公开(公告)号：US08870900B2

公开(公告)日：2014-10-28

申请号：US11689287

申请日：2007-03-21

申请人： Christopher A. Julian ,  Michael Ikeda ,  Andris D. Ramans ,  Dean F. Hoornaert ,  Margaret M. Isaac

发明人： Christopher A. Julian ,  Michael Ikeda ,  Andris D. Ramans ,  Dean F. Hoornaert ,  Margaret M. Isaac

IPC分类号： A61B17/08 ,  A61B1/32 ,  A61B19/00 ,  A61B17/122 ,  A61B17/132 ,  A61B17/04 ,  A61B17/00 ,  A61B17/12 ,  A61B17/29 ,  A61B17/02 ,  A61B17/30

CPC分类号： A61B17/00234 ,  A61B17/04 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0487 ,  A61B17/12013 ,  A61B17/122 ,  A61B17/1327 ,  A61B34/30 ,  A61B34/35 ,  A61B34/37 ,  A61B34/71 ,  A61B90/361 ,  A61B90/50 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/0404 ,  A61B2017/0414 ,  A61B2017/0454 ,  A61B2017/0464 ,  A61B2017/2905 ,  A61B2017/2932 ,  A61B2017/2933 ,  A61B2017/306 ,  A61B2034/742

摘要： Devices, systems and methods related to endoscopic surgery, particularly related to robotic surgical operations, provide a tissue stabilizer for endoscopically stabilizing a target tissue within a patient's body. For stabilizing a beating heart during a closed-chest coronary artery bypass grafting procedure, a stabilizer is inserted through an endoscopic cannula and provides sufficient surface area to contact the heart and effectively stabilize the target tissue area. The stabilizer can straddle a blood vessel, such as a coronary artery, which is targeted for an anastomosis. Vessel occlusion fasteners may occlude the target blood vessel prior to the anastomosis procedure.

摘要翻译： 与内窥镜手术有关的装置，系统和方法，特别是与机器人手术操作相关的装置，系统和方法提供用于内窥镜稳定患者体内的靶组织的组织稳定器。 为了在闭合胸腔冠状动脉旁路移植手术期间稳定跳动的心脏，通过内窥镜套管插入稳定器，并提供足够的表面积以接触心脏并有效地稳定目标组织区域。 稳定器可以跨越作为吻合靶向的血管，例如冠状动脉。 血管闭塞紧固件可能在吻合手术前闭塞目标血管。

公开(公告)号：US07250028B2

公开(公告)日：2007-07-31

申请号：US09998004

申请日：2001-11-28

申请人： Christopher A. Julian ,  Michael Ikeda ,  Andris D. Ramans ,  Dean F. Hoornaert ,  Margaret M. Isaac

发明人： Christopher A. Julian ,  Michael Ikeda ,  Andris D. Ramans ,  Dean F. Hoornaert ,  Margaret M. Isaac

IPC分类号： A61B19/00 ,  A61B17/00 ,  A61B17/04

CPC分类号： A61B17/00234 ,  A61B17/04 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0487 ,  A61B17/12013 ,  A61B17/122 ,  A61B17/1327 ,  A61B34/30 ,  A61B34/35 ,  A61B34/37 ,  A61B34/71 ,  A61B90/361 ,  A61B90/50 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/0404 ,  A61B2017/0414 ,  A61B2017/0454 ,  A61B2017/0464 ,  A61B2017/2905 ,  A61B2017/2932 ,  A61B2017/2933 ,  A61B2017/306 ,  A61B2034/742

摘要： Devices, systems and methods related to endoscopic surgery, particularly related to robotic surgical operations, provide a tissue stabilizer for endoscopically stabilizing a target tissue within a patient's body. For stabilizing a beating heart during a closed-chest coronary artery bypass grafting procedure, a stabilizer is inserted through an endoscopic cannula and provides sufficient surface area to contact the heart and effectively stabilize the target tissue area. The stabilizer can straddle a blood vessel, such as a coronary artery, which is targeted for an anastomosis. Vessel occlusion fasteners may occlude the target blood vessel prior to the anastomosis procedure.

