Robotically controlled medical instrument with a flexible section

Abstract

A robotically controlled medical instrument includes a bending section with a unibody construction, a tool supported at a distal end of the bending section and used to perform a medical procedure on a subject such as a human patient, and an electronic controller that controls the bending section to provide at least one degree-of-freedom of movement.

What is claimed is:  
     
         1 . A robotically controlled medical instrument comprising: 
 a bending section having a unibody construction, and being bendable with at least one degree-of-freedom;    a tool supported at a distal end of the bending section for performing a medical procedure on a subject; and    an electronic controller that controls the bending section to provide the at least one degree-of-freedom of movement.    
     
     
         2 . The medical instrument of  claim 1  further comprising a first pair of cables extending along the length of the bending section, tension being applied to at least one of the first pair of cables to operate the bending section with one degree-of-freedom.  
     
     
         3 . The medical instrument of  claim 2  further comprising a second pair of cables extending along the length of the bending section, tension being applied to at least one of the second pair of cables to operate the bending section with a second degree-of-freedom.  
     
     
         4 . The medical instrument of  claim 3  wherein the amount of tension being applied to the respective cables is controlled with the controller coupled with an input device operated by a user.  
     
     
         5 . The medical instrument of  claim 2  wherein the tool is movable with at least two additional degrees-of-freedom.  
     
     
         6 . The medical instrument of  claim 5  wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint, the first jaw being movable with one of the two additional degrees-of-freedom and the second jaw being movable with the other of the two additional degrees-of-freedom.  
     
     
         7 . The medical instrument of  claim 6  comprising a second pair of cables and a third pair of cables extending along the length of the bending section and coupled to the first jaw and second jaws, respectively, tension being applied to at least one of the second pair of cables to operate the first jaw, and to at least one of the third pair of cables to operate the second jaw.  
     
     
         8 . The medical instrument of  claim 7  wherein the second and third pair of cables are positioned near the longitudinal axis of the bending section.  
     
     
         9 . The medical instrument of  claim 8  wherein the second and third pair of cables are contained in a sleeve positioned along the longitudinal axis of the bending section, the second and third pair of cables being able to slide along the sleeve.  
     
     
         10 . The medical instrument of  claim 7  wherein the amount of tension being applied to the respective cables of the second and third pair of cables is controlled with the controller coupled with an input device operated by a user.  
     
     
         11 . The medical instrument of  claim 2  wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close.  
     
     
         12 . The medical instrument of  claim 11  further comprising an actuation element extending along the length of the bending section and coupled to the first and second jaws to operate the first and second jaws.  
     
     
         13 . The medical instrument of  claim 12  wherein the actuation element is a single cable, the single cable being coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the single cable and being opened by pushing on the single cable.  
     
     
         14 . The medical instrument of  claim 13  wherein the single cable is positioned near the longitudinal axis of the bending section.  
     
     
         15 . The medical instrument of  claim 14  wherein the single cable is contained in a sleeve positioned along the longitudinal axis of the bending section, the single cable being able to slide back and forth along the sleeve.  
     
     
         16 . The medical instrument of  claim 15  further comprising a helical spring positioned about the sleeve along the length of the bending section to keep the sleeve and single cable near the longitudinal axis of the bending section.  
     
     
         17 . The medical instrument of  claim 13  wherein the amount of pushing and pulling on the single cable is controlled with the controller coupled with an input device operated by a user.  
     
     
         18 . The medical instrument of  claim 1  wherein the bending section has a bellows construction with alternating peaks and valleys positioned between proximal and distal ends of the bending section.  
     
     
         19 . The medical instrument of  claim 1  wherein the bending section has a series of spaced ribs positioned along the length of the bending section between proximal and distal ends of the bending section.  
     
     
         20 . The medial instrument of  claim 19  wherein the bending section includes a set of opposed ridges extending along the length of the bending section, the individual ridges of the set of ridges being positioned in a respective slot defined by adjacent ribs.  
     
     
         21 . The medical instrument of  claim 19  wherein the bending section includes a first set of ridges extending along the length of the bending section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges.  
     
     
         22 . The medical instrument of  claim 21  wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section.  
     
     
         23 . The medical instrument of  claim 1  further comprising a second bending section with a unibody construction, and being bendable with at least one degree-of-freedom.  
     
