Apparatus and method for performing computer enhanced surgery with articulated instrument

A minimally invasive surgical method comprising:

• (a) providing a surgical instrument comprising a forearm member rotatable about a longitudinal axis, a wrist member pivotally connected to the forearm member, and a surgical end effector member moveably coupled to the wrist member;
• (b) inserting the surgical instrument into an anatomy of a person until the surgical end effector member reaches an internal surgical site within the anatomy of the person;
• (c) displaying an image of the surgical end effector at the internal surgical site for viewing by an eye of an operator at a control station;
• and
• (d) moving manually by the operator a surgical control handle of the control station to cause the surgical end effector to move and perform a surgical procedure at the internal surgical site within the anatomy of the person,
• wherein said wrist member is pivotally connected to the forearm member in a manner as to be capable of being pivoted about a first axis within said anatomy, and said surgical end effector member is moveably coupled to the wrist member in a manner as to be capable of being moved about a second axis within said anatomy, wherein said end effector moves about said longitudinal axis and said first and second axes relative to the surgical site as the surgical control handle of the control station is being manually moved by the operator.

A method of performing surgery within a body of a patient comprising:

• (a) providing a surgical instrument assembly comprising a moveable end effector and an elongate arm member having a proximal portion, an arm distal end, and a longitudinal axis between said proximal portion and said distal end, said proximal portion adapted to couple to a control assembly, said end effector coupled to the arm distal end in such a manner as to provide said end effector with at least three degrees of freedom of movement, said three degrees of freedom of movement including rotation of said end effector about said longitudinal axis relative to the surgical site, and rotation of said end effector about at least two other axes of rotation relative to the surgical site;
• (b) inserting at least a distal portion said surgical instrument assembly into said body through an aperture in a body wall until the end effector member reaches an internal surgical site, said at least two other distal axes of rotation within the patient's body distal of the body wall;
• (c) manipulating the proximal portion of said elongate arm member with said control assembly so as to cause the elongate arm to pivot about said aperture in said body wall in at least an additional two degrees of proximal freedom of movement;
• and
• (d) causing the end effector to rotate about one of more of said longitudinal and at least two other distal axes relative to the surgical site to manipulate tissue at the surgical site.

An endoscopic surgical system comprising a control section and an insertion section, wherein:

• the insertion section is insertable into a patient through an aperture in a body wall to location adjacent a surgical worksite in the patient, the insertion section comprising an elongate forearm link having proximal and distal ends and a longitudinal axis between said ends, and an end effector, said end effector coupled to the forearm link distal end in such a manner as to provide said end effector with rotational freedom of movement within said patient about at least a first and second substantially perpendicular distal axes of rotation, said forearm link proximal end coupled to said control section;
• and
• said control section comprising a remote control station having a manual controller, an articulate robotic arm having a plurality of joints, a plurality of motors, a plurality of drive members coupling said motors to said articulate arm joints and to said insertion section, said manual controller coupled to said articulate arm and said motors such that an operator can manually move said controller to remotely operate said insertion section at least to rotate said forearm link about said longitudinal axis, to pivot said forearm link about said aperture in two degrees of freedom of movement, to move said end effector about said first and second distal axes of rotation, said first and second distal axes of rotation to be within said patient's body distal of said body wall during movement and to manipulate tissue at the surgical site with said end effector.