Robotic medical instrument system

Abstract

A robotic medical apparatus for performing a medical procedure or application on an anatomy, said apparatus comprising: a first medical instrument member having a working end adapted to be disposed at an internal target area at which the medical procedure or application is to be performed; and a second medical instrument member having a working end adapted to be disposed at an internal target area at which the medical procedure or application is to be performed. The first medical instrument member is disposed so as to extend into the anatomy at a first ingress location and passing intraluminally; and the second medical instrument member is disposed so as to extend into the anatomy at a second ingress location different than said first ingress location and passing extraluminally. A controller is provided for receiving remotely generated control commands for respectively controlling the motion of said first and second medical instrument members so that said first and second medical instrument members are separately and controllably operable to perform the medical procedure or application.

What is claimed is:  
     
         1 . A robotic medical apparatus for performing a medical procedure or application on an anatomy, said apparatus comprising: 
 a first medical instrument member having a working end adapted to be disposed at an internal target area at which the medical procedure or application is to be performed;    a second medical instrument member having a working end adapted to be disposed at an internal target area at which the medical procedure or application is to be performed;    said first medical instrument member disposed so as to extend into the anatomy at a first ingress location and passing intraluminally;    said second medical instrument member disposed so as to extend into the anatomy at a second ingress location different than said first ingress location and passing extraluminally; and    a controller for receiving remotely generated control commands for respectively controlling the motion of said first and second medical instrument members so that said first and second medical instrument members are separately and controllably operable to perform the medical procedure or application.    
     
     
         2 . The robotic medical apparatus of  claim 1  wherein said first and second medical instrument members are separately and controllably operable, in unison, to perform the medical procedure or application.  
     
     
         3 . The robotic medical apparatus of  claim 1  wherein said first medical instrument member comprises a rigid shaft instrument, and said second medical instrument member comprises a flexible shaft instrument.  
     
     
         4 . The robotic medical apparatus of forth in  claim 3  wherein said first medical instrument member extends into the anatomy at the first ingress location defined by a small incision.  
     
     
         5 . The robotic medical apparatus of  claim 4  wherein said second medical instrument member extends into the anatomy at the second ingress location defined by a percutaneous or surgical access, or by introduction through a natural orifice.  
     
     
         6 . The robotic medical apparatus of  claim 1  wherein said first medical instrument member comprises a rigid shaft instrument, and said second medical instrument member comprises a flexible shaft instrument, said flexible shaft instrument adapted to extend intralumenally through an anatomic vessel, or the like.  
     
     
         7 . The robotic medical apparatus of  claim 6  wherein said rigid shaft instrument is adapted to extend extralumenally about the anatomic vessel.  
     
     
         8 . The robotic medical apparatus of  claim 1  wherein both said first and second medical instruments are flexible shaft instruments.  
     
     
         9 . The robotic medical apparatus of  claim 1  wherein both said first and second medical instruments are rigid shaft instruments.  
     
     
         10 . The robotic medical apparatus of  claim 1  wherein said first medical instrument member is rigid entering the anatomy laparoscopically, while the second medical instrument member is flexible and meant to enter a body lumen such as through a natural body orifice or percutaneously.  
     
     
         11 . The robotic medical apparatus of  claim 1  wherein the working end of each instrument member is at its distal end and includes a tool for performing the medical procedure or application.  
     
     
         12 . The robotic medical apparatus of  claim 11  wherein said tool is for sewing.  
     
     
         13 . The robotic medical apparatus of  claim 11  wherein said tool is for suturing.  
     
     
         14 . The robotic medical apparatus of  claim 11  wherein said tool is for grasping.  
     
     
         15 . The robotic medical apparatus of  claim 11  wherein said tool is for applying clips, staples, or clamps.  
     
     
         16 . The robotic medical apparatus of  claim 1  including separate input devices communicating with the controller.  
     
     
         17 . The robotic medical apparatus of  claim 16  wherein the input devices issue the control commands for respectively controlling the motion of said first and second medical instrument members, and are disposed at a master control station remote from said instrument members.  
     
     
         18 . A robotic medical apparatus for performing a securing procedure, at an internal body site, said apparatus comprising: 
 a medical instrument member having a working end adapted to be disposed at the internal body site at which the securing procedure is to be performed;    and a controller for receiving a remotely generated control command for controlling the motion of said medical instrument member to perform the securing procedure;    said medical instrument member including, at a distal section thereof, a securing tool having one and another ends adapted to be disposed at opposite sides of a tissue that is to be secured; and    at least one of said tool ends adapted to hold a securing member for securing said tissue.    
     
