surgical instrument manipulator aspect

Abstract

This invention relates to surgical instrument manipulators. A remote central manipulator for minimally invasive robotic surgery includes a base link that remains stationary relative to the patient, an instrument holder, and a linkage mechanism connecting the instrument holder to the base link. First and second links of the linkage mechanism are linked to limit the rotational movement of a second link about a first axis intersecting the remote manipulator center. A parallelogram-shaped link mechanism portion of the linkage mechanism allows the instrument holder to pitch about a second axis intersecting the remote manipulator center. The second axis forms a non-zero angle offset from the first axis, which is not 90 degrees.

Description

[0001] This application is a divisional application of application 2020104187027, filed on May 31, 2013, entitled "Surgical Instrument Manipulator". Divisional application 2020104187027 is a divisional application of application 2017100887042, which is a divisional application of Chinese Patent Application 201380028807.X (PCT / US2013 / 043602).

[0002] Cross-reference to related applications

[0003] This application claims priority to U.S. Patent Application No. 61 / 654377, filed June 1, 2012, the entire contents of which are incorporated herein by reference. Background Technology

[0004] Minimally invasive medical techniques aim to reduce the amount of external tissue damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and harmful side effects. One effect of minimally invasive surgery is, for example, reduced postoperative hospital stays. Since the average hospital stay for standard open surgery is typically significantly longer than the average stay for similar minimally invasive procedures, increasing the use of minimally invasive techniques could save millions of dollars in hospitalization costs annually. While many surgeries performed each year in the United States may be performed minimally invasively, currently only a portion of these advanced techniques are used due to the availability of minimally invasive surgical instruments and the additional surgical training required to master them.

[0005] Minimally invasive robotic surgery, or remote surgery systems, have been developed to increase surgeon dexterity and avoid some of the limitations of traditional minimally invasive techniques. In remote surgery, surgeons manipulate surgical instruments using some form of remote control (e.g., servo mechanisms) instead of directly holding and moving the instruments by hand. In remote surgery systems, images of the surgical site can be provided to the surgeon at a surgical workstation. While the surgeon can view two-dimensional or three-dimensional images of the surgical site on a monitor, they manipulate a master control unit, which in turn controls the servo mechanisms to manipulate the movement of instruments, thus performing the surgical procedure for the patient.

[0006] Servo mechanisms used in remote surgery typically receive input from two master controllers (each corresponding to each of the surgeon's hands) and may include two or more robotic arms, with surgical instruments mounted on each of the two or more robotic arms. Operational communication between the master controllers and the associated robotic arms and instrument assemblies is typically achieved through a control system. The control system typically includes at least one processor that relays input commands from the autonomous controllers to the associated robotic arms and instrument assemblies and, in cases such as force feedback, returns them from the instrument and arm assemblies to the associated master controller. An example of a robotic surgical system could be commercially available from Intuitive Surgical, Inc., Sunnyvale, California. system.

[0007] Various structural arrangements are used to support surgical instruments at the surgical site during robotic surgery. Driven linkages, or “followers,” are often referred to as robotic surgical manipulators, and exemplary linkage arrangements used as robotic surgical manipulators during minimally invasive robotic surgery are described in U.S. Patents Nos. 7,594,912 (filed September 30, 2004), 6,758,843 (filed April 26, 2002), 6,246,200 (filed August 3, 1999), and 5,800,423 (filed July 20, 1995), all of which are incorporated herein by reference. These linkages often manipulate instrument holders on which instruments with axes are mounted. Such manipulator structures may include a parallelogram linkage portion that generates movement of the instrument holder, said parallelogram linkage portion being restricted to rotation about a pitch axis intersecting a remote manipulation center located along the length of the instrument axis. Such manipulator structures may also include a deflection joint / connector that generates instrument gripper movement, the deflection joint being restricted to rotation about a deflection axis perpendicular to the pitch axis and intersecting the telemanipulation center. By aligning the telemanipulation center with the incision point at the internal surgical site (e.g., with a trocar or cannula in the abdominal wall during laparoscopic surgery), the end effector / actuator of the surgical instrument can be safely positioned without imposing potentially harmful forces on the abdominal wall by using a manipulator linkage to move the proximal end of the axis. Alternative manipulator structures are described, for example, in U.S. Patent Nos. 6,702,805 (filed November 9, 2000), 6,676,669 (filed January 16, 2002), 5,855,583 (filed November 22, 1996), 5,808,665 (filed September 9, 1996), 5,445,166 (filed April 6, 1994), and 5,184,601 (filed August 5, 1991), all of which are incorporated herein by reference.

[0008] While new remote surgical systems and devices have proven efficient and advantageous, further improvements are still needed. Generally, providing improved structures and systems for performing minimally invasive robotic surgery would be desirable. More specifically, enhancing the efficiency and ease of use of these systems would be beneficial. For example, improving the range of motion provided by the robotic surgical manipulator without imposing potentially harmful forces on the abdominal wall would be particularly advantageous. Summary of the Invention

[0009] To provide a basic understanding of the invention, a brief overview of some embodiments of the invention is given below. This overview is not a comprehensive summary of the invention. It is not intended to identify key / essential elements of the invention or to depict its scope. Its sole purpose is to serve as a prelude to the specific embodiments described below, to present certain embodiments of the invention in a simplified manner.

[0010] An improved remote central manipulator is disclosed that, during minimally invasive robotic surgery, supports surgical instruments and provides a center of manipulation at the desired location of the instrument, away from any bearings or mechanical supports. This remote central manipulator restricts instrument movement in the vicinity of the remote manipulation center, preferably coinciding with the patient's entry incision, such as the patient's abdominal wall. The improved remote central manipulator includes a linkage mechanism that couples a surgical instrument holder to a mounting base. This linkage mechanism is operable to rotate the instrument holder about a deflection axis intersecting the remote manipulation center, and to rotate the instrument holder about a pitch axis also intersecting the remote manipulation center (pitch). The pitch axis is transverse but not perpendicular to the deflection axis, thus serving as a reduced operating space envelope for the improved manipulator. In many embodiments, the linkage mechanism includes links that move in separate planes of motion, thereby providing freedom of movement for links that would otherwise be impossible to move in the same plane of motion.

[0011] Therefore, in one aspect, a remote central manipulator for limiting the position of surgical instruments during minimally invasive robotic surgery is disclosed. The surgical instrument includes an elongated shaft having a distal working end configured for insertion into a patient's body cavity via a remote manipulator center. The remote central manipulator includes a mounting base, an instrument holder configured to be coupled to the surgical instrument, and a linkage mechanism coupling the instrument holder to the mounting base. First and second links of the linkage mechanism are coupled to limit the rotational movement of a second link relative to the first link about a deflection axis intersecting the remote manipulator center. The linkage mechanism includes three rotatable coupling joints configured to produce a restricted parallelogram-shaped movement of the linkage mechanism, thereby limiting the movement of the instrument holder to rotation about a pitch axis intersecting the remote manipulator center. This pitch axis is offset from the deflection axis by a non-zero angle other than 90 degrees.

[0012] In many embodiments, the deflection axis is offset from the pitch axis by an appropriate angle from the vertical, an angle suitable for minimizing the operating space envelope of the remote central manipulator during rotation of the instrument holder about the deflection axis. For example, in many embodiments, the deflection axis is offset from the pitch axis by an angle of 1.0 to 10.0 degrees from the vertical. In many embodiments, the deflection axis is offset from the pitch axis by an angle of 1.5 to 5.0 degrees from the vertical. And in many embodiments, the deflection axis is offset from the pitch axis by an angle of 2.0 to 3.5 degrees from the vertical.

[0013] In many embodiments, the remote central manipulator is configured to provide a large range of motion for the instrument holder near the deflection axis. For example, in many embodiments, the second link can rotate at least 540 degrees relative to the first link. And in many embodiments, the second link can rotate at least 600 degrees relative to the first link.

[0014] In many embodiments, the remote central manipulator is configured to provide a large range of motion for the instrument holder near the pitch axis. For example, in many embodiments, the instrument holder can rotate at least 140 degrees about the pitch axis.

[0015] On the other hand, a remote central manipulator for limiting the position of surgical instruments during minimally invasive robotic surgery is disclosed. The surgical instrument includes an elongated shaft with a distal working end configured for insertion into a patient's body cavity via a remote manipulator center. The remote central manipulator includes a mounting base, a parallelogram linkage base, a first drive module, a second drive module, a first link, a second link, and an instrument holder. The parallelogram linkage base is coupled to the mounting base for rotation relative to the mounting base about a deflection axis intersecting the remote manipulator center. The first drive module motiveably couples the parallelogram linkage base to the mounting base, allowing selective rotation of the parallelogram base relative to the mounting base about the deflection axis. The second drive module is rotatably coupled to the parallelogram linkage base and has a second drive module output. The second drive module is configured to selectively rotate its output relative to the parallelogram linkage base. The first link has a proximal end and a distal end. The proximal end of the first link is coupled to a parallelogram base for rotation relative to the parallelogram base in response to rotation of the output of the second drive module. The second link has a proximal end and a distal end. The proximal end of the second link is coupled to the distal end of the first link for rotation relative to the first link in response to rotation of the output of the second drive module. An instrument holder is coupled to the proximal end of the second link for rotation relative to the second link in response to rotation of the output of the second drive module. Rotation of the output of the second drive module generates movement of the instrument holder, which is restricted to rotation about a pitch axis intersecting the remote control center. This pitch axis is offset from the deflection axis by a non-zero angle not exceeding 90 degrees. A common drive module can be used for each of the first and second drive modules.

