HK1220098B - Articulated tool positioner and system employing same - Google Patents

Description

Articulated tool positioner and system using the same

Technical Field

The present invention relates to robotic manipulators and, more particularly, to the use of articulated tool positioners, such as for laparoscopic surgery.

Background Art

Articulated surgical systems for laparoscopic surgery are gaining acceptance. Various systems exist, including the system described in US Publication No. 2012/0253131 A1, published October 4, 2012, to Malkowski et al.

Malkowski et al. describe a surgical system comprising one or more arms defining a pathway therethrough. The arms include a proximal portion configured for positioning outside a patient's body and a distal portion configured for positioning within an internal body cavity. The distal portion includes first and second articulatable segments spaced apart from one another and capable of independently articulating between a substantially straight configuration and an articulated configuration. A first articulation assembly is coupled to the proximal portion of one arm and is transitionable between a first state and a second state to articulate the first articulatable segment between the substantially straight configuration and the articulated configuration. A second articulation assembly is coupled to the proximal portion of the arm and is configured to move between a plurality of positions to articulate the second articulatable segment between the substantially straight configuration and the articulated configuration. The articulatable segments forming these articulation assemblies are connected by springs biased to a substantially straight position, and cables are tightened and loosened to selectively pull the portions of the first and second articulation assemblies to neutralize tension between opposing internal cables, thereby enabling the arm to move between a plurality of positions.

Because of the springs in the links, the arrangement described by Malkowski et al. would be complex to assemble and would likely require careful manipulation by an operator who would have to be careful to counteract the bias applied by the springs to avoid unwanted straightening of the articulatable sections.

Summary of the Invention

The present invention provides an alternative articulated tool positioning device that avoids the need for springs to bias the articulated sections into a straight position by using tensionable cables and compression connection termination members between the articulated links, thereby supporting push and pull of the cables and providing simpler assembly.

According to one aspect of the present invention, an articulated tool positioning device is provided. The device includes a base member, an intermediate member, an end member, and a first tool holder arranged in series, each of the base member, the intermediate member, the end member, and the tool holder having a corresponding central opening. The device further includes a first plurality of coupling guides between the base member and the intermediate member, at least one of the first plurality of coupling guides being coupled to the base member, and at least one of the first plurality of coupling guides being coupled to the intermediate member. Each coupling guide in the first plurality of coupling guides has a corresponding central opening. The device further includes a second plurality of coupling guides between the intermediate member and the end member. At least one of the second plurality of coupling guides is coupled to the intermediate member, and at least one of the second plurality of coupling guides is coupled to the end member. Each coupling guide in the second plurality of coupling guides also has a corresponding central opening. The device further includes a third plurality of coupling guides between the end member and the tool holder. At least one of the third plurality of coupling guides is coupled to the end member, and at least one of the third plurality of coupling guides is coupled to the tool holder. Each coupling guide in the third plurality of coupling guides also has a corresponding central opening. The apparatus further includes a first guide opening in the base member and a corresponding first guide opening in each of the first plurality of coupling guides. A first plurality of flexible control links arranged in parallel and spaced relationship extend through corresponding openings of the first guide openings in the base member and through corresponding openings of the corresponding first guide openings in the first plurality of coupling guides. Each of the first plurality of flexible control links has a corresponding first end portion connected to the intermediate member and a corresponding second end portion extending away from the base member.

The device further includes a second guide opening in the intermediate member and a corresponding second guide opening in each of the first and second pluralities of coupling guides. The device further includes a second plurality of flexible control links arranged in a parallel, spaced relationship, each of the second plurality of flexible control links having a first end connected to the end member and a second end connected to at least one of the base member and an object spaced from the base member. Each of these second flexible control links includes an intermediate portion between the first and second ends. Each intermediate portion extends through a corresponding second guide opening in the intermediate member and through a corresponding second guide opening in each of the first and second pluralities of coupling guides.

The device further comprises a third guide opening in the base member, and in each coupling guide of the first plurality of coupling guides, and in the intermediate member, and in each coupling guide of the second plurality of coupling guides, and in the end member, and in each coupling guide of the third plurality of coupling guides.

The apparatus further includes a third plurality of flexible control links arranged in a parallel, spaced-apart relationship and extending through the corresponding third guide openings in the base member, in each of the first plurality of coupled guides passing through the corresponding third guide openings, in the intermediate member passing through the corresponding third guide openings, in each of the second plurality of coupled guides passing through the corresponding third guide openings, in the end member, and through the corresponding third guide openings in each of the third plurality of coupled guides. Each flexible control link of the third plurality has a first end connected to the tool holder and a second end extending away from the base member.

Pushing or pulling a control link of the first plurality of control links causes the base member, the first plurality of coupled guides, the intermediate member, the second plurality of coupled guides, and the end member to selectively define a continuous curve. When either the first or third flexible control links are pushed or pulled, the second plurality of control links causes the end member to maintain substantially the same orientation as the base member. Pushing or pulling a control link of the third plurality of control links causes the tool holder to selectively move into any one of a plurality of orientations such that the third plurality of coupled guides between the end member and the tool holder define a continuous curve from the end member to the tool holder.

The first, second and third pluralities of flexible control links may comprise wires capable of withstanding approximately 200 N of tension and compression without deformation and capable of withstanding strains of up to approximately 2% to 4%.

These wires may be composed of a metal alloy of nickel and titanium that exhibits shape memory and superelasticity.

The second plurality of control links may comprise wires of ordinary stiffness.

The base member, the intermediate member, the end member, the first tool holder, and the coupled guides of the first, second, and third pluralities of coupled guides may each have a generally cylindrical outer surface portion, and each generally cylindrical outer surface portion may have a common diameter.

The base member, the intermediate member, the end member, the first tool holder, and the coupled guides of the first, second, and third pluralities of coupled guides may each have a generally annular segment. At least one annular segment of the base member and at least one annular segment of each coupled guide of the first plurality of coupled guides may have a first guide opening. At least one annular segment of each coupled guide of the first and second pluralities of coupled guides and at least one annular segment of the intermediate member may have a second guide opening, and at least one annular segment of each of the base member, the intermediate member, the end member, and each coupled guide of the first, second, and third pluralities of coupled guides may have a third guide opening.

Each annular segment of a coupled guide of the first plurality of coupled guides may have opposing faces arranged at an acute angle to an axis of a central opening in the coupled guide.

Each annular segment of the second plurality of coupled guides may have opposing faces arranged at an acute angle to an axis of a central opening in the coupled guide.

Each annular segment of the third plurality of coupled guides may have opposing faces arranged at an acute angle to an axis of a central opening in the coupled guide.

The opposing faces of the annular segments of the coupling guides of the first and second pluralities of coupling guides may be arranged at a first acute angle to the axis, and the opposing faces of the annular segments of the coupling guides of the third pluralities of coupling guides may be arranged at a second acute angle to the axis, which may be different from the first acute angle.

The second acute angle may be greater than the first acute angle.

Adjacent pairs of coupled guides of the first, second and third pluralities of coupled guides may be coupled by at least one protrusion on one guide of the pair and a receiver on another guide of the pair for receiving the protrusion.

Each of the first, second, and third pluralities of coupled guides may have an axially extending protrusion with a truncated spherical portion and an axially aligned socket for receiving the axially extending protrusion of an adjacent coupled guide, thereby allowing adjacent coupled guides to spherically pivot relative to each other. The central opening of the coupled guide may have a first end at the protrusion and a second end in the socket, such that the central openings of adjacent coupled guides communicate with each other, thereby defining a central passage operable to receive a portion of a tool held by the tool holder.

The device may further include a first support conduit having first and second open ends, and the base may be connected to the first open end of the support conduit supporting the base, and the second end portions of the first and third control links may extend through the first support conduit and out of the second open end of the first support conduit.

According to another aspect of the present invention, a tool assembly is provided that includes the apparatus described above and further includes a first tool. The first tool may include a first end effector, a first coupler for coupling the first end effector to a first tool holder, and a first flexible shaft portion having a length substantially equal to a length defined between the base member and the tool holder, and a first rigid shaft portion having a length substantially equal to a length of the first support conduit. The tool may further include a first tool control link having a first end connected to the first end effector and a second end extending from the first rigid shaft portion. The first rigid shaft portion may be received in a central opening of the first tool holder and may extend through the central openings of the third plurality of coupled guides, through the central opening of the end member, through the central opening of the second plurality of coupled guides, through the central opening of the intermediate member, through the central opening of the first plurality of coupled guides, and through the central openings of the base member and the first support conduit, such that the first flexible shaft portion is coaxial with the tool positioning apparatus, the first rigid shaft portion is substantially coaxial with the first support conduit, and the second end of the first tool control link extends from the second end portion of the first support conduit.

