Co-manipulation surgical system for bedside robotic laparoscopic surgery using surgical instruments
Co-manipulation robotic systems are described herein that may be used for assisting with laparoscopic surgical procedures. The co-manipulation robotic systems allow a surgeon to use commercially-available surgical tools while providing benefits associated with surgical robotics. Advantageously, the surgical tools may be seamlessly coupled to the robot arms using a disposable coupler while the reusable portions of the robot arm remain in a sterile drape. Further, the co-manipulation robotic system may operate in multiple modes to enhance usability and safety, while allowing the surgeon to position the instrument directly with the instrument handle and further maintain the desired position of the instrument using the robot arm.
1. A method for assisting with laparoscopic surgery using a robot arm configured to be removably coupled to a surgical instrument having a handle, an operating end, and an elongated shaft therebetween, the laparoscopic surgery performed bedside adjacent to a bed holding a patient, the method comprising:
positioning the robot arm bedside for performing the laparoscopic surgery;
removably coupling the surgical instrument to a coupler body at a distal end of the robot arm, the robot arm further comprising a proximal end and a plurality of links and a plurality of joints between the proximal end and the distal end;
transitioning the coupler body from an open state, where the elongated shaft is slidably moveable within a lumen of the coupler body, to a closed state; and
freely moving, while the coupler body is in the closed state, the robot arm by moving the handle of the surgical instrument coupled thereto while the robot arm remains positioned bedside to perform the laparoscopic surgery using the surgical instrument.
2. The method of claim 1 , wherein a practitioner performing the laparoscopic surgery remains bedside while performing the laparoscopic surgery using the surgical instrument coupled to the robot arm.
3. The method of claim 1 , wherein removably coupling the surgical instrument to the coupler body at the distal end of the robot arm comprises removably coupling the surgical instrument to the coupler body at the distal end of the robot arm using a pure mechanical coupling.
4. The method of claim 1 , wherein removably coupling the surgical instrument to the coupler body at the distal end of the robot arm comprises removably coupling the coupler body to only the elongated shaft of the surgical instrument.
5. The method of claim 1 , wherein removably coupling the surgical instrument to the coupler body at the distal end of the robot arm comprises removably coupling the surgical instrument to the coupler body at the distal end of the robot arm while keeping a handle of the surgical instrument completely exposed for contact with a surgeon's hand.
6. The method of claim 1 , wherein removably coupling the surgical instrument to the coupler body at the distal end of the robot arm comprises removably coupling the surgical instrument to the coupler body at the distal end of the robot arm while the robot arm is positioned bedside.
7. The method of claim 1 , further comprising, before removably coupling the surgical instrument to the coupler body at the distal end of the robot arm, removably coupling the coupler body to a coupler interface disposed at the distal end of the robot arm.
8. The method of claim 7 , further comprising, after performing the laparoscopic surgery, transitioning the coupler body from the closed state to the open state;
removing the surgical instrument from the coupler body for performing additional laparoscopic surgeries using the surgical instrument; and
removing the coupler body from the coupler interface for disposal of the coupler body.
9. The method of claim 7 , further comprising positioning a sterile drape between the coupler body and the coupler interface prior to removably coupling the coupler body to the coupler interface.
10. The method of claim 1 , wherein, when the coupler body is in the closed state, longitudinal movement of the elongated shaft relative to the coupler body is inhibited while rotational movement of the elongated shaft relative to the coupler body is permitted responsive to movement at the handle of the surgical instrument.
11. The method of claim 10 , wherein, when the coupler body is in the closed state, the coupler body applies a friction force against the elongated shaft sufficient to permit rotational movement of the elongated shaft relative to the coupler body, while inhibiting longitudinal movement of the elongated shaft relative to the coupler body.
12. The method of claim 1 , wherein, removably coupling the surgical instrument to the coupler body comprises removeably coupling the coupler body to a fixed point along the elongated shaft to provide a consistent point of reference for force calculations of the surgical instrument.
