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US-12616542-B2 - Robotic microsurgical assembly

US12616542B2US 12616542 B2US12616542 B2US 12616542B2US-12616542-B2

Abstract

A robotic surgical assembly includes a slave manipulator with an actuator, a pushing device connected to the actuator, a sensor detecting a contact force on the pushing device, a position sensing system, and a control unit. A surgical instrument is detachable to the slave manipulator and separated from the slave manipulator by a sterile barrier. The surgical instrument includes a frame; an articulated link; a tendon associated with the actuator, having proximal and distal portions secured to the link. A transmission device in contact with the tendon proximal portion exerts a traction action. The transmission device has one degree of freedom of motion relative to the frame. The pushing device releasably and selectively connects with the transmission device to transmit a pushing action to the transmission device through the sterile barrier. An elastic device biases the transmission device to exert a traction action on the tendon.

Inventors

  • Massimiliano Simi
  • Giuseppe Maria Prisco
  • Cesare Stefanini

Assignees

  • Medical Microinstruments, Inc.

Dates

Publication Date
20260505
Application Date
20240521
Priority Date
20170414

Claims (20)

  1. 1 . A robotic surgical assembly comprising: a slave manipulator comprising: an actuator, a pushing element coupled to said actuator, and a sterile barrier; a surgical instrument operated by said slave manipulator and separated from said slave manipulator by said sterile barrier, said surgical instrument comprising: a frame, a link articulating in a joint with respect to said frame, a tendon coupled to said actuator and to said link, a transmission element to exert a traction action on said tendon, and an elastic element coupled to said frame and to said transmission element; wherein: said pushing element releasably and selectively connects with said transmission element to transmit a pushing action to said transmission element through said sterile barrier, said elastic element biases said transmission element away from the pushing element and preloads said tendon.
  2. 2 . The robotic surgical assembly of claim 1 , wherein said transmission element is constrained to have a single degree of freedom of motion with respect to said frame.
  3. 3 . The robotic surgical assembly of the previous claim 2 , wherein said single degree of freedom of motion is a single degree of freedom of linear motion.
  4. 4 . The robotic surgical assembly of claim 1 , wherein said pushing element is selectively connected with said transmission element and engages unidirectionally with said transmission element to transmit said pushing action.
  5. 5 . The robotic surgical assembly of claim 1 , wherein the preload on said tendon is maintained while said pushing element selectively detaches from said transmission element.
  6. 6 . The robotic surgical assembly of claim 1 , wherein said pushing element is coupled to said transmission device to selectively detach from said transmission element, and wherein the preload on said tendon is maintained when said pushing element is detached from said transmission element from biasing action of said elastic element.
  7. 7 . The robotic surgical assembly of claim 1 , wherein said tendon preload is a minimum value required to avoid slack in the tendon.
  8. 8 . The robotic surgical assembly of claim 1 , wherein said surgical instrument is detachably attached to said slave manipulator, and said tendon is preloaded when the instrument is detached from the slave manipulator.
  9. 9 . The robotic surgical assembly of claim 1 , wherein the pushing action of said pushing element transmitted to said transmission element adds to biasing action of said elastic element.
  10. 10 . The robotic surgical assembly of claim 1 , wherein biasing action of said elastic element has a value equal to or lower than the 10% of a breaking load of said tendon.
  11. 11 . The robotic surgical assembly of claim 1 , wherein the sterile barrier comprises an elastic stretchable drape interposed between said pushing element and said transmission element.
  12. 12 . The robotic surgical assembly of claim 1 , wherein a proximal portion of said tendon has a proximal termination secured to said transmission element.
  13. 13 . The robotic surgical assembly of claim 1 , wherein a proximal portion of said tendon has a proximal termination secured to said frame.
  14. 14 . The robotic surgical assembly of claim 1 , wherein said transmission element comprises a plunger.
  15. 15 . The robotic surgical assembly of claim 1 , wherein said transmission element comprises a lever connected to the frame in a fulcrum joint.
  16. 16 . The robotic surgical assembly of claim 1 , wherein one of said transmission element and said pushing element comprises a cam and the other of said transmission element and said pushing element comprises a follower cooperating with said cam.
  17. 17 . The robotic surgical assembly of claim 1 , wherein said transmission element comprises a pulley to contact said proximal portion of the tendon.
  18. 18 . The robotic surgical assembly of claim 1 , wherein said tendon is a polymeric tendon.
