System and method for proximal control of surgical instruments

Abstract

The present invention relates to a system and method for proximal control of a surgical instrument, and provides a robotic surgical system, comprising: an instrument chassis having a proximal mounting portion and a distal mounting portion. The system also comprises: an instrument guide movably coupled to the distal mounting portion and an actuator coupled to the proximal mounting portion. A linkage system operably interconnects the actuator and the instrument guide to transmit motion from the actuator to the instrument guide.

Description

[0001] This application is a divisional application of Chinese patent application 201810014321.5, entitled “System and method for proximal control of surgical instruments”, filed on January 8, 2018, and the aforementioned patent application is a divisional application of Chinese patent application 201480008846.8, entitled “System and method for proximal control of surgical instruments”, filed on February 14, 2014. Technical Field

[0002] The present disclosure relates to surgical systems and methods for minimally invasive robotic-assisted surgery, and more particularly to systems and methods for moving a surgical instrument about a pivot positioned proximal to an anatomical access point. Background Art

[0003] Minimally invasive medical technology is intended to reduce the amount of external tissue damaged during diagnosis or surgical procedures, thereby reducing patient recovery time, discomfort and harmful side effects. Minimally invasive robotic surgery or telesurgery systems have been developed to increase the surgeon's agility and avoid some limitations of traditional minimally invasive techniques. In telesurgery, the surgeon uses some form of remote control (e.g., servomechanisms, etc.) to manipulate the movement of surgical instruments, rather than directly holding and moving the instruments by hand. In a telesurgery system, the surgeon can be provided with an image of the surgical site at the operating table. When the two-dimensional or three-dimensional image of the surgical site is seen on the display, the surgeon performs the surgical procedure on the patient by manipulating the main control device and then controlling the movement of the instrument operated by the servomechanism.

[0004] In robotic-assisted remote surgery, the surgeon typically operates a master controller to control the movement of surgical instruments at the surgical site from a location that may be remote from the patient (e.g., across the operating room, in a different room, or in a completely different building from the patient). The master controller typically includes one or more manual input devices (such as a handheld wrist gimbal, a joystick, a skeletal glove, etc.) operably coupled to the surgical instrument, which is releasably coupled to a patient-side surgical manipulator ("slave device"). The master controller controls the position, orientation, and engagement of the instrument at the surgical site. The slave device is an electromechanical assembly including one or more arms, joints, linkages, servomotors, etc., connected together to support and control the surgical instrument. During the surgical procedure, surgical instruments (including endoscopes) can be introduced directly into the open surgical site through a natural cavity or directly into a body cavity through a cannula.

[0005] For minimally invasive surgical procedures, surgical instruments controlled by surgical manipulators can be introduced into a body cavity through a single surgical incision site, multiple spaced dense incision sites on the patient's body, and / or one or more natural cavities in the patient's anatomical structure. For some minimally invasive surgical procedures performed through particularly small access ports, multiple surgical instruments can be introduced in a tightly packed family with nearly parallel instrument axes. Previous surgical systems and techniques maintained the movement of a common center known as a "remote center" that was in an area close to the anatomical entry point. Attempts to maintain the center of rotation at the anatomical entry point through particularly narrow surgical incisions or particularly narrow natural cavities (such as the human throat or cervix) can result in collisions of the proximal ends of surgical instruments. Improved systems and methods are needed for controlling these surgical instruments while minimizing the incidence of surgical instrument collisions. Summary of the invention

[0006] Embodiments of the invention are summarized by the appended claims. In one embodiment, a robotic surgical system includes an instrument chassis having a proximal mounting portion and a distal mounting portion. The system also includes an instrument guide movably coupled to the distal mounting portion and an actuator coupled to the proximal mounting portion. A linkage system operably interconnects the actuator and the instrument guide to transmit motion from the actuator to the instrument guide.

[0007] In another embodiment, a method of robotic surgery includes providing an instrument chassis having a proximal mounting portion and a distal mounting portion. An instrument guide assembly is movably coupled to the distal mounting portion. A pair of proximal actuators are coupled to the proximal mounting portion, and a linkage system operably interconnects the actuators and the instrument guide assembly. The method further includes providing a first control signal to one of the proximal actuators to cause the linkage system to move the instrument guide assembly in a first rotational degree of freedom. The method also includes providing a second control signal to another of the proximal actuators to cause the linkage system to move the instrument guide assembly in a second rotational degree of freedom.

