterile drape of claim 8 wherein at least a portion of the pocket is housed within a protrusion that extends from the first surface of the bottom plate.
10. The instrument sterile drape of claim 9 wherein the protrusion is a cylindrical protrusion and an end of the cylindrical protrusion furthest from the first surface is chamfered.
11. The instrument sterile drape of claim 6 wherein: the bottom plate includes a mounting surface that provides a first datum plane for mounting the ISA on a carriage that includes actuators and a plurality of landing pads that extend through the top plate to provide a second datum plane for a surgical instrument coupled to the ISA such that a distance between the carriage and the surgical instrument is controlled only by the bottom plate.
12. The instrument sterile drape of claim 11 wherein the plurality of landing pads and the mounting surface are opposing parallel surfaces on the bottom plate.
13. A method for assembling an instrument sterile drape, the method comprising: creating a first opening in a plastic sheet; forming a pouch to fit around a carriage that includes actuators, the pouch including a first opening to receive the carriage and a second opening; sealing the first opening of the pouch to the first opening in the plastic sheet; and joining a stiffener to the pouch around the second opening in the pouch to provide an area that is less elastic than the remainder of the pouch.
14. The method of claim 13 wherein the plastic sheet is a single layer of thermoplastic polyurethane about 100 micrometers (0.004 inch) thick in the form of a tube and the plastic sheet includes a lubricant.
15. The method of claim 13 wherein the pouch is formed to provide a loose form fit around the carriage.
16. The method of claim 13 further comprising: cutting the stiffener from a sheet that includes a layer of thermoplastic urethane (TPU) and a layer of polyethylene terephthalate glycol-modified (PETG); and joining the stiffener to the pouch by heat sealing.
17. The method of claim 13 further comprising: placing a bottom plate of an instrument sterile adapter (ISA) over the second opening on a first side of the pouch; placing a top plate of the ISA over the second opening on a second side of the pouch opposite the first side; and joining the bottom plate and the top plate to couple the ISA to the pouch.
18. The method of claim 17 wherein the top plate is joined to the bottom plate by passing pins between the top and bottom plates and through the pouch and the stiffener.
19. The method of claim 17 further comprising applying an adhesive to the stiffener to retain the pouch between the top and bottom plates.
20. The method of claim 13 further comprising: joining a bottom plate of an instrument sterile adapter (ISA) to a top plate located on an opposite side of the second opening of the pouch; the bottom plate including a mounting surface that provides a first datum plane for mounting the ISA on a carriage that includes actuators; and extending a plurality of landing pads that are included in the bottom plate through the pouch and the top plate to provide a second datum plane for a surgical instrument coupled to the ISA such that a distance between the carriage and the surgical instrument is controlled only by the bottom plate.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0021] The invention may best be understood by referring to the following description and accompanying drawings that are used to illustrate embodiments of the invention by way of example and not limitation. In the drawings, in which like reference numerals indicate similar elements:
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DESCRIPTION OF EMBODIMENTS
[0034] In the following description, numerous specific details are set forth.
[0035] However, it is understood that embodiments of the invention may be practiced without these specific details. In other instances, well-known circuits, structures and techniques have not been shown in detail in order not to obscure the understanding of this description.
[0036] In the following description, reference is made to the accompanying drawings, which illustrate several embodiments of the present invention. It is understood that other embodiments may be utilized, and mechanical compositional, structural, electrical, and operational changes may be made without departing from the spirit and scope of the present disclosure. The following detailed description is not to be taken in a limiting sense, and the scope of the embodiments of the present invention is defined only by the claims of the issued patent.
[0037] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. Spatially relative terms, such as beneath, below, lower, above, upper, and the like may be used herein for ease of description to describe one element's or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as below or beneath other elements or features would then be oriented above the other elements or features. Thus, the exemplary term below can encompass both an orientation of above and below. The device may be otherwise oriented (e.g., rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
[0038] As used herein, the singular forms a, an, and the are intended to include the plural forms as well, unless the context indicates otherwise. It will be further understood that the terms comprises and/or comprising specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof.
[0039]
[0040] Each surgical instrument manipulator 112 supports one or more surgical instruments 120 that operate at a surgical site within the patient's body 122. Each manipulator 112 may be provided in a variety of forms that allow the associated surgical instrument to move with one or more mechanical degrees of freedom (e.g., all six Cartesian degrees of freedom, five or fewer Cartesian degrees of freedom, etc.). Typically, mechanical or control constraints restrict each manipulator 112 to move its associated surgical instrument around a center of motion on the instrument that stays stationary with reference to the patient, and this center of motion is typically located to be at the position where the instrument enters the body.
[0041] The term surgical instrument is used herein to describe a medical device configured to be inserted into a patient's body and used to carry out surgical or diagnostic procedures. The surgical instrument typically includes an end effector associated with one or more surgical tasks, such as a forceps, a needle driver, a shears, a bipolar cauterizer, a tissue stabilizer or retractor, a clip applier, an anastomosis device, an imaging device (e.g., an endoscope or ultrasound probe), and the like. Some surgical instruments used with embodiments of the invention further provide an articulated support (sometimes referred to as a wrist) for the end effector so that the position and orientation of the end effector can be manipulated with one or more mechanical degrees of freedom in relation to the instrument's shaft. Further, many surgical end effectors include a functional mechanical degree of freedom, such as jaws that open or close, or a knife that translates along a path. Surgical instruments may also contain stored (e.g., on a semiconductor memory inside the instrument) information that may be permanent or may be updatable by the surgical system. Accordingly, the system may provide for either one-way or two-way information communication between the instrument and one or more system components.