  19. 19 . The robotic surgical assembly of claim 1 , wherein said slave manipulator comprises a pair of pushing elements configured as antagonistic pushing elements, and said surgical instrument comprises a pair of transmission elements configured as antagonistic transmission elements and a pair of tendons configured as antagonistic tendons to provide opposite motion to said link.
  20. 20 . The robotic surgical assembly of claim 1 , wherein the surgical instrument comprises a plurality of links connected to each other by joints and wherein, preferably, said surgical instrument also comprises a shaft proximally connected to said frame and distally connected to said links.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application is a Continuation of U.S. patent application Ser. No. 17/697,328, filed Mar. 17, 2022, which is a Continuation of U.S. patent application Ser. No. 16/605,165, filed 14 Oct. 2019, which is a National Stage Application of PCT/IB2018/052626, filed 16 Apr. 2018, which claims the benefit of Serial No. 102017000042116, filed 14 Apr. 2017 in Italy, and which applications are incorporated herein by reference. To the extent appropriate, a claim of priority is made to each of the above-disclosed applications. FIELD OF THE INVENTION It is an object of the present invention a robotic surgical assembly. The present invention relates to a robotic microsurgical assembly of the type comprising a slave manipulator and a surgical instrument. The present invention also relates to method for controlling a surgical instrument. PRIOR ART Robotic assemblies for surgery or microsurgery comprising multi-joint robotic arms terminating with surgical instruments are known in the field. For instance, document U.S. Pat. No. 7,155,316 discloses a robotic assembly for performing brain microsurgery under Magnetic Resonance Imaging (MRI) guidance comprising an MRI-based image acquisition system and two multi-joint arms, each with three rotary joints with vertical axes to avoid direct gravity loads (as shown for instance in FIG. 7 of said document U.S. Pat. No. 7,155,316), each connected to its respective end-effector endowed with an internal degree of freedom of motion for gripping. It is also notable that the execution of the principal surgical primitives, such as tissue tensioning and anastomotic suturing, requires the ability to orient the surgical instrument tip in a large spatial cone of directions and to rotate the instrument around its longitudinal axis (roll), for example to guide the needle through the tissue with the tip of the needle holder instrument, in a similar manner as the human hand is jointed at the wrist and the elbow. Robotic assemblies for surgery or microsurgery comprising a teleoperated master-slave system are generally known, as described, for example, in document U.S. Pat. No. 6,963,792 and, more specifically for the microsurgical application by U.S. Pat. No. 6,385,509, and US-2014-0135794, that describe kinematic solutions for the movement of the surgical instrument tip that require coordination of a plurality of joints in a serial kinematic chain that clutter the operating field. Such encumbrance effect is increasingly pronounced as the joints articulating the tip of the instrument are further away from the tip itself. Moreover said micro-surgical systems do not allow adequate movement, and more specifically adequate re-orientation, of the instrument tip when in an operating site inside a lesion as little as 10 centimeters from the surface of the skin. The adoption of robotic technologies can bring about great benefits, allowing both a high degree of miniaturization of the instruments and scaling the size of the movements in the operating field, hence eliminating the effect of physiological tremor and easing the manual task. For example, microsurgical procedures are carried out in several phases of the reconstruction of biological tissues, such as for example in the execution of blood vessel anastomosis, comprising small diameter vessels, and nerves. Such procedures are carried out to reconstruct anatomy after the occurrence of traumatic lesions or of lesions produced by surgical removal of tissue, to reattach limbs and to revascularize tissues, all performed in an open surgery set-up given the pre-existence of a superficial lesion. Other examples of application of microsurgical techniques are found in transplant surgery, neurosurgery or in vascular surgery, as well as in surgery around and inside the eye, and in the inner ear, as in the case of cochlear implants. Also the prominent surgical procedure of cardiac by-pass comprises the critical step of anastomosis of the coronary arteries. The need for instrument miniaturization is also felt in other surgical techniques, for example in minimal invasive surgery, such as laparoscopy and endoscopy, that are aimed at limiting the invasiveness of surgical instruments on biological tissue. With reference to laparoscopy, the technical solutions known in the art do not allow a satisfactory miniaturization of the diameter of the laparoscopic instruments employed in Single Incision Laparoscopic Surgery or Single Port Surgery. Moreover, it is worth noticing that the endoscopes typically employed in minimally invasive surgery (MIS) have an instrument channel with a diameter between 1 and 3.2 millimeters. Such dimensions limit the functionality of current surgical instrumentation available through the endoscope instrument channel, which at present is typically just capable of gripping action. Therefore, it is strongly felt the need to miniaturize surgical instruments for robotic surgery. Document U.S. Pat. No. 6,951,535 d