Surgical puncture device insertion systems and related methods

Abstract

A medical puncture device system includes a puncture device, a sensor, and an indicator system. The puncture device is configured to create a puncture through patient tissue and into an internal patient cavity to enable a medical tool to be inserted through the puncture into the cavity. The sensor is configured to generate a signal indicative of motion of the puncture device through the tissue into the cavity. The indicator system is operable by a controller to produce human-perceptible feedback in response to the signal generated by the sensor.

1 - 54 . (canceled) 
     
     
         55 . A medical puncture system comprising:
 a controllable manipulator configured to support a puncture device, the puncture device configured to create a puncture through patient tissue and into an internal patient cavity, wherein the controllable manipulator comprises one or more joints;   a sensor configured to generate signals indicative of a parameter associated with a joint of the one or more joints of the controllable manipulator;   a drive system configured to drive the one or more joints of the controllable manipulator; and   a controller operably coupled to the sensor and the drive system, the controller configured to:
 when the puncture device is supported by the controllable manipulator, operate the drive system, based on at least one signal generated by the sensor as the puncture device is moved through the patient tissue into the cavity, to cause the controllable manipulator to guide creation of the puncture by the puncture device, the at least one signal being indicative of motion of the puncture device from a first layer of the patient tissue to a second layer of the patient tissue or indicative of the motion of the puncture device from the patient tissue into the cavity. 
   
     
     
         56 . The medical puncture system of  claim 55 , wherein the medical puncture system further comprises an indicator system, and wherein the indicator system is operable by the controller to produce human-perceptible feedback based on the at least one signal in combination with patient information, the patient information comprising information selected from the group consisting of: a location of an insertion site for the puncture, a physical characteristic of the patient, and data representing an image of the patient tissue and the cavity. 
     
     
         57 . The medical puncture system of  claim 56 , wherein the information comprises the physical characteristic of the patient, and the physical characteristic comprises at least one characteristic selected from the group consisting of: a posture of the patient, a size of the patient, or a thickness of the patient tissue. 
     
     
         58 . The medical puncture system of  claim 55 , wherein the parameter associated with the joint comprises at least one parameter selected from the group consisting of:
 a force applied to the joint, a torque applied to the joint, a motion of the joint, and an electrical current or voltage associated with the joint.   
     
     
         59 . The medical puncture system of  claim 55 , wherein the at least one signal comprises:
 a first signal indicative of the motion of the puncture device from the first layer of the patient tissue to the second layer of the patient tissue; and   a second signal indicative of the puncture device being in the cavity.   
     
     
         60 . The medical puncture system of  claim 55 , wherein the controller is configured to operate the drive system based on the at least one signal to cause the controllable manipulator to guide the creation of the puncture by:
 operating the drive system to inhibit movement of the puncture device in response to the at least one signal.   
     
     
         61 . The medical puncture system of  claim 60 , wherein operating the drive system to inhibit the movement of the puncture device comprises:
 inhibiting a range of motion of the puncture device.   
     
     
         62 . The medical puncture system of  claim 61 , wherein inhibiting the range of motion of the puncture device comprises:
 inhibiting translational motion of the puncture device to within a distance of an initial position of the puncture device; or   inhibiting movement of the puncture device such that an angle of an insertion axis of the puncture device relative to the patient tissue is within a predefined range.   
     
     
         63 . The medical puncture system of  claim 55 , wherein the sensor is a first sensor, and the medical puncture system further comprises a second sensor configured to generate a signal indicative of motion of the puncture device relative to the patient tissue, the second sensor comprising at least one sensor selected from the group consisting of:
 a compressible device configured to compress relative to a stiffness of the patient tissue surrounding the compressible device, and the signal is indicative of the stiffness of the patient tissue; or   an optical sensor configured to emit light and detect a reflection of the light to generate the signal; or   an audible signal sensor configured to generate the signal in response to an audible signal indicative of the puncture device moving through the patient tissue or moving into the cavity; or   a force sensor configured to generate the signal in response to a force on the puncture device; or   an electrical characteristic sensor configured to detect at least one electrical characteristic selected from the group consisting of: an electrical capacitance associated with the patient tissue, an electrical impedance associated with the patient tissue, an electrical inductance associated with the patient tissue; or   a pressure sensor to generate the signal in response to a pressure proximate a distal portion of the puncture device.   
     