[0008] In another embodiment, a robotic surgical system includes an instrument chassis assembly having a proximal mounting portion and a distal mounting portion. The chassis includes an instrument interface coupled to the proximal mounting portion. The surgical system further includes an actuation system coupled to the proximal mounting portion. The surgical system further includes a linkage system operably coupled between the actuation system and the distal mounting portion. The linkage system includes an instrument guide. The surgical system further includes a surgical instrument configured to couple to the instrument interface and the instrument guide. BRIEF DESCRIPTION OF THE DRAWINGS

[0009] When read in conjunction with the accompanying drawings, various aspects of the present disclosure can be best understood from the following detailed description. It is emphasized that, in accordance with standard practice in the industry, various features are not drawn to scale. In fact, the sizes of various features can be arbitrarily increased or reduced to facilitate a clearer discussion. In addition, the present disclosure may repeat reference numbers and / or letters in various examples. Repetition is for the purpose of simplicity and clarity and does not in itself indicate the relationship between the various embodiments and / or configurations discussed.

[0010] Figure 1 is a schematic description of a robotic surgery system according to an embodiment of the present disclosure.

[0011] Figure 2A , Figure 2B and Figure 2C is a schematic description of a minimally invasive surgical system according to an embodiment of the present disclosure.

[0012] Figure 3 is a perspective view of a minimally invasive surgical system according to another embodiment of the present disclosure.

[0013] Figure 4 is a schematic diagram of an instrument interface of a robotic surgery system according to an embodiment of the present disclosure.

[0014] Figure 5 A robotic surgery method according to an embodiment of the present disclosure.

[0015] Figure 6 is a side view of a distal end of a surgical instrument according to an embodiment of the present disclosure. DETAILED DESCRIPTION

[0016] In the following detailed description of embodiments of the present invention, many specific details are set forth to provide a thorough understanding of the disclosed embodiments. However, it will be apparent to those skilled in the art that embodiments of the present invention can be practiced without these specific details without these specific details. In other cases, well-known methods, procedures, components, and circuits are not described in detail to avoid unnecessary confusion of various aspects of embodiments of the present invention.

[0017] Refer to the attached figure Figure 1, a robotic surgical system is generally indicated by reference numeral 100. The robotic surgical system 100 includes a master system 102, also referred to as a master console or surgeon console, for inputting surgical procedures, and a slave system 104, also referred to as a patient-side manipulator (PSM), for robotically moving surgical instruments at a surgical site within a patient's body. The robotic surgical system 100 is used to perform minimally invasive robotic surgery. One embodiment of a robotic surgical system architecture that can be used to implement the systems and techniques described in the present disclosure is a da The robotic surgical system 100 also includes a control system 108 that is operably linked to the sensors, motors, actuators, and other components of the master system 102 and the slave system 104 and to the image capture system 106.

[0018] The system 100 is used by a system operator, who is typically a surgeon performing a minimally invasive surgical procedure on a patient. The system operator sees images, captured by an image capture system 106, presented for viewing at the master system 102. In response to the surgeon's input commands, a control system 108 implements servomechanical motion of surgical instruments coupled to the robotic slave system 104.

[0019] The control system 108 includes at least one processor and typically multiple processors for implementing control between the master system 102, the slave system 104, and the image capture system 106. The control system 108 also includes software programming instructions to implement part or all of the methods disclosed herein. Figure 1 , but the system may include multiple data processing circuits (e.g., on the master system 102 and / or on the slave system 104), wherein at least a portion of the processing circuits optionally causes the proximity input device to be executed, a portion causes the proximity manipulator to be executed, and so on. Any of a variety of centralized or distributed data processing architectures may be employed. Similarly, the programming code may be implemented as a number of independent programs or subroutines, or may be incorporated into several other aspects of the robotic system described herein. In one embodiment, the control system 108 may support wireless communication protocols such as Bluetooth, infrared data standard protocol (IrDA), home radio frequency, IEEE802.11, DECT, and wireless telemetry.