     
         19 . The robotic medical apparatus of  claim 18  wherein said medical instrument member includes an instrument shaft.  
     
     
         20 . The robotic medical apparatus of  claim 19  including a controllably bendable section along said instrument shaft for directing the position of said tool.  
     
     
         21 . The robotic medical apparatus of  claim 20  including a remote input device controlled by an operator, and coupled by way of said controller to remotely control said bendable section.  
     
     
         22 . The robotic medical apparatus of  claim 19  wherein said instrument shaft is rigid.  
     
     
         23 . The robotic medical apparatus of  claim 18  wherein said tool is for sewing.  
     
     
         24 . The robotic medical apparatus of  claim 18  wherein said tool is for suturing.  
     
     
         25 . The robotic medical apparatus of  claim 11  wherein said tool is for applying clips, staples, or clamps.  
     
     
         26 . The robotic medical apparatus of  claim 18  wherein one end of said tool is active while another end is passive.  
     
     
         27 . A robotic medical apparatus for performing a medical procedure or application on an anatomy, said apparatus comprising: 
 a first medical instrument member having a working end adapted to be disposed at an internal target area at which the medical procedure or application is to be performed;    a second medical instrument member having a working end adapted to be disposed at an internal target area at which the medical procedure or application is to be performed;    said first medical instrument member disposed so as to extend into the anatomy at a first ingress location;    said second medical instrument member disposed so as to extend into the anatomy at a second ingress location different than said first ingress location;    a controller for receiving remotely generated control commands for respectively controlling the motion of said first and second medical instrument members so that said first and second medical instrument members are separately and controllably operable to perform the medical procedure or application;    both said first and second medical instrument members comprising active work elements at said respective member working ends and disposed at opposite sides of an anatomic wall; and    said active work elements being controlled cooperatively to perform the medical procedure or application.    
     
     
         28 . The robotic medical apparatus of  claim 27  wherein said active work elements include at least one element that extends a securing piece through said body vessel wall.  
     
     
         29 . The robotic medical apparatus of  claim 27  wherein said active work element comprises an end effector.  
     
     
         30 . A robotic medical apparatus for performing a medical procedure or application on an anatomy, said apparatus comprising: 
 a first medical instrument member having a working end adapted to be disposed at an internal target area at which the medical procedure or application is to be performed;    a second medical instrument member having a working end adapted to be disposed at an internal target area at which the medical procedure or application is to be performed;    said first medical instrument member disposed so as to extend into the anatomy at a first ingress location;    said second medical instrument member disposed so as to extend into the anatomy at a second ingress location different than said first ingress location;    and    a controller for receiving remotely generated control commands for respectively controlling the motion of said first and second medical instrument members so that said first and second medical instrument members are separately and controllably operable to perform the medical procedure or application.    
     
     
         31 . The robotic medical apparatus of  claim 30  wherein said first medical instrument passes intralumenally and said second medical instrument passes extralumenally.  
     
     
         32 . The robotic medical apparatus of  claim 30  including a first master input device remote from said first medical instrument for control thereof, and a second master input device remote from said second medical instrument for control thereof.  
     
     
         33 . A robotic medical apparatus for performing a securing procedure, at an internal body site, said apparatus comprising: 
 a medical instrument member having a working end adapted to be disposed at the internal body site at which the securing procedure is to be performed;    a controller for receiving a remotely generated control command for controlling the motion of said medical instrument member to perform the securing procedure;    said medical instrument member including, at a distal section thereof, a securing tool having one and another ends adapted to be disposed at opposite sides of a tissue that is to be secured; and    at least one of said tool ends adapted to hold a securing member for securing said tissue.    
     
     
         34 . The robotic medical apparatus of  claim 33  wherein said medical instrument member includes an instrument shaft.  
     
     
         35 . The robotic medical apparatus of  claim 34  including a controllably bendable section along said instrument shaft for directing the position of said tool.  
     
     
         36 . The robotic medical apparatus of  claim 35  including a remote input device controlled by an operator, and coupled by way of said controller to remotely control said bendable section.  
     
     
         37 . The robotic medical apparatus of  claim 34  wherein said instrument shaft is rigid.  
     
     
         38 . The robotic medical apparatus of  claim 33  wherein said tool is for sewing.  
     
     
         39 . The robotic medical apparatus of  claim 33  wherein said tool is for suturing.  
     
     
         40 . The robotic medical apparatus of  claim 33  wherein said tool is for applying clips, staples, or clamps.  
     
     
         41 . The robotic medical apparatus of  claim 33  wherein one end of said tool is active while another end is passive.