According to another aspect of the present invention, a tool controller assembly is provided that includes the above-described tool assembly and further includes a first control mount. The first support conduit of the tool positioning device can be connected to the first control mount so that the first control mount can be on a first side of a first longitudinal axis of the first support conduit. The first control mount can have a first plurality of actuators connected to corresponding flexible control links of the first and third pluralities of flexible control links of the first tool positioning device, for selectively pushing and pulling on the second end portions of these corresponding flexible control links, thereby causing the base member, the first plurality of coupling guides, the intermediate member, the second plurality of coupling guides, and the end member to selectively define a continuous curve, and causing the tool holder to selectively move into any of a plurality of orientations such that the third plurality of coupling guides between the end member and the first tool holder device can define a continuous curve from the end member to the first tool holder. The first control mount can include a first tool actuator connected to the first tool control link of the first tool, for selectively pushing and pulling on the second end portion of the first tool control link to achieve operation of the end effector.

Each actuator of the first plurality of actuators and the first tool actuator may include a corresponding rotatable spool portion having a corresponding control link coupled thereto to allow a portion of the corresponding control link to be picked up or paid out from the spool portion in response to a corresponding rotation of the spool portion, and a corresponding driver for selectively rotating the spool portion in first and second opposite directions. When the spool portion is rotated in the first direction to pick up the corresponding control link, the corresponding control link may be pulled, and when the spool portion is rotated in the second direction to pay out a portion of the corresponding control link, the corresponding control link may be pushed.

Each drive may include a gear segment.

The first control mount may have a first mounting surface, and each gear segment may have a portion that projects beyond the first mounting surface to engage a corresponding drive gear on the first tool controller mount.

According to another aspect of the present invention, a tool controller mount is provided comprising a first tool controller assembly mounting interface as described above for holding a first tool controller, and may further comprise a first plurality of drive gears for engaging corresponding gear segments on the first tool controller assembly.

The drive gears of the first plurality of drive gears may include corresponding linear gear racks operably configured to slide linearly in parallel, spaced-apart relationship.

The apparatus may include a first plurality of linear actuators connected to corresponding linear gear racks for linearly sliding the linear gear racks to impart motion to corresponding gears of the second plurality of drive gears.

The apparatus may include a second tool controller mounting interface including a second plurality of drive gears for engaging corresponding gear segments on a second tool controller similar to the first tool controller described above.

The drive gears of the second plurality of drive gears may include corresponding linear gear racks operably configured to slide linearly in parallel, spaced-apart relationship.

The apparatus may include a second plurality of actuators connected to corresponding linear gear racks to linearly slide the linear gear racks to impart motion to corresponding drive gears of the second plurality of drive gears.

According to another aspect of the present invention, a tool monitoring device is provided that includes a positioning tube positioned to receive at least one support conduit of a tool controller assembly as described above. The positioning tube may have a length that is approximately the same as or shorter than the length of the support conduit, such that a tool holder supported by the support conduit extends from a distal end of the positioning tube. The tool monitoring device further includes a camera holder positioned off-axis of the positioning tube such that a camera can be directed toward an end effector of a tool held by the tool holder to facilitate visual monitoring of movement of the end effector.

The camera mount may include the tool mount. A support conduit of the camera mount may extend within the positioning tube, and a tool positioner of the camera mount may extend from a distal end of the positioning tube and be operably configured to hold and position the camera at a position offset from a second axis. The second axis may be substantially perpendicular to a longitudinal axis of the support conduit.

BRIEF DESCRIPTION OF THE DRAWINGS

In the accompanying drawings, embodiments of the present invention are shown.

1 is a perspective view of an articulated tool positioning device according to a first embodiment of the present invention;

FIG2 is a perspective view of the distal end of the base member of the device shown in FIG1;

FIG3 is a distal end view of the base member shown in FIG2 ;

FIG4 is a perspective view of the proximal side of the coupling guide of the device shown in FIG1 ;

FIG5 is a top view of the coupling guide shown in FIG1 ;

6 is an exploded view of two coupling guides of the device shown in FIG. 1 , including the coupling guides shown in FIGS. 4 and 5 ;

FIG7 is a side view of the coupled guide member shown in FIG6;

FIG8 is a perspective view of the apparatus shown in FIG1 , illustrating a curved configuration of the tool positioner shown in FIG1 ;

FIG9 is a perspective view of the proximal end face of the intermediate member of the device shown in FIG1 ;

FIG10 is a perspective view of the distal end surface of the intermediate member shown in FIG9;

FIG11 is a perspective view of the proximal side of the end member of the device shown in FIG1 ;

FIG12 is a perspective view of the distal side of the side member shown in FIG11;

FIG13 is a perspective view of the proximal side of the tool holder of the apparatus shown in FIG1 ;

FIG14 is a perspective view of the distal side of the tool holder shown in FIG13;

FIG15 is a side view of a tool assembly for use with the tool positioner shown in FIG1;

FIG16 is a perspective view of a tool assembly comprising the apparatus shown in FIG1 having the tool apparatus shown in FIG15 coupled thereto;

FIG17 is a perspective view showing a tool controller connected to the tool assembly shown in FIG16;

FIG18 is a perspective view of a laparoscopic surgical apparatus employing the apparatus shown in FIG17;

FIG19 is a side view of the head of the device shown in FIG18 and a coupler operably coupled to the head;

FIG20 is a side view of the head and coupler of FIG19 with the coupler connected to the head;

21 is a side view of the coupler connected to the head of FIGS. 19 and 20 with a sterile cover connected to the coupler wrapped around the head and adjacent components;

22 is a side view of the head and coupler of FIGS. 19-21 and a camera/delivery tube assembly operably coupled to the coupler;

FIG23 is a detailed view of the camera/delivery tube assembly shown in FIG22;

24 is a side view of the camera/delivery tube assembly shown in FIG. 23 coupled to the coupler shown in FIGS. 19-22 ;

Fig. 25 is a side view of a camera/delivery tube assembly coupled to the coupler and a tool positioning device of the type shown in Fig. 17 engaged therewith;

26 is a perspective view from below of the tool controller of FIG. 17 connected to the coupler of FIGs. 19-22 with the tube associated with the tool positioning apparatus inserted into the delivery tube shown in FIG. 23 ;

27 is a side view of the delivery tube of FIG. 23 with a first tube supporting the tool positioner of FIG. 1 extending therethrough;

28 is a side view of the apparatus of FIG. 27 further comprising a second tool support tube supporting a second tool positioner extending through the delivery tube of FIG. 23 ;

FIG29 is a side view of a laparoscopic surgical apparatus employing the apparatus described in FIG1-28; and

30 is a perspective view of a surgeon's workstation for controlling the apparatus shown in FIG. 29 .

Fig. 31 is a perspective view from below of two tool controls of the type shown in Fig. 17 on a coupler according to an alternative embodiment of the present invention;

Figure 32 is a segmented side view of the first and second articulated tool positioning devices extending at different distances from one end of the delivery tube of the connector shown in Figure 31 when the first and second tool controllers are arranged at different linear distances from the delivery tube on the first and second articulated tool positioning devices.

DETAILED DESCRIPTION

Referring to FIG. 1 , an articulated tool positioning device according to a first embodiment of the present invention is generally shown at 20. In this embodiment, the device 20 includes a base member 22, an intermediate member 24, an end member 26, and a first tool holder 28 arranged in series as shown in FIG. The base member 22 can be considered to be in a proximal position, while the tool holder can be considered to be in a distal position. Thus, the base member 22, the intermediate member 24, the end member 26, and the first tool holder 28 are arranged in series from the proximal position to the distal position.

The device 20 further includes a first plurality of coupled guides 30 disposed between the base member 22 and the intermediate member 24. At least one (32) of the first plurality of coupled guides 30 is coupled to the base member 22, and another (34) of the first plurality of coupled guides 30 is coupled to the intermediate member 24. Each of the first plurality of coupled guides 30 is coupled to an adjacent guide or to the base member 22 or the intermediate member 24.

The tool positioning device 20 further includes a second plurality of coupled guides 36 between the intermediate member 24 and the end member 26. At least one (38) of the second plurality of coupled guides 36 is coupled to the intermediate member 24, and another (40) of the second plurality of coupled guides 36 is coupled to the end member 26. Thus, each of the coupled guides of the second plurality of coupled guides 36 is connected to an adjacent second plurality of guides or to the intermediate member 24 or the end member 26.