摘要翻译： 与内窥镜手术有关的装置，系统和方法，特别是与机器人手术操作相关的装置，系统和方法提供用于内窥镜稳定患者体内的靶组织的组织稳定器。 为了在闭合胸腔冠状动脉旁路移植手术期间稳定跳动的心脏，通过内窥镜套管插入稳定器，并提供足够的表面积以接触心脏并有效地稳定目标组织区域。 稳定器可以跨越作为吻合靶向的血管，例如冠状动脉。 血管闭塞紧固件可能在吻合手术前闭塞目标血管。

公开(公告)号：US06770081B1

公开(公告)日：2004-08-03

申请号：US09478953

申请日：2000-01-07

申请人： Thomas G. Cooper ,  Christopher A. Julian ,  Michael Ikeda ,  Daniel T. Wallace ,  David J. Rosa ,  Andris D. Ramans ,  Frederic H. Moll ,  Robert G. Younge

发明人： Thomas G. Cooper ,  Christopher A. Julian ,  Michael Ikeda ,  Daniel T. Wallace ,  David J. Rosa ,  Andris D. Ramans ,  Frederic H. Moll ,  Robert G. Younge

IPC分类号： A61B1900

CPC分类号： A61B17/1285 ,  A61B17/06061 ,  A61B17/11 ,  A61B17/32053 ,  A61B34/30 ,  A61B34/37 ,  A61B34/71 ,  A61B2017/00252 ,  A61B2017/00287 ,  A61B2017/00362 ,  A61B2017/00477 ,  A61B2017/0243 ,  A61B2017/1107 ,  A61B2017/1135 ,  A61B2017/2902 ,  A61B2017/2931 ,  A61B2017/2937 ,  A61B2017/294 ,  A61B2017/2946

摘要： Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Some accessories need to be actuated to effect a predetermined treatment, such as an aortic punch, clamps, pliers, and the like. For such accessories, the actuation can conveniently be performed by an operator such as an assistant remotely from outside the patient's body while placement of the accessories takes place in the surgical site by manipulating the accessories using robotic surgical tools in the site. A lockdown feature may be incorporated in accessories to lock them in place remotely from outside the surgical site upon actuation.

摘要翻译： 手术附件在体内呈现，并在手术部位使用外科手术工具进行附加任务，而无需从手术部位移除刀具以进行换刀或仪器装载。 一些附件需要被致动以实现预定的处理，例如主动脉打孔，夹具，钳子等。 对于这种附件，致动可以方便地由操作者（例如远程地从患者身体外部的助手）执行，同时通过使用该部位中的机器人手术工具来操纵附件来进行附件的放置。 锁定功能可以结合在附件中，以便在致动时将其锁定在远离外科手术部位的地方。

公开(公告)号：US08105235B2

公开(公告)日：2012-01-31

申请号：US10864899

申请日：2004-06-08

申请人： Andris D. Ramans ,  David J. Rosa ,  Volkmar Falk

发明人： Andris D. Ramans ,  David J. Rosa ,  Volkmar Falk

IPC分类号： A61B1/32

CPC分类号： A61B19/2203 ,  A61B17/04 ,  A61B17/0469 ,  A61B34/20 ,  A61B34/30 ,  A61B34/35 ,  A61B34/37 ,  A61B34/71 ,  A61B90/361 ,  A61B2017/00243 ,  A61B2017/00477 ,  A61B2034/305 ,  A61B2034/715 ,  A61B2034/742

摘要： Surgical methods and devices allow closed-chest surgery to be performed on a heart of a patient while the heart is beating. A region of the heart is stabilized by engaging a surface of the heart with a stabilizer without having to stop the heart. Motion of the target tissues is inhibited sufficiently to treat the target tissues with robotic surgical tools which move in response to inputs of a robotic system operator. A stabilizing surface of the stabilizer is coupled to a drive system to position the surface from outside the patient, preferably by actuators of the robotic servomechanism. Exemplary stabilizers includes a suture or other flexible tension member spanning between a pair of jointed bodies, allowing the member to occlude a coronary blood vessel and/or help stabilize the target region between the stabilizing surfaces.