[0020] The robotic surgical system 100 further includes an instrument chassis 110 coupled to the slave system 104. The instrument chassis 110 provides a common platform for coupling surgical instruments 112 and an endoscope 114 for introduction into a patient entry point 116. In this embodiment, the patient entry point is a human mouth that provides access to the throat or larynx. It should be appreciated that embodiments of the present disclosure may be used to access body tissue through other natural or surgically created orifices.

[0021] Figure 2A 2 is a schematic depiction of a minimally invasive surgical system 200 according to an embodiment of the present disclosure. The system 200 includes an instrument chassis 202 having a proximal portion 204 and a distal portion 206. The chassis 202 supports an endoscope 216. Typically, the size and shape of the chassis at its distal portion 206 are reduced compared to the size and shape of its proximal end 204 to minimize the volume of surgical equipment near the surgical entry point. Instrument interfaces 208, 210 are movably mounted to the proximal portion 204 of the instrument chassis 202. A surgical instrument 212 is mounted to the instrument interface 208 at its proximal portion 213. A surgical instrument 214 is mounted to the instrument interface 210 at its proximal end 215. The interface 208 drives a movable component in the surgical instrument 212, as described in U.S. Pat. No. 6,491,701, which is hereby incorporated by reference in its entirety. The interface 210 drives the instrument 214 in a similar manner. The surgical instruments 212, 214 are also movably coupled to the distal portion 206 of the chassis 202. As will be described in detail below, the instrument interfaces 208, 210 are mounted to the proximal portion 204 of the chassis 202 to allow rotational and linear motion. Specifically, the instrument interface mounting or flexible instrument shaft allows for pitch motion of the instrument interfaces 208, 210 relative to the chassis 202, yaw motion of the instrument interface relative to the chassis, and insertion sliding motion of the instrument interface relative to the chassis. The system 200 operates in a manner similar to the operation of chopsticks, because a small motion at the proximal end of the tool near the pivot position can correspond to a larger motion at the distal end of the tool for manipulating an object.

[0022] Actuation system 220 operates components of instrument 212, such as an end effector and various wrist joints. Actuation system 222 operates components of instrument 214, such as an end effector and various wrist joints. Actuation systems 220, 222 may include motors, actuators, drive systems, control systems, and other components for implementing control of the instruments. Interface actuation system 224 controls movement of instrument 212 with respect to chassis 202, and interface actuation system 226 controls movement of instrument 214 with respect to chassis 202. Reference system X1, Y1, Z1 moves with instrument 212 and reference system X2, Y2, Z2 moves with instrument 214. Although surgical system 200 can be configured to manipulate two instruments as shown, in alternative embodiments, the system can be used to control the movement of more than two instruments.

[0023] Figure 2B is a schematic depiction of a minimally invasive surgical system 200 according to another embodiment of the present disclosure. In this embodiment, the interface actuation system 224′ includes a motor M1 that drives an orientation system G (e.g., such as Figure 3 The gimbal system 226′ shown in the figure, the gimbal assemblies 334, 336) are used to control the proximal instrument interface 208 to move in yaw motion (e.g., around axis Y1). The interface actuation system 224′ also includes a motor M2, which drives the orientation system G to control the proximal instrument interface 208 to move in pitch motion (e.g., around axis X1). The interface actuation system 224′ also includes a motor M3 to control the proximal instrument interface 208 to move axially along axis Z1 (e.g., for instrument insertion and withdrawal). Although not shown in detail, the interface actuation system 226′ may include similar components for implementing similar motions in the proximal instrument interface 210. Therefore, in this embodiment, the movement of the instrument can be controlled at the proximal end without the need for support or control at the distal end. In this embodiment, the interface actuation systems 224′ and 226′ are between the proximal instrument interfaces 208, 210. Although the surgical system 200 can be configured to manipulate two instruments as shown, in alternative embodiments, the system can be used to control the movement of more than two instruments.