The apparatus 20 further includes a third plurality of coupled guides 42 between the end member 26 and the tool holder 28. At least one (44) of the third plurality of coupled guides 42 is coupled to the end member 26, and another (46) of the third plurality of coupled guides 42 is coupled to the tool holder 28. Each of the third plurality of coupled guides 42 is thus connected to an adjacent third plurality of coupled guides or to the end member 26 or the tool holder 28.

2 , the base member 22 has a first, generally cylindrical outer surface portion 50 having a first diameter and a coaxial, generally cylindrical second surface portion 52 having a second diameter that is smaller than the first diameter. The surface portion 52 having the smaller diameter facilitates connection to an adjacent support conduit as will be described below.

1 , the intermediate member 24 also has a generally cylindrical outer surface portion 54, the end member 26 has a similar outer surface portion 56, and the tool holder 28 has a similar outer surface portion 58, all of which have the same diameter as the first outer surface portion 50 of the base member 22. Additionally, each of the coupled guides of the first, second, and third pluralities 30, 36, and 42 has a cylindrical outer surface portion, examples of which are shown at 60, 62, and 64, respectively. Thus, the tool positioning device 20 has a plurality of generally coaxially aligned components, all of which have outer surfaces having the same common diameter.

2 and 3 , the base member 22 has a generally cylindrical body with a distally facing end face 66 having an axially extending projection 68 with a truncated spherical portion 70 through which a central opening 72 is formed. The central opening 72 extends axially through the entire base member 22. The distally facing end face 66 also has receivers 74 and 76 arranged diametrically opposite each other and extending into the outer surface portion 50 for receiving corresponding projections on the coupling guide 32 shown in FIG.

1 and 2 , as will be explained below, the truncated ball portion 70 and the receivers 74 and 76 are used to couple the base member 22 to the coupled guides 32 of the first plurality of coupled guides 30 .

Referring back to FIGS. 2 and 3 , the distal facing end surface 66 further has a first plurality of guide openings 80 , 82 , 84 , 86 through which a first plurality of flexible control links 88 , 90 , 92 , 94 connected to the intermediate member 24 extend through the base member 22 .

In the illustrated embodiment, the distal-facing end face 66 also has a plurality of receptacles 96, 98, 100, and 102 to which corresponding ends of a second plurality of flexible control links 104, 106, 108, 110 extending between the base member 22 and the end member 26 are connected. In an alternative embodiment, the plurality of receptacles 96, 98, 100, and 102 may instead extend through a plurality of openings in the base member 22, thereby allowing the second plurality of flexible control links 104, 106, 108, 110 to extend through and out of the base member 22. In this alternative embodiment, corresponding ends of the second plurality of flexible control links 104, 106, 108, 110 are connected to a fixed object (not shown) spaced apart from the base member 22. The fixed object may be a tool controller of the type depicted at 602 in FIG. 17 , suitably modified so that corresponding ends of the second plurality of flexible control links 104, 106, 108, 110 are connected to, for example, the base plate 612.

The distal facing end surface 66 also has a third plurality of guide openings 112 , 114 , 116 , 118 through which a corresponding third plurality of flexible control links 120 , 122 , 124 , 126 connected to the tool holder 28 extend through the base member 22 .

Each link of the first, second, and third pluralities of flexible control links can be a single nitinol wire capable of withstanding approximately 200N of tension or compression without permanent deformation and capable of withstanding strains up to approximately 4%. Nitinol is an alloy of nickel and titanium that exhibits shape memory and superelasticity, and its ability to support both tension and compression allows the links to be selectively pushed or pulled with similar forces without permanent deformation, which provides precise control, actuation redundancy, and increased structural rigidity to the flexible control links. Accordingly, only two flexible control links are required in each of the first, second, and third pluralities of flexible control links to achieve the full range of motion of the tool holder relative to the base member 22.

Referring back to FIG1 , the first plurality of coupling guides 30 are configured to cause the tool positioning device 20 to have a flexible section while maintaining the first, second, and third flexible control links 88, 90, 92, 94, 104, 106, 108, 110, 120, 122, 124, 126 in a predefined spaced relationship relative to one another. Typically, the individual flexible control links within each plurality are angularly spaced on a circle such that the flexible control links of a given plurality are spaced as far apart from one another as possible. This reduces and balances actuation loads, increases the stiffness of the flexible section, and reduces the backlash effect when the direction of the forces on the flexible control links is changed in response to pushing and pulling of the flexible control links.

In the illustrated embodiment, the first plurality of coupled guides 30 includes fourteen coupled guides. Coupled guide 32 is an example of the first plurality of coupled guides 30 and is shown in greater detail in FIG.

4 , the coupling guide 32 has a body having proximal and distal facing sides 130 and 132 and first and second annular sections 134 and 136 .

The proximal-facing side 130 has first and second protrusions 138 and 140 disposed diametrically opposite one another with annular segments 134 and 136 defined therebetween. The protrusions 138 and 140 are operably shaped to be received in the receivers 74 and 76 on the base member 22. The annular segments 134 and 136 have receivers 142 and 144 disposed diametrically opposite one another and at an angular offset of 90 degrees from the first and second protrusions 138 and 140.

The proximal-facing side 130 also has a socket 146 having a shape complementary to the truncated spherical shape of the protrusion 68 on the base member 22 for receiving this protrusion therein. The protrusion 68 on the base member 22 and the socket 146 on the coupling guide 32 allow the coupling guide to pivot about the protrusion 68, and such pivoting is constrained in the vertical or pitch direction (e.g., up and down in the plane of the figure, FIG. 7 ) via the protrusions 138 and 140 being received in the receivers 74 and 76 on the distal-facing end face 66 of the base member 22.

5 , the cylindrical wall 148 defines a central opening 152 in the body of the coupling guide 32. The socket 146 terminates in a cylindrical wall 148 disposed in a truncated knob 150, which can be seen extending from the distal facing side 132 in FIG.

Referring back to FIG. 4 , the annular segments 134 and 136 have a first plurality of guide openings 160 , 162 , 164 and 166 that are generally aligned with the first guide openings 80 , 82 , 84 and 86 in the base member 22 to guide the first plurality of flexible control links ( 88 , 90 , 92 and 94 ) through the coupling guide 32 .

The annular segments 134 and 136 also have a second plurality of guide openings 168, 170, 172 and 174 that are roughly aligned with the second receivers 96, 98, 100 and 102 (shown in Figures 2 and 3) in the base member 22 to guide the second plurality of flexible control links (shown as 104, 106, 108 and 110 in Figures 2 and 3) through the connecting guide 32.

The annular segments 134 and 136 also have a third plurality of guide openings 176 , 178 , 180 and 182 that are generally aligned with the third plurality of guide openings 112 , 114 , 116 and 118 in the base member 22 to guide the third plurality of flexible control links ( 120 , 122 , 124 and 126 ) through the coupling guide 32 .

5 , the coupling guide 32 is shown viewed from above in the direction of arrow 189 in FIG1 . The annular segments 134 and 136 have portions 190 and 192, respectively, having angled surfaces 194 and 196 that form obtuse angles in a horizontal plane intersecting the axis 200 of the coupling guide 32. These surfaces 194 and 196 extend symmetrically at an angle of approximately 6 degrees to a first plane 198 perpendicular to the axis 200 of the coupling guide 32.

4 , the coupling guide 32 also has proximally facing surfaces 202 and 204 defined between the receivers 142 and 144 that form an obtuse angle in a vertical plane intersecting the axis 200 of the coupling guide 32. This can be seen as a slight incline in the proximally facing surface 202 in FIG5 , which forms an angle of approximately 6 degrees with a second plane 199 that is perpendicular to the axis 200 of the coupling guide 32 and provides for up to 6 degrees of rotation in the pitch direction relative to the base member 22.

6 , the distal-facing side 132 of the coupling guide 32 is shown together with the immediately distally adjacent coupling guide 60. The immediately distally adjacent coupling guide 60 is similar to the coupling guide 32 in that it includes an annular segment having the same first plurality of guide openings 160, 162, 164, and 166, the same second plurality of guide openings 168, 170, 172, and 174, and the same third plurality of guide openings 176, 178, 180, and 182. It also has a truncated knob 207 having an inner bore 209. On its proximal-facing side, it also has a socket (not shown) that is similar to the socket 146 in the coupling guide 32.