[0016] In many embodiments, the parallelogram linkage base includes a yaw / pitch housing. In many embodiments, each of the first and second drive modules is at least partially disposed within the yaw / pitch housing.

[0017] In many embodiments, the parallelogram linkage base includes an extension having a proximal end and a distal end. The proximal end of the extension is fixedly attached to a deflection / pitch housing. A first link proximal end is coupled to the distal end of the extension for rotation relative to the extension in response to rotation of the output of a second drive module. In many embodiments, the extension includes a drive coupling that drivably couples rotation of the second link to rotation of the output of the second drive module. The drive coupling extends between the proximal and distal ends of the extension. In many embodiments, the drive coupling includes a metal strip drivably coupled to a pulley. In many embodiments, the drive coupling includes a sine / cosine link. And in many embodiments, the drive coupling includes a sine / cosine link with directional deflection.

[0018] The remote central manipulator can be manufactured from one or more replaceable units. For example, the remote central manipulator may include first to fifth independent field replaceable units. The first field replaceable unit includes a yaw / pitch housing, a first drive module, a second drive module, and a second drive module output. The second field replaceable unit includes an extension. The third field replaceable unit includes a first link. The fourth field replaceable unit includes a second link. And the fifth replaceable unit includes an instrument holder.

[0019] In many embodiments, the remote central manipulator is configured to avoid interference between manipulator components. For example, an extension may be biased to one side of the first link, allowing the first link to be movable and aligned with the extension. Similarly, a second link may be biased to one side of the first link, allowing the second link to be movable and aligned with the first link.

[0020] In many embodiments, the remote central manipulator is configured to provide a large range of motion for the instrument holder near the deflection axis. For example, in many embodiments, the parallelogram base can rotate at least 540 degrees relative to the mounting base. And in many embodiments, the parallelogram base can rotate at least 600 degrees relative to the mounting base.

[0021] In many embodiments, the remote central manipulator is configured to provide a large range of motion for the instrument holder near the pitch axis. For example, in many embodiments, the instrument holder can rotate at least 140 degrees about the pitch axis.

[0022] In many embodiments, the deflection axis is offset from the pitch axis by an appropriate angle from the vertical, an angle suitable for minimizing the operating space envelope of the remote central manipulator during rotation of the instrument holder about the deflection axis. For example, in many embodiments, the deflection axis is offset from the pitch axis by an angle of 1.0 to 10.0 degrees from the vertical. In many embodiments, the deflection axis is offset from the pitch axis by an angle of 1.5 to 5.0 degrees from the vertical. And in many embodiments, the deflection axis is offset from the pitch axis by an angle of 2.0 to 3.5 degrees from the vertical.

[0023] To gain a more complete understanding of the nature and advantages of this invention, reference should be made to the specific embodiments and accompanying drawings. Other aspects, objectives, and advantages of this invention will become apparent from the following drawings and specific embodiments. Attached Figure Description

[0024] Figure 1 This is a plan view of a minimally invasive robotic surgical system for performing surgery, according to many embodiments.

[0025] Figure 2This is a perspective view of a surgeon's console for a robotic surgical system, according to many embodiments.

[0026] Figure 3 This is a perspective view of an electronic trolley for a robotic surgical system according to many embodiments.

[0027] Figure 4 A robotic surgical system according to many embodiments is illustrated in outline.

[0028] Figure 5A This is a front view / main view of a patient-side trolley (surgical robot) of a robotic surgical system according to many embodiments.

[0029] Figure 5B This is a front view of a robotic surgical tool according to many embodiments.

[0030] Figure 6 This is a perspective view of a remote central manipulator according to many embodiments, the remote central manipulator including a tapered swing joint operable with a reorientation instrument holder without moving the remote manipulator center.

[0031] Figure 7 This is a perspective view of a remote center manipulator according to many embodiments, the remote center manipulator including a tapered swing link that can operate the outer portion of a reorientation manipulator without moving the remote control center.

[0032] Figure 8 This is a perspective schematic diagram of a remote central controller according to many embodiments, the remote central controller including Figure 6 tapered swing joint and Figure 7 A conical swing link.

[0033] Figure 9 This is a perspective view of a remote center controller according to many embodiments, the remote center controller including a pitch linkage mechanism that allows operation of the outer portion of a reorientation controller without moving the remote control center.

[0034] Figure 10 This is a perspective schematic diagram of a remote central controller according to many embodiments, the remote central controller including Figure 6 tapered swing joint, Figure 7 The conical swing link and Figure 9 The pitch linkage mechanism.

[0035] Figure 11 A remote center manipulator according to many embodiments is shown, the remote center manipulator including a linkage mechanism assembly that operates a reorientation manipulator without moving a tapered swing link of the remote control center.

[0036] Figure 12A remote center manipulator according to many embodiments is shown, the remote center manipulator including a tapered swing joint operable with a redistribution device holder without moving the remote control center.

[0037] Figure 13A , Figure 13B and Figure 13C The instrument holder is shown in different orientations. Figure 8 Remote central controller.

[0038] Figure 14A This illustrates what can be used for rotatable couplings according to many embodiments. Figure 8 The sine / cosine linkage of two parallelogram joints in the remote central controller.

[0039] Figure 14B The diagram illustrates directional deflection according to many embodiments for mitigating loads caused by angular forces in a link used for rotatable connection to two parallelogram joints in a remote center manipulator.

[0040] Figure 15 A remote center manipulator according to many embodiments is shown, the remote center manipulator including a bending feature having a fixed radius of curvature relative to the remote manipulator center, and the base link of the outer linkage mechanism can be repositioned along the bending feature.

[0041] Figure 16 A remote central manipulator according to many embodiments is shown, the remote central manipulator including a closed-loop curve feature, to which a base link of an outer linkage is connected, such that the base link is restricted to movement along the closed-loop curve feature.

[0042] Figure 17 This is a perspective view of a remote center manipulator according to many embodiments, in which an instrument holder rotates about a deflection axis passing through the remote center and about a pitch axis passing through the remote center, the deflection axis not being perpendicular to the pitch axis.

[0043] Figure 18 This is a perspective schematic diagram of a remote central manipulator according to many embodiments, wherein in Figure 17 The remote central controller further includes Figure 9 The pitch linkage mechanism.

[0044] Figure 19 This is a perspective schematic diagram of a remote central manipulator according to many embodiments, wherein in Figure 18 The remote central controller further includes Figure 6 A tapered swing joint.

[0045] Figure 20This is a side view of a remote central controller according to many embodiments.

[0046] Figure 21 yes Figure 20 A top view of the remote central controller.

[0047] Figure 22 The diagram illustrates how tilting the pitch axis achieves this. Figure 20 The operating space envelope of the remote central controller is reduced.

[0048] Figure 23 According to many embodiments Figure 20 The side view of the remote center manipulator in the instrument holder relative to the remote control center achieves maximum pitch return in the configuration. Detailed Implementation

[0049] In the following description, various embodiments of the invention will be described. Specific constructions and details are set forth for illustrative purposes to provide a thorough understanding of the described embodiments. However, the invention can be practiced without these specific details, as will be apparent to those skilled in the art. Furthermore, well-known features may be omitted or simplified so as not to obscure the described embodiments.

[0050] Minimally invasive robotic surgery

[0051] Referring now to the accompanying drawings, which run through several drawings, the same reference numerals denote the same parts. Figure 1This is a plan view illustration of a minimally invasive robotic surgical (MIRS) system 10, typically used for minimally invasive diagnostic or surgical procedures on a patient 12 lying on a worktable 14. The system may include a surgeon's console 16 for use by a surgeon 18 during the procedure. One or more assistants 20 may also participate in the procedure. The MIRS system 10 may further include a patient-side trolley 22 (surgical robot) and an electronic trolley 24. The patient-side trolley 22 can manipulate at least one detachably coupled tool assembly 26 (hereinafter simply referred to as "tools") through a minimally invasive incision in the patient 12, while the surgeon 18 views an image of the surgical site via the console 16. The image of the surgical site can be obtained via an endoscope 28 (e.g., a stereoscopic endoscope), which can be manipulated by the patient-side trolley 22 to position and orient the endoscope 28. The electronic trolley 24 can be used to process the surgical site image for subsequent display to the surgeon 18 via the surgeon's console 16. The number of surgical tools 26 used at one time typically depends on the diagnostic or surgical procedure, space constraints within the operating room, and other factors. If it is necessary to change one or more tools 26 in use during the surgical procedure, the assistant 20 can remove the tool 26 from the patient-side trolley 22 and replace it with another tool 26 from the tray 30 in the operating room.

[0052] Figure 2 A perspective view of the surgeon's console 16 is shown. The surgeon's console 16 includes a left-eye display 32 and a right-eye display 34, which are used to present the surgeon 18 with a cooperative stereoscopic view of the surgical site capable of depth perception. The console 16 further includes one or more input controls 36, which in turn cause the patient-side trolley 22 (in...) Figure 1 (As shown in the diagram) Operate one or more tools. Input control device 36 can provide the associated tool 26 (in...) Figure 1 (As shown in the diagram) the same degrees of freedom are provided to the surgeon to offer a telepresence or perception integrated with the tool 26 via the input control device 36, so that the surgeon has a strong perception of direct control over the tool 26. For this purpose, position, force, and tactile feedback sensors (not shown) can transmit position, force, and tactile sensations from the tool 26 to the surgeon's hand via the input control device 36. Each individual input control device 36 acts as a human master controller to control the corresponding surgical tool for remote operation. Telepresence of sensation is achieved when this remote operation is combined with a display of the surgical site in three-dimensional perception and when the surgeon's hand is positioned on the master controller at a location corresponding to the tool image observed at the surgical site.