[0024] Figure 2C is a schematic depiction of a minimally invasive surgical system 200 according to another embodiment of the present disclosure. In this embodiment, interface actuation systems 224″ and 226″ are substantially similar to interface actuation systems 224′ and 226′, respectively, but in this embodiment, proximal instrument interfaces 208, 210 are between interface actuation systems 224″ and 226″. Although surgical system 200 can be configured to manipulate two instruments as shown, in alternative embodiments, the system can be used to control the movement of more than two instruments.

[0025] Early robotic surgical methods and systems involved the use of a surgical instrument coupled to a robotic manipulator arm and to an insertion linkage system that constrained the movement of the surgical instrument about a remote center of motion aligned along the axis of the surgical instrument and coincident with a patient entry point (such as an incision). U.S. Patents 5,817,084 and 6,441,577 describe further details of these methods and systems, which are incorporated herein by reference in their entireties. Embodiments of the present disclosure remove the constraint on the remote center of motion at the patient entry point and allow the surgical instrument to pivot with at least one rotational degree of freedom about a spatial position proximal to or coincident with the proximal end of the surgical instrument. For example, when using a surgical instrument approximately 40-50 cm long, the proximal pivot position can be approximately 30 cm from the patient entry point.

[0026] Figure 3 300 is a perspective view of a minimally invasive surgical system 300 according to another embodiment of the present disclosure. The system 300 can effectively avoid instrument collisions when working in a small space. The system 300 includes an instrument chassis 302 and instrument interfaces 304, 306 for mounting surgical instruments 308, 310 to the chassis respectively. The surgical instrument 308 includes an end effector 308a and a wrist mechanism 308b. The surgical instrument 310 includes an end effector 310a and a wrist mechanism 310b. The surgical instruments 308, 310 move independently of each other based on control input signals from the main system 102 and manipulator actuation signals from the control system 108. The system 300 further includes an actuation system 312 mounted on the chassis and a linkage system 314 that interconnects the actuator system 312 and the surgical instruments 308, 310. The image capture system 316 is supported by the chassis 302 and is generally aligned along the central axis 318 (in the Z-axis direction) through the chassis.

[0027] In more detail, the instrument chassis 302 includes a proximal portion 320 and a distal portion 322. The system 300 generally includes a left half-side 324 and a right half-side 326 that are generally separated about a central axis 318. In this embodiment, the structure and function of the right half-side and the left half-side of the system 300 are substantially the same. Thus, a complete description of the structure and function of the system 300 will be directed to the left half-side 324, and it will be understood that the structure and function of the right half-side 326 are the same.

[0028] The instrument chassis 302 includes a bridge 328 at a proximal end 329 of the chassis and includes a bridge 330 at a distal end 331 of the chassis. A support tube 332 generally extends along the axis 318 and supports the image capture system 316. The support tube 332 rigidly connects the bridges 328, 330. The components of the instrument chassis can be formed of relatively rigid metal, plastic or ceramic. The instrument chassis 302 further includes a gimbal support 334 pivotally connected to a gimbal plate 336. The gimbal systems 334, 336 allow yaw motion (i.e., rotational freedom in the Y-axis direction) of the surgical instrument 308 and allow pitch motion (i.e., rotational freedom in the X-axis direction) of the surgical instrument 308. The motion of the gimbal systems 334, 336 is passive because the motion is responsive to other actuation forces in the system 300, as will be described in more detail. In alternative embodiments, other joint or pivot systems including multi-axis gimbals, ball / socket joints, and hinges may provide one or more degrees of freedom at the proximal portion of the chassis.

[0029] The instrument chassis 302 also includes a guide (not shown) that is slidably engaged with a track (not shown) of the instrument interface 304. The guide 338 and track 340 are more clearly visible on the right half 326 of the system 300. The guide and track of the left half 324 allow the surgical instrument 308 to be inserted roughly along the Z-axis direction. Insertion drive systems 341a, 341b are coupled to the instruments 308, 310, respectively, to provide a driven insertion movement that moves the guide and track relative to each other. The insertion drive systems 341a, 341b include a drive motor and a drive mechanism, such as a lead screw, a ball screw, a cable drive, or a rack and pinion system. Alternatively, the movement of the guide / track can be passive because the movement is responsive to other actuating forces in the system 300.

