Abstract: A robotic instrument system and method, comprising at least two instrument drive assemblies each detachably coupled to a respective instrument assembly. Each instrument assembly comprising an elongate, flexible guide instrument configured to be inserted into a patient's body. The instrument drive assemblies comprise one or more motors configure to operate a respective instrument assembly. One or more controllers are operatively coupled to the instrument drive assemblies. The method comprises maneuvering a distal end of each of the respective guide instruments into a patient's heart by actuating the respective drive assembly performing a procedure controlled by the one or more controllers.

Abstract: Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Examples of in vivo accessories include fastening accessories such as surgical clips for use with a clip applier, single working member accessories such as a blade which can be grasped and manipulated by a grasping tool for cutting, sheath accessories that fit over working members of a tool, flow tubes for providing suction or introducing a fluid into the surgical site, and a retraction member resiliently biased to retract a tissue to expose an area in the surgical site for treatment. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site.

Abstract: A method and system for performing a cardiopulmonary bypass procedure are provided. The method includes accessing a source of blood in a patient body from which source the blood is to be passed through a cardiopulmonary bypass machine, drawing blood from the source through the cardiopulmonary bypass machine and introducing the blood into an aortic artery of the patient body through a plurality of separate passages, after the blood has been passed through the cardiopulmonary bypass machine. The system includes a cardiopulmonary bypass machine, a tubular member coupled to an outlet port of the cardiopulmonary bypass machine and a plurality of separate needle members connected in fluid flow communication with the tubular member, the needle members being arranged to be connected in fluid flow communication with an aortic artery, during a cardiopulmonary bypass procedure.

Abstract: A surgical system or assembly for performing cardiac surgery includes a surgical instrument; a servo-mechanical system engaged to the surgical instrument for operating the surgical instrument; and an attachment assembly for removing at least one degree of movement from a moving surgical cardiac worksite to produce a resultant surgical cardiac worksite. The surgical system or assembly also includes a motion tracking system for gathering movement information on a resultant surgical cardiac worksite. A control computer is engaged to the attachment assembly and to the motion tracking system and to the servo-mechanical system for controlling movement of the attachment assembly and for feeding gathered information to the servo-mechanical system for moving the surgical instrument in unison with the resultant surgical cardiac worksite such that a relative position of the moving surgical instrument with respect to the resultant surgical cardiac worksite is generally constant.

Abstract: Improved robotic surgical systems, devices, and methods often include a first assembly with a surgical end effector supported and manipulated relative to a first base by a first robotic linkage, while a second surgical end effector manipulated and supported relative to a second, independent base by a second robotic linkage. One or more of these robotic assemblies may be moved relative to the other. To coordinate the end effector movements with those of input devices being manipulated by a surgeon relative to a display of a surgical worksite, the processor deriving the commands for movement of the robotic linkages may make use of a signal indicating a relative orientation of the bases of the robotic arm assemblies. Surprisingly, the robotic arm assemblies may not transmit signals to the processor indicating a relative translational position of the bases.

Abstract: Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Some accessories need to be actuated to effect a predetermined treatment, such as an aortic punch, clamps, pliers, and the like. For such accessories, the actuation can conveniently be performed by an operator such as an assistant remotely from outside the patient's body while placement of the accessories takes place in the surgical site by manipulating the accessories using robotic surgical tools in the site. A lockdown feature may be incorporated in accessories to lock them in place remotely from outside the surgical site upon actuation.

Abstract: A method of providing access to tissue for a surgical instrument through a body wall is provided. The method includes providing an expandable retractor having a flexible sheath, the retractor being in a collapsed state; introducing the retractor into the body and placing the retractor adjacent the tissue; expanding the retractor; deploying the flexible sheath by engaging the flexible sheath with a tool and driving the flexible sheath through the body wall with the tool; and inserting the surgical instrument from outside the body through the flexible sheath to provide access to the tissue by the surgical instrument.