     
         24 . A robotically controlled medical instrument comprising: 
 a bending section being bendable with two degrees-of-freedom and having a unibody construction with a series of spaced ribs, the ribs being positioned along the length of the bending between proximal and distal ends of the bending section, the bending section including a first set of ridges extending along the length of the bending section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges;    a first pair of cables and a second pair of cables extending along the length of the bending section, tension being applied to at least one of the first pair of cables to operate the bending section with one degree-of-freedom, and to at least one of the second pair cables to operate the bending section with a second degree-of-freedom;    a tool supported at the distal end of the bending section for performing a medical procedure on a subject; and    an electronic controller that controls the bending section to provide the at least one degree-of-freedom of movement.    
     
     
         25 . The medical instrument of  claim 24  wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close.  
     
     
         26 . The medical instrument of  claim 25  further comprising an actuation element extending along the length of the bending section and coupled to the first and second jaws to operate the first and second jaws.  
     
     
         27 . The medical instrument of  claim 26  wherein the actuation element is a single cable, the single cable being coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the single cable and being opened by pushing on the single cable.  
     
     
         28 . The medical instrument of  claim 27  wherein the single cable is contained in a sleeve positioned along the longitudinal axis of the bending section, the single cable being able to slide back and forth along the sleeve.  
     
     
         29 . The medical instrument of  claim 24  wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section.  
     
     
         30 . A method of remotely controlling a medical instrument comprising: 
 controlling the bending movements of a bending section with a unibody construction having at least one degree-of-freedom with an electronic controller; and    performing a medical procedure on a subject with a tool supported at a distal end of the bending section.    
     
     
         31 . The method of  claim 30  wherein the controlling includes applying a tension to at least one of a first pair of cables extending along the length of the bending section to operate the bending section with one degree-of-freedom.  
     
     
         32 . The method of  claim 31  wherein controlling includes applying a tension to at least one of a second pair cables extending along the length of the bending section to operate the bending section with a second degree-of-freedom.  
     
     
         33 . The method of  claim 32  wherein the controlling includes controlling with the controller coupled with an input device operated by a user.  
     
     
         34 . The method of  claim 31  wherein the performing includes applying a tension to at least one of a second pair of cables extending along the length of bending section and coupled to a first jaw of the tool, and applying a tension to at least one of third pair of cables extending along the length of bending section and coupled to a second jaw of the tool.  
     
     
         35 . The method of  claim 34  wherein the applying includes applying a respective tension to the cables with the controller coupled with an input device operated by a user.  
     
     
         36 . The method of  claim 31  wherein the performing includes pushing and pulling an actuation element extending along the length of the bending section and coupled to a first jaw and a second jaw connected to the first jaw at a pivot joint, the pushing and pulling causing the jaws to open and close, respectively.  
     
     
         37 . The method of  claim 36  wherein the pushing and pulling are controlled by the controller coupled with an input device operated by a user.  
     
     
         38 . The method of  claim 30  further comprising controlling a second bending section with a unibody construction having at least one degree-of-freedom.  
     
     
         39 . A method of remotely controlling a medical instrument comprising: 
 controlling the bending movements of a bending section with two degrees-of-freedom, the bending section having a unibody construction with a series of spaced ribs, the ribs being positioned along the length of the bending section between proximal and distal ends of the bending section, the bending section including a first set of ridges extending along the length of the bending section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges; and    performing a medical procedure on a subject with a tool supported at a distal end of the bending section.    
     
     
         40 . The method of  claim 39  wherein the controlling includes applying a tension to at least one of a first pair of cables extending along the length of the bending section to operate the bending section with one degree-of-freedom, and applying a tension to at least one of a second pair cables extending along the length of the bending section to operate the bending section with a second degree-of-freedom.  
     
     
         41 . The method of  claim 39  wherein the performing includes pushing and pulling an actuation element extending along the length of the bending section and coupled to a first jaw and a second jaw connected to the first jaw at a pivot joint, the pushing and pulling causing the jaws to open and close, respectively.  
     
     
         42 . The method of  claim 39  wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bending section.  
     