The immediately adjacent coupling guide 60 differs from coupling guide 32 in that it has receivers 210 and 212 where the protrusions 138 and 140 of coupling guide 32 are located, and has multiple protrusions, only one of which is shown at 214 where the receivers 142 and 144 of coupling guide 32 are located.

7 , the immediately adjacent coupled guide 60 has annular segments 216 and 218 extending between the receivers 210 and 212, the annular segments having portions 220 and 222 having distally facing surfaces 224 and 226 and proximally facing surfaces that form an obtuse angle in a vertical plane intersecting the axis of the immediately distally adjacent coupled guide 60, only one of these proximally facing surfaces being visible at 227 in FIG7 , extending between the receivers 210 and 212 that form an obtuse angle in a horizontal plane intersecting the axis 230. The distally facing surfaces 224 and 226 are arranged at an angle of approximately 6 degrees with a first vertical plane 228 that intersects and is perpendicular to the axis 230, and the proximally facing surfaces (only one of which is shown at 227) are arranged at an angle of approximately 6 degrees with a second vertical plane 229 that intersects the axis 230.

7 , it can be seen that the coupled guide 32 and the closely distally adjacent coupled guide 60 are coupled together to form a pair of coupled guides by receiving the protrusions 150 of the coupled guide 32 in the sockets (not shown) of the closely distally adjacent coupled guide 60 and receiving the proximally facing protrusions (only one of which is shown at 214) of the closely distally adjacent coupled guide 60 in corresponding receptacles (only one of which is shown at 144 of the coupled guide 32). The protrusions 150 and socket arrangement provide for pivoting in any direction, and the proximally facing protrusions 214 received in corresponding receptacles 144 prevent torsional movement of the closely distally adjacent coupled guide 60 relative to the coupled guide 32 about the axis 230 and restrict relative rotational movement, shown as the horizontal or yaw direction, i.e., in and out of the plane of the page. The immediately distally adjacent angled surface 227 of the coupling guide 60 faces the angled surface 196 of the coupling guide 32 and this provides up to a total of 12 degrees of clearance in the yaw direction for relative movement pivoting about the truncated knob 150 .

Similarly, the angled distal-facing surfaces 224 and 226 on the immediately distally adjacent coupling guide 60 will face proximally-facing surfaces that are like the surfaces 202 and 204 on the next distally adjacent coupling guide 205, and this will provide up to 12 degrees of relative rotational motion in the pitch direction between the immediately adjacent coupling guide 60 and the next distally adjacent coupling guide 205. Thus, each pair of coupling guides provides limited, restricted motion in both the pitch and yaw directions. More generally, all odd-numbered coupling guides are operable to rotate in the vertical plane (pitch direction), and all even-numbered coupling guides are operable to rotate in the horizontal plane (yaw direction).

Referring back to FIG1 , in the embodiment shown, the first plurality of coupled guides 30 includes seven pairs of coupled guides, enabling the first plurality of coupled guides to have pitch and yaw curvature components sufficient to define a continuous arc extending up to 90 degrees. Thus, the intermediate member 24 can be positioned in any orientation relative to the axis of the base member 22, up to an angle of approximately 90 degrees from the axis of the base member, as shown in FIG8 .

9 , the intermediate member 24 has a body having proximal and distal facing sides 250 and 252. The proximal facing side 250 has first and second annular sections 254 and 256 disposed between first and second protrusions 258 and 260 that protrude proximally toward the first plurality of coupled guides 30. These protrusions 258 and 260 are received in receivers, such as those shown at 210 and 212 in FIG6 in the immediately adjacent coupled guides 34 of the first plurality of coupled guides 30, as can be seen in FIG1 . Referring back to FIG9 , the proximal facing side 250 has a socket 262 that terminates in an annular wall 264 that defines a central opening 266 through the body. The protrusion of the immediately adjacent coupled guide 32 of the first plurality of coupled guides 30, as shown at 207 in Figure 6, is operably received in the receptacle 262, and the protrusions 258 and 260 are received in receivers similar to those of the immediately adjacent coupled guide 34 shown at 210 and 212 in Figure 6. This allows the immediately adjacent coupled guide 34 to pivot about the protrusion 207 in the pitch direction.

The intermediate member 24 further includes first, second, third and fourth receivers 270, 272, 274 and 276, which are arranged at positions aligned with the first set of guide openings 160, 162, 164 and 166 of the closely adjacent connecting guides 34 so as to respectively receive and retain the ends of the first plurality of flexible control links 88, 90, 92 and 94, which extend through the first set of guide openings 160, 162, 164 and 166 of the closely adjacent connecting guides 34.

The proximal facing side 250 further includes a second plurality of openings 280, 282, 284, and 288 extending completely through the intermediate member 24 for guiding therethrough the second plurality of flexible control links 104, 106, 108, and 110. Additionally, the proximal facing side 250 includes a third plurality of guide openings 290, 292, 294, and 296 extending entirely through the intermediate member 24 for guiding therethrough the third plurality of flexible control links 120, 122, 124, and 126.

10 , the intermediate member 24 further includes a protrusion 300 protruding from the distal-facing side 252 and having first and second receivers 302 and 304 diametrically opposed and disposed in the outer surface portion 54 and terminating at an end surface 306 of the distal-facing side 252. Referring back to FIG1 , the receivers 302 and 304 receive corresponding protrusions on the immediately adjacent coupled guides 38 of the second plurality of coupled guides 36. The second plurality of coupled guides 36 is identical to the first plurality of coupled guides described above with respect to FIG4 through FIG7 .

11 , the end member 26 has a body having proximal and distal facing sides 350 and 352. The proximal facing side 350 has first and second annular sections 354 and 356 disposed between first and second protrusions 358 and 360 that protrude proximally toward the second plurality of coupled guides 36. These protrusions 358 and 360 are received in receivers, such as those shown at 210 and 212 in FIG6 , in the immediately adjacent coupled guides 40 of the second plurality of coupled guides 36, as can be seen in FIG1 . Referring back to FIG11 , the proximal facing side 350 has a socket 362 that terminates in an annular wall 364 that defines a central opening 366 through the body. The protrusions of the adjacent coupled guides 40 of the second plurality of coupled guides 36 as shown at 207 in Figure 6 are operably received in the sockets 362, and the protrusions 358 and 360 are received in receivers similar to those of the immediately adjacent coupled guides 40 shown at 210 and 212 in Figure 6. This allows the immediately adjacent coupled guides 40 to pivot about the protrusions (207) in the pitch direction.

The end member 26 further includes first, second, third and fourth receivers 370, 372, 374 and 376, which are arranged at positions aligned with the second set of guide openings 168, 170, 172 and 174 in the adjacent connecting guides 40 so as to respectively receive and retain the ends of the second plurality of flexible control links 104, 106, 108 and 110, which extend through the second guide openings 168, 170, 172 and 174 in the adjacent connecting guides 40.

The proximal-facing side 350 further includes a third plurality of openings 380 , 382 , 384 , and 386 extending completely through the tip member 26 for guiding the third plurality of flexible control links 120 , 122 , 124 , and 126 therethrough.

12 , the end member 26 further includes a protrusion 400 that protrudes from the distal-facing side 352 and has first and second receivers 402 and 404 that are disposed in the outer surface portion 56 and terminate in a flat annular end surface 406 of the distal-facing side 352. Referring back to FIG1 , the receivers 402 and 404 receive corresponding protrusions on the immediately adjacent coupled guides 44 of the third plurality of coupled guides 42.

The third plurality of coupled guides 42 comprises coupled guides identical to those shown in Figures 4 to 7, except that surfaces 194 and 196 extend symmetrically at an angle of approximately 8.5 degrees to a first plane 198 perpendicular to the axis of the coupled guides, and proximally facing surfaces 202 and 204 form an angle of approximately 8.5 degrees to a second plane 199 perpendicular to the axis of the coupled guides. With the angles of the planes indicated on the third plurality of coupled guides being slightly greater than those on the first and second pluralities of coupled guides, the third plurality of coupled guides can include fewer elements, such as in the embodiment shown, where there are only approximately 10 coupled guides, and enable the portion extending from the distal member 26 to bend at a tighter radius than the first and second pluralities of coupled guides 30 and 36 shown in Figure 8.