[0053] The surgeon's console 16 is typically located in the same room as the patient so that the surgeon can directly monitor the surgical procedure, and if necessary, physically be present and speak directly to assistants instead of via telephone or other communication media. However, the surgeon may be located in a different room, a completely different building, or another location far from the patient to allow for remote surgical procedures.

[0054] Figure 3 A perspective view of an electronic trolley 24 is shown. The electronic trolley 24 can be coupled to an endoscope 28 and may include a processor for processing captured images for subsequent display to the surgeon on a surgeon's console or other suitable display located locally and / or remotely. For example, when using a stereoscopic endoscope, the electronic trolley 24 may process the captured images to present the surgeon with a co-stereoscopic image of the surgical site. Such co-processing may include alignment between relative images and may include adjusting the stereoscopic working distance of the stereoscopic endoscope. As another example, image processing may include compensating for imaging errors, such as optical aberrations, of the image capture device using previously determined camera calibration parameters.

[0055] Figure 4 A schematic diagram of a robotic surgical system 50 (e.g.) Figure 1 The MIRS system 10). As described above, the surgeon's console 52 (e.g., Figure 1 The surgeon's console 16) can be used by the surgeon during minimally invasive surgery to control the patient-side trolley (surgical robot) 54 (e.g. Figure 1 The patient-side trolley 22). The patient-side trolley 54 can use an imaging device such as a stereoscopic endoscope to capture images of the surgical site and transmit them to an electronic trolley 56 (e.g., an electronic endoscope). Figure 1 The electronic trolley 54 outputs captured images. As described above, the electronic trolley 56 can process the captured images in various ways before any subsequent display. For example, the electronic trolley 56 can overlay the captured images with a virtual control interface before displaying the combined images to the surgeon via the surgeon's console 52. The patient-side trolley 54 can output captured images for processing by the external electronic trolley 56. For example, the patient-side trolley 54 can output captured images to a processor 58, which can be used to process the captured images. Images can also be processed in combination with the electronic trolley 56 and the processor 58, which can be coupled together to process the captured images jointly, sequentially, and / or in combination. One or more separate displays 60 can also be coupled to the processor 58 and / or the electronic trolley 56 for local and / or remote display of images (e.g., images of the surgical site or other relevant images).

[0056] Figure 5A and 5BPatient-side trolley 22 and surgical instrument 62 are shown separately. Surgical instrument 62 is an example of surgical instrument 26. The illustrated patient-side trolley 22 provides manipulation of three surgical instruments 26 and an imaging device 28, such as a stereoscopic endoscope for capturing images of the surgical site. Manipulation is provided via a robotic mechanism with several robotic joints. The imaging device 28 and surgical instruments 26 can be positioned and manipulated through an incision inside the patient so that the remote center of motion is held at the incision to minimize incision size. Images of the surgical site may include images of the distal end of the surgical instrument 26 when it is positioned within the field of view of the imaging device 28. Diagnostic or therapeutic end effectors 63 are typically located distal to the long axis of the surgical instrument.

[0057] Hardware-constrained remote central control

[0058] Figure 6 A perspective view of a remote central manipulator 70 according to many embodiments is shown. The remote central manipulator 70 is supported by a mounting base 72. The remote central manipulator 70 includes a base link 74, a deflection joint 76, an extension link 78, a base parallelogram joint 80, a first parallelogram link 82, a first parallelogram joint 84, a second parallelogram link 86, a second parallelogram joint 88, a conical oscillation mechanism 90, and an instrument holder 92, all supported by the mounting base 72. The instrument holder 92 is configured to support and translate a surgical instrument 94 along an insertion axis 96 (i.e., the instrument holder 92 includes at least one prismatic joint of the surgical instrument 94 for insertion and removal into or out of an incision in the patient's body wall or at a patient's natural body orifice along the insertion axis 96). A surgical end effector 95 is located at the distal end of the surgical instrument 94. The end effector can be used for any surgical function, including therapeutic, diagnostic, or imaging surgical devices. Rolling of the end effector can be accomplished in a variety of known manners. For example, the instrument holder 92 or the instrument 94 itself may include an instrument axis rolling capability that allows the instrument axis to roll about the insertion axis 96. As an alternative example, the axis may remain stationary while rolling, and the end effector rolls at the end of the instrument axis.

[0059] Mounting base 72 allows the remote central manipulator 70 to be mounted and supported via a trolley base's setting arm / joint, top plate base, floor / column base, or other base surface, so that the base remains effectively stationary in a ground reference frame (as indicated by the symbol for the ground). The remote central manipulator 70 is configured such that the remote manipulation center (RC) does not move relative to mounting base 72 when the surgical instrument 94 is manipulated. By supporting mounting base 72 in a fixed position and orientation relative to the patient, the remote manipulation center (RC) remains fixed relative to the patient, thereby providing an entry point for the surgical instrument 94. With the remote manipulation center (RC) fixed relative to the patient, manipulation of the surgical instrument 94 can be achieved without the risk of imposing potentially harmful forces on the patient's cellular tissue at the entry point of the surgical instrument 94. In embodiments where the surgical instrument axis passes through a cannula, the remote manipulation center is typically defined at a point along the cannula's centerline, although in some embodiments, the cannula may be optional.

[0060] Deflector 76 rotatably connects the proximal end of extension link 78 to the distal end of base link 74. Deflector 76 is operable to produce controlled rotation (rolling) of extension link 78 about deflection axis 98 extending through the remote control center (RC). Because instrument holder 92 is connected to extension link 78 via an intervention linkage component of remote control center 70, rotation (rolling) of extension link 78 about deflection axis 98 produces a corresponding rotation of instrument holder 92 about deflection axis 98, thereby maintaining the position and orientation of remote control center (RC) relative to mounting base 72 for all angular orientations of deflector 76. The term "deflection" is arbitrary, and it can be seen that in the case of this term, rotation of the remote control center (RC) at rest about deflection axis 98 will cause the distal end of surgical instrument 94 to move in the manner defined by deflection.

[0061] The parallelogram linkage portion 100 of the remote central manipulator 70 is configured to produce movement of the instrument holder 92 limited by rotation about a pitch axis 102, which intersects the remote manipulator center (RC). By limiting the corresponding movement of the instrument holder 92 to rotation (pitch) about the pitch axis 102, the insertion axis 96 continues to intersect the remote manipulator center (RC), and the distance between the instrument holder 92 and the remote manipulator center (RC) is maintained. The term "pitch" is arbitrary, and it can be seen that in the case of this term, rotation about the pitch axis 102 while the remote manipulator center (RC) is stationary will cause the distal end of the surgical instrument 94 to move in the manner defined by pitch.

[0062] The parallelogram linkage portion 100 includes a parallelogram base connector 80, a first parallelogram link 82, a first parallelogram connector 84, a second parallelogram link 86, a second parallelogram connector 88, a conical oscillating mechanism 90, and an instrument holder 92. The base parallelogram connector 80 rotatably connects the first parallelogram link 82 to the distal end of an extension link 78. The base parallelogram connector 80 is operable to produce controlled rotation of the first parallelogram link 82 about a base connector axis 104 parallel to the pitch axis 102. The position and orientation of the base connector axis 104 are fixed relative to the extension link 78. The first parallelogram connector 84 rotatably connects the proximal end of the second parallelogram link 86 to the distal end of the first parallelogram link 82 for rotation of the second parallelogram link 86 about a first connector axis 106 parallel to the pitch axis 102. The position and orientation of the first connector axis 106 are fixed relative to the first parallelogram link 82. The second parallelogram link 88 rotatably connects the proximal end of the conical oscillating mechanism 90 to the distal end of the second parallelogram link 86, allowing the conical oscillating mechanism 90 to rotate about the second connector axis 108, which is parallel to the pitch axis 102. The position and orientation of the second connector axis 108 are fixed relative to the second parallelogram link 86. Because the instrument holder 92 is connected to the distal end of the conical oscillating mechanism 90, the instrument holder 92 is restricted to rotating about the second connector axis 108.

[0063] First and second parallelogram joints 84, 88 are rotatably coupled to base parallelogram joint 80 such that actuation of base parallelogram joint 80 actuates parallelogram linkage portion 100, thereby producing a corresponding movement in which instrument holder 92 is restricted to rotation about pitch axis 102. Any suitable arrangement can be used to rotatably couple base parallelogram joint 80, first parallelogram joint 84, and second parallelogram joint 88. For example, base parallelogram joint 80 may include a base pulley rotatably fixed to extension link 78 and mounted to rotate about base joint axis 104 relative to first parallelogram link 82. First parallelogram joint 84 may include a first pulley rotatably fixed to second parallelogram link 86 and mounted to rotate about first joint axis 106 relative to first parallelogram link 82. By connecting the rotation of the first pulley to the rotation of the second pulley, for example via one or more drive belts or one or more links, the rotation of the second parallelogram link 86 relative to the first parallelogram link 82 can be driven by the rotation of the first parallelogram link 82 relative to the extension link 78, such that the same relative orientation between the second parallelogram link 86 and the extension link 78 is maintained in all angular orientations of the first parallelogram link 82 relative to the extension link 78. Similarly, the first parallelogram joint 84 may include a third pulley rotatably fixed to the first parallelogram link 82 and mounted to rotate about the first joint axis 106 relative to the second parallelogram link 86. The second parallelogram joint 88 may include a fourth pulley rotatably fixed to the proximal end of the conical oscillating mechanism 90 and mounted to rotate about the second joint axis 108 relative to the second parallelogram link 86. By connecting the rotation of the third pulley to the rotation of the fourth pulley, for example via one or more drive belts or one or more links, the rotation of the conical oscillating mechanism 90 relative to the second parallelogram link 86 can be driven by the rotation of the second parallelogram link 86 relative to the first parallelogram link 82, such that the same relative orientation between the insertion axis 96 and the first parallelogram link 82 is maintained in all angular orientations of the second parallelogram link 86 relative to the first parallelogram link 82.