Abstract: Improved robotic surgical systems, devices, and methods include selectably associatable master/slave pairs, often having more manipulator arms than will be moved simultaneously by the two hands of a surgeon. Four manipulator arms can support an image capture device, a left hand tissue manipulation tool, a right hand tissue manipulation tool, and a fourth surgical instrument, particularly for stabilizing, retracting, tool change, or other functions benefiting from intermittent movement. The four or more arms may sequentially be controlled by left and right master input control devices. The fourth arm may be used to support another image capture device, and control of some or all of the arms may be transferred back-and-forth between the operator and an assistant. Two or more robotic systems each having master controls and slave manipulators may be coupled to enable cooperative surgery between two or more operators.

Abstract: Improved robotic surgical systems, devices, and methods include selectably associatable master/slave pairs, often having more manipulator arms than will be moved simultaneously by the two hands of a surgeon. Four manipulator arms can support an image capture device, a left hand tissue manipulation tool, a right hand tissue manipulation tool, and a fourth surgical instrument, particularly for stabilizing, retracting, tool change, or other functions benefiting from intermittent movement. The four or more arms may sequentially be controlled by left and right master input control devices. The fourth arm may be used to support another image capture device, and control of some or all of the arms may be transferred back-and-forth between the operator and an assistant. Two or more robotic systems each having master controls and slave manipulators may be coupled to enable cooperative surgery between two or more operators.

Abstract: An inflatable retraction apparatus is provided for retracing an organ inside a body to gain access to an adjacent tissue. The apparatus includes an able chamber formed from a single thin envelope, and capable of being collapsed for insertion through an incision and being expanded to a predetermined shape for retracing the organ. An inflation mechanism is adapted to selectively inflate the chamber to the predetermined shape. The inflation mechanism includes at least one inflation tube attached to the inflatable chamber in fluid communication theretween, and an inflatable maintaining lattice operatively enveloping the inflatable chamber and in operative association with the inflation mechanism.

Abstract: A method and system for performing a cardiopulmonary bypass procedure are provided. The method includes accessing a source of blood in a patient body from which source the blood is to be passed through a cardiopulmonary bypass machine, drawing blood from the source through the cardiopulmonary bypass machine and introducing the blood into an aortic artery of the patient body through a plurality of separate passages, after the blood has been passed through the cardiopulmonary bypass machine. The system comprises a cardiopulmonary bypass machine, a tubular member coupled to an outlet port of the cardiopulmonary bypass machine and a plurality of separate needle members connected in fluid flow communication with the tubular member, the needle members being arranged to be connected in fluid flow communication with an aortic artery, during a cardiopulmonary bypass procedure.

Abstract: A method and system for performing a cardiopulmonary bypass procedure are provided. The method includes accessing a source of blood in a patient body from which source the blood is to be passed through a cardiopulmonary bypass machine, drawing blood from the source through the cardiopulmonary bypass machine and introducing the blood into an aortic artery of the patient body through a plurality of separate passages, after the blood has been passed through the cardiopulmonary bypass machine. The system comprises a cardiopulmonary bypass machine, a tubular member coupled to an outlet port of the cardiopulmonary bypass machine and a plurality of separate needle members connected in fluid flow communication with the tubular member, the needle members being arranged to be connected in fluid flow communication with an aortic artery, during a cardiopulmonary bypass procedure.

Abstract: A surgical system or assembly for performing cardiac surgery includes a surgical instrument; a servo-mechanical system engaged to the surgical instrument for operating the surgical instrument; and an attachment assembly for removing at least one degree of movement from a moving surgical cardiac worksite to produce a resultant surgical cardiac worksite. The surgical system or assembly also includes a motion tracking system for gathering movement information on a resultant surgical cardiac worksite. A control computer is engaged to the attachment assembly and to the motion tracking system and to the servo-mechanical system for controlling movement of the attachment assembly and for feeding gathered information to the servo-mechanical system for moving the surgical instrument in unison with the resultant surgical cardiac worksite such that a relative position of the moving surgical instrument with respect to the resultant surgical cardiac worksite is generally constant.