13 and 14 , the tool holder 28 has a body having proximal and distal facing sides 450 and 452. The proximal facing side 450 has first and second annular segments 454 and 456 disposed between first and second protrusions 458 and 460 that protrude proximally toward the third plurality of coupled guides 42. These protrusions 458 and 460 are received in receivers, such as those shown at 210 and 212 in FIG6 , in the immediately adjacent coupled guides 46 of the third plurality of coupled guides 42, as can be seen in FIG1 . Referring back to FIG13 , the proximal facing side 450 has a socket 462 that terminates in an annular wall 464 that defines a central bore 466 extending through the body. The protrusion of an adjacent coupled guide 46 of the third plurality of coupled guides 42, as shown at 207 in Figure 6, is operably received in the socket 462, and the protrusions 458 and 460 are received in receivers similar to those of the immediately adjacent coupled guide 46 shown at 210 and 212 in Figure 6. This allows the immediately adjacent coupled guide 46 to pivot about the protrusion 207 in the pitch direction.

The tool holder 28 further includes first, second, third and fourth receivers 470, 472, 474 and 476, which are arranged at positions aligned with the third set of guide openings 176, 178, 180 and 182 of the adjacent connecting guides 46 so as to respectively receive and hold the ends of the third plurality of flexible control links 120, 122, 124 and 126, which extend through the second set of guide openings 176, 178, 180 and 182 of the closely adjacent connecting guides 46.

14 , the tool holder 28 has a flat annular end face 500 on the distal-facing side 452, and the inner bore 466 is connected to the annular end face 500. Aligned openings 502 and 504 are aligned on a chord extending through the wall 464 and are operable to receive, for example, a threaded fastener for securing a tool in the tool holder 28 such that the tool can be axially rotated therein.

Referring to FIG15 , an exemplary tool for use in the tool holder shown in FIGS. 13 and 14 is generally shown at 550. In the illustrated embodiment, the tool 550 includes an end effector 552, which in the illustrated embodiment includes a gripper having a fixed jaw extending from a base 558 and pivotally opposed jaws 554 and 556. Other tool arrangements may alternatively be employed. For example, the tool may alternatively be a cauterization device, a suction device, a retraction device, or a gripping device. In the illustrated embodiment, a flexible tool control link 560 is connected to the pivoting jaw 556 and extends through an axial opening in the base 558, thereby opening and closing the pivoting jaw 554 on the fixed jaw 556 in response to linear movement of the flexible control link 560.

The tool 550 further includes a coupler comprised of first and second spaced-apart cylinders 562 and 564 rigidly connected to the base 558 and having outer cylindrical surfaces 563 and 565 that are slightly smaller than the diameter of the inner bore 466 in the tool holder 28 so that the tool 550 can be snugly retained in the tool holder 28. A flexible conduit 566 having a length approximately equal to the distance between the tool holder 28 and the base member 22 has a first end 568 connected to the cylinder 564 and a second end 570 connected to a first end 572 of a rigid conduit 574 via a crimp connector 576. A flexible tool control link 560 extends through the cylinders 562 and 564, through the flexible conduit 566, and through the rigid conduit 574 and has a second end 578 that extends outwardly from a proximal end 580 of the rigid conduit 574. Accordingly, linear movement of the second end 578 of the flexible tool-controlled link 560 relative to the proximal end 580 of the rigid conduit 574 causes the pivoting jaws 556 to open and close.

15 and 16 , a tool 550 is shown mounted in a tool holder 28 such that only the base 558 and jaws 554 and 556 protrude distally from the tool holder, and a flexible conduit 566 extends through the central opening 152 in the third plurality of coupling guides 42, the central opening 266 in the end member 26, the central opening 152 in the second plurality of coupling guides 36, the central opening 266 in the intermediate member 24, and the central opening (152) in the first plurality of coupling guides 30. A crimp connector 576 is positioned in the central opening 72 of the base member 22 and has approximately the same length as the base member, and a rigid conduit 574 extends proximally outwardly from the base member. Thus, the tool 550 mounted in the tool holder forms a tool assembly 600 consisting of the tool 550 and the tool positioning device 20.

17 , a tool assembly 600 is connected to a tool controller 602 that includes a second rigid conduit 604 having a first end 606 rigidly connected to the reduced diameter outer surface portion 52 of the base member 22 and a second end 608 connected to a drive mechanism 610. The drive mechanism 610 includes a base plate 612 having a conduit connector 614 for rigidly connecting the second rigid conduit 604 to the base plate 612. Additionally, the drive mechanism includes a rotary joint 616 connected to the proximal end 580 of the rigid conduit 574, such that rotation of the rotary joint 616 causes corresponding rotational movement of the rigid conduit 574 about its axis. A rotationally flexible control link 618 is connected to the rotary joint 616 and routed to a rotational spool 620 connected to a gear segment 622, such that when the gear segment rotates, the rigid conduit 574 rotates by a corresponding amount. This rotation of the rigid conduit 574 causes the tool 550 to rotate by a corresponding amount.

The first, third, and tool flexible control links 88, 90, 92, and 94; 120, 122, 124, and 126; and 560 extend through the interior of the second rigid conduit 604 and exit from the second end 608 of the second rigid conduit 604. The drive mechanism 610 has a link guide, shown generally at 624, for guiding the tool control link 560 to a tool spool 626 connected to a tool gear segment 628. The tool control link 560 is wound around the tool spool 626 such that rotation of the tool gear in a first direction opens the end effector 552 of the tool 550, and rotation of the tool spool 626 in a second, opposite direction closes the end effector.

Two of these third flexible control links, for example links 120 and 126 or links 122 and 124, in the horizontal plane with the tool holder 28 are wound in opposite directions on a horizontal tool control spool 630, which is connected to a horizontal tool control gear 632, so that rotation of the horizontal tool control gear 632 in a first direction pulls, say, the left link 120 or 122 while pushing the corresponding right link 126 or 124, and rotation of the horizontal tool control gear 632 in a second direction opposite to the first direction pushes the left link 120 or 122 while pulling the corresponding right link 126 or 124. This has the effect of moving the tool holder 28 to the left or right.

Two of these third flexible control links in the vertical plane at the tool holder 28, such as links 120 and 122 or links 124 and 126, depending on which of these links are not already connected to the horizontal tool control spool 630, are wound in opposite directions on a vertical tool control spool 634, which is connected to a vertical tool control gear 636, such that rotation of the vertical tool control gear 636 in a first direction pulls, say, the upper link 120 or 126 while pushing the corresponding lower link 122 or 124, and rotation of the vertical control gear 636 in a second direction, opposite to the first direction, pushes the upper link 120 or 122 while pulling the corresponding lower link 122 or 124. This has the effect of moving the tool holder 28 up and down.

Two of these first flexible control links, for example links 88 and 94 or links 90 and 92, in the horizontal plane of intermediate member 24 are wound in opposite directions on a horizontal s-curve control spool 638, which is connected to a horizontal s-curve gear 640, so that rotation of the horizontal s-curve control gear 640 in a first direction pulls, say, left link 88 or 90 while pushing the corresponding right link 92 or 94, and rotation of the horizontal s-curve control gear 640 in a second direction opposite to the first direction pushes the left link 88 or 90 while pulling the corresponding right link 92 or 94. This has the effect of moving intermediate member 24 to the left or right.

Two of these first flexible control links in the vertical plane at the intermediate member 24, such as links 88 and 90 or links 92 and 94, depending on which of these links are not already connected to the horizontal s-curve control spool 638, are wound in opposite directions on a vertical s-curve control spool 642, which is connected to a vertical s-curve control gear 644, such that rotation of the vertical s-curve control gear 644 in a first direction pulls, say, the upper link 88 or 94 while pushing the corresponding lower link 90 or 92, and rotation of the vertical s-curve control gear 644 in a second direction, opposite to the first direction, pushes the upper link 88 or 94 while pulling the corresponding lower link 90 or 92. This has the effect of moving the intermediate member 24 up and down.

Although spools 626, 620, 630, 634, 638, and 642, and corresponding gear segments 628, 622, 632, 636, 640, and 644 are arranged in the particular order depicted in FIG17, the order is not important. Thus, for example, spool 626 and corresponding gear segment 628 can be arranged so that they are positioned between spool 620 and corresponding gear segment 622, and spool 630 and corresponding gear segment 632.

A second plurality of flexible control links 104, 106, 108, and 110 connected between the base member 22 and the end member 26 act like a two-dimensional parallelogram tending to maintain the end member 26 in the same orientation as the base member 22. The first plurality of flexible control links 88, 90, 92, and 94 cause the intermediate member 24 to move, but the parallelogram effect of the second plurality of control links maintains the end member 26 in the same orientation as the base member 22. Similarly, the third plurality of control links 120, 122, 124, and 126 cause the tool holder 28 to move, but again the end member 26 is held within the constraints of the parallelogram formed by the second plurality of flexible control links and in the same orientation as the base member 22.

