Apparatus for Positioning a Medical Instrument Relative to a Patient

Abstract

The present device provides an apparatus for securely positioning a medical instrument through an incision within a patient. The apparatus comprises a trocar for extending through the incision in the patient and receiving the medical instrument. The apparatus also comprises a drive assembly for moving the medical instrument within the trocar in a direction that extends substantially parallel to the length of the trocar. The drive assembly can have a housing that is spaced from the trocar or that forms a portion of the trocar. The apparatus also includes a positioning system for rotating the medical instrument about a plurality of spaced points located outside the body and a plurality of perpendicularly extending axes. The positioning system includes an adapter for securing the trocar to the positioning system. A first motor system rotates the adapter and trocar about a first axis that extends substantially perpendicular to the length of the trocar and a second motor system rotates the adapter, the trocar and the drive assembly about a second axis that extends substantially perpendicular to the first axis.

1 . A trocar for receiving and positioning a medical instrument, said trocar comprising:
 a housing and a motor assembly positioned within said housing, said motor assembly including a motor, a first medical instrument engaging member operatively connected to said motor and moveable relative to said housing, and a second medical instrument engaging member, wherein when the medical instrument is positioned within said housing between the first and second medical instrument engaging members, the operation of said motor causes said first and second medical instrument engaging members to move the medical instrument in a first direction; wherein the trocar has a means for attaching it to a positioning system.   
   
   
       2 . A trocar according to  claim 1  wherein said first medical instrument engaging member includes at least one drive roller and said second medical instrument engaging member includes at least one idler roller biased in the direction of said first medical instrument engaging member, wherein at least the drive roller has a friction material for engaging the medical instrument. 
   
   
       3 . A trocar according to  claim 1  further comprising a system for rotating the medical instrument when positioned within said trocar, said system including a rotatable member supporting said first and second medical instrument engaging members and at least one drive roller for moving said rotatable member and said medical instrument engaging members relative to said housing of said trocar. 
   
   
       4 . A trocar according to  claim 1  further including a spring that biases said second medical instrument engaging member toward said first medical instrument engaging member. 
   
   
       5 . An apparatus for moving a medical instrument relative to the body of a patient in at least one direction, said apparatus comprising:
 a drive assembly releasably securable to a trocar, said drive assembly comprising a housing including an opening for receiving the medical instrument, at least one motor, at least one drive roller operatively coupled to said motor, where the rotation of said drive roller causes the medical instrument to move within the trocar, wherein the drive assembly is securable to an instrument positioning system that is capable of moving said medical instrument about multiple axes   
   
   
       6 . An apparatus of  claim 5  further comprising a system for rotating the medical instrument when positioned within said trocar, said system including a rotatable member supporting said rollers and at least one rotational drive roller for moving said rotatable member along a substantially circular path relative to said housing wherein the at least one rotational drive roller is coupled to a motor for rotating said at least one rotational drive roller relative to said housing. 
   
   
       7 . An apparatus for positioning a medical instrument relative to the body of a patient, said apparatus comprising:
 a medical instrument drive assembly comprising a motor, a drive roller operatively coupled to said motor, an idler roller for cooperating with said drive roller for moving the medical instrument and a housing, said housing comprising a first housing portion supporting one of said drive roller and said idler roller and a second housing portion supporting the other of said drive roller and said idler roller, said second housing portion being moveable relative to said first housing portion, wherein said rollers each include an outer surface at least partially covered by a friction material, and wherein said friction material engages the medical instrument when the rollers move in response to the operation of said motor.   
   
   
       8 . An apparatus of  claim 7  wherein said second housing portion is pivotable relative to said first housing portion. 
   
   
       9 . An apparatus of  claim 7  wherein said second housing portion supports said idler roller, and further including a spring that biases said idler roller and said second housing portion toward said drive roller. 
   
   
       10 . An apparatus of  claim 7  further comprising a member for securely coupling said housing to a positioning system. 
   
   
       11 . A powered trocar according to  claim 1  wherein said drive assembly further comprises a second drive roller and a pair of pinch rollers that are biased in the direction of said drive rollers. 
   
   
       12 . A powered trocar according to  claim 1  further comprising a system for rotating the medical instrument within said trocar, said system including a rotatable member supporting said rollers and at least one rotational drive roller for moving said rotatable member relative to said first portion. 
   
   
       13 . A powered trocar according to  claim 1  wherein said at least one rotational drive roller of said system further includes a plurality of rotational drive rollers that engage said rotatable support member and move said rotatable support member in a substantially circular direction about the longitudinal axis of said trocar. 
   
   
       14 . A powered trocar according to  claim 11  wherein said drive roller includes a central opening through which said motor extends. 
   
   
       15 . A powered trocar according to  claim 14  wherein said motor includes a drive wheel that engages an interior support ring of said drive roller. 
   
   
       16 . A powered trocar according to  claim 15  wherein an exterior surface of said support ring carries a friction material for engaging and moving the medical instrument in response to the operation of said motor. 
   
   
       17 . A powered trocar according to  claim 11  wherein a seal extends between said first and second portions of said trocar. 
   
   
       18 . A powered trocar according to  claim 1  further comprising a member for securely coupling said powered trocar to a positioning system.