[0030] The left half of the actuation system 312 includes actuators 340, 342 coupled to the chassis 302. The actuators 340, 342 each include a motor M1, M2, and have a drive mechanism and encoders E1, E2 that provide variable and controllable force and position control, respectively, which are used to provide the rotational position of the corresponding motor drive shaft to the control system 108. U.S. Patent 5,792,135 provides further details of the actuation system including suitable alternatives, which is incorporated herein by reference in its entirety. The actuators 340, 342 are coupled to the linkage system 314 that transmits the actuation. Each actuator provides a predetermined type of actuation. For example, the actuator 340 provides actuated pitch motion (around the X-axis direction), and the actuator 342 provides actuated yaw motion (around the Y-axis direction).

[0031] The left half of the linkage system 314 includes an actuation rod 346 coupled between ball and socket joints 348, 350. The ball and socket joint 348 is coupled to the actuator 340. The linkage system 314 also includes an instrument guide 352 coupled to the ball and socket joint 350. In this embodiment, the instrument guide 352 is a tubular sleeve sized to accommodate the shaft of the surgical instrument 308. In alternative embodiments, the instrument guide can be a ring, a tray, an open tube, or other structure that allows the surgical instrument to be movably linked to the chassis. The couplings 346, 348, 350 help transmit motion from the actuator 340 to the instrument guide 352. Specifically, the coupling can move the instrument guide 352 in a generally linear Y direction or in a rotational pitch motion. The linkage system 314 also includes an actuation rod 354 coupled between ball and socket joints 356 (obscured from view by the chassis), 358. The ball and socket joint 350 is coupled to the actuator 342. The instrument guide 352 is also coupled to the ball and socket joint 358. The couplings 354, 356, 358 are used to transmit motion from the actuator 342 to the instrument guide 352. Specifically, the coupling can move the instrument guide 352 in a general X direction or in a rotational deflection motion. The linkage system 314 further includes a ball joint 360 positioned within a socket formed in the distal bridge 330. The ball joint 360 is coupled to the instrument guide 352 to tether the instrument guide to the chassis 302. The components of the linkage system can be formed of relatively rigid metal, plastic, or ceramic. The components of the linkage system can be sterilizable or disposable. The components of the linkage system can have a small cross-sectional area to minimize the volume of surgical equipment near the patient access point. For example, the rod coupling can have a diameter of approximately 1-3 mm. In alternative embodiments, other coupling components can be suitable for transmitting a predetermined motion. Such alternative components may include one-way hinge joints, saddle joints, sliding joints, flexible components such as springs and fixed joints.

[0032] The chassis 302 also supports an image capture system 316. More specifically, an endoscopic instrument 370 of the image capture system 316 extends through the support tube 332. The endoscopic instrument 370 has a viewing end 372 and is operably connected to a viewer in the main system 102 to display an image captured at the viewing end of a surgeon or other observer. The endoscopic instrument 370 can be fixed relative to the instrument chassis 302 or can be constrained to move along an insertion axis that is generally aligned with the axis 318. Alternatively, the endoscopic instrument can be maneuverable, pivotable, or otherwise articulated relative to the instrument chassis to change the viewpoint of the viewing end.

[0033] Figure 4The instrument interface 304 is shown in greater detail. A chassis interface plate 380 (which may be considered part of the chassis or part of the interface) is rotationally connected to an instrument interface plate 382. Rotational motion may be provided by a swivel joint, a ball / socket joint, or other known mechanisms to provide full or partial rotational motion. The rotational motion between the plates 380, 382 is passive in that the motion is responsive to other actuation forces in the system 300, as will be described in greater detail.

[0034] Actuators 384, 386, 388, 390 are operably coupled to interface disks 392, 394, 396, 398, respectively. For example, U.S. Pat. No. 7,963,913, filed Dec. 10, 2006, entitled "Instrument Interface of Robotic Surgical System," fully discloses a more detailed description of the interface disk and its function of driving predetermined motions in attached surgical instruments, which is hereby incorporated by reference in its entirety. In this embodiment, each actuator includes a motor M and an encoder E. Each actuator 384-390 affects a specific motion in the end effector 308a and / or wrist mechanism 308b of the surgical instrument 308. As an example, actuator 384 can control the rolling motion of the wrist mechanism 308b. Actuator 386 can control the pitch motion of the actuation of the wrist mechanism 308b. Actuator 388 and actuator 390 can cooperate to control the actuated yaw and grasping motion of the wrist mechanism. The assigned control of each actuator is merely an example. In alternative embodiments, the actuators can be configured to control different motions in the surgical end effector or wrist. For example, a single actuator can control grasping, while the coordinated combination of two actuators can control the pitch and yaw of the wrist mechanism.