摘要翻译： 手术方法和装置允许在心脏跳动时对患者的心脏进行闭胸手术。 通过使心脏的表面与稳定剂接合而不必停止心脏来稳定心脏的区域。 目标组织的运动受到充分的抑制，用机器人手术工具治疗目标组织，这些手术工具响应于机器人系统操作者的输入而移动。 稳定器的稳定表面联接到驱动系统以将表面从患者外部优选地通过机器人伺服机构的致动器定位。 示例性稳定器包括横跨在一对接合体之间的缝合线或其它柔性张紧构件，允许构件闭塞冠状血管和/或帮助稳定稳定表面之间的目标区域。

公开(公告)号：US20110137322A1

公开(公告)日：2011-06-09

申请号：US12959704

申请日：2010-12-03

申请人： Frederic H. Moll ,  David J. Rosa ,  Andris D. Ramans ,  Steven J. Blumenkranz ,  Gary S. Guthart ,  Gunter D. Niemeyer ,  William C. Nowlin ,  J. Kenneth Salisbury, JR. ,  Michael J. Tierney

发明人： Frederic H. Moll ,  David J. Rosa ,  Andris D. Ramans ,  Steven J. Blumenkranz ,  Gary S. Guthart ,  Gunter D. Niemeyer ,  William C. Nowlin ,  J. Kenneth Salisbury, JR. ,  Michael J. Tierney

IPC分类号： A61B19/00

CPC分类号： A61B19/2203 ,  A61B34/30 ,  A61B34/35 ,  A61B34/37 ,  A61B34/76 ,  A61B90/361 ,  A61B2017/00199 ,  A61B2034/305 ,  A61B2034/742 ,  A61B2090/506 ,  G06F19/00 ,  G09B23/285

摘要： Improved robotic surgical systems, devices, and methods include selectably associatable master/slave pairs, often having more manipulator arms than will be moved simultaneously by the two hands of a surgeon. Four manipulator arms can support an image capture device, a left hand tissue manipulation tool, a right hand tissue manipulation tool, and a fourth surgical instrument, particularly for stabilizing, retracting, tool change, or other functions benefiting from intermittent movement. The four or more arms may sequentially be controlled by left and right master input control devices. The fourth arm may be used to support another image capture device, and control of some or all of the arms may be transferred back-and-forth between the operator and an assistant. Two or more robotic systems each having master controls and slave manipulators may be coupled to enable cooperative surgery between two or more operators.

摘要翻译： 改进的机器人手术系统，装置和方法包括可选择地可关联的主/从对，通常具有比外科医生的两只手同时移动的更多的操纵臂。 四个操纵臂可以支撑图像捕获装置，左手组织操作工具，右手组织操作工具和第四手术器械，特别是用于稳定，缩回，换刀或受益于间歇运动的其他功能。 四个或更多个臂可以顺序地由左和右主输入控制装置控制。 第四臂可以用于支持另一图像捕获装置，并且可以在操作者和助手之间来回传送一些或所有臂的控制。 可以耦合两个或更多个具有主控制器和从动操纵器的机器人系统，以实现两个或多个操作者之间的协作手术。

公开(公告)号：US06858003B2

公开(公告)日：2005-02-22

申请号：US10214286

申请日：2002-08-06

申请人： Philip C. Evans ,  Frederic H. Moll ,  Gary S. Guthart ,  William C. Nowlin ,  Rand P. Pendleton ,  Christopher P. Wilson ,  Andris D. Ramans ,  David J. Rosa ,  Volkmar Falk ,  Robert G. Younge

发明人： Philip C. Evans ,  Frederic H. Moll ,  Gary S. Guthart ,  William C. Nowlin ,  Rand P. Pendleton ,  Christopher P. Wilson ,  Andris D. Ramans ,  David J. Rosa ,  Volkmar Falk ,  Robert G. Younge

IPC分类号： A61B17/00 ,  A61B17/04 ,  A61B19/00

CPC分类号： A61B34/32 ,  A61B17/04 ,  A61B17/0469 ,  A61B34/20 ,  A61B34/30 ,  A61B34/35 ,  A61B34/37 ,  A61B34/70 ,  A61B34/71 ,  A61B34/77 ,  A61B90/361 ,  A61B2017/00243 ,  A61B2017/00703 ,  A61B2034/2065 ,  A61B2034/305 ,  A61B2034/742 ,  A61B2090/064

