# US 11,026,666 B2 · Articulated tool positioner and system employing same

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- Number: US 11,026,666 B2
- Document ID: US11026666B2
- Status: Granted
- Kind: B2
- Application number: 16/185,788
- Filed: 2018-11-09
- Published: 2019-05-23
- Granted: 2021-06-08
- Earliest claimed: 2013-06-19
- Assignees: Titan Medical Inc.
- Applicants: Titan Medical Inc.
- Inventors: Rene Robert; David Allen Zitnick; Peter John Kenneth Cameron; Leonard M. Faria; Andrea Bajo
- Web page: https://patentgrep.com/patent/US11026666B2

## CPC

- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 1/0055: {Constructional details of insertion parts, e.g. vertebral elements}
- A61B 1/0057: {Constructional details of force transmission elements, e.g. control wires}
- A61B 17/29: Forceps for use in minimally invasive surgery
- A61B 34/30: Surgical robots
- A61B 46/10: specially adapted for instruments{, e.g. microscopes}
- A61B 50/13: Trolleys{, e.g. carts}
- A61M 25/0147: {with movable mechanical means, e.g. pull wires}
- A61B 1/00193: {adapted for stereoscopic vision}
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- A61B 2017/00314: {Separate linked members}
- A61B 2017/00323: {Cables or rods}
- A61B 2017/2903: {transferring rotary motion}
- A61B 2017/2905: {flexible}
- A61B 2017/2906: {Multiple forceps}
- A61B 2034/301: {for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes}
- A61B 2034/306: {Wrists with multiple vertebrae}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

An articulated tool positioning apparatus comprising a base member, an intermediate member, an end member and a first tool holder arranged in succession, each of the base member, intermediate member, end member and tool holder having a respective central opening. A first plurality of coupled guides id positioned between the base member and the intermediate member and a second plurality of coupled guides is positioned between the intermediate member and the end member. A third plurality of coupled guides is diposed between the end member and the tool holder. The base member, intermediate member, end member, first tool holder and first second and third pluralities of coupled guides all have a central opening and guide openings or securing points for securing pluralities of flexible control links to the base member or to an object separated from the base member. Pushing or pulling control links of a 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. A second plurality of control links causes the end member to maintain an orientation generally the same as the base member, when any of the other flexible control links is pushed or pulled. Pushing or pulling control links of a third plurality of control links causes the tool holder to be selectively moved into any of a plurality of orientations, such that the third plurality of coupled guides between the end member and the tool holder defines a continuous curve from the end member to the tool holder. At least one mechanism for pushing and pulling the flexible control links is described and a use of the apparatus for positioning a tool for laparoscopic surgery applications is described.

## Claims

### Claim 1

A surgical tool apparatus comprising:
a tool holder defining a bore therethrough and a pair of radially oriented openings configured to support threaded fasteners projecting radially inward into the bore;
an articulated tool positioner having a central opening extending along a length thereof, wherein the tool positioner extends through the bore of the tool holder;
a coupler connected to the tool positioner, the coupler including first and second axially spaced apart cylinders sized to receive and to hold in the bore of the tool holder, whereby the coupler is held in the tool holder by the threaded fasteners projecting radially inward from the tool holder;
an end effector coupled to a distal end of the tool positioner;
a conduit received within the opening of the tool positioner and including a distal end coupled to the end effector; and
a control link extending through the conduit and the first and second axially spaced apart cylinders of the coupler, the control link having a distal end coupled to the end effector, the conduit and the control link each having a flexible portion at their respective distal ends to permit the tool positioner to move to position the end effector during a surgical operation, the control link being operable to actuate at least a first movement of the end effector, the conduit being operable to actuate a second movement of the end effector.

### Claim 2 (depends on 1)

The apparatus of claim 1 wherein the end effector comprises a base and wherein:
the control link extends axially through the base and couples to a moveable portion of the end effector associated with the first movement; and
the conduit is coupled to the base, the second movement of the end effector being actuated by rotation of the conduit within the central opening of the tool positioner.

### Claim 3 (depends on 2)

The apparatus of claim 2 wherein the base further comprises the coupler configured to be received within a tool holder disposed at a distal end of the tool positioner.

### Claim 4 (depends on 3)

The apparatus of claim 3 wherein the coupler includes a first connector portion and the tool holder includes a second connector portion configured to receive the first connector portion of the coupler to allow a portion of the apparatus to be received in the tool holder while permitting the end effector to remain outside the tool holder.

### Claim 5 (depends on 4)

The apparatus of claim 4 wherein when the second connector portion is coupled to the first connector portion, the end effector is configured to rotate in the tool holder.

### Claim 6 (depends on 4)

The apparatus of claim 4 wherein the first and second connector portions are sized to prevent the end effector from retreating inside the tool holder.

### Claim 7 (depends on 1)

The apparatus of claim 1 wherein the control link is configured to move in a longitudinal direction with respect to the conduit and the conduit is configured to rotate within the central opening of the tool positioner and cause rotational movement of the end effector.

### Claim 8 (depends on 1)

The apparatus of claim 1 wherein when received in the central opening of the tool positioner, the conduit extends through the central opening and includes a proximal end extending beyond the central opening, the proximal end being coupled to a rotational coupler in a tool controller to cause the rotation of the conduit.

### Claim 9 (depends on 1)

The apparatus of claim 1 wherein the conduit comprises a flexible portion and a rigid portion and wherein the flexible portion facilitates transverse bending movements of the conduit in response to movement of the tool positioner.

### Claim 10 (depends on 9)

The apparatus of claim 9 wherein the control link comprises a flexible portion extending through at least the flexible portion of the conduit, and wherein the flexible portion of the control link is configured to transmit both compressive and tensional forces.

### Claim 11 (depends on 9)

The apparatus of claim 9 wherein the flexible portions of the conduit and the control link are disposed at the respective distal ends of the conduit and the control link.

### Claim 12 (depends on 1)

The apparatus of claim 1 wherein the end effector comprises a pair of opposing jaws, one of which is movable about a pivot to provide the first movement in response to longitudinal movement of the control link within the conduit.

### Claim 13 (depends on 1)

The apparatus of claim 1 wherein the tool positioner comprises a plurality of coupled guides each including a central opening that provides the central opening of the tool positioner, the plurality of coupled guides being actuated to move by a plurality of flexible control links disposed extending through respective openings in the coupled guides, the plurality of flexible control links comprising corresponding control links disposed on either side of the central opening, and wherein pushing on one control link while pulling on a corresponding control link of said first plurality of control links causes the plurality of coupled guides to bend toward the pulled control link.

### Claim 14 (depends on 13)

The apparatus of claim 13 wherein the conduit includes a diameter selected to permit free movement of the control link within the conduit.

### Claim 15 (depends on 1)

The apparatus of claim 1 wherein the control link and the conduit are each independently moveable such that the first movement and the second movement comprise independent movements.

### Claim 16 (depends on 1)

The apparatus of claim 1 wherein the end effector comprises a pair of opposing jaws, at least one of which is movable about a pivot to provide the first movement in response to longitudinal movement of the control link within the conduit.

### Claim 17 (depends on 1)

The apparatus of claim 1 wherein the conduit is translatably received within the central opening of the tool positioner.

### Claim 18 (depends on 1)

The apparatus of claim 1 wherein the control link is operable to actuate the first movement of the end effector upon an axial translation thereof relative to the conduit.

### Claim 19 (depends on 1)

The apparatus of claim 1 wherein the conduit includes:
a flexible distal portion defining the distal end and which is coupled to the end effector; and
a rigid proximal portion having a respective distal end connected to a proximal end of the flexible distal portion.