MEDICAL APPARATUS WITH OPTICAL SENSING, AND RELATED DEVICES AND METHODS
20230046962 · 2023-02-16
Assignee
Inventors
Cpc classification
A61B18/1445
HUMAN NECESSITIES
A61B90/37
HUMAN NECESSITIES
A61B34/76
HUMAN NECESSITIES
A61B2090/364
HUMAN NECESSITIES
A61B2017/00128
HUMAN NECESSITIES
International classification
Abstract
A method comprises grasping material between a pair of jaw members of a medical instrument; sensing light transmitted from the material grasped between the pair of jaw members to a location exterior to the pair of jaw members; and altering a grasping force exerted by the pair of jaw members on the material being grasped based on the sensing of the light transmitted.
Claims
1. A method comprising: grasping material between a pair of jaw members of a medical instrument; sensing light transmitted from the material grasped between the pair of jaw members to a location exterior to the pair of jaw members; and altering a grasping force applied by the pair of jaw members on the material being grasped based on the sensing of the light transmitted.
2. The method of claim 1, wherein the sensing the light is via a sensor at a location external to the pair of jaw members.
3. The method of claim 1, further comprising: processing the light sensed using optical flow, digital image correlation, or both optical flow and digital image correlation; and altering the grasping force based on the processing.
4. The method of claim 3, wherein altering the grasping force applied by the pair of jaw members occurs in response to the processing being indicative of one or both of deformation or slip of the material grasped between the pair of jaw members.
5. The method of claim 3, wherein altering the grasping force comprises decreasing a grasping force applied by the pair of jaw members in response to the processing being indicative of deformation of the material grasped between the pair of the jaw members.
6. The method of claim 3, wherein altering the grasping force comprises increasing the grasping force applied by the pair of jaw members in response to the processing being indicative of slip of the material grasped between the pair of jaw members.
7. A method comprising: grasping material between a pair of jaw members of a medical instrument, the pair of jaw members comprising a first jaw member and a second jaw member; sensing light transmitted through a transparent portion of a first jaw member of the pair of jaw members; and altering a grasping force applied by the pair of jaw members on the material being grasped based on the sensing of the light transmitted.
8. The method of claim 7, wherein the sensing the light is via a sensor at a location external to the pair of jaw members.
9. The method of claim 7, further comprising: processing the light sensed using optical flow, digital image correlation, or both optical flow and digital image correlation; and altering the grasping force based on the processing.
10. The method of claim 9, wherein altering the grasping force applied by the pair of jaw members occurs in response to the processing being indicative of one or both of deformation or slip of the material grasped between the pair of jaw members.
11. The method of claim 9, wherein altering the grasping force comprises decreasing a grasping force applied by the pair of jaw members in response to the processing being indicative of deformation of the material grasped between the pair of the jaw members.
12. The method of claim 9, wherein altering the grasping force comprises increasing the grasping force applied by the pair of jaw members in response to the processing being indicative of slip of the material grasped between the pair of jaw members.
13. The method of claim 7, further comprising: transmitting light toward the material grasped between the pair of jaw members from a light source chosen from at least one of an electron-stimulation source, an incandescent source, a light emitting diode source, an electroluminescence source, a gas discharge source, a high-intensity discharge source, a laser source, a chemiluminescence source, a fluorescence source, and a phosphorescence source.
14. A method comprising: grasping material between a pair of jaw members of a medical instrument; capturing images at a location exterior to the pair of jaw members of a region between the pair of jaw members; and providing feedback regarding a state of the material grasped between the pair of jaw members based on the captured images.
15. The method of claim 14, further comprising: processing the captured images using optical flow, digital image correlation, or both optical flow and digital image correlation.
16. The method of claim 15, further comprising: detecting, in response to the processing of the captured images, deformation of the material grasped between the pair of jaw members, detecting slip of the material grasped between the pair of jaw members, or detecting both deformation and slip of the material grasped between the pair of jaw members.
17. The method of claim 16, further comprising: in response to detecting deformation of the material, decreasing a grasping force applied by the pair of jaw members to the material grasped between the pair of jaw members.
18. The method of claim 16, further comprising: in response to detecting slip of the material, increasing a grasping force applied by the pair of jaw members to the material being grasped between the pair of jaw members.
19. The method of claim 14, wherein capturing the images comprises capturing the images using an endoscope.
20. The method of claim 14, further comprising: in response to a state of the material grasped between the pair of jaw members, altering a grasping force exerted by the pair of jaw members on the material grasped between the pair of jaw members.
