1. A robotic surgical system for performing surgery, the system comprising:
a robotic arm with an end effector comprising a surgical instrument guide configured to hold andor restrict movement of a surgical instrument there through; and
a manipulator configured to allow robotically-assisted or unassisted positioning andor movement of the surgical instrument guide by a user with at least four degrees of freedom to align an axis defined by the instrument guide at a desired trajectory in relation to a patient situation,
wherein the surgical instrument guide comprises a rigid hollow tubular structure having a first open end and a second open end, said structure defining the axis along which movement of a surgical instrument (fitted with a tool support) sliding through the structure is restricted,
wherein the tubular structure has an interior surface shaped and sized to accommodate the tool support sliding through the guide such that movement of the tool support is constrained in all directions except along the axis defined by the guide,
wherein the tubular structure has an exterior surface comprising at least one flange that is configured for secure coupling of the guide to the end effector of the robotic surgical system,
and wherein the tubular structure comprises a longitudinal notch along its length, wherein the longitudinal notch is sized in relation to a peg to (i) permit a navigation marker attached to the tool support via the peg to be viewable by a navigation camera along an entire range of movement of the tool support through the guide, (ii) constrain movement of the marker in a fixed orientation along the axis defined by the guide, and (ii) permit the tool support to slide along the axis defined by the guide while the guide is held in a fixed position by the robotic surgical system.
2. The robotic surgical system of claim 1, wherein the surgical instrument is a member selected from the group consisting of: a drill bit, tap, screw driver, and awl.
3. The robotic surgical system of claim 1, wherein the surgical instrument is a drill bit and the surgical instrument guide is a drill guide.
4. The robotic surgical system of claim 1, wherein the rigid hollow tubular structure is a cylindrical structure.
5. The robotic surgical system of claim 1, wherein the longitudinal notch is a slot.
6. The robotic surgical system of claim 1, wherein the navigation marker is used by navigation camera to track the surgical instrument.
7. The robotic surgical system of claim 1, wherein the longitudinal notch is sized in relation to a peg to permit the surgical instrument to slide along the axis of insertion in reference to the tool support.
8. The robotic surgical system of claim 1, wherein the surgical instrument guide is configured to be used to guide a screw implant and a tissue protector.
9. The robotic surgical system of claim 1, wherein the axis can be aligned with the desired trajectory in relation to the patient situation via the manipulator.
10. The robotic surgical system of claim 1, wherein the surgical instrument guide comprises one or more input devices.
11. The robotic surgical system of claim 1, wherein the surgical instrument guide comprises an activation switch.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
What is claimed is:
1. A surgical apparatus comprising:
a first tube including a proximal end and a distal end;
a passageway for the inflow and outflow of coolant comprising:
a second tube extending over at least a portion of said first tube, said second tube including a proximal end and a distal end, and providing for coolant inflow in said passageway; and
a third tube extending over at least a portion of said second tube and including a proximal and a distal end, said distal end including at least one outwardly extending portion forming an expansion chamber for said coolant inside said third tube and for transferring cooling from said expansion chamber to outside of said third tube, and providing coolant outflow in said passageway;
said second tube including a bore at said distal end for coolant flow into said expansion chamber;
a fourth tube extending over at least a portion of said third tube, said fourth tube including a proximal end and a distal end and configured for communication with an electrical power source so as to heat when power from said power source is supplied to said fourth tube, said fourth tube positioned to extend over at least a portion of said third tube to limit conduction of said cooling toward at least said proximal end of said third tube;
said distal end of said first tube extending beyond said distal ends of said second and third tubes; and
said distal ends of said second and third tubes extending beyond said distal end of said fourth tube.
2. The apparatus of claim 1, additionally comprising a drill member, said drill member including a shaft having a distal end and a drill bit at said distal end, said drill member housed at least in partially in said first tube.
3. The apparatus of claim 2, additionally comprising a motor, said motor coupled with said drill member.
4. The apparatus of claim 1, additionally comprising a carrier tube intermediate said first tube and said second tube, said carrier tube including a proximal end and a distal end, said distal end extending to a point intermediate said distal ends of said second and third tubes and said distal end of said third tube.