[0035] like Figure 3 As shown, surgical instrument 308 includes a proximal housing 394 coupled to interface 304. Instrument shaft 396 extends between proximal housing 394 and wrist mechanism 308b. U.S. Patent Nos. 5,792,135; 6,331,181; and 6,817,974 explain various embodiments of surgical instruments, end effectors, and wrist mechanisms in detail and are hereby incorporated by reference in their entirety.

[0036] When assembled, the proximal housing 394 is coupled to the instrument interface 304, and the shaft 396 is inserted through the instrument guide 352. In response to an actuation force in the system 300, the shaft 396 passively slides within the instrument guide 352. For example, the actuators 340, 342 can provide coupled motion in pitch about axis X and coupled motion in yaw about axis Y. When both actuators 340, 342 move in the same direction about axis Y, the shaft 396 moves in yaw. When both actuators 340, 342 move in opposite directions about axis Y, the shaft 396 moves in pitch. The combined movement of the actuators 340, 342 can be controlled by a 2×2 coupling matrix to move the shaft 396 in a range of directions.

[0037] System 300 as previously described allows surgical instruments to access body tissue through small, natural or surgically created patient access points. The system may be particularly suitable for surgical access to the larynx or throat tissue via an open patient's mouth or access to uterine tissue via the cervix to perform a vaginal hysterectomy. Alternatively, system 300 may be used to perform surgeries that may be tiring for the surgeon or may require inconvenient positioning, such as breast surgery. Compared to robotic surgical systems that require multiple large, dedicated manipulator arms to control the rotation and insertion motion of surgical instruments, system 300 uses a chassis of minimal size to support multiple surgical instruments. Although system 300 describes the use of two surgical instruments coupled to a common chassis, in alternative embodiments, three or more surgical instruments may be mounted and controlled from a common chassis. Positioning the actuation system for controlling the movement of the instrument guide at the proximal portion of the chassis minimizes the number and size of structures required at intermediate or distal locations along the instrument axis to support and control multiple surgical instruments. A linkage system allows the actuation system to remotely control the movement of the instrument guide.

[0038] Prior to using the system 300, the manipulator arm of the slave manipulator system 104 is positioned and locked in place. For example, the manipulator arm may be a da The arm of the surgical system may be a manipulator of a smaller scale, wherein the coupling arm has up to six degrees of freedom. In some embodiments, the manipulator arm of the support system 300 is not controlled by a motor. The manipulator arm may be a passive lockable arm, wherein one or more balanced joints have a brake or a lock. The passive lockable arm can move freely in the released configuration, thereby allowing the system to be positioned at the surgical site with the orientation selected. The passive lockable arm then moves to the locked configuration, wherein the brake maintains the orientation selected. In other embodiments, the system 300 may be held by a sturdy intern holding a passive multi-joint unbalanced arm that can be manually locked.

[0039] Reference Figure 5, a general method 400 of robotic surgery using the system 300 is provided. At 402, a housing 394 at a proximal end of a surgical instrument 308 is received to engage with an instrument interface 304. At 404, a shaft 396 of a surgical instrument 309 is received in an instrument guide 352 at a distal end of the instrument chassis 302. More specifically, a distal end or intermediate portion of the shaft 396 is received in the instrument guide 352. At 406, an actuation system 312 actuates a linkage system 314 to move the instrument guide 352 relative to the instrument chassis 302. More specifically, the actuator 340 receives a control signal from the control system 108 to drive the linkage system 314, including moving a ball and socket joint 348, which moves a rod 346. Further, the actuator 342 receives a control signal from the control system 108 to drive the linkage system 314, including moving a ball and socket joint 356, which moves a rod 354. When rod 346 and rod 354 move together, instrument guide 352 moves in the X-axis direction. When rod 346 and rod 354 move in opposite directions, instrument guide 352 moves in the Y-axis direction. If only one rod 346 or 354 moves, instrument guide 352 moves at an angle to both the X-axis direction and the Y-axis direction. Instrument guide 352 is tethered to distal portion 330 of chassis 302 via ball joint 360.