     
         43 . A robotically controlled medical instrument comprising: 
 a means for supporting a tool;    a means for bending the means for supporting with at least one degree-of-freedom with an electronic controller; and    a means for operating the tool to perform a medical procedure on a subject.    
     
     
         44 . A robotically controlled medical instrument system comprising: 
 an elongated shaft having proximal and distal ends;    a tool supported from the distal end of said elongated shaft and useable in performing a medical procedure on a subject;    at least one controllably bendable section of said shaft; and    an electrical controller for receiving a command from an input device, and for, in turn, controlling said bendable section to provide at least one degree-of-freedom at said bendable section.    
     
     
         45 . The instrument system of  claim 44  further including a mechanically drivable mechanism at the proximal end of said elongated shaft.  
     
     
         46 . The instrument system of  claim 2  wherein said mechanically drivable mechanism has at least one coupling tendon extending via said elongated shaft for operating said tool.  
     
     
         47 . The instrument system of  claim 44  including mechanical cabling comprised of at least one cable for operating said tool and at least another cable for controlling said bendable section.  
     
     
         48 . The instrument system of  claim 44  wherein said input device is controlled by a medical practitioner that issues commands for also controlling at least one degree-of-freedom of said tool.  
     
     
         49 . The instrument system of  claim 44  including a drive unit intercoupled with said elongated shaft for controlling the bending action at said bendable section and, via a mechanically drivable portion, actuation of said distally placed tool.  
     
     
         50 . The instrument system of  claim 44  wherein the bendable section preferably has a length in a range on the order of ¾ inch to 4 inches.  
     
     
         51 . The instrument system of  claim 44  wherein the distance between the too] pivot point and the distal end of the bendable section is preferably equal to or less than the length of the bendable section.  
     
     
         52 . The instrument system of  claim 44  further comprising an actuation element extending with said instrument shaft and operable to control actuation of said tool.  
     
     
         53 . The instrument system of  claim 52  wherein said actuation element is positioned at at least one of a substantially center axis and substantially center plane of said controllably bendable section so as to de-couple motion at said controllable bendable section from tool actuation.  
     
     
         54 . A method of remotely controlling an instrument, comprising: 
 providing an instrument shaft of the instrument that has supported at its distal end a tool that is usable in performing a medical procedure or application;    providing a controllably bendable section along said instrument shaft;    inserting the shaft into a patient's body so as to dispose the tool at an internal operative site; and    controlling, from a remote location, an input device that effects bending of the controllably bendable section to thereby effect positioning of the tool at the operative site.    
     
     
         55 . A method as set forth in  claim 54  wherein the step of controlling also includes controlling, from the input device, the operation of said tool.  
     
     
         56 . A method as set forth in  claim 54  wherein said input device is controlled by a medical practitioner that issues commands for also controlling at least one degree-of-freedom of said tool.  
     
     
         57 . A method as set forth in  claim 54  wherein the step of inserting includes inserting through an incision.  
     
     
         58 . A method as set forth in  claim 54  wherein the step of inserting includes inserting through a natural body orifice.  
     
     
         59 . A method as set forth in  claim 54  wherein the step of inserting includes inserting percutaneously.  
     
     
         60 . A robotically controlled medical instrument comprising: 
 an elongated shaft having proximal and distal ends;    a tool supported from the distal end of said elongated shaft and useable in performing a medical procedure on a subject;    at least one controllably bendable section of said shaft disposed proximally of said tool; and    an actuation element extending with said instrument shaft and operable to control actuation of said tool;    said actuation element positioned at at least one of a substantially center axis and substantially center plane of said controllably bendable section so as to de-couple motion at said controllable bendable section from tool actuation.    
     
     
         61 . The medical instrument of  claim 60  further comprising a first pair of cables extending along a length of the bendable section, tension being applied to at least one of the first pair of cables to operate the bendable section with one degree-of-freedom.  
     
     
         62 . The medical instrument of  claim 61  further comprising a second pair of cables extending along the length of the bendable section, tension being applied to at least one of the second pair of cables to operate the bendable section with a second degree-of-freedom.  
     
     
         63 . The medical instrument of  claim 60  further including an electrical controller coupled with an input device operated by a user for remote control of at least said tool.  
     
     
         64 . The medical instrument of  claim 60  wherein the tool is movable with at least two additional degrees-of-freedom.  
     