Abstract: Improved robotic surgical systems, devices, and methods include selectably associatable master/slave pairs, often having more manipulator arms than will be moved simultaneously by the two hands of a surgeon. Four manipulator arms can support an image capture device, a left hand tissue manipulation tool, a right hand tissue manipulation tool, and a fourth surgical instrument, particularly for stabilizing, retracting, tool change, or other functions benefiting from intermittent movement. The four or more arms may sequentially be controlled by left and right master input control devices. The fourth arm may be used to support another image capture device, and control of some or all of the arms may be transferred back-and-forth between the operator and an assistant. Two or more robotic systems each having master controls and slave manipulators may be coupled to enable cooperative surgery between two or more operators.

Abstract: A surgical system or assembly for performing cardiac surgery includes a surgical instrument; a servo-mechanical system engaged to the surgical instrument for operating the surgical instrument; and an attachment assembly for removing at least one degree of movement from a moving surgical cardiac worksite to produce a resultant surgical cardiac worksite. The surgical system or assembly also includes a motion tracking system for gathering movement information on a resultant surgical cardiac worksite. A control computer is engaged to the attachment assembly and to the motion tracking system and to the servo-mechanical system for controlling movement of the attachment assembly and for feeding gathered information to the servo-mechanical system for moving the surgical instrument in unison with the resultant surgical cardiac worksite such that a relative position of the moving surgical instrument with respect to the resultant surgical cardiac worksite is generally constant.

Abstract: Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Examples of in vivo accessories include fastening accessories such as surgical clips for use with a clip applier, single working member accessories such as a blade which can be grasped and manipulated by a grasping tool for cutting, sheath accessories that fit over working members of a tool, flow tubes for providing suction or introducing a fluid into the surgical site, and a retraction member resiliently biased to retract a tissue to expose an area in the surgical site for treatment. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site.

Abstract: Improved robotic surgical systems, devices, and methods often include a first assembly with a surgical end effector supported and manipulated relative to a first base by a first robotic linkage, while a second surgical end effector manipulated and supported relative to a second, independent base by a second robotic linkage. One or more of these robotic assemblies may be moved relative to the other. To coordinate the end effector movements with those of input devices being manipulated by a surgeon relative to a display of a surgical worksite, the processor deriving the commands for movement of the robotic linkages may make use of a signal indicating a relative orientation of the bases of the robotic arm assemblies. Surprisingly, the robotic arm assemblies may not transmit signals to the processor indicating a relative translational position of the bases.

Abstract: Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Examples of in vivo accessories include fastening accessories such as surgical clips for use with a clip applier, single working member accessories such as a blade which can be grasped and manipulated by a grasping tool for cutting, sheath accessories that fit over working members of a tool, flow tubes for providing suction or introducing a fluid into the surgical site, and a retraction member resiliently biased to retract a tissue to expose an area in the surgical site for treatment. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site.

Abstract: An apparatus and method for separating a first layer of tissue from a second layer of tissue. An inflatable balloon is mounted to a delivery device. The inflatable balloon has a first, inwardly-displaced portion which everts when the balloon is inflated. The balloon is inserted into a patient between the first and second tissue layers when the balloon is in the deflated state. The balloon is then inflated so that the first portion is everted thereby minimizing trauma to the tissue layers.

Abstract: An improved surgical instrument, which can advantageously be used in the field of minimally invasive surgery, is provided. A method of performing a surgical procedure with such an improved surgical instrument is also provided. The improved surgical instrument includes an elongate shaft defining opposed ends. An end effector is mounted on one of the ends of the shaft. The end effector has at least one finger pivotally connected at the one end of the shaft selectively to be displaceable angularly about an end effector pivot axis at the one end of the shaft, such that a free end of the finger is displaceable about the end effector pivot axis. The finger has a length, defined between its free end and the end effector pivot axis, of at least 18 mm.