[0040] At 408, in response to motor-driven actuation of the instrument guide 352, the proximal end of the surgical instrument 308 is permitted to passively move in multiple rotational degrees of freedom. More specifically, the proximal end of the surgical instrument 308 is permitted to passively rotate (yaw) about the Y-axis direction with the gimbal plate 336. Additionally, the proximal end of the surgical instrument 308 is permitted to passively rotate (pitch) about the X-axis direction with the instrument interface plate 382 relative to the chassis interface plate 380. Because of the proximal position of the passive rotation joint, movement of the instrument guide 352 near the distal or intermediate position of the instrument shaft 396 implements a smaller scale of motion at the proximal end of the surgical instrument 308. The smaller scale of motion at the proximal end of the surgical instrument reduces or prevents proximal instrument collisions. To avoid robot arm collisions, some existing systems may require spacing between instrument anatomical entry points of approximately 8-9 cm. The system of the present disclosure may allow for closer instrument spacing while avoiding robot arm collisions.

[0041] In an alternative embodiment, one or more of the gimbals or other rotating joints at the proximal end of the chassis can be replaced with fixed joints. In this embodiment, a flexible instrument shaft can be used to allow a surgical instrument to have a limited amount of rotational movement relative to the chassis.

[0042] In order to provide additional degrees of freedom to surgical instruments and increase the working space between relatively parallel instruments inserted into narrow patient access points, a parallel motion mechanism or "meshing joint" can be added to the distal end of the surgical instrument. The parallel motion mechanism includes a series of joints and couplings at the distal end of the surgical instrument, proximal to the end effector, that allow for lateral displacement of the end effector. U.S. Patent No. 7,942,868 and U.S. Patent Application No. 12 / 489,566 provide descriptions of meshing joints and parallel motion mechanisms, which are hereby incorporated by reference in their entirety. Figure 6 5 is a side view of a distal surgical instrument portion 500 having a shaft 501. Portion 500 includes joints 502, 504, 506, and couplings 508, 510. Joints 502, 504 allow for + / - 45° of rotation and joint 510 allows for + / - 90° of rotation. Joints 502, 504, 506, and couplings 508, 510 provide for a lateral displacement D from the axis of shaft 510, thereby allowing for a larger surgical workspace between substantially parallel surgical instruments.

[0043] One or more elements in the embodiments of the present invention may be implemented in software to be executed on a processor of a computer system (such as control system 108). When implemented in software, the elements of the embodiments of the present invention are essentially code segments that perform necessary tasks. Programs or code segments can be stored in a processor-readable storage medium or device and can be downloaded in the form of a computer data signal embodied as a carrier wave through a transmission medium or a communication link. Processor-readable storage devices may include any medium capable of storing information, including optical media, semiconductor media, and magnetic media. Examples of processor-readable storage devices include: electronic circuits; semiconductor devices, semiconductor storage devices, read-only memories (ROMs), flash memories, erasable programmable read-only memories (EPROMs); floppy disks, CD-ROMs, optical disks, hard disks, or other storage devices. Code segments may be downloaded via a computer network (such as the Internet, a local area network, etc.).

[0044] Note that the processes and displays presented may not be inherently related to any particular computer or other device. Various general purpose systems may be used in conjunction with programs according to the teachings herein, or may prove convenient to construct more specific devices to perform the described operations. The structures required for various of these systems will appear as elements in the claims. In addition, embodiments of the present invention are described without reference to any special programming language. It should be appreciated that various programming languages ​​may be used to implement the teachings of the invention as described herein.

[0045] Although specific exemplary embodiments of the present invention have been described and shown in the accompanying drawings, it is to be understood that such embodiments are merely illustrative and not restrictive of the broad invention, and that the embodiments of the present invention are not limited to the specific construction and arrangements shown and described, since various other modifications will occur to those skilled in the art.