     
         64 . The medical puncture system of  claim 55 , wherein:
 the controllable manipulator is configured to support a medical tool insertable into the cavity through the puncture created by the puncture device; and   the controller is configured to:
 when the medical tool is supported by the controllable manipulator, operate the drive system to cause the controllable manipulator to control movement of the medical tool. 
   
     
     
         65 . The medical puncture system of  claim 64 , wherein the controller is configured to operate the drive system to cause the controllable manipulator to control movement of the medical tool when the medical tool is supported by the controllable manipulator by:
 operating the drive system to cause the controllable manipulator to control movement of an end effector of the medical tool in the cavity when the end effector is inserted through a port device in the puncture forming an access port to the cavity, wherein the puncture device comprises the port device or the port device is inserted into the puncture after the puncture device creates the puncture.   
     
     
         66 . The medical puncture system of  claim 55 , wherein the at least one signal is at least one first signal, further comprising:
 a sensor system comprising the sensor, wherein the sensor system is configured to generate at least one second signal indicative of a location of the puncture device relative to the patient tissue along an insertion axis of the puncture device.   
     
     
         67 . The medical puncture system of  claim 66 , wherein the sensor system further comprises a plurality of electrode sensors configured to generate the at least one second signal, wherein the plurality of electrode sensors are arranged to contact distinct portions of the patient tissue as the puncture device is moved through the patient tissue into the cavity. 
     
     
         68 . The medical puncture system of  claim 67 , wherein the plurality of electrode sensors are positioned along the insertion axis of the puncture device and spaced apart from one another. 
     
     
         69 . The medical puncture system of  claim 67 , wherein the plurality of electrode sensors form a matrix of electrodes to generate the at least one second signal, wherein the at least one second signal is indicative of an impedance map along the insertion axis of the puncture device. 
     
     
         70 . The medical puncture system of  claim 67 , wherein:
 the plurality of electrode sensors comprises at least three electrode sensors, and the at least one second signal comprises at least three second signals, and   each of the at least three electrode sensors is configured to generate a corresponding signal of the at least three second signals.   
     
     
         71 . The medical puncture system of  claim 55 , further comprising:
 a stabilizing device to apply a stabilizing force to a region of the tissue, the stabilizing device comprising a grasping device operable to grasp the region of the tissue or a suction device operable to apply traction to the region of the tissue.   
     
     
         72 . A method of operating a controllable manipulator, the method comprising:
 detecting, based on at least one signal generated by a sensor of the controllable manipulator and indicative of a parameter associated with a joint of one or more joints of the controllable manipulator, motion of a puncture device supported by the controllable manipulator through patient tissue into an internal patient cavity or from a first layer of the patient tissue to a second layer of the patient tissue; and   causing the controllable manipulator, based on the detected motion, to guide insertion of the puncture device.   
     
     
         73 . The method of  claim 72 , wherein causing the controllable manipulator to guide insertion of the puncture device comprises:
 inhibiting movement of the puncture device in response to detecting the motion of the puncture device through the patient tissue into the cavity; or   inhibiting a range of motion of the puncture device.   
     
     
         74 . The method of  claim 72 , wherein causing the controllable manipulator to guide insertion of the puncture device comprises:
 inhibiting translational motion of the puncture device to within a distance of an initial position of the puncture device; or   inhibiting movement of the puncture device such that an angle of an insertion axis of the puncture device relative to the patient tissue is within a predefined range.