摘要： A surgical system or assembly for performing cardiac surgery includes a surgical instrument; a servo-mechanical system engaged to the surgical instrument for operating the surgical instrument; and an attachment assembly for removing at least one degree of movement from a moving surgical cardiac worksite to produce a resultant surgical cardiac worksite. The surgical system or assembly also includes a motion tracking system for gathering movement information on a resultant surgical cardiac worksite. A control computer is engaged to the attachment assembly and to the motion tracking system and to the servo-mechanical system for controlling movement of the attachment assembly and for feeding gathered information to the servo-mechanical system for moving the surgical instrument in unison with the resultant surgical cardiac worksite such that a relative position of the moving surgical instrument with respect to the resultant surgical cardiac worksite is generally constant. A video monitor is coupled to the control computer; and an input system is coupled to the servo-mechanical system and to the control computer for providing a movement of the surgical instrument. The video monitor displays movement of the surgical instrument while the resultant surgical cardiac worksite appears substantially stationary, and while a relative position of the surgical instrument moving in unison with the resultant surgical cardiac worksite, as a result from the movement information gathered by the motion tracking system, remains generally constant. A method of performing cardiac surgery without cardioplegia comprising removing at least one degree of movement freedom from a moving surgical cardiac worksite to produce at least a partially stationary surgical cardiac worksite while allowing a residual heart section, generally separate from the at least partially stationary surgical cardiac worksite, to move as a residual moving heart part. Cardiac surgery is performed on the at least partially stationary cardiac worksite with a surgical instrument such as needle drivers, forceps, blades and scissors.

公开(公告)号：US07865266B2

公开(公告)日：2011-01-04

申请号：US10424536

申请日：2003-04-24

申请人： Frederic H. Moll ,  David J. Rosa ,  Andris D. Ramans ,  Steven J. Blumenkranz ,  Gary S. Guthart ,  Gunter D. Niemeyer ,  William C. Nowlin ,  J. Kenneth Salisbury, Jr. ,  Michael J. Tierney

发明人： Frederic H. Moll ,  David J. Rosa ,  Andris D. Ramans ,  Steven J. Blumenkranz ,  Gary S. Guthart ,  Gunter D. Niemeyer ,  William C. Nowlin ,  J. Kenneth Salisbury, Jr. ,  Michael J. Tierney

IPC分类号： G06F19/00 ,  G05B19/18 ,  G05B15/02 ,  B25J1/00

CPC分类号： A61B19/2203 ,  A61B34/30 ,  A61B34/35 ,  A61B34/37 ,  A61B34/76 ,  A61B90/361 ,  A61B2017/00199 ,  A61B2034/305 ,  A61B2034/742 ,  A61B2090/506 ,  G06F19/00 ,  G09B23/285

摘要： Improved robotic surgical systems, devices, and methods include selectably associatable master/slave pairs, often having more manipulator arms than will be moved simultaneously by the two hands of a surgeon. Four manipulator arms can support an image capture device, a left hand tissue manipulation tool, a right hand tissue manipulation tool, and a fourth surgical instrument, particularly for stabilizing, retracting, tool change, or other functions benefiting from intermittent movement. The four or more arms may sequentially be controlled by left and right master input control devices. The fourth arm may be used to support another image capture device, and control of some or all of the arms may be transferred back-and-forth between the operator and an assistant. Two or more robotic systems each having master controls and slave manipulators may be coupled to enable cooperative surgery between two or more operators.

摘要翻译： 改进的机器人手术系统，装置和方法包括可选择地可关联的主/从对，通常具有比外科医生的两只手同时移动的更多的操纵臂。 四个操纵臂可以支撑图像捕获装置，左手组织操作工具，右手组织操作工具和第四手术器械，特别是用于稳定，缩回，换刀或受益于间歇运动的其他功能。 四个或更多个臂可以顺序地由左和右主输入控制装置控制。 第四臂可以用于支持另一图像捕获装置，并且可以在操作者和助手之间来回传送一些或所有臂的控制。 可以耦合两个或更多个具有主控制器和从动操纵器的机器人系统，以实现两个或多个操作者之间的协作手术。

公开(公告)号：US06764445B2

公开(公告)日：2004-07-20

申请号：US10017641

申请日：2001-12-14

申请人： Andris D. Ramans ,  David J. Rosa ,  Volkmar Falk

发明人： Andris D. Ramans ,  David J. Rosa ,  Volkmar Falk

IPC分类号： A61B132

CPC分类号： A61B19/2203 ,  A61B17/04 ,  A61B17/0469 ,  A61B34/20 ,  A61B34/30 ,  A61B34/35 ,  A61B34/37 ,  A61B34/71 ,  A61B90/361 ,  A61B2017/00243 ,  A61B2017/00477 ,  A61B2034/305 ,  A61B2034/715 ,  A61B2034/742