[0064] The conical oscillation mechanism 90 includes a proximal conical oscillation link 110 and a conical oscillation joint 112. The conical oscillation joint 112 rotatably connects the instrument holder 92 to the proximal conical oscillation link 110, such that actuation of the conical oscillation joint 112 reorients the instrument holder 92 relative to the proximal conical oscillation link 110 about a conical oscillation axis 114 intersecting the telemanipulation center (RC). Rotation of the conical oscillation joint 112 causes the axis of the surgical instrument 94 to oscillate along the surface of a cone centered on the conical oscillation axis 114 and having a apex at the telemanipulation center (RC). The reorientation of the instrument holder 92 about the conical oscillation axis 114 can be used for any suitable purpose, such as avoiding collisions with adjacent surgical manipulators and / or the patient, or providing increased space at the body wall to allow surgical personnel access to sterile surgical areas within the body. The reorientation of the instrument holder 92 about the conical oscillation axis 114 can also be used to extend the available range of motion of the instrument holder 92 relative to the patient. The tapered oscillation axis 114 provides a redundant axis about which the instrument holder 92 can rotate near the remote manipulation center (RC). The tapered oscillation axis 114 is not aligned with any of the deflection axis 98, pitch axis 102, or insertion axis 96. However, during surgery, the angle between the tapered oscillation axis 114 and the deflection axis 98 can be changed as the remote central manipulator 70 is hinged. The tapered oscillation mechanism 90 is optional and may be included or not included in various manipulator embodiments as described herein. For the purposes of this specification, the tapered oscillation mechanism 90 can be considered a distal tapered oscillation mechanism to distinguish it from other tapered oscillation mechanisms located more closely within the manipulator (e.g., see...). Figure 8 (This shows another "proximal" conical oscillating mechanism).

[0065] Figure 7 This is a perspective view of a remote central controller 120 according to various embodiments. The remote central controller 120 includes a number of... Figure 6 The remote central manipulator 120 uses the same components as the remote central manipulator 70. Shared components include a mounting base 72, a base link 74, a deflector joint 76, an extension link 78, a base parallelogram joint 80, a first parallelogram joint 82, a first parallelogram joint 84, a second parallelogram joint 86, a second parallelogram joint 88, and an instrument holder 92. The remote central manipulator 120 does not include a conical oscillating mechanism 90. Instead, the second parallelogram joint 88 rotatably connects the instrument holder 92 to the second parallelogram joint 86 for rotation of the instrument holder 92 relative to the second parallelogram joint 86 about a second joint axis 108.

[0066] The remote control center 120 further includes a conical oscillating mechanism 122. The conical oscillating mechanism 122 includes a conical oscillating joint 124 and a conical oscillating link 126 rotatably connected to a base link 74 via the conical oscillating joint 124. The conical oscillating joint 124 is operable to selectively rotate the conical oscillating link 126 about a conical oscillating axis 128 intersecting the remote control center (RC). The distal end of the conical oscillating link 126 supports a deflection joint 76. The conical oscillating link 126 is configured to position and orient the deflection joint 76 such that, for all orientations of the conical oscillating link 126 about the conical oscillating axis 128, the deflection axis 98 intersects the remote control center (RC). The conical oscillating mechanism 122 is operable to reorient the outer link mechanism of the remote control center 120 relative to the mounting base 72 while maintaining the position of the remote control center (RC) relative to the mounting base 72. Rotation of the tapered oscillating joint 124 causes the axis of the surgical instrument 94 to oscillate along the surface of a cone centered on the tapered oscillating axis 128 and having a apex at the remote manipulation center (RC). The tapered oscillating mechanism 122 can be used in any suitable manner, such as a setting joint for positioning / orienting the outer portion of the remote central manipulator 120 before the surgical procedure and / or for actively positioning / orienting the outer portion of the remote central manipulator 120 during the surgical procedure. The tapered oscillating axis 128 provides redundant degrees of freedom axes about which the instrument holder 92 can rotate near the remote manipulation center (RC). The tapered oscillating axis 128 is not aligned with any of the deflection axis 92, pitch axis 102, or insertion axis 96. The tapered oscillating axis 128 can be offset from the deflection axis 98 by any suitable angle (e.g., 15 degrees in one embodiment). Refer again Figure 6 The conical oscillating mechanism 122 is optional and may be included or not included in the various manipulator embodiments as described herein. For the purposes of this specification, the conical oscillating mechanism 122 may be considered as a proximal conical oscillating mechanism to be distinguished from other conical oscillating mechanisms located further away in the manipulator (e.g., see [reference needed]). Figure 8 (This shows another "far side" conical oscillating mechanism).

[0067] The connector associated with the conical oscillating mechanism 122 may be driven or undriven, and if driven, the connector may be part of a remote operating function under the active control of a surgeon or passively controlled by another person in the operating room. If passively controlled by a non-surgeon, the conical oscillating mechanism may be part of a setup to properly position the remote central manipulator for the procedure before and / or during the procedure. In some embodiments, a switch (button, rocker, etc.) controls the movement of the conical oscillating mechanism 122, moving a more distal portion of the manipulator to a desired position. Furthermore, the conical oscillating mechanism 122 may rotate a full 360 degrees or more, or its rotation may be limited to less than 360 degrees. For example, in one embodiment, the rotation is limited to approximately 180 degrees, between a linear ascending (12 o'clock) position and a linear descending (6 o'clock) position. If two or more similarly configured remote central manipulators are positioned adjacent to each other, each conical oscillating mechanism 122 may be limited to rotating the same radian to help eliminate collisions / conflicts. For example, each conical oscillating mechanism 122 can be restricted to rotate to any position on an arc from 12 o'clock through 3 o'clock to 6 o'clock. In other embodiments, the conical oscillating mechanism 122 is provided with center-of-gravity compensation features (e.g., by controlling motor torque according to the mechanical load position using current, by using springs to balance the mechanical load, etc.), which makes it easy for the hand to position when the mechanical load is effectively weightless or low. In a center-of-gravity compensation embodiment, the brake typically holds the manipulator in place until the time it takes for a person to move the manipulator to the desired position is released, and then the brake is reapplied at the new position to hold the manipulator.

[0068] In addition to being used for setting operations, the conical oscillation mechanism 122 can also be connected to the surgeon's active remote control of the surgical instrument 94. Therefore, the movement of the conical oscillation mechanism can occur automatically as a result of the surgeon's control input or as a result of, for example, avoiding collisions with nearby objects such as a second manipulator, the patient, or other operating room equipment.

[0069] The various aspects of the remote central manipulator disclosed herein can be combined in any suitable manner. For example, Figure 8 This is a perspective view of a remote central manipulator 130 according to various embodiments, the remote central manipulator including Figure 6 Remote central controller 70 and Figure 7The remote center manipulator 120 comprises both aspects. Specifically, the remote center manipulator 130 includes a conical oscillating mechanism 122, a conical oscillating mechanism 90, and a parallelogram linkage portion 100. Therefore, the remote center manipulator 130 has two redundant degrees of freedom axes, specifically including a conical oscillating axis 114 and a conical oscillating axis 128, about which the instrument holder 92 can rotate near the remote control center (RC). Each of the conical oscillating axes 114 and 128 is not aligned with any of the yaw axis 98, pitch axis 102, or insertion axis 96.

[0070] Because in Figures 6-8 The remote central manipulator embodiment shown includes a deflection axis and one or more conical oscillating mechanisms, each associated with a conical oscillating axis, and all axes of rotation aligned with the remote manipulator center. This redundant degree of freedom allows the instrument axis to remain stationary in space (i.e., in a ground reference frame associated with base 72), as if the remote central manipulator were placed in various configurations. Furthermore, by rolling the instrument end effector as described above, if the end effector orientation is not aligned with the insertion axis 96, then that end effector orientation can also remain stationary in space, as if the remote central manipulator were placed in various configurations. Such remote central manipulators safeguard the patient safety interests of hardware-constrained robotic surgical manipulators, where the hardware configuration prevents movement of the remote manipulator center relative to the patient, and add the benefits of allowing different configurations of instruments in different locations, useful features such as avoiding collisions with adjacent manipulators, patients, other equipment, and surgical personnel, thereby providing increased clearance between the manipulator and the patient, and providing increased access to the instrument entering the patient's surgical area.

[0071] However, it should be readily recognized that if the parallelogram linkage portion 100 is positioned with an insertion axis 96 that is not perpendicular to axis 98, then as the connector 76 rotates, the device 94 also oscillates along the surface of a cone on axis 96, which has a vertex at the remote control center, in a manner similar to the movement of the device 94 when the conical oscillating mechanism rotates as described above. Therefore, these features provide so-called arbitrary redundant "deflection type" degrees of freedom because the axis of rotation intersects the remote control center. However, the hardware-constrained remote center manipulator according to aspects of the invention is not limited to deflection type redundant degrees of freedom.