5. The apparatus of claim 4, wherein said carrier tube is configured for transport of irrigation fluid from an irrigation fluid source.
6. The apparatus of claim 1, wherein said second and third tubes are closed at said respective distal ends, closing said passageway to the ambient environment.
7. The apparatus of claim 6, wherein said closed distal ends of said second tube and said third tube define a shoulder, extending outward from said carrier tube.
8. The apparatus of claim 7, wherein said distal end of said first tube extends a distance beyond said shoulder, said distance corresponding to a maximum penetration depth for said first tube.
9. The apparatus of claim 1, wherein said first tube is configured for accommodating suction from a suction unit in communication with said first tube.
10. A method for surgery of tissue within a capsule comprising:
providing an apparatus comprising:
a conduit including a proximal end and a distal end, said conduit configured for coolant transport and including a portion configured for concentrating cooling at said distal end;
a drill member extending longitudinally through said conduit, said drill member including a distal end and a drill bit at said distal end;
a tube having a proximal end and a distal end, said tube extending over said conduit in an arrangement with the distal end of said conduit extending beyond the distal end of said tube, said tube configured for heating upon activation, to limit conduction of said cooling toward at least said proximal end of said conduit;
creating an opening in said capsule;
contacting said opening with said portion of said conduit configured for concentrating cooling at said distal end and cooling said conduit portion such that sufficient cooling transfers to said capsule allowing for gripping of said capsule by said apparatus;
activating said tube for heating, to limit conduction of said cooling toward at least said proximal end of said conduit;
inserting at least a portion of said drill bit through said opening into said capsule; and
rotating said drill bit so as to emulsify at least a portion of said tissue in said capsule.
11. The method of claim 10, wherein heating includes providing heat to maintain temperatures within a biocompatible range in at least said portion of said conduit that said tube extends over.
12. The method of claim 10, additionally comprising, removing emulsified tissue by suction.
13. The method of claim 10, wherein said encapsulated tissue includes a cataract and said capsule is a lens capsule.
14. The method of claim 13, wherein said creating an opening in said capsule includes creating an opening in said lens capsule proximate said cataract.
15. A method for cataract surgery comprising:
accessing a lens capsule having a cataract therein, at a surgical site;
creating an opening in said lens capsule;
placing a thermal probe having at least a portion dimensioned to accommodate said opening proximate the periphery of said opening;
cooling said dimensioned portion of said thermal probe to a temperature such that said dimensioned portion temporarily adheres to said capsule, for providing said thermal probe with a controllable grip on said capsule;
maintaining said cooling to an area proximate said opening by providing heat to said surgical site proximate to said opening; and
emulsifying at least a portion of said cataract.
16. The method of claim 15, wherein said creating an opening in said lens capsule includes:
providing a thermal cutting tool having at least one cutting end configured for concentrating heat, said thermal cutting tool being heated to concentrate heat at said at least one cutting end; and
placing said at least one cutting end into contact with said lens capsule.
17. The method of claim 15, wherein said placing a thermal probe having at least a portion dimensioned to accommodate said opening proximate said periphery of said opening includes positioning said portion dimensioned to accommodate said opening to surround at least a substantial portion of said opening proximate said periphery.
18. The method of claim 17, wherein said positioning includes surrounding all of said opening proximate said periphery.
19. The method of claim 18, wherein cooling includes cooling said portion dimensioned to accommodate said opening to a temperature sufficient to seal said opening.
20. The method of claim 15, wherein said providing heat includes providing heat for maintaining said surgical site outside of said area proximate said opening at temperatures in a biocompatible range.
21. The method of claim 15, wherein said emulsifying at least a portion of said cataract includes inserting a drilling device through said opening and at least partially into said lend capsule and rotating said drilling device at speeds sufficient to break said cataract apart.
22. The method of claim 15, additionally comprising, removing said emulsified cataract material by suction.
23. The method of claim 15, additionally comprising irrigating said surgical site.
24. The method of claim 15, additionally comprising pressurizing said surgical site.