Systems and methods for instrument based insertion architectures
Systems, devices and methods are provided in which an instrument can translate along an insertion axis. Rather than relying primarily on a robotic arm for instrument insertion, the instruments described herein have novel instrument based insertion architectures that allow portions of the instruments themselves to translate along an insertion axis. For example, an instrument can comprise a shaft, an end effector on a distal end of the shaft, and a handle coupled to the shaft. The architecture of the instrument allows the shaft to translate relative to the handle along an axis of insertion. The translation of the shaft does not interfere with other functions of the instrument, such as end effector actuation.
1. A medical device, comprising:
a shaft comprising a proximal portion and a distal portion;
an end effector connected to the distal portion of the shaft; and
a handle coupled to the shaft and configured to be releasably coupled to a robotic arm,
wherein the shaft is configured to, in use, translate relative to the handle.
2. The medical device of claim 1 , further comprising:
a first actuation mechanism configured to actuate the end effector; and
a second actuation mechanism configured to translate the shaft relative to the handle,
wherein the first actuation mechanism is decoupled from the second actuation mechanism.
3. The medical device of claim 2 , wherein the first actuation mechanism includes a first cable that extends through a first set of pulleys, wherein manipulation of at least one pulley of the first set of pulleys causes a change of length of the first cable within the handle, thereby causing actuation of the end effector.
4. The medical device of claim 3 , wherein the second actuation mechanism includes a second cable that engages a spool, wherein manipulation of the spool causes the shaft to translate relative to the handle.
5. The medical device of claim 4 , wherein the change of length of the first cable within the handle to cause actuation of the end effector is not affected by manipulation of the spool that causes the shaft to translate relative to the handle.
6. The medical device of claim 3 , wherein the first cable of the first actuation mechanism extends from the proximal portion of the shaft, through the first set of pulleys and to the distal portion of the shaft.
7. The medical device of claim 6 , wherein manipulation of the at least one pulley of the first set of pulleys to cause a change of length of the first cable within the handle comprises linear or rotary motion of the at least one pulley.
8. The medical device of claim 3 , wherein the first actuation mechanism is configured to permit free movement of the shaft relative to the first set of pulleys.
9. The medical device of claim 4 , wherein the spool comprises a zero-walk capstan.
10. The medical device of claim 9 , wherein rotation of the second mechanical input causes rotation of the zero-walk capstan.
11. The medical device of claim 2 , wherein the first actuation mechanism includes one or more cables that extend through a first set of pulleys, and the second actuation mechanism includes one or more cables and an insertion spool, wherein at least one of the one or more cables of the first actuation mechanism terminates on the insertion spool.
12. The medical device of claim 11 , wherein the one or more cables of the first actuation mechanism comprise end effector cables and the one or more cables of the second actuation mechanism comprise insertion cables.
13. The medical device of claim 11 , wherein rotation of the second mechanical input causes rotation of the insertion spool thereby causing translation of the shaft relative to the handle.
14. The medical device of claim 12 , wherein the one or more cables of the second actuation mechanism are pre-tensioned such that frictional force can be used to drive the one or more cables of the second actuation mechanism.
15. A medical system, comprising:
a base;
a tool holder coupled to the base and comprising an attachment interface;
a robotic arm between the base and the tool holder; and
an instrument, comprising:
a shaft comprising a proximal portion and a distal portion,
an end effector extending from the distal portion of the shaft, and
a handle coupled to the shaft, the handle including a reciprocal interface releasably attachable to the robotic arm via the attachment interface,
wherein the shaft is configured to, in use, translate relative to the handle.
16. The medical system of claim 15 , wherein the instrument further comprises
a first actuation mechanism configured to actuate the end effector; and
a second actuation mechanism configured to translate the shaft relative to the handle,
wherein the first actuation mechanism is decoupled from the second actuation mechanism.
17. The medical system of claim 16 , wherein the first actuation mechanism includes a first cable that extends through a first set of pulleys, wherein manipulation of at least one pulley of the first set of pulleys causes a change of length of the first cable within the handle, thereby causing actuation of the end effector, and wherein the translation of the shaft relative to the handle is performed via the second actuation mechanism that includes a second cable that engages a spool, wherein manipulation of the spool causes the shaft to translate relative to the handle.
18. The medical system of claim 17 , wherein the change of length of the first cable within the handle to cause actuation of the end effector is not affected by the manipulation of the spool that causes the shaft to translate relative to the handle.
19. The medical system of claim 18 , wherein manipulation of the at least one pulley of the first set of pulleys to cause a change of length of the first cable within the handle comprises linear or rotary motion of the at least one pulley.
20. The medical system of claim 16 , wherein the first actuation mechanism is configured to permit free movement of the shaft relative to the first set of pulleys.
21. A non-transitory computer readable storage medium having stored thereon instructions that, when executed, cause at least one computing device to:
control a robotic arm to manipulate an instrument through an incision or natural orifice of a patient to perform a procedure at a surgical site, wherein the instrument comprises:
a shaft including a proximal portion and a distal portion;
a handle coupled to the shaft and configured to be releasably coupled to the robotic arm; and
an end effector extending from the distal portion of the shaft; and
control the shaft to translate relative to the handle.
22. The non-transitory computer readable storage medium of claim 21 , wherein the instrument includes a first actuation mechanism for actuating the end effector and a second actuation mechanism for translating the shaft relative to the handle, wherein the first actuation mechanism comprises a first set of pulleys and a first cable and the second actuation mechanism comprises a spool and a second cable.
23. The non-transitory computer readable storage medium of claim 22 , further having stored thereon instructions that, when executed, cause at least one computing device to:
manipulate the end effector via the first actuation mechanism.
24. The surgical method of claim 23 , further having stored thereon instructions that, when executed, cause at least one computing device to:
translate the shaft via the second actuation mechanism, wherein the first actuation mechanism is decoupled from the second actuation mechanism.
25. A non-transitory computer readable storage medium having stored thereon instructions that, when executed, cause at least one computing device to:
control a robotic arm to guide an instrument through a portion of a patient's anatomy to perform a procedure at a surgical site, wherein the instrument comprises:
a shaft including a proximal portion and a distal portion,
a handle coupled to the shaft and configured to be releasably coupled to the robotic arm, and
an end effector extending from the distal portion of the shaft; and
control the end effector to cause the shaft to translate relative to the handle.
26. The surgical method of claim 25 , wherein the instrument includes a first actuation mechanism for actuating the end effector and a second actuation mechanism for translating the shaft relative to the handle, wherein the first actuation mechanism comprises a first set of pulleys and a first cable and the second actuation mechanism comprises a spool and a second cable.
27. The surgical method of claim 26 , further having stored thereon instructions that, when executed, cause at least one computing device to:
manipulate the end effector via the first actuation mechanism.
28. The medical device of claim 1 , wherein the handle comprises an actuation mechanism configured to translate the shaft relative to the handle.