[0072] Figure 9 This is a perspective view of a remote central controller 140 according to various embodiments. The remote central controller 140 includes several... Figure 6The remote center manipulator 140 contains the same components as the remote center manipulator 70. Shared components include a mounting base 72, a base link 74, a deflector 76, an extension link 78, a base parallelogram connector 80, a first parallelogram link 82, a first parallelogram connector 84, a second parallelogram link, a second parallelogram connector 88, and an instrument holder 92. The remote center manipulator 140 does not include a conical oscillation mechanism 90. Instead, the second parallelogram connector 88 rotatably connects the instrument holder 92 to the second parallelogram link 86 for rotation of the instrument holder 92 relative to the second parallelogram link 86 about a second connector axis 108. The remote center manipulator 140 further includes a reorientation mechanism 142 operable to reorient the outer portion of the remote center manipulator 140 about an axis 144 intersecting the remote control center (RC). The reorientation mechanism 142 includes a base 146 and a movable link 148 coupled to the base 146 and reorientable relative to the base 146 along a curved path with a constant radius relative to the remote control center (RC), thereby restricting the corresponding movement of the instrument holder 92 to rotation about the remote control center (RC). In the illustrated embodiment, axis 144 coincides with pitch axis 102. Therefore, as shown, each of the parallelogram linkage portion and the reorientation mechanism 142 individually rotates the instrument 94 near the coincident axes 102, 144 at the remote control center (RC) to provide redundant degrees of freedom. Furthermore, the hardware design of the remote control center 140 physically restricts the rotation of the instrument 94 at the remote control center (RC). Those skilled in the art will understand that other mechanical structures can be used to provide the functionality schematically shown and described for the reorientation mechanism 122. Furthermore, one or more additional reorientation mechanisms having similar functions to reorientation mechanism 142 can be inserted into the link between base 72 and instrument holder 92 so that remote central manipulator 140 has additional redundant degrees of freedom.

[0073] The reorientation mechanism 142 can also be configured such that axis 144 is not aligned with (not coincident with) pitch axis 102. For example, the reorientation mechanism 142 can be configured such that axis 144 is aligned with insertion axis 96, and can be configured such that axis 144 is at any suitable angle relative to pitch axis 102 and / or insertion axis 96.

[0074] The connector associated with the reorientation mechanism 142 may be driven or undriven, and if driven, it may be actively controlled by the surgeon or passively controlled by operating room personnel. In passive control, the reorientation mechanism 142 may be used as a pre-operative setup connector to correctly position the remote central manipulator 140 for the procedure, and / or during the procedure it may be used to actively reorient the lateral linkage mechanism while maintaining the position relative to the remote manipulator center (RC) of the mounting base 72 and thus relative to the patient and the position of the instrument 94 entering the patient's incision. In some passive control embodiments, a switch (e.g., an on / off button, a spring rocker, etc.) controls the movement of the reorientation mechanism 142 so that personnel operate controls to move the remote central manipulator to the desired position. In other passive control embodiments, the reorientation mechanism is equipped with a center-of-gravity compensation feature (e.g., compensation for motor current control based on mechanical load position) to allow the manipulator to feel effectively weightless and easily moved by hand. For example, the brake can hold the reorientation mechanism 142 in place until it is released when a person can easily reposition the reorientation mechanism, and then the brake can be applied again to hold the manipulator in place.

[0075] Figure 10 This is a perspective view of a remote central controller 150 according to various embodiments. The remote central controller 150 includes... Figure 8 Remote central controller 130 and Figure 9 The remote center controller 150 comprises both aspects of the remote center controller 140. Specifically, the remote center controller 150 includes a reorientation mechanism 142, a conical oscillating mechanism 122 (which may optionally be omitted), a conical oscillating mechanism 90 (which may optionally be omitted), and a parallelogram linkage portion 100. Thus, the remote center controller 150 has three redundant degrees of freedom (fewer if one of the conical oscillating mechanisms is removed; more if an additional conical oscillating mechanism or reorientation mechanism is added), and these degrees of freedom derive from the ability to rotate about axis 144 (driven by reorientation mechanism 142), conical oscillating axis 114 (driven by conical oscillating mechanism 90), and conical oscillating axis 128 (driven by conical oscillating mechanism 122). In an alternative embodiment, axis 144 may coincide with pitch axis 102 when it does not coincide with pitch axis 102 in the remote center controller 150.

[0076] Each of the reorientation mechanism 142 and the conical swing mechanism 122 can be used as a setting connector before the surgical procedure and / or during the surgical procedure to actively reorient the lateral linkage mechanism while physically limiting the position of the remote control center (RC) relative to the mounting base 72 and thus maintaining the position of the remote control center (RC) relative to the patient. The use of the reorientation mechanism 142 as part of the setting structure is described above, and the conical swing mechanism 122 can be used in the same way.

[0077] It should be noted that each embodiment of the remote central manipulator is narrow to some extent so that two or more of these manipulators can be positioned adjacent to each other on the surgical robot, and the space between adjacent manipulators can be reduced to allow each manipulator to control instruments close to another instrument for efficient surgical instrument placement.

[0078] Figure 11 A hardware-constrained remote central manipulator 160 according to many embodiments is shown. The manipulator 160 includes a base link 162, a tapered swing link 164, a parallelogram base link 166, a parallelogram first link 168, a parallelogram second link 170, an instrument holder 172 configured to support a detachable surgical instrument (not shown; the instrument axis passes through a cannula 173 shown coupled to the distal end of an instrument holder 172), and a tapered swing connector 174. In many embodiments, the base link 162 is held in a fixed position relative to a patient undergoing surgery via the remote central manipulator 160. The tapered swing link 164 has a distal end 176 mounted on the base link 162 for rotation of the tapered swing link 164 relative to the base link 162 about a first axis 178 intersecting a remote center of motion (RC), defined by a centerline of the cannula passing along the instrument axis. The tapered swing link 164 has a tapered swing link distal end 180 offset from the first axis 178, and a tapered swing link body section 182 connecting the tapered swing link proximal end 176 to the tapered swing link distal end 180.

[0079] The linkage mechanism on the outer (distal) side of the manipulator 160 of the tapered oscillating link 164 is configured to provide selective movement of the instrument holder 172, which is limited to two-dimensional rotation of the instrument holder 172 about a remote center (RC) (surgical instruments not shown). Regarding the first direction of rotation of the instrument holder 172 about the remote center (RC), referred to herein as deflection, the parallelogram base link 166 has a proximal end 184 mounted on the distal end 180 of the tapered oscillating link for rotation relative to the distal end of the tapered oscillating link about a second axis 186 that also intersects the remote center (RC). By selectively rotating the parallelogram base link 166 relative to the distal end 180 of the tapered oscillating link, the linkage mechanism on the outer side of the manipulator 160 of the parallelogram base link 166 also selectively rotates about the second axis 186, thereby selectively rotating the instrument holder 172 about the second axis 186.

[0080] Regarding the second direction of rotation of the instrument holder 172 about a remote center (RC), also referred to herein as pitch, the instrument holder 172 and parallelogram first and second links 168, 170 are connected to form a parallelogram linkage mechanism providing movement of the instrument holder 172, which is restricted to rotation about the remote center (RC) near an axis that is substantially perpendicular to a second axis 186 and to the plane of motion of the parallelogram linkage mechanism. The parallelogram first link 168 has a proximal end 188 rotatably connected to the distal end 190 of the parallelogram base link 166 via a first parallelogram joint 192. The parallelogram second link 170 has a proximal end 194 rotatably connected to the distal end 196 of the parallelogram first link 168 via a second parallelogram joint 198. The instrument holder 172 is connected to the distal end 200 of the second parallelogram link 170 via a third parallelogram joint 202. The second and third parallelogram joints 198, 202 are rotatably driven by rotation of the first parallelogram joint 192, such that the first parallelogram link 168, the second parallelogram link 170, and the instrument holder 172 form a parallelogram linkage mechanism. In the illustrated position, the first parallelogram link 168 defines a first parallelogram side 204 extending between the first and second parallelogram joints 192, 198; the second parallelogram link 170 defines a second parallelogram side 206 extending between the second and third parallelogram joints 198, 202; and the instrument holder 172 defines a third parallelogram side 208 extending between the third parallelogram joint 202 and the remote center (RC). To illustrate the motion of the parallelogram linkage, the rotating first parallelogram side 204R is shown to represent the corresponding rotational position of the first parallelogram link 168 relative to the parallelogram base link 166, and the repositioned second and third parallelogram sides 206R and 208R are shown to represent the positions of the second parallelogram link 170 and the instrument holder 172, respectively, corresponding to the rotational position of the first parallelogram link 168. As shown, the rotation of the first parallelogram link 168 relative to the parallelogram base link 166 is used to move the instrument holder 172 so that the distal end of the third parallelogram side 208 remains aligned with the remote control center (RC), thereby causing the instrument holder 172 to pitch about an axis substantially perpendicular to the second axis 186.

[0081] When the axis of the surgical instrument is aligned along the second axis 186 (the deflection axis), the linkage mechanism outside the manipulator 160 of the tapered oscillating link 164 has an inherent singularity. Even when the surgical instrument axis is not aligned along the second axis 186, the kinematic adjustment is poor when the angle between the surgical instrument axis and the second axis 186 is small (e.g., 15 degrees or less). Another practical limitation of extending the parallelogram linkage to the extent required to align the surgical instrument axis with the second axis 186 is that the resulting length of the manipulator 160 may be undesirable for use in an operating room environment.