Description
BRIEF DESCRIPTION OF DRAWINGS
[0014] The present disclosure can be understood from the following detailed description, either alone or together with the accompanying drawings. The drawings are included to provide a further understanding of the present disclosure, and are incorporated in and constitute a part of this specification. The drawings illustrate one or more exemplary embodiments of the present teachings and together with the description serve to explain certain principles and operation. In the drawings,
[0015]
[0016]
[0017]
[0018]
[0019]
DETAILED DESCRIPTION
[0020] This description and the accompanying drawings that illustrate exemplary embodiments should not be taken as limiting. Various mechanical, compositional, structural, electrical, and operational changes may be made without departing from the scope of this description and the claims, including equivalents. In some instances, well-known structures and techniques have not been shown or described in detail so as not to obscure the disclosure. In addition, in some in various instances, similar or the same numbers in two or more figures may be used to represent the same or similar elements. Furthermore, elements and their associated features that are described in detail with reference to one embodiment may, whenever practical, be included in other embodiments in which they are not specifically shown or described. For example, if an element is described in detail with reference to one embodiment and is not described with reference to a second embodiment, the element may nevertheless be claimed as included in the second embodiment.
[0021] For the purposes of this specification and appended claims, unless otherwise indicated, all numbers expressing quantities, percentages, or proportions, and other numerical values used in the specification and claims, are to be understood as being modified in all instances by the term “about,” to the extent they are not already so modified. Accordingly, unless indicated to the contrary, the numerical parameters set forth in the following specification and attached claims are approximations that may vary depending upon the desired properties sought to be obtained. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques.
[0022] Further, this description's terminology is not intended to limit the invention. For example, spatially relative terms—such as “beneath”, “below”, “lower”, “above”, “upper”, “proximal”, “distal”, and the like—may be used to describe one element's or feature's relationship to another element or feature as illustrated in the figures. These spatially relative terms are intended to encompass different positions (i.e., locations) and orientations (i.e., rotational placements) of a device in use or operation in addition to the position and orientation shown in the figures. For example, if a device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be “above” or “over” the other elements or features. Thus, the exemplary term “below” can encompass both positions and orientations of above and below. A device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Likewise, descriptions of movement along and around various axes includes various special device positions and orientations. In addition, the singular forms “a”, “an”, and “the” are intended to include the plural forms as well, unless the context indicates otherwise. And, the terms “comprises”, “comprising”, “includes”, and the like 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. Components described as coupled may be electrically or mechanically directly coupled, or they may be indirectly coupled via one or more intermediate components. Mathematical and geometric terms are not necessarily intended to be used in accordance with their strict definitions unless the context of the description indicates otherwise, because a person having ordinary skill in the art would understand that, for example, a substantially similar element that functions in a substantially similar way could easily fall within the scope of a descriptive term even though the term also has a strict definition.
[0023] Various exemplary embodiments of the present disclosure contemplate systems, methods, and devices that can be used to sense, via optical sensing, the nature of tissue manipulation, and consequent effect on the manipulated tissue, occurring during use of a surgical instrument end effector performing a surgical procedure. By using image capturing and processing capabilities for the optical sensing, information regarding tissue movement and/or deformation (or other effects on the tissue relating to tissue manipulation) can be accurately determined, allowing for better control of the tissue manipulations being performed. Tissue manipulations that may benefit from stable gripping control, include, but are not limited, to, stapling, suturing, moving of tissue from one position to another, and other tissue manipulations those having ordinary skill in the art would be familiar with.
[0024] In accordance with various exemplary embodiments, the present disclosure contemplates surgical instruments comprising end effectors having jaw members that open and close relative to each other, with a gripping region being defined between opposing surfaces of the jaw members. Such a jaw assembly is configured to grip tissue as the jaw members are approximated (moved toward each other). For training and/or testing purposes, the exemplary surgical instruments described herein can also be used on materials having properties similar to tissue. Moreover, those having ordinary skill in the art would appreciate that the principles and exemplary embodiments disclosed herein may be used in applications outside of medical and surgical applications where stable gripping of material and/or the ability to determine movement or deformation of material (such as may occur during gripping or otherwise manipulating material) may be desired, particularly when the material is flexible, conformable, and/or elastic. Applications outside of the medical and surgical fields may include, for example, other manufacturing or robotic applications in which handling of materials in a controlled and stable manner, without excessive deformation or slip, is desirable, such as, for example, in the food services industry.