摘要： Surgical methods and devices allow closed-chest surgery to be performed on a heart of a patient while the heart is beating. A region of the heart is stabilized by engaging a surface of the heart with a stabilizer without having to stop the heart. Motion of the target tissues is inhibited sufficiently to treat the target tissues with robotic surgical tools which move in response to inputs of a robotic system operator. A stabilizing surface of the stabilizer is coupled to a drive system to position the surface from outside the patient, preferably by actuators of the robotic servomechanism. Exemplary stabilizers includes a suture or other flexible tension member spanning between a pair of jointed bodies, allowing the member to occlude a coronary blood vessel and/or help stabilize the target region between the stabilizing surfaces.

摘要翻译： 手术方法和装置允许在心脏跳动时对患者的心脏进行闭胸手术。 通过使心脏的表面与稳定剂接合而不必停止心脏来稳定心脏的区域。 目标组织的运动受到充分的抑制，用机器人手术工具治疗目标组织，这些手术工具响应于机器人系统操作者的输入而移动。 稳定器的稳定表面联接到驱动系统以将表面从患者外部优选地通过机器人伺服机构的致动器定位。 示例性稳定器包括横跨在一对接合体之间的缝合线或其它柔性张紧构件，允许构件闭塞冠状血管和/或帮助稳定稳定表面之间的目标区域。

公开(公告)号：US06206903B1

公开(公告)日：2001-03-27

申请号：US09415783

申请日：1999-10-08

申请人： Andris D. Ramans

发明人： Andris D. Ramans

IPC分类号： A61B1728

CPC分类号： A61B17/29 ,  A61B34/30 ,  A61B34/70 ,  A61B34/71 ,  A61B2017/2929 ,  A61B2017/2939

摘要： A robotic surgical tool includes an end effector having a pair of fingers and incorporating a mechanical advantage. In specific embodiments, a pulley and cable mechanism is used to actuate the end effector by applying cable tension. The coupling between the pulleys and the fingers of the end effector takes advantage of changes in moment arms for force transfer to avoid or minimize force reduction between the applied cable tension and the resultant force at or near the distal tip of each finger. In some embodiments, the coupling of the pulleys and fingers results in a force gain, a moment gain, or both.

摘要翻译： 机器人手术工具包括具有一对手指并结合机械优点的末端执行器。 在具体实施例中，滑轮和缆索机构用于通过施加电缆张力致动末端执行器。 皮带轮和末端执行器的手指之间的联接利用力矩传递的力矩臂的变化，以避免或最小化施加的电缆张力与在每个手指的远侧末端附近的合力之间的力减小。 在一些实施例中，滑轮和手指的联接导致力增益，力矩增益或两者。

公开(公告)号：US09119654B2

公开(公告)日：2015-09-01

申请号：US13350459

申请日：2012-01-13

申请人： Andris D. Ramans ,  David J. Rosa ,  Volkmar Falk

发明人： Andris D. Ramans ,  David J. Rosa ,  Volkmar Falk

IPC分类号： A61B1/32 ,  A61B19/00 ,  A61B17/04 ,  A61B17/00

CPC分类号： A61B19/2203 ,  A61B17/04 ,  A61B17/0469 ,  A61B34/20 ,  A61B34/30 ,  A61B34/35 ,  A61B34/37 ,  A61B34/71 ,  A61B90/361 ,  A61B2017/00243 ,  A61B2017/00477 ,  A61B2034/305 ,  A61B2034/715 ,  A61B2034/742

摘要： Surgical methods and devices allow closed-chest surgery to be performed on a heart of a patient while the heart is beating. A region of the heart is stabilized by engaging a surface of the heart with a stabilizer without having to stop the heart. Motion of the target tissues is inhibited sufficiently to treat the target tissues with robotic surgical tools which move in response to inputs of a robotic system operator. A stabilizing surface of the stabilizer is coupled to a drive system to position the surface from outside the patient, preferably by actuators of the robotic servomechanism. Exemplary stabilizers includes a suture or other flexible tension member spanning between a pair of jointed bodies, allowing the member to occlude a coronary blood vessel and/or help stabilize the target region between the stabilizing surfaces.