[0082] To address the aforementioned problems, the movement of the parallelogram linkage can be restricted, for example, by limiting the angle of the surgical instrument axis relative to the second axis 186 to at least a suitable angle (e.g., approximately 15 degrees). However, with such angular restrictions, there remains a conical volume that the surgical instrument tip cannot reach for any particular position and orientation of the second axis 186. Therefore, the conical oscillating mechanism 122 provides a way to reposition and reorient the second axis 186 so that the inaccessible conical volume is placed in a location on the patient where the surgeon is not interested in performing the procedure. The conical oscillating mechanism 122 can also be used as an alternative to the instrument holder 172 near the second axis 186 to rotate the instrument holder 172 near the first axis 178.

[0083] Redundant axes and associated redundant degrees of freedom on hardware-constrained remote control centers allow the control center to position surgical instruments in unique locations using one of more than one possible combination of connector angles. Therefore, redundant axes (the axes of the connectors that provide redundant degrees of freedom) can be used to avoid collisions with adjacent control centers, patient anatomy, or equipment such as the operating table. When the redundant axis is mechanically constrained through the remote control center (RC), it can be reoriented during the surgical procedure without the risk of moving the RC relative to the patient.

[0084] A tapered swivel joint 174 connects the distal end 200 of the second parallelogram link 170 to the instrument holder 172. The tapered swivel joint 174 is operable to selectively change the orientation of the instrument holder 172 relative to the second parallelogram link 170 about a third axis 210 intersecting the distal center (RC). This ability to change the orientation of the instrument holder 172 relative to the second parallelogram link 170 can be used to avoid interference between the instrument holder 172 and adjacent manipulators, to avoid interference between the instrument holder 172 and the patient, and to increase the range of motion of the instrument holder 172. In the illustrated embodiment, the third axis 210 coincides with the third parallelogram side 208, thereby ensuring that the third parallelogram side 208 does not change length in response to rotation of the instrument holder 172 about the third axis 210.

[0085] Figure 12 The tapered oscillating joint 174 is further illustrated. As shown, the third axis 210 is not aligned with the centerline 228 of the surgical instrument (not shown) supported by the instrument holder 172, along which the surgical instrument is inserted and withdrawn, and the instrument axis rolls near the third axis. The angular offset between the third axis 210 and the centerline 228 allows the rotation of the tapered oscillating joint 174 to reorient the surgical instrument relative to the remote center (RC), thereby allowing the surgical instrument to reach different areas within the patient's body. Furthermore, as described above, in combination with the pitch motion function of the parallelogram mechanism, the rotation of the tapered oscillating joint 174 can maintain the position and orientation of the surgical instrument relative to the remote center (RC) of motion, allowing repositioning of the instrument holder 172 to avoid interference with adjacent instrument holders / surgical instruments.

[0086] Figure 13A , Figure 13B and Figure 13C This illustrates the range of motion provided by the tapered swing joint 174. Figure 13A In the center, the tapered swing joint 174 is in a centered configuration, with the instrument holder 172 aligned with the second parallelogram link 170. Figure 13B In the diagram, the tapered swing joint 174 is shown fully rotating in one direction, thereby orienting the instrument holder 172 in the direction shown. And in Figure 13C In the figure, the tapered swing joint 174 is shown fully rotating in opposite directions, thereby orienting the instrument holder 172 in the opposite directions shown. As shown, the different possible orientations of the instrument holder 172 provided by the tapered swing joint 174 serve as corresponding different insertion directions for providing surgical instruments (not shown) supported by the instrument holder 172. Similarly, the redundant degrees of freedom provided by the tapered swing joint 174 allow the manipulator to have a series of joint positions for each unique instrument position. Although not shown, it can be seen that in Figure 11 The proximal tapered oscillating joint shown provides similar functionality. Furthermore, the combined action of two tapered oscillating joints can deflect the deflector and parallelogram mechanism to one side or the other while the instrument remains stationary. As described above, the rolling end effector relative to the instrument body (e.g., rolling the end effector on a shaft, or rolling the entire shaft using an attached end effector) allows the end effector to remain stationary in space as the manipulator moves. Therefore, during remote surgery, the manipulator's movements, taking full advantage of redundant degrees of freedom, are transparent to the surgeon, who will not feel any movement of the corresponding surgical end effector.

[0087] Figure 14AA first sine / cosine link 228 and a second sine / cosine link 230 are shown, rotatably connecting a second parallelogram joint 198 and a third parallelogram joint 200 of a manipulator 160 in some embodiments. The first and second sine / cosine links 228 and 230 are so named to reflect the manner in which they are connected to the parallelogram joints 198 and 200. As shown at the second parallelogram joint 198, the connection between the first and second sine / cosine links 228 and 230 and the second parallelogram joint 198 is offset by 90 degrees, and the connection between the first and second sine / cosine links 228 and 230 and the third parallelogram joint 200 is similarly configured. While a 90-degree connection offset is preferred, other offset angles may also be used. The connection offset ensures that at least one of the links 228, 230 is always offset from the centerline 232 passing through both the first and second parallelogram joints 198, 200, so as to always have the offset required to transmit torque between the second and third parallelogram joints 198, 200. By connecting each end of each of the first and second sine / cosine links 228, 230 with the same angular orientation and radial distance, the transmission or rotational movement between the second and third parallelogram joints 198, 200 can be achieved in a reliable and smooth manner.

[0088] In many embodiments, the lengths of the first and second sine / cosine links 228, 230 are adjustable to better match the lengths of the connection points with the lengths of the second and third parallelogram joints 198, 200. Because linkage mechanisms are kinematically constrained, geometric deviations in the mechanical components (e.g., length, angle, or operating radius) can result in the formation of high forces and / or angular forces in some or all of the components. The first sine / cosine link 228 includes a proximal portion 234 and a distal portion 236 of the first link, which are fixed together at the first link joint 238. Similarly, the second sine / cosine link 230 includes a proximal portion 240 and a distal portion 242 of the second link, which are fixed together at the second link joint 244. The first and second link joints 238, 244 are configured such that the length of each of the first and second sine / cosine links 228, 230 can be changed to match a specified length of the second parallelogram link 170 on which they are mounted. For example, the proximal portion 234 and the distal portion 236 of the first link can first be connected to the second parallelogram connector 198 and the third parallelogram connector 200, respectively, and then connected to each other via the first link connector 238 to match the specified length of the second parallelogram link 170 in which they are mounted.

[0089] Figure 14BA third sine / cosine link 246 and a fourth sine / cosine link 248 are shown that rotatably connect the first parallelogram joint 192 and the second parallelogram joint 198 of the actuator 160. The third and fourth sine / cosine links 246, 248 are configured and connected to the parallelogram joints 192, 198 in a manner similar to the first and second sine / cosine links 228, 230, and therefore their identical description will not be repeated here. Figure 14B Directional deflections 250 and 252 are shown, configured to reduce the working angle force levels of the third and fourth sine / cosine links 246 and 248 (and can also be used to reduce the working angle force levels of the first and second sine / cosine links 228 and 230). Each of the directional deflections 250 and 252 is configured as a cantilever beam having a rigid orientation and a compliant orientation, wherein the directional deflection in the rigid orientation is aligned with the attached sine / cosine link (as shown at the connection of the fourth sine / cosine link 248 to the second parallelogram joint 198), and the directional deflection in the compliant orientation is oriented perpendicular to the attached sine / cosine link (as shown at the connection of the third sine / cosine link 246 to the first parallelogram joint 192). The directional flexures 250 and 252 are configured such that the stiffness of the provided load path is maximized when the attached sine / cosine link provides the maximum mechanical advantage for torque transmission, and the stiffness of the provided load path is minimized when the attached sine / cosine link provides the minimum mechanical advantage for torque transmission.

[0090] As in Figure 14A and Figure 14B The use of the sine / cosine link shown is optional, and as mentioned above, other well-known methods (e.g., gears, belts, etc.) exist to connect the parallelogram link so that the parallelogram mechanism functions correctly.

[0091] Figure 15 Another embodiment is shown for redundant axes and associated redundant mechanical degrees of freedom via a remote control center (RC). Figure 15A remote central manipulator 260 according to various embodiments is shown, comprising a mounting base 262 including a curved feature 264 having a constant radius of curvature relative to the remote manipulator center (RC), and a base link 266 of an outer (proximal) linkage of the manipulator 260 being repositionable along this curved feature. The outer linkage is mounted to the base link 266, which includes a "deflection" joint feature for rotation about a first axis 268 intersecting the remote manipulator center (RC). The base link 266 is connected to the curved feature 264 such that the base link 266 is restricted to selective repositioning along the curved feature 264, thereby maintaining the position of the remote manipulator center (RC) relative to the mounting base 262, which is held in a fixed position relative to the patient. The curved feature 264 is configured such that movement of the base link 266 is restricted to rotation about a second axis 270 intersecting the remote manipulator center (RC). By changing the position of the base link 266 along the bending feature 264, the orientation of the outer link mechanism of the manipulator 260 relative to the patient can be altered, thereby providing an increased range of motion for the surgical instrument manipulated by the remote central manipulator 260. The parallelogram mechanism 272 provides rotation near axis 274. It can be seen that as the entire parallelogram mechanism rotates near axis 268, axes 270 and 274 can be aligned. Figure 9 The configurations of the embodiments shown are similar. Figure 15 As can be further seen from the embodiments shown, parallelogram mechanisms 140 and 272 are similar, and deflection joints 76 and 266 are similar.