[0025] With reference to
[0026] Although controller 30 is depicted in
[0027]
[0028] Coupled to the proximal end of the shaft 211 is a backend transmission mechanism 216 comprising one or more drive members (e.g., gears, rotating shafts, levers, etc.) to convert input at the backend transmission mechanism 216 to the various drive members and along actuation elements (e.g., rods, cables, or other types of tension/compression members (not shown)) extending down the shaft. In this manner input at the transmission mechanism 216 can be transmitted as force to actuate motion of the shaft, end effector components, and optional joint members. For manually operated surgical instruments, the backend transmission mechanism 216 may comprise a handle with various triggers, buttons, and other input devices operable by a user of the instrument. Alternatively, for surgical instruments configured for use in teleoperated computer-assisted surgical systems (sometimes referred to as robotic surgical systems), the backend transmission mechanism 216 has an interface for operably engaging with various drive mechanisms at a patient side cart that holds the surgical instrument during a surgical procedure, which drive mechanisms are operable via servomotors. Examples of teleoperated computer-assisted surgical systems for which various exemplary embodiments of the present disclosure may be used include, but are not limited to, the daVinci® Surgical Systems.
[0029] As further depicted in the box diagram components of
[0030] Referring again to
[0031] Nonlimiting examples of image capture devices that are suitable for use in optical flow and/or digital image correlation processing techniques include a pixel sensor or image sensor array, a charged coupled device, and/or an endoscope, which in various exemplary embodiments may utilize such sensors or have other imaging devices associated with it. When selecting image capture devices suitable for use in various exemplary embodiments, it is desirable to select devices having relatively high resolution, shorter focal lengths (which can help to reduce overall size), and/or relatively fast frame rates. Moreover, light sources may be selected so as to enhance the contrast of features of the material being observed (e.g., tissue). In some exemplary embodiments, image post-processing may be utilized to address any shortcomings in the image capture device ability to achieve the desired characteristics noted above.
[0032] As mentioned above, the surgical system of
[0033] In various exemplary embodiments, based on the processing of the captured image data, the controller 30 is programmed to determine the nature of the tissue manipulation occurring at the end effector and the effect on the tissue; for example, if tissue gripped by a jaw assembly is slipping, excessively deforming, or alternatively is being stably gripped. For example, successive image frames can be compared for changes to determine if threshold levels of changes occur or are exceeded (370 in
[0034] To make these determinations, exemplary embodiments compare the speckle pattern (an inherent characteristic of tissue) in successive frames of captured images, processing the image data to compare differences in the speckle pattern, which can include either relative shifts in movement or appearance of the speckles within the pattern (which may be indicative of excessive deformation for example) or whole translation shifts of the entire pattern relative to fixed points of the captured image (which may be indicative of tissue slip). In various exemplary embodiments, the present disclosure contemplates the use of an injectable tracer that may be used to track blood flow during the optical imaging in accordance with various exemplary embodiments of the present disclosure. Use of such a tracer may provide additional useful information, such as, for example, relating to perfusion of grasped tissue, flow patterns, etc.
[0035] For example, local tissue movement (i.e., movement of tissue gripped between jaws of a jaw assembly) can arise from any combination of motion, including rigid body motion such as translation and rotation, and flexible body motion such as dilations, extension, shear, and other deformation. The surgeon feedback provided and/or the control schemes imposed can differ based on the nature of the motion. For example, translation typically is associated with slip or loss of stable grip and thus a control that corrects the slip and/or provides corresponding feedback, may be warranted. Deformation, on the other hand, may be tolerated to a certain level (e.g., threshold), which if sensed may then be subject to corrective control. The image processing methods discussed above (e.g., DIC and optical flow) serve the purpose of describing the motion of pixels in the image (in some cases, sub-pixels can be sensed, depending on the algorithm), producing a vector field of displacements. The components of motion and deformation can then be extracted from the overall motion from the vector field of displacements. In an exemplary embodiment, this may be accomplished by fitting an affine transformation and estimating the components of movement of interest, (e.g., translation, rotation, dilation, stretch, etc.)
[0036] The controller 30 also can be programmed to output commands to the surgical system to provide various feedback (shown at 390 in
[0037] By way of nonlimiting example, the controller 30 may be programmed to provide a feeling to a user of a hard stop or stiff spring either as part of a virtual environment when attempting to pull back on gripped tissue to a dangerous extent, or as additional resistance when attempting to grasp harder than is deemed safe.
[0038] Aside from providing feedback, and as depicted at 400 of the exemplary workflow of
[0039] In accordance with various exemplary embodiments, an optical sensing module including an image capture device can be integrated as part of the surgical instrument itself or can be provided as a separate device used in conjunction with the surgical instrument. Exemplary embodiments of such arrangements are illustrated respectively in
[0040] Referring to
[0041] The view of
[0042] Circuitry, such as for transmission of data and power to and from the image capture device 425 and shown for simplicity by reference numeral 428, can be routed through the instrument to appropriate connections with external equipment in a manner similar to circuitry used with various minimally invasive electrosurgical instruments, as would be understood by those having ordinary skill in the art. To save space within the instrument and simplify the structure, data and power can be routed through the same wire. In another exemplary embodiment, the wire(s) could be routed external to the instrument and loosely encapsulated within a silicone (or similar) sleeve. In yet other exemplary embodiments, wireless transmission (e.g., via RFID, radio, ZigBee, Bluetooth, etc.) of data and/or power can be employed.