     
         65 . The medical instrument of  claim 64  wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint, the first jaw being movable with one of the two additional degrees-of-freedom and the second jaw being movable with the other of the two additional degrees-of-freedom.  
     
     
         66 . The medical instrument of  claim 65  comprising a second pair of cables and a third pair of cables extending along the length of the bendable section and coupled to the first jaw and second jaws, respectively, tension being applied to at least one of the second pair of cables to operate the first jaw, and to at least one of the third pair of cables to operate the second jaw.  
     
     
         67 . The medical instrument of  claim 66  wherein the second and third pair of cables are positioned near the longitudinal axis of the bendable section.  
     
     
         68 . The medical instrument of  claim 67  wherein the second and third pair of cables are contained in a sleeve positioned along the longitudinal axis of the bendable section, the second and third pair of cables being able to slide along the sleeve.  
     
     
         69 . The medical instrument of  claim 66  wherein the amount of tension being applied to the respective cables of the second and third pair of cables is controlled with a controller coupled with an input device operated by a user.  
     
     
         70 . The medical instrument of  claim 60  wherein the tool includes a first jaw and a second jaw connected to the first jaw at a pivot joint such that the first and second jaws open and close.  
     
     
         71 . The medical instrument of  claim 70  wherein the actuation element extends along the length of the bendable section and couples to the first and second jaws to operate the first and second jaws.  
     
     
         72 . The medical instrument of  claim 71  wherein the actuation element is a single cable, the single cable being coupled to the first and second jaws with a pair of linkages, the first and second jaws being closed by pulling on the single cable and being opened by pushing on the single cable.  
     
     
         73 . The medical instrument of  claim 72  wherein the single cable is positioned near the longitudinal axis of the bendable section.  
     
     
         74 . The medical instrument of  claim 73  wherein the single cable is contained in a sleeve positioned along the longitudinal axis of the bendable section, the single cable being able to slide back and forth along the sleeve.  
     
     
         75 . The medical instrument of  claim 74  further comprising a helical spring positioned about the sleeve along the length of the bendable section to keep the sleeve and single cable near the longitudinal axis of the bendable section.  
     
     
         76 . The medical instrument of  claim 72  wherein the amount of pushing and pulling on the single cable is controlled with a controller coupled with an input device operated by a user.  
     
     
         77 . The medical instrument of  claim 60  wherein the bendable section has a bellows construction with alternating peaks and valleys positioned between proximal and distal ends of the bendable section.  
     
     
         78 . The medical instrument of  claim 60  wherein the bendable section has a series of spaced ribs positioned along the length of the bendable section between proximal and distal ends of the bendable section.  
     
     
         79 . The medial instrument of  claim 78  wherein the bendable section includes a set of opposed ridges extending along the length of the bendable section, the individual ridges of the set of ridges being positioned in a respective slot defined by adjacent ribs.  
     
     
         80 . The medical instrument of  claim 78  wherein the bendable section includes a first set of ridges extending along the length of the bendable section, the individual ridges of the first set of ridges being positioned in every other slot defined between adjacent ribs, and a second set of ridges, the individual ridges of the second set of ridges being positioned in respective slots unoccupied by the first set of ridges.  
     
     
         81 . The medical instrument of  claim 80  wherein the first set of ridges is positioned at about 90 degrees from the second set of ridges about the longitudinal axis of the bendable section.  
     
     
         82 . The medical instrument of  claim 60  further comprising a second bendable section with a unibody construction, and being bendable with at least one degree-of-freedom.  
     
     
         83 . A method of operating a medical instrument comprising: 
 controlling the bending movements of a bending section with a unibody construction having at least one degree-of-freedom; and    performing a medical procedure on a subject with a tool supported at a distal end of the bending section;    said step of controlling including controlling the one degree-of-freedom, from a remote location via an electrical controller with an input device that effects bending of the controllably bendable section to thereby effect positioning of the tool at the operative site.    
     
     
         84 . The method of  claim 83  wherein the controlling includes applying a tension to at least one of a first pair of cables extending along the length of the bending section to operate the bending section with one degree-of-freedom.  
     
     
         85 . The method of  claim 84  wherein controlling includes applying a tension to at least one of a second pair cables extending along the length of the bending section to operate the bending section with a second degree-of-freedom.  
     