While the second plurality of flexible control links 104, 106, 108, and 110 have been shown connected between the base member 22 and the end member 26, it is only necessary to secure the proximal ends of the second plurality of flexible control links to some reference point. Thus, for example, they need not be connected to the base member 22 but could instead be connected to some other fixed structure located proximally away from the base member 22.

Thus, by rotating gear segments 622, 628, 632, 636, 640, and 644, the end effector can be moved with five degrees of freedom, and the jaws can be opened and closed. As described below, a suitable gear drive mechanism can be used to drive gear segments 622, 628, 632, 636, 640, and 644 to spatially manipulate end effector 550 to perform an operation. Such an operation can be, for example, a medical operation.

For example, the apparatus described herein can be used to perform laparoscopic surgery, such as shown in FIG18 . To this end, a movable platform 700 is provided to which is mounted a housing 702 housing a computer 704, which is connected, either wired or wirelessly, to a computer network, such as an Ethernet network. A coarse positioning mechanism, generally shown at 706, is connected to the housing 702 and has a head 708 to which the tool controller 602 shown in FIG17 is ultimately mounted. The coarse positioning mechanism 706 and the movable platform 700 allow the head 708 to be spatially positioned so that the tool positioning apparatus 20 can be placed at a location within the patient's body, thereby allowing the desired laparoscopic surgery to be performed.

Referring to FIG19 , to facilitate connection of the tool controller (602) to the head 708 while maintaining a sterile environment, the head is equipped with a first portion 712 of a mechanical connector and first and second pluralities of spaced-apart, coaxial drive gear segments, only one of each of which is shown at 710 and 711 in FIG19 . As will be described below, the first plurality of drive gear segments controls the position of the camera, and the second plurality of drive gear segments controls the tool controller (602). In this embodiment, corresponding separate motors (only two shown at 714 and 715) are provided to independently drive each drive gear in a certain direction and at a certain speed for a certain time in response to control signals received from the computer 704 shown in FIG18 .

Computer 704 can receive instructions from the network to control the motors, and a separate computer (shown in FIG30 ) connected to an input device controlled by the operating surgeon can generate instructions in response to, for example, movements of the operating surgeon's hands, fingers, and arms and transmit them to the network. The operating surgeon can be located near the patient in the operating room or remotely anywhere in the world.

The coupler 720, which includes a housing 722 and a second connector portion 724 of a mechanical connector, has a plastic cover 726 attached around the perimeter of the housing 722, just below the second connector portion 724 of the mechanical connector. Before the second connector portion 724 of the mechanical connector is connected to the first connector portion 712, the plastic cover 726 is arranged to hang downwardly, with the open end portion 728 of the plastic cover 726 facing downward. The coupler 720 is then moved into position so that the second connector portion 724 mates with the first connector portion 712, as shown in FIG20. Then, referring to FIG21, the plastic cover 726 is raised above the head 708 and onto a portion of the coarse positioning arm 706, leaving only the portion of the coupler 720 below the perimeter line (where the plastic cover 726 is attached to the housing 722) exposed to the patient.

22 , a coupler 720 is used to couple a camera/delivery tube assembly 730 to the head 708 and further used to connect one or more tool controllers of the type shown at 602 in FIG. 17 to the head 708 .

The camera/delivery tube assembly includes a base 732 having a connector portion 734 that mates with a corresponding connector portion 736 on the coupler 720. A clear plastic delivery tube 738 (approximately 1 inch (2.5 cm) in diameter, approximately 20 inches (51 cm) long, and having a wall thickness of approximately 0.035 inches (0.1 cm)) has a proximal end portion 740 connected to the base 732 and a distal second end portion 742. A camera assembly 748 including a camera 750 and a camera positioner 752 is positioned at the distal end of the delivery tube, and a rigid camera positioner support tube 754 extends from the distal second end portion 742 of the delivery tube 738 from the camera positioner 752 on the delivery tube 738 and is rigidly connected to the base 732. Referring to FIG23 , the camera positioner 752 can be identical to the tool positioner 20 and coupled to a camera controller 760 (similar to the tool controller shown at 602 in FIG17 ), enabling the camera 750 to be positioned on or off the axis 762 of the delivery tube 738. The camera 750 does not need to have the same range of motion as the tool positioner 20 described previously, so fewer flexible control links can be used in the camera positioner 752. For example, only two of the first flexible control links may be needed to move the camera positioner 752 in an off-axis vertical direction of the delivery tube 738, and no flexible control link may be required to rotate the tool. This simplifies the camera controller 760 because it has fewer spools and gear segments. Only one gear segment is shown at 761 in FIG23 , but there are as many gear segments as there are flexible control links for controlling the camera position. Referring back to FIG19 , each gear segment engages a corresponding linear gear rack 763 on the coupling. The linear gear rack 763 on the connector 720 has an upward facing gear portion that engages with the gear segment 711 on the head 708 and has a downward facing gear portion that engages with the gear segment 761 on the camera/delivery tube assembly 730 shown in Figure 23.

Returning to reference Figure 19, the connector 720 also has a plurality of linear gear racks having upward-facing gear portions 765 for engaging corresponding gear segments 710 on the head 708, and having downward-facing gear portions 767 for engaging corresponding gear segments on at least one tool controller such as 602 in Figure 17, as will be described below.

Referring back to FIG23 , the base 732 further has an optical connector 770 and an electrical connector 772 protruding proximally from the base 732, such that when the base is coupled to the adapter 720 shown in FIG22 , they mate with corresponding optical and electrical connectors 774 and 776 on the head 708. The optical connector 774 on the head 708 provides light via an optical fiber 778, and a corresponding optical fiber 780 connected to the optical connector 770 on the base 732 is routed through the camera positioner and terminates at a location above the lens 781 on the camera 750, thereby illuminating the subject being imaged by the camera 750. The electrical connector 772 on the base connects to the camera 750 to receive image signals and transmits these image signals to the electrical connector 776 on the head 708, and then to the computer 704 shown in FIG18 . The camera 750 may have two lenses or be otherwise configured to produce 3D image signals, for example. When necessary, computer 704 formats these image signals and transmits them to a network so that they can be captured by devices connected to the network, including a display that can be positioned at or near an input device operated by the surgeon.

Referring back to FIG. 23 , the delivery tube 738 has a proximal portion 782 that extends rearwardly of the base 732 .

24, the base 732 is shown coupled to the coupler 720 so that the gear segments (one of which is shown at 711) for controlling the camera positioner 752 engage with a linear gear rack 763 on the coupler 720. Additionally, the gear segment 710 associated with the tool positioner engages with a corresponding linear gear rack 765 on the coupler 720. Space is provided near the linear gear rack 765 so that at least one tool controller can be mounted in the space in such a manner that the gear segments (628, 622, 632, 636, 640, and 644 on the tool controller 602) engage with corresponding linear gear racks, only one of which is shown at 765 in FIG24. Also in the position shown in FIG24, optical connectors (770) and (774) connect with electrical connectors (772) and (776) to allow light to be transmitted to the camera head and to allow the camera to send image signals to the computer 704 in FIG18. Likewise, when the camera/delivery tube assembly 730 is connected to the coupler 720 , the proximal end portion 782 of the delivery tube is disposed adjacent the space adjacent the linear gear rack 765 .

25, with the camera/delivery tube assembly 730 connected to the coupler 720, the tool controller 602 can be installed. Referring to FIG26, to install the tool controller 602, the tool controller is positioned so that the tool 550 is inserted into the proximal portion 782 of the delivery tube (738) and pushed through the delivery tube until the tool 550 and the tool locator 20 extend outward from the distal second end portion 742 of the delivery tube, as shown in FIG27. Thus, the second rigid conduit 606 extends inside the delivery tube parallel to the camera locator support tube 754, and the tool locator 20 can move freely in the space adjacent to the distal second end portion 742 of the delivery tube. 26 and 27 , the length of the second rigid conduit 606 is preconfigured so that the tool locator 20 is completely outside the delivery tube 738 when the gear segments 628 , 622 , 632 , 636 , 640 and 644 are engaged with their respective linear gear racks ( 629 , 623 , 633 , 637 , 641 and 645 ).