13. The method of claim 1 , further comprising disposing of the coupler body after a single laparoscopic surgery.
14. The method of claim 1 , wherein the robot arm is not teleoperated via user input received at a remote surgeon console.
15. The method of claim 1 , wherein freely moving the robot arm by moving the handle of the surgical instrument coupled thereto comprises applying a force at the robot arm via the surgical instrument that exceeds a predetermined threshold to thereby automatically switch the robot arm to a co-manipulation mode where an impedance is applied to the robot arm to account for weight of the surgical instrument and the robot arm.
16. The method of claim 15 , further comprising adjusting, via a graphical user interface operatively coupled to the robot arm, the predetermined threshold of force applied at the robot arm to cause the robot arm to automatically switch to the co-manipulation mode.
17. The method of claim 15 , wherein the plurality of joints of the robot arm comprises one or more motorized joints operatively coupled to one or more motors disposed in a base coupled to the proximal end of the robot arm, the method further comprising measuring current of the one or more motors, the current indicative of the force applied at the robot arm via the surgical instrument.
18. The method of claim 17 , wherein the impedance applied to the robot arm to account for weight of the surgical instrument and the robot arm is applied via the one or more motorized joints of the robot arm.
19. The method of claim 1 , further comprising maintaining movement of the robot arm within a predetermined amount for at least a predetermined dwell time period to thereby automatically switch the robot arm to a passive mode where the robot arm maintains a static position.
20. The method of claim 19 , further comprising adjusting, via a graphical user interface operatively coupled to the robot arm, at least one of the predetermined amount of movement of the robot arm or the predetermined dwell time period to cause the robot arm to automatically switch to the passive mode.
21. The method of claim 1 , further comprising moving the robot arm by moving the handle of the surgical instrument outside a predefined haptic barrier to thereby automatically switch the robot arm to a haptic mode where an impedance is applied to the robot arm to make movement of the robot arm responsive to movement at the handle of the surgical instrument more viscous in the haptic mode.
22. The method of claim 21 , further comprising adjusting, via a graphical user interface operatively coupled to the robot arm, a position of the predefined haptic barrier.
23. The method of claim 1 , further comprising selecting, via a graphical user interface operatively coupled to the robot arm, an identity of the surgical instrument coupled to the robot arm.
24. The method of claim 1 , wherein the proximal end of the robot arm is coupled to a base, the base coupled to a platform via a stage assembly configured to move the base in at least two degrees of freedom relative to the platform, the method further comprising adjusting at least one of a vertical height or a horizontal position of the robot arm relative to the platform via the stage assembly.
25. The method of claim 24 , wherein adjusting at least one of the vertical height or the horizontal position of the robot arm via the stage assembly comprises providing user input via at least one of a graphical user interface operatively coupled to the stage assembly or application of force by a user at a distal region of the robot arm in at least one of the at least two degrees of freedom.
26. The method of claim 24 , wherein the platform comprises a plurality of wheels, and wherein positioning the robot arm bedside for performing the laparoscopic surgery comprises moving the platform relative to the bed via the plurality of wheels.
27. The method of claim 26 , further comprising disengaging a braking mechanism of the plurality of wheels to permit movement of the platform via the plurality of wheels.
28. The method of claim 24 , further comprising displaying a virtual map comprising graphical representations of the platform relative to the bed within an area surrounding the platform to facilitate positioning of the robot arm bedside for performing the laparoscopic surgery.
29. The method of claim 1 , further comprising adjusting at least one of a height or orientation of an optical sensor having a field of view of a surgical scene comprising at least one of the robot arm, the surgical instrument coupled to the robot arm, or the bed, to thereby optimize the field of view of the optical sensor.
30. The method of claim 1 , further comprising:
selecting a laparoscope, a retractor tool, a grasper tool, or a surgical cutting tool,
wherein removably coupling the surgical instrument to the coupler body at the distal end of the robot arm comprises removably coupling the laparoscope, the retractor tool, the grasper tool, or the surgical cutting tool to the coupler body at the distal end of the robot arm.