Surgical manipulator for a telerobotic system

Abstract

The invention is directed to mainpulator assembly ( 2 ) for holding and manipulating a surgical instrument ( 14 ) in a telerobotic system. The assembly comprises a base ( 6 ) fixable by passive or power driven positioning devices to a surface, such as an operating table, and an instrument holder ( 4 ) movably mounted on the base. The instrument holder comprises a chassis ( 6 ) and an instrument support ( 70 ) movably mounted on the body and having an interface engageable with the surgical instrument to releasably mount the instrument to the instrument holder. A drive assembly ( 7 ) is operatively coupled to the instrument holder for providing the instrument with at least two degrees of freedom. The instrument holder is separable from the base and the drive assembly so that the holder can be sterilized. The assembly further includes a force sensing element ( 52 ) mounted distal to the holder and the drive assembly for detecting forces exerted on the surgical instrument and providing feedback to the surgeon. The assembly is attached to a remote center positioner ( 300 ) for constraining the instrument to rotate a point coincident with the entry incision and an inclinometer ( 350 ) for preventing gravitational forces acting on the system's mechanisms from being felt by the surgeon.

1 - 23 . (canceled)  
     
     
         24 . A surgical instrument comprising: 
 an elongate member comprising a proximal portion, a bendable and steerable distal portion, and an inner lumen;    an end effector coupled to the bendable and steerable distal portion of the elongate member;    an actuator assembly coupled to the proximal portion of the elongate member, the actuator assembly comprising a linkage positioned within the inner lumen, wherein a first end of the linkage is coupled to the end effector and a second end of the linkage is releasably coupleable to a robotic manipulator assembly.    
     
     
         25 . The surgical instrument of  claim 24 , wherein the inner lumen receives one or more control wires for controlling steering of the distal portion of the elongate shaft.  
     
     
         26 . The surgical instrument of  claim 25 , wherein a first end of the control wires are coupled to the bendable and steerable distal portion of the elongate member and a second end of the control wires are coupled to the actuator assembly.  
     
     
         27 . The surgical instrument of  claim 26 , wherein the actuator assembly comprises one or more control motors coupled to the control wires to operate the control wire(s).  
     
     
         28 . The surgical instrument of  claim 24 , wherein the actuator assembly comprises a movable actuator pin laterally extending from the linkage and extending through an axially extending slot in the elongate member to releasably couple the actuator assembly to the robotic manipulator assembly.  
     
     
         29 . The surgical instrument of  claim 24 , wherein longitudinal movement of the second end of the linkage actuates the end effector.  
     
     
         30 . The surgical instrument of  claim 24 , wherein the end effector comprises jaws, wherein longitudinal movement of the second end of the linkage moves the jaws between an open position and a closed position.  
     
     
         31 . The surgical instrument of  claim 24 , wherein the end effectors are coupled to the bendable and steerable distal portion of the elongate member with a wrist.  
     
     
         32 . The surgical instrument of  claim 24 , wherein the end effector has at least three degrees of freedom.  
     
     
         33 . The surgical instrument of  claim 24  further comprising a cannula configured to be insertable through a percutaneous incision in the body of a patient during a surgical procedure, the cannula comprising an axial passage for supporting and receiving the elongate member therethrough so that the end effector is disposed adjacent a target site within the body of the patient.  
     
     
         34 . The surgical instrument of  claim 33 , wherein the cannula comprises a force sensing element.  
     
     
         35 . The surgical instrument of  claim 33 , wherein the elongate member of the surgical instrument is rotatable and axially movable within the axial passage of the cannula.  
     
     
         36 . The surgical instrument of  claim 33 , wherein the cannula is substantially rigid and straight.  
     
     
         37 . The surgical instrument of  claim 33 , wherein the cannula defines a longitudinal axis, wherein the end effectors are configured to be movable off of the longitudinal axis of the cannula.  
     
     
         38 . A robotic surgical system comprising: 
 a manipulator assembly comprising an instrument holder; and    a surgical instrument comprising: 
 an elongate member comprising a proximal portion, a bendable and steerable distal portion, and an inner lumen;  
 an end effector coupled to the bendable and steerable distal portion of the elongate member;  
 an actuator assembly coupled to the proximal portion of the elongate member, the actuator assembly comprising a linkage positioned within the inner lumen, wherein a first end of the linkage is coupled to the end effector and a second end of the linkage is releasably coupleable to the instrument holder of the manipulator assembly.  
   
     
     
         39 . The robotic surgical system of  claim 38  further comprising a cannula coupled to the instrument holder and configured to be insertable through a percutaneous incision in the body of a patient during a surgical procedure, the cannula comprising an axial passage for supporting and receiving the elongate member therethrough so that the end effector is disposed adjacent a target site within the body of the patient.  
     
     
         40 . The robotic surgical system of  claim 39 , wherein the elongate member of the surgical instrument is rotatable and axially movable within the axial passage of the cannula.  
     
     
         41 . The robotic surgical system of  claim 38 , wherein the manipulator assembly includes a first controllable motor for rotating the surgical instrument about an instrument centerline, a second controllable motor for actuating the end effector on the surgical instrument and a third controllable motor for axially translating the surgical instrument relative to the manipulator assembly.  
     
     
         42 . The robotic surgical system of  claim 38 , further comprising a plurality of different surgical instruments, the surgical instruments sequentially coupleable to the instrument holder of the manipulator assembly so that different surgical instruments may be used during a surgical procedure.  
     
     
         43 . The robotic surgical system of  claim 38 , further comprising an input control device located remotely from the manipulator assembly and coupled to a servomechanism of the manipulator assembly so as to permit an operator to remotely control the surgical instrument with the input control device.