Referring to FIG. 26 , in this illustrated example, the coupler 720 has first and second linear rack and pinion assemblies 800 and 802 operable to receive first and second tool controllers, respectively. The first tool controller is shown at 602, and the second tool controller is shown in interrupted outline at 804. In the above-described design of the first tool controller 602, each gear segment 628, 622, 632, 636, 640, and 644 has symmetrically opposing gear segments 928, 922, 932, 936, 940, and 944 on the same hub. These gear segments 928, 922, 932, 936, 940, and 944 are located in corresponding parallel planes at a predetermined distance from the parallel plane of the base plate 612 and protrude beyond the edge 950 of the base plate 612 by the same amount that their corresponding opposing gear segments protrude beyond the opposing edge 952 of the base plate 612. In the illustrated embodiment, the first tool control 602 is mounted on the coupler 720 for cooperation with the first linear rack and pinion assembly 800 , with an edge 952 of the first tool control 602 facing the first linear rack and pinion assembly 800 when mounted for such cooperation.

The second tool controller 804 is identical to the first tool controller 602, except that it is mounted in a mirror-image orientation relative to the first tool controller 602, as shown in broken outline in FIG26. In this orientation, edge 954 of the second tool controller 804, corresponding to edge 950 of the first tool controller 602, faces the second linear rack and pinion assembly 802, and the gear segments of the second tool controller 804 (equivalent to 928, 922, 932, 936, 940, and 944 of the first tool controller 602) engage corresponding linear rack and pinion segments of the second linear rack and pinion assembly 802. Thus, the second tool positioner 812 connected to the second tool controller 804 can communicate with the delivery tube 738, thereby extending outside the delivery tube, as shown in FIG28.

With reference to FIG29 , the laparoscopic surgical apparatus shown in FIG18 is further described, using the components described above connected together as described. The head 708 can be moved using the movable platform 700 to the position shown, wherein the tools 550 and 810 and the camera 750 are positioned within the patient's body through a single, relatively small incision (not shown). Initially, the camera 750 and the first and second tool positioners are positioned so as to be closely adjacent to each other within the diameter of the delivery tube 738 to facilitate insertion of the camera, the first and second tool positioners 20 and 812, and the tools 550 and 810 thereon into the patient's body through the small incision. The patient can then be insufflated with CO2 in a conventional manner, and the camera can then be positioned, for example, upwardly, off-axis relative to the delivery tube, and positioned so that its field of view encompasses, for example, the position of the tools 550 and 810. The camera 750 may also have a zoom capability to zoom in on any particular area of interest within the patient's body near the tools 550 and 810. The tools 550 and 810 can then be positioned and manipulated to perform the procedure while their movements are observed via the camera 750 .

The positioning and manipulation of the tools 550 and 810 are guided by a surgeon operating a workstation having a 3D door 862, such as that shown at 860 in FIG. 30 , which is used, for example, to view a three-dimensional image on a screen generated by the camera 750 and has left and right input devices 864 and 866, a handstand 868, and a support cabinet 870 mounted on a movable platform 872. The movable platform may have first and second foot switches 874 and 876. The support cabinet 870 may include a computer 878 that is operably configured to receive signals from the left and right input devices 864 and 866 and from the first and second foot switches 874 and 876 and to generate and transmit command signals over a network to the computer of the laparoscopic surgical apparatus 850 shown in FIG. 29 to cause the linear racks and pinions to move in a direction and distance that will accomplish the desired movement of the tools.

As mentioned above, the end effector or tool can be moved with five degrees of freedom by pushing or pulling different links of the first, second, and/or third plurality of flexible control links 88, 90, 92, 94, 104, 106, 108, 110, 120, 122, 124, 126 by moving corresponding ones of these linear rack and pinion assemblies. A sixth degree of freedom of movement is provided by moving the tool assembly 600 and tool controller 602 in a direction along the axis of the second rigid guide tube 604. Such movement can be provided by moving the head 708 in a linear direction along a line that is aligned with, for example, the delivery tube 738.

Alternatively, referring to Figures 26 and 31, in an alternative embodiment of the coupling 720, the first and second linear rack and pinion assemblies 800 and 802 can be formed on separate bases 900 and 902, and the cooperating rack and pinion (765 on the coupling 720) can be made long enough to allow the first and second linear rack and pinion assemblies 800 and 802 to move linearly relative to the base 904 of the coupling 720, thereby providing a sixth degree of freedom of movement in the axial direction of the delivery tube 738. To achieve this movement, the base 904 can be equipped with first and second rack and pinion assemblies 906 and 908, which engage with corresponding linear gear segments (not shown) on the bottom surfaces of the first and second bases 900 and 902. The first and second rack and pinion assemblies can be actuated by corresponding mating rack and pinion assemblies (not shown) on the head 708 in a manner similar to the manner in which the separate racks of the first and second linear rack and pinion assemblies 800 and 802 are actuated.

In an alternative embodiment of the connector 720 shown in Figure 31, referring to Figure 32, when the first and second tool controllers 602 and 804 are arranged at different distances from the proximal portion 782 of the delivery tube, the corresponding tool locators 20 and 812 are arranged at different distances from the distal portion 742 of the delivery tube, wherein the tool locators position the corresponding tools 550 and 810 at different distances from the distal portion of the delivery tube.

Advantageously, the apparatus described herein provides for different types of tools to be held by the same type of tool positioning device, which separates the tool positioning function from the tool operating function. Thus, a single type of tool positioner can be provided, and different types of tools can be selectively used in the tool positioning device if desired. Additionally, the apparatus provides for left and right surgical tools to be received through the same incision in the patient, and allows these tools to be positioned on opposite sides of the axis defined by the delivery tube. This enables access to the area in which the operation is being performed from either side, allowing the surgeon to perform the operation directly in much the same manner as if in conventional fashion. Furthermore, the same tools used to perform the function of the end effector can be rotated about their longitudinal axis, thereby providing for more convenient and independent positioning of the end effector.

While specific embodiments of the present invention have been described and shown, such embodiments should be considered illustrative of the invention only and not limiting of the invention as construed according to the appended claims.

Claims (27)