[0092] Figure 16 Another embodiment for a redundant axis is shown, which is provided with associated redundant degrees of freedom via a remote control center (RC). Figure 16A remote central manipulator 280 according to various embodiments is shown, comprising a mounting base 282 including a closed-loop bend feature 284, to which a base link 286 of an outer (distal) linkage of the manipulator 280 can be repositioned inside the closed-loop bend feature 284. As shown, a central mounting element 285 rotates inside the closed-loop bend feature 284. The base link 286 is mounted on the central mounting element 285, which is oriented inwardly toward the remote manipulator center. An outer linkage is mounted to the base link 286 for rotation about a first axis 288 intersecting the remote manipulator center (RC). The closed-loop bend feature 284 is configured such that for all positions of the base link 286 near the bend feature 284, the position of the remote manipulator center (RC) remains fixed relative to the mounting base 282, which in turn remains fixed relative to the patient. The closed-loop bending feature 284 is circular and axially symmetrical about a second axis 290 intersecting the remote control center (RC). By changing the position of the base link 286 near the closed-loop bending feature 284, the orientation of the outer link mechanism of the manipulator 280 relative to the patient can be altered, thereby providing an increased range of motion, avoiding arm-to-arm or arm-to-environment collisions, and / or avoiding kinematic singularities of the remote central manipulator 280. A "partial circle" feature or a full circle feature where the mounting base is only transverse to a portion of the circle can also be used. It can be seen that the bending feature 284 and its associated central mounting feature 285 act as a tapered swing joint. Therefore, Figure 16 The illustrated embodiments and Figure 7 The embodiments shown are similar, the tapered swing joints 122 and 284 are similar, and the deflection joints 76 and 286 are similar.

[0093] Figure 17 This is a perspective view of a remote central controller 300 according to various embodiments. The remote central controller 300 includes several... Figure 6The remote central manipulator 300 shares the same components as the remote central manipulator 70. Shared components include a mounting base 72, base link 74, deflector 76, base parallelogram connector 80, first parallelogram link 82, first parallelogram connector 84, second parallelogram link 86, second parallelogram connector 88, and instrument holder 92. The remote central manipulator 300 may also include a tapered oscillation assembly 90 (not shown). The remote central manipulator 300 includes an offset extension link 302 that offsets the parallelogram link mechanism portion 100 from the deflection axis 98, thereby orienting it to a pitch axis 102 that is not perpendicular to the deflection axis 98. The offset of the parallelogram link mechanism portion 100 from the deflection axis 98 can be reduced by the remote central manipulator 300 rotating near the deflection axis 98 via the deflector 76, thereby increasing the clearance to the patient and / or increasing the clearance to adjacent remote central manipulators (multiple manipulators). As a non-limiting example, in some embodiments the offset angle is 2.7 degrees. While the additional clearance provided by the offset is small, it is significant during surgery because several such manipulators are typically positioned close together to control the instruments inserted into the patient. Even more significantly, the increased clearance from the patient can allow for a greater range of motion of the instrument end effector within the patient, which allows the surgeon to reach further tissues for therapeutic purposes if necessary.

[0094] Figure 18 This is a perspective view of a remote central controller 310 according to various embodiments. The remote central controller 310 includes... Figure 17 Remote central controller 300 and Figure 9 The remote central manipulator 140 comprises both aspects. Specifically, the remote central manipulator 310 includes a reorientation mechanism 142, an offset extension link 302, and a parallelogram linkage portion 100. Thus, the remote central manipulator 310 has a redundant axis and associated degrees of freedom, specifically having an axis 144 (which may be shown in this embodiment not aligned with the pitch axis 102) about which the instrument holder 92 can rotate near the remote manipulator center (RC). The reorientation mechanism 142 can be used as a setting connector before the procedure and / or during the procedure to actively reorient the lateral (distal) linkage while maintaining the position of the remote manipulator center (RC) relative to the mounting base 72, and thus maintaining the position of the remote manipulator center (RC) relative to the patient.

[0095] Any suitable combination of the remote center manipulator disclosed herein may be employed. For example, the remote center manipulator may include any suitable combination of the reorientation mechanism 142, the conical swing mechanism 122, the offset extension link 302, and the conical swing mechanism 90. Figure 19The remote center manipulator 312 is shown, which includes a reorientation mechanism 142, an offset extension link 302, a parallel link mechanism portion 100, and a conical swing mechanism 90.

[0096] Figure 20 A remote central manipulator 320 according to many embodiments is shown. The manipulator 320 includes five units configured for field replacement. The five field-replaceable units (FRUs) include a yaw / pitch drive assembly 332, an extension 324 having a proximal extension 326 and a distal extension 328, a first parallelogram link 330 having a proximal first link 332 and a distal first link 334, a second parallelogram link 336 having a proximal second link 338 and a distal second link 340, and an instrument holder 342.

[0097] The deflection / pitch drive assembly 322 includes a mounting base 344 and a deflection / pitch housing 346 coupled to the mounting base 344 for rotation near a deflection axis 348 intersecting with a remote control center (RC), wherein the remote control center (RC) has a fixed position relative to the mounting base 344. The mounting base 344 allows the remote control center 320 to be mounted and supported via a setting arm / joint of a trolley base, a top plate base, a base plate / column base, or other mounting surfaces. By supporting the mounting base 344 in a fixed position and orientation relative to the patient, the remote control center (RC) is held fixed relative to the patient, thereby providing an entry point for surgical instruments held by the manipulated instrument holder 342 without exerting potentially harmful forces on patient tissue at the entry point of the surgical instruments. The yaw / pitch drive assembly 322 is operable to selectively rotate the yaw / pitch housing 346 relative to the mounting base 344, thereby rotating the outer portion of the remote center manipulator 320 such that the instrument holder 342 rotates (yaws) near the yaw axis 348 without moving the remote control center (RC) relative to the mounting base 344.

[0098] Extension 324 provides support to the base joint 350 of the parallelogram linkage portion of the remote center controller 320. The proximal end 326 of the extension is fixedly mounted to the yaw / pitch housing 346. The proximal end 332 of the first link is connected to the distal end 328 of the extension via the base joint 350, such that the first parallelogram link 330 rotates relative to the extension 324 near the first offset pitch axis 352. The first parallelogram link 330 is offset to one side of the extension 324, such that the first parallelogram link 330 moves in a plane of motion offset from the extension 324, and thus can be rotated to align with and pass through the extension 324 without interfering with the extension 324.

[0099] The parallelogram linkage portion of the remote central manipulator 320 includes a first parallelogram link 330, a second parallelogram link 336, and an instrument holder 342. The proximal end 338 of the second link is connected to the distal end 334 of the first link via a first intermediate joint 354, such that the second parallelogram link 336 rotates relative to the first parallelogram link 330 and is fixed relative to the distal end 334 of the first link near a second offset pitch axis 356 parallel to the first offset pitch axis 352. The second parallelogram link 336 is offset to one side of the first parallelogram link 330, allowing it to move in a plane of motion offset from the first parallelogram link 330, and thus to rotate, align with, and pass through the first parallelogram link 330 without interfering with it. The instrument holder 342 is connected to the distal end 340 of the second link via a second intermediate joint 358, such that the instrument holder 342 rotates relative to the second parallelogram link 336 and is fixed relative to the distal end 340 of the second link near a third offset pitch axis 360 parallel to the first offset pitch axis 352. Rotation of each of the first and second intermediate joints 354, 358 is connected to rotation of the base joint 350, such that the first parallelogram link 330, the second parallelogram link 336, and the instrument holder 342 are restricted to move with the parallelogram linkage mechanism, thereby rotating (pitching) about a pitch axis 362 intersecting the remote control center (RC).

[0100] The instrument holder 342 includes a carriage assembly 364 on which surgical instruments are mounted. The instrument holder 342 includes an insertion drive mechanism operable to translate the carriage assembly 364 along an insertion axis 366, thereby controlling the insertion of the surgical instruments through a remote control center (RC). The surgical instruments typically pass through a cannula 368, which is typically mounted at the distal end of the instrument holder 342, and a remote control center (RC) for defining the surgical instruments along a centerline coinciding with axis 366.

[0101] Figure 21 A top view of the remote center controller 320 is shown. As shown, the yaw axis 348 is angularly offset from the pitch axis 366 instead of by 90 degrees. In the illustrated embodiment, the yaw axis 348 is angularly offset from the pitch axis 366 by 87.3 degrees. By offsetting the yaw axis 348 from the pitch axis 366 by a non-90-degree angle, the workspace envelope (oscillation) of the remote center controller 320 rotating about the yaw axis 348 is reduced relative to using a 90-degree angular offset between the yaw axis 348 and the pitch axis 366. This reduction in the oscillation of the remote center controller 320 rotating about the yaw axis 348... Figure 22As shown in the diagram. For the illustrated embodiment, an 87.3-degree angular offset produces a relatively smaller swing amount 368 with a diameter of 7.95 inches at the base joint 350. In contrast, when using a deflection axis 370 with a 90-degree angular offset from the pitch axis 366, it produces a relatively larger swing amount 372 with a diameter of 8.98 inches at the base joint 350. Therefore, using an 87.3-degree angular offset produces approximately 0.5 inches of additional patient clearance, as described above, which can have a significant impact on surgical performance.