     
         86 . The method of  claim 83  further including controlling actuation of the tool by means of at least one actuation element.  
     
     
         87 . The method of  claim 86  wherein said actuation element is positioned at at least one of a substantially center axis and substantially center plane of said controllably bendable section so as to de-couple motion at said controllable bendable section from tool actuation.  
     
     
         88 . The method of  claim 83  further comprising controlling a second bendable section with a unibody construction having at least one degree-of-freedom.  
     
     
         89 . A robotically controlled medical instrument comprising: 
 a means for supporting a tool;    a means of bending the means for supporting with at least one degree-of-freedom;    a means for operating the tool to perform a medical procedure on a subject;    an actuation means operable to control actuation of said tool;    said actuation means positioned at least one of a substantially center axis and substantially center plane of said means for bending so as to de-couple motion at said means for bending from tool actuation.    
     
     
         90 . A robotically controlled medical instrument comprising: 
 an elongated shaft having proximal and distal ends;    a tool supported from the distal end of said elongated shaft and useable in performing a medical procedure on a subject;    the distal end of said elongated shaft and the tool having respective removably engaging portions that are readily engagable for positioning the tool at the distal end of said elongated shaft in operative position relative to said elongated shaft, and readily disengagable for removal of said tool from the distal end of said elongated shaft.    
     
     
         91 . The medical instrument of  claim 90  further including a mechanically drivable mechanism at the proximal end of said elongated shaft.  
     
     
         92 . The medical instrument of  claim 91  wherein said mechanically drivable mechanism, elongated shaft, and tool comprise a single piece disposable unit.  
     
     
         93 . The medical instrument of  claim 91  wherein said mechanically drivable mechanism has at least one coupling tendon extending via said elongated shaft for operating said tool.  
     
     
         94 . The medical instrument of  claim 93  wherein said tool is controlled remotely from an electrical controller.  
     
     
         95 . The medical instrument of  claim 94  wherein said electrical controller couples from a user interface controlled by an operator to remotely and telerobotically control said tool.  
     
     
         96 . The medical instrument of  claim 90  wherein said tool is disposable.  
     
     
         97 . The medical instrument of  claim 90  wherein said tool is readily disengagable to allow the substitution of a different tool at the distal end of said elongated shaft.  
     
     
         98 . The medical instrument of  claim 90  wherein said elongated shaft has a segment thereof that is controllably bendable.  
     
     
         99 . The medical instrument of  claim 90  wherein said engaging portions include mating threaded portions.  
     
     
         100 . The medical instrument of  claim 90  including at least one actuation element extending via said elongated shaft and for control of said tool.  
     
     
         101 . The medical instrument of  claim 100  wherein said actuation element and said tool have removably engaging sections that are readily engagable to provide mechanical drive from the actuation element to the tool, and readily disengagable for removal of said tool from said actuation element.  
     
     
         102 . The medical instrument of  claim 100  wherein said actuation element includes a tendon that is sufficiently rigid to enable linear translation relative to said tool for actuation and deactuation of said tool.  
     
     
         103 . A robotically controlled medical instrument comprising: 
 an elongated support shaft having proximal and distal ends; and    a tool supported from the distal end of said elongated support shaft and controllable in performing a medical procedure on a subject;    said tool being removably coupled with the distal end of said elongated support shaft.    
     
     
         104 . The medical instrument of  claim 103  wherein said disposable tool is readily attachable to and detachable from said elongated support shaft.  
     
     
         105 . The medical instrument of  claim 103  further including a mechanically drivable mechanism disposed at the proximal end of the elongated support shaft and having extending therefrom at least one control tendon coupling to said tool for operation thereof.  
     
     
         106 . The medical instrument of  claim 103  wherein said tool is actuated remotely via a computer from a user interface device.  
     
     
         107 . A flexible surgical instrument comprising a controllably flexible elongated section having a distal end for positioning at an anatomical site of interest of a subject, and at least one cable attached at or near the distal end of the section, the cable extending from its point of attachment exteriorly of the section through an aperture in the section at a position spaced a selected distance along the length of the section away from the distal end, a proximal end of the cable extending from the aperture through the shaft and being tensionable to controllably bend the flexible section.