1. A hinged tool positioning device, the device comprising: A base member, an intermediate member, an end member, and a first tool holder are arranged in a continuous manner, each of which has a corresponding central opening; A first plurality of connecting guides are provided between the base member and the intermediate member, wherein at least one of the first plurality of connecting guides is connected to the base member, and at least one of the first plurality of connecting guides is connected to the intermediate member, and wherein each of the first plurality of connecting guides has a corresponding central opening. A second plurality of connecting guides are provided between the intermediate member and the end member, wherein at least one of the second plurality of connecting guides is connected to the intermediate member, and at least one of the second plurality of connecting guides is connected to the end member, and wherein each of the second plurality of connecting guides has a corresponding central opening; A third plurality of connecting guides are provided between the end member and the tool holder, wherein at least one of the third plurality of connecting guides is connected to the end member and at least one of the third plurality of connecting guides is connected to the tool holder, and wherein each of the third plurality of connecting guides has a corresponding central opening. A first guide opening in the base member and a corresponding generally aligned first guide opening in each of the first plurality of connecting guides; The first plurality of flexible control links are arranged in a parallel, spaced-apart relationship and extend through corresponding openings of the first guide openings in the base member and through corresponding openings of the respective first guide openings in the first plurality of connecting guides. Each of the first plurality of flexible control links has a corresponding first end portion connected to the intermediate member and a corresponding second end portion extending away from the base member. The second guide opening in the intermediate member and the corresponding generally aligned second guide openings in each of the first and second plurality of connecting guides; The second plurality of flexible control links are arranged in a parallel, spaced-apart relationship, each having a first end connected to the end member, a second end connected to at least one of the base member and an object spaced apart from the base, and having an intermediate portion between the first end and the second end, each of the intermediate portions extending through a corresponding second guide opening in the intermediate member and through a corresponding second guide opening in each of the first and second plurality of connecting guides. A third guide opening, wherein the third guide opening is in the base member, and in each of the first plurality of connecting guides, and in the intermediate member, and in each of the second plurality of connecting guides, and in the end member, and in each of the third plurality of connecting guides; and A third plurality of flexible control links are arranged in a parallel, spaced-apart relationship and extend through the corresponding third guide opening in the base member, in each of the first plurality of connecting guides passing through the corresponding third guide opening, in the intermediate member passing through the corresponding third guide opening, in each of the second plurality of connecting guides passing through the corresponding third guide opening, in the end member, and in each of the third plurality of connecting guides, each of the flexible control links has a first end connected to the tool holder and a second end extending away from the base member; The first and third flexible control links are both pushable and pullable. The selective pushing and pulling of the control links of the first plurality of control links causes the base member, the first plurality of connecting guides, the intermediate member, the second plurality of connecting guides and the end member to selectively define the position of a continuous curve; When either the first or third flexible control link is selectively pushed and pulled, the second plurality of control links cause the end member to maintain approximately the same orientation as the base member; and The control links of the third plurality of control links, which are selectively pushed and pulled, cause the tool holder to move selectively to any of a plurality of orientations, such that the third plurality of connection guides between the end member and the tool holder define a continuous curve from the end member to the tool holder. 2. The device as claimed in claim 1, wherein the first, second, and third plurality of flexible control links comprise metal wires capable of withstanding tension and compression of approximately 200 N without deformation, and capable of withstanding strain of up to 2% to 4%. 3. The device as claimed in claim 2, wherein at least one of the metal wires is composed of a nickel-titanium metal alloy having shape memory and superelasticity. 4. The apparatus as claimed in claim 1 or 2, wherein the second plurality of control links comprises metal wires having ordinary stiffness. 5. The apparatus of claim 1 or 2, wherein the base member, the intermediate member, the end member, the tool holder, and the connecting guides of the first, second, and third plurality of connecting guides each have a generally cylindrical outer surface portion, each of the generally cylindrical outer surface portions having a common diameter. 6. The apparatus of claim 5, wherein the base member, the intermediate member, the end member, the tool holder, and each of the first, second, and third plurality of connecting guides has a generally annular segment, and wherein: At least one annular segment of the base member and at least one annular segment of each of the first plurality of connecting guides have the first guide opening. At least one annular segment of each of the first and second plurality of connecting guides and at least one annular segment of the intermediate member have the second guide opening; and At least one annular segment of each of the base member, the intermediate member, the end member, and each of the first, second, and third plurality of connecting guides has the third guide opening. 7. The apparatus of claim 6, wherein each of the annular segments of the first plurality of coupling guides has a face arranged at an acute angle to the axis of the central opening in the coupling guide. 8. The apparatus of claim 7, wherein each of the annular segments of the second plurality of coupling guides has a face arranged at an acute angle to the axis of the central opening in the coupling guide. 9. The apparatus of claim 8, wherein each of the annular segments of the third plurality of connecting guides has a face arranged at an acute angle to the axis of the central opening in the connecting guide. 10. The apparatus of claim 9, wherein the opposing faces of the annular segments of the first and second plurality of connecting guides are arranged at a first acute angle to the axis, and wherein the opposing faces of the annular segments of the third plurality of connecting guides are arranged at a second acute angle to the axis, the second acute angle being different from the first acute angle. 11. The apparatus of claim 10, wherein the second acute angle is greater than the first acute angle. 12. The apparatus according to any one of claims 6-11, wherein adjacent coupling guide pairs of the first, second, and third plurality of coupling guides are coupled by at least one protrusion on one guide of the pair and a receiver on the other guide of the pair for receiving the protrusion. 13. The apparatus of any one of claims 1, 2, 6-11, characterized in that each of the first, second, and third plurality of coupling guides has an axially extending protrusion having a truncated spherical portion and a socket for receiving an axially aligned protrusion of an adjacent coupling guide to allow adjacent coupling guides to pivot spherically relative to each other, the central opening of the coupling guide having a first end on the protrusion and a second end in the socket such that the central openings of adjacent coupling guides communicate with each other, thereby defining a central channel that operatively receives a portion of a tool held by the tool holder. 14. The apparatus of any one of claims 1, 2, 6-11, further comprising a first support conduit having first and second open ends, the base being connected to the first open end of the support conduit supporting the base, and the second end portion of the first and third control links extending through the first support conduit and extending from the second open end of the first support conduit. 15. A tool assembly comprising the apparatus of claim 14, the tool assembly further comprising a first tool including a first end effector, a first connector for coupling the first end effector to a first tool holder, a first flexible shaft portion having a length substantially equal to the length defined between the base member and the tool holder, a first rigid shaft portion having a length substantially equal to the length of the first support conduit, and a first tool control link having a first end connected to the first end effector and a second end extending away from the first rigid shaft portion, the first rigid shaft portion being received in the central opening of the first tool holder and extending through the central opening of the third plurality of coupling guides, the central opening of the end member, the central opening of the second plurality of coupling guides, the central opening of the intermediate member, the central opening of the first plurality of coupling guides, the central opening of the base member, and the first support conduit, such that the first flexible shaft portion is coaxial with the tool positioning device, and the first rigid shaft portion is substantially coaxial with the first support conduit, and such that the second end portion of the first tool control link extends away from the second end portion of the first support conduit. 16. A tool controller assembly comprising the tool assembly of claim 15 and further comprising a first control mount, wherein the first support conduit of the tool positioning device is connected to the first control mount such that the first control mount is on a first side of a first longitudinal axis of the first support conduit, and wherein the first control mount has a first plurality of actuators for corresponding flexible control links of the first and third plurality of said flexible control links of the first tool positioning device, for selectively pushing and pulling on the second end portions of the corresponding flexible control links, thereby causing the base member, the first plurality of coupling guides, the intermediate member, the second plurality of coupling guides and the end member to selectively define a continuous curve and selectively cause the tool holder to move in any of a plurality of orientations, such that the third plurality of coupling guides between the end member and the first tool holder device define a continuous curve from the end member to the first tool holder; and The first control mount includes a first tool actuator connected to the first tool control link of the first tool, for selectively pushing and pulling on the second end portion of the tool control link to operate the end effector. 17. The tool controller assembly of claim 16, wherein each of the first plurality of actuators and the first tool actuator comprises: A corresponding rotatable spool portion, to which a corresponding control link is connected, allowing a portion of the corresponding control link to pick up or release the spool portion in response to a corresponding rotation of the spool portion; and A corresponding driver is provided for selectively rotating the spool portion in first and second opposing directions, wherein the corresponding control link is pulled when the spool portion rotates in the first direction to pick up the portion of the corresponding control link, and wherein the corresponding control link is pushed when the spool portion rotates in the second direction to release the portion of the corresponding control link. 18. The tool controller assembly of claim 17, wherein each of the drivers comprises a gear segment. 19. The tool controller assembly of claim 18, wherein the first control mount has a first mounting surface, and wherein each of the gear segments has a portion protruding beyond the first mounting surface to engage a corresponding drive gear on the first tool controller mount. 20. A tool controller mounting base, comprising a first tool controller mounting interface for retaining a first tool controller assembly as claimed in claim 19, and further comprising a first plurality of drive gears for engaging corresponding gear segments on the first tool controller assembly. 21. The tool controller mounting base as claimed in claim 20, wherein the drive gears of the first plurality of drive gears include corresponding linear gear racks operably configured to slide linearly in a parallel-spaced relationship. 22. The tool controller mounting base as claimed in claim 21, further comprising a first plurality of linear actuators connected to the corresponding linear gear rack to cause the linear gear rack to slide linearly and impart motion to the corresponding gears of the second plurality of drive gears. 23. The tool controller mounting base as claimed in any one of claims 20-22, further comprising a second tool controller mounting interface, the second tool controller mounting interface including a second plurality of drive gears for engaging corresponding gear segments on the second tool controller assembly as claimed in claim 19. 24. The tool controller mounting base as claimed in claim 23, wherein the drive gears of the second plurality of drive gears include corresponding linear gear racks operably configured to slide linearly in a parallel-spaced relationship. 25. The tool controller mounting base as claimed in claim 24, further comprising a second plurality of actuators connected to the corresponding linear gear rack to allow the linear gear rack to slide linearly and impart motion to the respective drive gears of the second plurality of drive gears. 26. A tool monitoring device, comprising: A positioning tube, positioned to receive at least one support conduit of the tool controller assembly as claimed in claim 19, wherein the positioning tube has a length substantially the same as or smaller than the length of the at least one support conduit, such that a tool holder supported by the at least one support conduit extends away from the distal end of the positioning tube; and A camera bracket is positioned away from the second axis of the positioning tube, such that the camera is oriented toward the end effector of the tool held by the at least one tool bracket, so as to facilitate visual monitoring of the movement of the end effector. 27. The tool monitoring device of claim 26, wherein the camera bracket includes a tool bracket as claimed in any one of claims 1-19, and wherein the support conduit of the camera bracket extends inside the positioning tube, and the tool locator of the camera bracket extends away from the distal end of the positioning tube and is operably configured to hold and position the camera at the position away from the second axis, wherein the second axis is substantially perpendicular to the longitudinal axis of the support conduit.