MINIMALLY INVASIVE SURGICAL APPARATUS WITH SIDE EXIT INSTRUMENTS
Two surgical instruments are inserted through a guide tube and exit via side exit ports of the guide tube. The side exit ports are on opposite sides of the guide tube. A stereoscopic image capture component is at the distal end of the guide tube. Both the surgical instruments and the guide tube may be flexible, and in some aspects the guide tube is retroflexive. The guide tube and the instruments are telemanipulatively controlled. The guide tube has an oblong-shaped cross section, and the instruments pass through opposite ends of the oblong shape, which allows the guide tube to have a reduced cross sectional area.
1 . A surgical instrument assembly comprising:
a guide tube having at least two side exit ports;
a first surgical instrument that extends through the guide tube and exits via a first one of the side exit ports;
a second surgical instrument that extends through the guide tube and exits via a second one of the side exit ports; and
a stereoscopic image capture component positioned at a distal end of the guide tube.
2 . The assembly of claim 1:
wherein the first side exit port and the second side exit port are substantially opposite one another on the guide tube.
3 . (canceled)
4 . The assembly of claim 1:
wherein the first surgical instrument comprises a bend sensor.
5 . The assembly of claim 1:
wherein at least a portion of the first surgical instrument that extends from the first one of the side exit ports comprises an actively controllable flexible segment.
6 . The assembly of claim 1 further comprising:
a third surgical instrument;
wherein the first surgical instrument and the third surgical instrument are interchangeable during a surgical procedure.
7 . The assembly of claim 1 , further comprising:
a third surgical instrument that extends through and exits the distal end of the guide tube.
8 . The assembly of claim 7:
wherein the third surgical instrument comprises a passively flexible instrument that includes a gripping end effector.
9 . The assembly of claim 1:
wherein the guide tube comprises an actively controllable flexible portion.
10 . The assembly of claim 1:
wherein the guide tube comprises an actively controllable retroflexive portion.
11 . The assembly of claim 10:
wherein the retroflexive portion retroflexes in a pitch degree of freedom in a yaw degree of freedom, or in both pitch and yaw degrees of freedom.
12 . The assembly of claim 1:
wherein a portion of the guide tube between the side exit ports and the distal end is flexible; and
wherein the portion of the guide tube between the side exit ports and the distal end is movable while the positions of the side exit ports remain unchanged.
13 . The assembly of claim 1:
wherein a cross section of the guide tube comprises an oblong shape;
wherein the first surgical instrument extends through a first end of the oblong shape; and
wherein the second surgical instrument extends through a second end of the oblong shape.
14 . The assembly of claim 1 further comprising:
a telemanipulative control system that controls motion of the guide tube, the first surgical instrument, and the second surgical instrument.
15 . (canceled)
16 . A method comprising:
extending a first surgical instrument through a first side exit port in a guide tube;
extending a second surgical instrument through a second side exit port in the guide tube; and
positioning a distal end of the first surgical instrument and a distal end of the second surgical instrument within a field of view of an stereoscopic image capture component positioned at a distal end of the guide tube.
17 . The method of claim 16 , further comprising:
automatically extending the distal end of the first surgical instrument into the field of view of the image capture component as the first surgical instrument is extended from the first side exit port.
18 . The method of claim 16 , further comprising:
replacing the first surgical instrument with a third surgical instrument during a surgical procedure; and
positioning a distal end of the third surgical instrument within the field of view of the image capture component.
19 . The method of claim 16 , further comprising:
extending a third surgical instrument through an exit port at the distal end of the guide tube.
20 . The method of claim 16 , further comprising:
retroflexing the guide tube.
21 . The method of claim 16 , further comprising:
retroflexing the guide tube in a pitch degree of freedom in a yaw degree of freedom or in both pitch and yaw degrees of freedom.
22 . The method of claim 16 , further comprising:
moving a segment of the guide tube that is between the side exit ports and the distal end of the guide tube while the side exit ports remain stationary.
23 . The method of claim 16 , further comprising:
telemanipulatively controlling the guide tube, the first surgical instrument, and the second surgical instrument.
24 . The method of claim 16:
wherein the first side exit port and the second side exit port are substantially opposite one another on the guide tube.
25 . The assembly of claim 1:
wherein the stereoscopic image capture component positioned at the distal end of the guide tube is movable with reference to the guide tube.
26 . The assembly of claim 1 further comprising:
a control system that automatically guides a distal end of the first surgical instrument into a field of view of the image capture component as the first surgical instrument is extended from the first one of the side exit ports.
27 . A method comprising:
automatically guiding a distal portion of a surgical instrument as the distal portion extends through a side exit port of a guide tube so that a distal end of the surgical instrument is moved into a field of view of an endoscopic vision system positioned at a distal end of the guide tube.