[0042] A functional teleoperated surgical system will generally include a vision system portion (not shown) that enables the operator to view the surgical site from outside the patient's body 122. The vision system typically includes a surgical instrument that has a video-image-capture function 128 (a camera instrument) and one or more video displays for displaying the captured images. In some surgical system configurations, the camera instrument 128 includes optics that transfer the images from the distal end of the camera instrument 128 to one or more imaging sensors (e.g., CCD or CMOS sensors) outside of the patient's body 122. Alternatively, the imaging sensor(s) may be positioned at the distal end of the camera instrument 128, and the signals produced by the sensor(s) may be transmitted along a lead or wirelessly for processing and display on the video display. An illustrative video display is the stereoscopic display on the surgeon's console in surgical systems commercialized by Intuitive Surgical, Inc., Sunnyvale, Calif.
[0043] A functional teleoperated surgical system will further include a control system portion (not shown) for controlling the movement of the surgical instruments 120 while the instruments are inside the patient. The control system portion may be at a single location in the surgical system, or it may be distributed at two or more locations in the system (e.g., control system portion components may be in the system's patient-side portion 100, in a dedicated system control console, or in a separate equipment rack). The teleoperated master/slave control may be done in a variety of ways, depending on the degree of control desired, the size of the surgical assembly being controlled, and other factors. In some embodiments, the control system portion includes one or more manually-operated input devices, such as a joystick, exoskeletal glove, a powered and gravity-compensated manipulator, or the like. These input devices control teleoperated motors which, in turn, control the movement of the surgical instrument.
[0044] The forces generated by the teleoperated motors are transferred via drivetrain mechanisms, which transmit the forces from the teleoperated motors to the surgical instrument 120. In some telesurgical embodiments, the input devices that control the manipulator(s) may be provided at a location remote from the patient, either inside or outside the room in which the patient is placed. The input signals from the input devices are then transmitted to the control system portion. Persons familiar with telemanipulative, teleoperative, and telepresence surgery will know of such systems and their components, such as the da Vinci Surgical System commercialized by Intuitive Surgical, Inc. and the Zeus Surgical System originally manufactured by Computer Motion, Inc., and various illustrative components of such systems.
[0045] As shown, both the surgical instrument 120 and an optional entry guide 124 (e.g., a cannula in the patient's abdomen) are removably coupled to the distal end of a manipulator 112, with the surgical instrument 120 inserted through the entry guide 124. Teleoperated actuators in the manipulator 112 move the surgical instrument 120 as a whole. The manipulator 112 further includes an instrument carriage 130. The surgical instrument 120 is detachably connected to the carriage 130. The teleoperated actuators housed in the carriage 130 provide a number of controller motions which the surgical instrument 120 translates into a variety of movements of the end effector on the surgical instrument. Thus the teleoperated actuators in the carriage 130 move only one or more components of the surgical instrument 120 rather than the instrument as a whole. Inputs to control either the instrument as a whole or the instrument's components are such that the input provided by a surgeon to the control system portion (a master command) is translated into a corresponding action by the surgical instrument (a slave response).
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[0050] The pouch 500 may be made from a materials such as low density polyethylene (LDPE), ethylene-vinylacetate copolymers (EVA), and/or thermoplastic urethane (TPU), which may be the same material used for the plastic sheet 300 but with a greater thickness. Other suitable materials may be used for the pouch. The pouch 500 may be fabricated from a plastic sheet of an appropriate thickness by a suitable process such as heat-forming, thermo-forming, or vacuum-forming. The pouch 500 may be flexible but it should return to its original shape when not subject to stress. The pouch 500 provides a portion of the drape that is a loose form fit around the carriage 130 to provide a clear work space for the actuators and the surgical instrument. There may be certain areas where the pouch 500 is more closely fitted to the carriage 130, such as the region 410 where a shaft of a surgical instrument passes the carriage. It may be desirable to form the pouch 500 from a transparent or translucent material so that features of the carriage 130, such as indicator lights, can be seen through the pouch. In some embodiments, the pouch may be formed of two or more parts. For example, part of the pouch may be formed from a more rigid material and part of the pouch may be formed from a more flexible material.
[0051] An aperture 520 is formed in the plastic sheet 300 where the pouch 500 is joined to the plastic sheet. It is desirable to join the pouch 500 to the plastic sheet 300 with the pouch positioned over the aperture 520 rather than extending through the aperture. The plastic sheet may be joined to the pouch by any process that is compatible with the materials of the sheet and the pouch, such as by heat welding or a pressure sensitive adhesive (PSA). The aperture 520 may be formed in the plastic sheet 300 before or after the pouch 500 is joined to the plastic sheet.
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[0062] The protrusions 1106 may be chamfered at the end that enters the carriage to assist in positioning the ISA on the carriage. Referring to
[0063] While certain exemplary embodiments have been described and shown in the accompanying drawings, it is to be understood that such embodiments are merely illustrative of and not restrictive on the broad invention, and that this invention is not limited to the specific constructions and arrangements shown and described, since various other modifications may occur to those of ordinary skill in the art. The description is thus to be regarded as illustrative instead of limiting.