Minimally invasive surgical devices, systems, and methods

Abstract

A surgical instrument assembly is provided. In some embodiments, an example surgical instrument assembly includes a surgical instrument configured to pass through a guide tube having a proximal end and a distal end. The surgical instrument can include one or more arms configured to extend from the intermediate position, each arm having one or more joints positioned along the arm and an end effector attached at the distal end of each arm. The surgical instrument assembly can include a control assembly positioned at the proximal end and configured to control the movement of the joints and the end effectors.

1 . (canceled) 
     
     
         2 . A method of operating a surgical instrument assembly, comprising:
 while a medical imaging source is connected to an imaging arm and positioned at a distal end of a micro guide tube having an outer diameter of 2 mm or less, advancing both a first tool arm having a first distal end effector including adjustable jaws and a second tool arm having a second distal end effector through the micro guide tube shaft having the outer diameter of 2 mm or less;   while both the first and second tool arms are positioned through the micro guide tube having the outer diameter of 2 mm or less and while at least a portion of the first and second distal end effectors are in an image target area of the medical imaging source at the distal end of the micro guide tube, manipulating a first control actuator tool located at a proximal end of the first arm to actuate the adjustable jaws of first distal end effector from an open configuration to a closed configuration; and   manipulating a second control actuator tool located at a proximal end of the second tool arm to actuate the second distal end effector while in the image target area of the medical imaging source positioned at the distal end of the micro guide tube having the outer diameter of 2 mm or less.   
     
     
         3 . The method of  claim 2 , further comprising:
 after said advancing the first and second tool arms through the micro guide tube having the outer diameter of 2 mm or less, removably attaching a proximal end of the micro guide tube to a connector positioned at distal ends of the first and second control actuator tools such that the first and second tool arms extend distally of the connector and through an interior the micro guide tube having the outer diameter of 2 mm or less.   
     
     
         4 . The method of  claim 2 , wherein the first distal end effector is actuated in response to movement of a portion of the first distal end effector relative to the micro guide tube having the outer diameter of 2 mm or less. 
     
     
         5 . The method of  claim 2 , wherein each of the first and second tool arms has a maximum outer diameter of less than 1 mm. 
     
     
         6 . The method of  claim 2 , wherein the adjustable jaws of first distal end effector are adjustable between the open configuration and the closed configuration without manipulation of a wire connected with the first distal end effector. 
     
     
         7 . The method of  claim 2 , wherein the adjustable jaws of first distal end effector are adjustable between the open configuration and the closed configuration by relative longitudinal movement between the first distal end effector and the first tool arm. 
     
     
         8 . The method of  claim 2 , further comprising:
 while both the first and second tool arms are positioned through the micro guide tube having the outer diameter of 2 mm or less and while said at least a portion of the first and second distal end effectors are in the image target area of the medical imaging source at the distal end of the micro guide tube, applying a vacuum source to one or more hollow channels of the first distal end effector.   
     
     
         9 . The method of  claim 2 , further comprising extending the first tool arm distally from the micro guide tube having the outer diameter of 2 mm or less such that a shape memory element of the first arm exhibits a predefined curvature along a portion of the first tool arm extending from the micro guide tube. 
     
     
         10 . A surgical instrument assembly, comprising:
 a first tool arm having a proximal end and a distal end, a first distal end effector located at the distal end of the first tool arm and including jaws adjustable between an open configuration and a grasping configuration;   a second tool arm having a proximal end and a distal end, a second distal end effector located at the distal end;   a control actuator tool located at the proximal ends of the first and tool second arms, the control actuator tool including a first actuator that manipulates the first distal end effector, a second actuator that manipulates the second end effector, a first arm input that controls at least one degree of freedom of the first tool arm, and a second arm input that controls at least one degree of freedom of the second tool arm; and   a medical imaging arm having a camera connected at a distal end of the medical imaging arm,   wherein all of the first tool arm, the second tool arm, and the medical imaging arm are configured to extend through a micro guide tube having an outer diameter of 2 mm or less while the first and second tool arms and first and second distal end effectors are manipulated by the control actuator tool.   
     
     
         11 . The surgical instrument assembly of  claim 10 , wherein the control actuator tool includes a first control housing and a second control housing that is separate from the first control housing, the first control housing comprising a first handle, the first arm input, and the first actuator, and the second control housing comprising a second handle, the second arm input, and the second actuator. 
     
     
         12 . The surgical instrument assembly of  claim 11 , wherein each of the first and second tool arms has a maximum outer diameter of less than 1 mm. 
     
     
         13 . The surgical instrument assembly of  claim 11 , wherein each of the first tool arm and the second tool arm includes a shoulder joint, an elbow joint spaced distally from the shoulder joint, a wrist joint spaced distally from the should joint and the elbow joint, and an effector joint spaced distally from the should, elbow, and wrist joints. 
     
     
         14 . The surgical instrument assembly of  claim 13 , wherein the shoulder, elbow, wrist, elbow, and effector joints are controllable with a total of six wires or less within each arm. 
     
     
         15 . The surgical instrument assembly of  claim 13 , wherein the shoulder joint, the elbow joint, the wrist joint, and the effector joint of the first arm are each independently controllable at the first control assembly. 
     
     
         16 . The surgical instrument assembly of  claim 10 , wherein the medical imaging arm is an articulation arm of an articulating imaging source, the camera being attached to the distal end of the articulating arm. 
     
     
         17 . The surgical instrument assembly of  claim 10 , wherein the control actuator tool comprises a connector positioned at a distal of the control actuator tool to removably attach with a proximal end of the micro guide tube having the outer diameter of 2 mm or less such that the first and second tool arms extend distally from the distal end of the control actuator tool and into an interior of the micro guide tube having the outer diameter of 2 mm or less. 
     
     
         18 . The surgical instrument assembly of  claim 10 , wherein the first distal end effector includes the adjustable jaws for grasping and a blade for cutting that is movable relative to the adjustable jaws. 
     
     
         19 . The surgical instrument assembly of  claim 18 , wherein the adjustable jaws of the first distal end effector are adjustable between the open configuration and the grasping configuration without manipulation of a wire connected with the first distal end effector. 
     
     
         20 . The surgical instrument assembly of  claim 10 , wherein the first distal end effector includes the adjustable jaws for grasping and at least a vacuum port for fluid communication with a vacuum source.