[0102] Figure 23 This is a side view of the remote center manipulator 320, in which the instrument holder 342 is pitched back to its maximum extent. In the configuration shown, the first parallelogram link 330 has been swung to a position aligned with the extension link 324, and the second parallelogram link 336 has been swung to a position just aligned with the first parallelogram link 330, thereby orienting the insertion axis 366 at an angle offset from the deflection axis 348 from vertical 374 to 75 degrees. While the remote center manipulator 320 can be configured, for example by increasing the length of the extension link 324, so that the instrument holder 342 does not contact the deflection / pitch housing 346 to achieve even greater maximum pitch recovery angles, given the kinematic conditions of the remote center manipulator 320, i.e., when the angle between the insertion axis 366 and the deflection axis 348 decreases to below 15 degrees, and the deflection of the instrument holder 342 relative to the remote control center (RC) gradually worsens, the additional pitch recovery angle obtained may be an impractical value.

[0103] Other variations are within the spirit and scope of this invention. Therefore, while various modifications and alternative structures may be assumed in this invention, specific embodiments thereof have been shown in the accompanying drawings and described in detail above. However, it should be understood that this invention is not limited to the specific forms or forms disclosed; on the contrary, it covers all modifications, alternatives, and equivalent structures falling within the spirit and scope of this invention, as defined in the appended claims.

[0104] In the context of describing the invention (especially in the context of the appended claims), the terms “a,” “an,” and “the,” and similar references, should be interpreted to cover both singular and plural forms, unless otherwise indicated herein or expressly denied in the context. The terms “comprising,” “having,” “including,” and “containing” should be interpreted as open-ended terms (i.e., meaning “including but not limited to”), unless otherwise indicated. The term “connected” should be interpreted as being partially or wholly included, attached, or joined together, even if something intervenes in between. The range of values ​​referenced herein is intended only as a shorthand method for individually referring to each individual value falling within the range, unless otherwise indicated herein, and each individual value is incorporated in this specification as if it were individually referenced herein. All methods described herein may be performed in any suitable order, unless otherwise indicated herein or expressly denied in the context. Any and all examples or exemplary language (e.g., “for example”) provided herein are intended to better illustrate embodiments of the invention and are not intended to limit the scope of the invention, unless otherwise claimed. No language in this specification should be construed as indicating any unclaimed element necessary for practicing the invention.

[0105] This document describes preferred embodiments of the invention, including the best modes known to the inventors for carrying out the invention. Variations of those preferred embodiments will be apparent to those skilled in the art upon reading the foregoing description. The inventors intend for those skilled in the art to employ such variations where appropriate, and the inventors intend to practice the invention in other ways different from those specifically described herein. Therefore, the invention includes all modifications and equivalents of the subject matter referenced in the claims as permitted by applicable regulations. Moreover, any combination of the foregoing elements in all possible variations is included within the scope of the invention unless otherwise indicated herein or expressly denied in the context.

[0106] All references cited in this article (including publications, patent applications and patents) are incorporated herein by and against the same degree as each individually and specifically cited reference is incorporated herein by and against the same degree.

Claims

1. A remote central controller, comprising: An instrument holder configured for detachable mounting of surgical instruments to the instrument holder, wherein the instrument holder is operable to translate the surgical instruments along an insertion axis intersecting a remote control center; A deflection assembly including a mounting base and a deflection housing, wherein the deflection assembly is operable to rotate the deflection housing relative to the mounting base such that the instrument holder rotates about a deflection axis intersecting the remote control center. An offset extension link includes a proximal end and a distal end, wherein the proximal end is fixedly attached to the deflection housing, wherein the offset extension link is offset to one side of the deflection axis, and wherein rotation of the deflection housing relative to the mounting base causes the offset extension link to rotate by an oscillation amount having a proximal oscillation amount diameter at the proximal end and a distal oscillation amount diameter at the distal end, the distal oscillation amount diameter being smaller than the proximal oscillation amount diameter; and The parallelogram linkage portion is connected to the distal end of the offset extension link and the instrument holder. The parallelogram linkage mechanism includes a base joint connecting the parallelogram linkage mechanism to the offset extension link, a first parallelogram link connected to the base joint, a second parallelogram link, a first intermediate joint connecting the first parallelogram link and the second parallelogram link, and a second intermediate joint connecting the second parallelogram link and the instrument holder. The parallelogram linkage portion is operable to rotate the instrument holder about a pitch axis that intersects with the remote control center.

2. The remote central manipulator of claim 1, wherein the distal diameter of the oscillation is at least 1 inch smaller than the proximal diameter of the oscillation.

3. The remote center controller of claim 1, wherein the deflection axis is offset from the pitch axis by an angle of 1.0 to 10.0 degrees from vertical.

4. The remote center controller of claim 3, wherein the deflection axis is offset from the pitch axis by an angle of 1.5 to 5.0 degrees from the vertical.

5. The remote center controller of claim 4, wherein the deflection axis is offset from the pitch axis by an angle of 2.0 to 3.5 degrees from the vertical.

6. The remote center manipulator of claim 1, wherein the deflection assembly is operable to rotate the offset extension link about the deflection axis by at least 540 degrees.

7. The remote center manipulator of claim 1, wherein the deflection assembly is operable to rotate the offset extension link about the deflection axis by at least 600 degrees.

8. The remote central manipulator of claim 1, wherein the parallelogram linkage portion is operable to rotate the instrument holder about the pitch axis by at least 140 degrees.

9. The remote central manipulator of claim 1, wherein the first parallelogram link is offset to one side of the offset extension link and movable to align with the offset extension link.

10. The remote central manipulator of claim 9, wherein the second parallelogram link is offset to one side of the first parallelogram link and is movable to align with the first parallelogram link.

11. A remote central controller, comprising: An instrument holder configured for detachable mounting of surgical instruments to the instrument holder, wherein the instrument holder is operable to translate the surgical instruments along an insertion axis intersecting a remote control center; A deflection joint operable to rotate the instrument holder about a deflection axis that intersects the remote control center; The parallelogram linkage portion is operable to rotate the instrument holder about a pitch axis that intersects with the remote control center; as well as An offset extension link connects the parallelogram linkage portion to the deflection joint and offsets the parallelogram linkage portion from the deflection axis such that the pitch axis and the deflection axis are offset at an angle other than 90 degrees. The parallelogram linkage mechanism includes a base joint connecting the parallelogram linkage mechanism to the offset extension link, a first parallelogram link connected to the base joint, a second parallelogram link, a first intermediate joint connecting the first parallelogram link and the second parallelogram link, and a second intermediate joint connecting the second parallelogram link and the instrument holder.

12. The remote central controller according to claim 11, wherein, The deflection axis is offset from the pitch axis by an angle of 1.0 to 10.0 degrees from vertical.

13. The remote central controller according to claim 12, wherein, The deflection axis is offset from the pitch axis by an angle of 1.5 to 5.0 degrees from the vertical.

14. The remote central controller according to claim 13, wherein, The deflection axis is offset from the pitch axis by an angle of 2.0 to 3.5 degrees from vertical.

15. The remote central controller according to claim 11, wherein, The deflection joint is operable to rotate the offset extension link about the deflection axis by at least 540 degrees.

16. The remote central controller according to claim 11, wherein, The deflection joint is operable to rotate the offset extension link about the deflection axis by at least 600 degrees.

17. The remote central manipulator of claim 11, wherein the parallelogram linkage portion is operable to rotate the instrument holder about the pitch axis by at least 140 degrees.

18. The remote central manipulator of claim 11, further comprising a tapered oscillating joint operable to rotate the instrument holder about a tapered oscillating axis intersecting the remote manipulator center, such that the instrument holder oscillates along the surface of a cone having a apex at the remote manipulator center.

19. The remote central controller according to claim 18, wherein, The tapered swing joint is connected between the deflection joint and the mounting base for the remote central manipulator.

20. The remote central controller according to claim 19, wherein, The tapered swing joint is operated manually as part of the remote operation function.

21. The remote central manipulator of claim 19, wherein the tapered swing joint operates automatically in response to the surgeon's control input or to avoid collisions between the remote central manipulator and adjacent remote central manipulators.

22. The remote central controller according to claim 19, wherein, The conical swing axis forms a 15-degree angle with the deflection axis.

23. The remote central manipulator of claim 18, further comprising a second conical swing joint operable to rotate the instrument holder about a second conical swing axis intersecting the remote manipulator center, such that the instrument holder swings along the surface of a second cone having a apex at the remote manipulator center, wherein the second conical swing joint is coupled between the instrument holder and the parallelogram linkage portion.

24. The remote center manipulator of claim 11, further comprising a reorientation mechanism coupled between the deflector and a mounting base for the remote center manipulator, wherein the reorientation mechanism is operable to reorient the deflector about a reorientation axis intersecting the remote control center.

25. The remote central manipulator of claim 24, further comprising a second conical oscillating joint operable to rotate the instrument holder about a second conical oscillating axis intersecting the remote manipulator center, such that the instrument holder oscillates along the surface of a second cone having a apex at the remote manipulator center, wherein the second conical oscillating joint is coupled between the instrument holder and the parallelogram linkage portion.

26. The remote central controller according to claim 11, wherein, The base joint, the first intermediate joint, and the second intermediate joint of the parallelogram linkage are configured to generate a restricted parallelogram motion of the parallelogram linkage, which causes the instrument holder to rotate about the pitch axis.

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