Claims

1. A robotic surgery system, comprising: an instrument chassis assembly comprising an elongated tubular member extending along a central axis of the instrument chassis assembly, a proximal mounting portion, a distal mounting portion, and an instrument interface coupled to the proximal mounting portion; an actuation system coupled to the proximal mounting portion; a linkage system operably coupled between the actuation system and the distal mounting portion and including an instrument guide; as well as A surgical instrument comprising a proximal portion coupled to the instrument interface and a distal portion coupled to the instrument guide, the surgical instrument being pivotable relative to the central axis via the instrument guide, Wherein the actuation system includes a plurality of motors positioned to drive the linkage system and move the instrument guide in at least two rotational degrees of freedom.

2. The system of claim 1, wherein the instrument interface is pivotally coupled to the proximal mounting portion.

3. The system of claim 2, wherein the instrument interface is coupled to the proximal mounting portion via a gimbal.

4. The system of claim 2, wherein the instrument interface has two rotational degrees of freedom relative to the proximal mounting portion.

5. The system of claim 1, wherein the instrument interface is slidably coupled to the proximal mounting portion.

6. The system of claim 1, wherein the instrument guide is slidably coupled to the surgical instrument.

7. The system of claim 1, wherein the instrument guide is pivotally coupled to the distal mounting portion of the instrument chassis assembly.

8. The system of claim 1, wherein the surgical instrument comprises a flexible shaft.

9. The system of claim 1, wherein the linkage system comprises an actuation rod pivotally coupled to the instrument guide, and wherein the surgical instrument is pivotable relative to the actuation rod via the instrument guide.

10. The system of claim 1, wherein the instrument guide is movable in a linear direction relative to the central axis.

11. A teleoperated surgical system, comprising: Equipment chassis; a first instrument interface adapted to receive a proximal portion of a first surgical instrument movably coupled to a distal portion of the instrument chassis; a second instrument interface adapted to receive a proximal portion of a second surgical instrument movably coupled to the distal portion of the instrument chassis; a tethering system that tethers the distal portion of the first surgical instrument to the instrument chassis and tethers the distal portion of the second surgical instrument to the instrument chassis, wherein the tethering system comprises: a first instrument guide coupled to the instrument chassis and the distal portion of the first surgical instrument; and a second instrument guide coupled to the instrument chassis and the distal portion of the second surgical instrument; a first interface actuation system coupled between the instrument chassis and the first instrument interface, the first interface actuation system being configured to move an end effector and / or a wrist structure of the first surgical instrument with at least two degrees of freedom; and a second interface actuation system coupled between the instrument chassis and the second instrument interface, the second interface actuation system being configured to move an end effector and / or a wrist structure of the second surgical instrument with at least two degrees of freedom, wherein the proximal portion of the first surgical instrument is configured to move in a smaller scale in response to movement of the first instrument guide at the distal portion of the first surgical instrument, and Wherein the proximal portion of the second surgical instrument is configured to move at a smaller scale in response to movement of the second instrument guide at the distal portion of the second surgical instrument.

12. The teleoperated surgical system of claim 11, wherein the first interface actuation system and the second interface actuation system each comprise a plurality of motors.

13. The teleoperated surgical system of claim 11, wherein the first interface actuation system and the second interface actuation system each comprise a plurality of gimbals.

14. The teleoperated surgical system of claim 11, wherein the first instrument guide is slidably movable relative to the instrument chassis, and wherein the second instrument guide is slidably movable relative to the instrument chassis.

15. The teleoperated surgical system of claim 11, wherein the first instrument guide is pivotally movable relative to the instrument chassis, and wherein the second instrument guide is pivotally movable relative to the instrument chassis.

16. The teleoperated surgical system of claim 11, wherein the instrument chassis comprises an elongated tubular member extending along a central axis of the instrument chassis, a proximal mounting portion, and a distal mounting portion.

17. The teleoperated surgical system of claim 16, wherein the first instrument interface and the second instrument interface are each coupled to the proximal mounting portion.

18. The teleoperated surgical system of claim 11, wherein the instrument chassis comprises an elongated tubular member extending along a central axis of the instrument chassis, the elongated tubular member being configured to accommodate an imaging instrument.

Images