[0043] With reference now to
[0044] The image capture device 525 may be a device such as an endoscope inserted through the same incision or body orifice, or through a separate incision or body orifice, and positioned so as to be able to illuminate and capture images through the transparent portion of the jaw member 512a. The view of
[0045] Circuitry relating to providing power and data to the image capture device 525 (not shown in
[0046] In various exemplary embodiments, the light sources that may be used in conjunction with the optical sensing modules and image capture devices of the present disclosure may generate light in various ways such as, but not limited to, electron-stimulation, incandescent lamps, light emitting diodes, electroluminescence, gas discharge, high-intensity discharge, lasers, chemoluminescence, fluorescence, and/or phosphorescence. It is contemplated as within the scope of the present disclosure that the light is guided through fiber optic cables or light pipes (not shown), or that a plurality of light sources is used.
[0047] In the exemplary embodiments of
[0048] Aside from surface features, the overall curvature of the transparent portion may be selected as desired. For example, the transparent portion can have a flat grasping surface that can compress tissue to remove natural curvature from the tissue during gripping, which may facilitate image capture and processing. In other situations, the transparent portion can have a curved surface on one or both sides of the transparent portion. In other exemplary embodiments, the transparent portion can be recessed away from the tissue slightly as compared to other non-transparent portions of the jaw member.
[0049] Various indicia, such as one or more etchings, imprints, laser cut markings, etc. can be provided on the transparent portion(s) of the jaw member. Such indicia can serve as a fixed reference by which to assist in the image processing and comparison of image data.
[0050] As discussed above, in the exemplary embodiments of
[0051] As noted above, various embodiments disclosed herein contemplate being used with teleoperated computer-assisted surgery. Such systems employ various robotic elements to assist the surgeon in the operating theater and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment.
[0052] The teleoperated computer-assisted surgical systems may be employed with one or more consoles that are in or adjacent to the operating theater or located in a remote location.
[0053] Exemplary teleoperated, computer-assisted surgical systems (sometimes referred to as robotic surgical systems) with which exemplary embodiments of the present disclosure may be implemented include those described in, for example, U.S. Patent App. Pub. No. US 2013/0325033 A1 (published Dec. 5, 2013), entitled “Multi-Port Surgical Robotic System Architecture,” U.S. Patent App. Pub. No. US 2013/0325031 A1 (published Dec. 5, 2013), entitled “Redundant Axis and Degree of Freedom for Hardware-Constrained Remote Center Robotic Manipulator,” and U.S. Pat. No. No. 8,852,208 (issued Oct. 7, 2014), entitled “Surgical System Instrument Mounting,” and U.S. Pat. No. 8,545,515 (issued Oct. 1, 2013), entitled Curved Cannula Surgical System, each of which is hereby incorporated by reference in its entirety. Further, the exemplary embodiments described herein may be used, for example, with a da Vinci® Surgical System, such as the da Vinci Si® Surgical System or the da Vinci Xi® Surgical System, both with or without Single-Site® single orifice surgery technology, all commercialized by Intuitive Surgical, Inc. Although the above references discuss surgical instruments and other devices related to a patient side cart of a teleoperated surgical system, the present disclosure is not limited to use with surgical instruments for a teleoperated surgical system, but rather extends to manually operated surgical instruments/systems.
[0054] Further, exemplary embodiments using controllers and processors can be implemented in computing hardware (computing apparatus) and/or software, such as (in a non-limiting example) any computer that can store, retrieve, process and/or output data and/or communicate with other computers. The results produced can be shown on a display of the computing hardware or a separate display operably coupled to such hardware. One or more programs/software comprising algorithms to effect the various responses and signal processing in accordance with various exemplary embodiments of the present disclosure can be implemented by a processor of or in conjunction with an electronics/control console, such as is generally one of the core components of a teleoperated computer-assisted surgical system, and may be recorded on computer-readable media including computer-readable recording and/or storage media. Examples of the computer-readable recording media include a magnetic recording apparatus, an optical disk, a magneto-optical disk, and/or a semiconductor memory (for example, RAM, ROM, etc.). Examples of the magnetic recording apparatus include a hard disk device (HDD), a flexible disk (FD), and a magnetic tape (MT). Examples of the optical disk include a DVD (Digital Versatile Disc), a DVD-RAM, a CD-ROM (Compact Disc-Read Only Memory), and a CD-R (Recordable)/RW.
[0055] While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Any combination of the above embodiments is also envisioned and is within the scope of the appended claims. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.