Abstract
A minimally invasive surgery system including a robot, a cannula assembly and a computer system. The robot has at least one movable robot arm and the cannula assembly is detachably mounted to the robot arm. The cannula assembly includes a cannula and a pattern generating member. The cannula has a distal end and a proximal end with a flange portion and an elongate cannula shaft portion extending from the proximal end to the distal end and an access port through the elongate cannula shaft portion. The pattern generating member includes a pattern light source and a projector temporarily or permanently fixed to the cannula shaft portion. The pattern light source is operatively connected to the projector for projecting a light pattern. The computer system is configured for in real time receiving image data representing light pattern reflections from a surgical surface and for determining a real-time spatial position of the cannula assembly relative to the surgical surface.
Claims
1-20. (canceled)
21. A minimally invasive surgery system, comprising a robot comprising at least one movable robot arm; an elongate cannula detachably mounted to the robot arm, the cannula having a distal end and a proximal end with a lumen extending between the distal and proximal ends along a longitudinal axis of the cannula; a projector disposed on an outer surface of the cannula and configured to project a light pattern onto a tissue; and a computer system configured to: receive image data, in real time, characterizing an image of the light pattern projected onto the tissue, determine a spatial position of the cannula relative to the tissue based on the image data, determine an orientation of a distal end of a surgical tool of a surgical instrument disposed in the elongate shaft portion relative to the longitudinal axis of the cannula, and determine a distance between the distal end of the surgical tool and the tissue based on the determined spatial position of the cannula and the determined orientation of the distal end of the surgical tool.
22. The minimally invasive surgery system of claim 21, wherein the determined spatial position of the cannula characterizes a distance between the distal end of the cannula and the tissue.
23. The minimally invasive surgery system of claim 21, further comprising a camera configured to acquire the image of the light pattern, to generate the image data, and to transmit the image data in real time to the computer system.
24. The minimally invasive surgery system of claim 23, wherein the camera is mounted to or integrated with the robot.
25. The minimally invasive surgery system of claim 21, further comprising the surgical instrument, the surgical instrument being detachably mounted to the at least one movable robot arm.
26. The minimally invasive surgery system of claim 21, wherein the computer system is configured to determine a real-time spatial position of a portion of the surgical instrument relative to the surgical surface from the determined spatial position of the cannula relative to the tissue and the determined distance between the cannula and the portion of the surgical instrument.
27. The minimally invasive surgery system of claim 21, wherein the robot comprises at least one encoder configured for tracking real time movements of the surgical tool and for transmitting the tracked movements in real time to the computer system.
28. The minimally invasive surgery system of claim 27, wherein the at least one encoder comprises at least one of a rotary or a linear encoder on the at least one robot arm.
29. The minimally invasive surgery system of claim 27, wherein the at least one encoder is a mechanical encoder, a magnetic encoder, an optical encoder, a capacitive encoder, or a combination thereof.
30. The minimally invasive surgery system of claim 21, wherein the robot comprises a tracking sensor configured for real time tracking of movements of the surgical tool
31. The minimally invasive surgery system of claim 30, wherein the tracking sensor is a time-of-flight sensor, a magnetic sensors, or a structured light sensor.
32. The minimally invasive surgery system of claim 21, wherein the computer system is configured to control movements of the at least one movable robot arm of the robot.
Description
BRIEF DESCRIPTION OF EXAMPLES
[0221] Preferred embodiments of the invention will be further described with reference to the drawings.
[0222] FIG. 1a is a schematic view of an embodiment of a cannula assembly kit.
[0223] FIG. 1b is a schematic view of an embodiment of an obturator adapted to be used together with the cannula assembly kit of FIG. 1a.
[0224] FIG. 1c and FIG. 1d are schematic views of a trocar assembly kit comprising the cannula assembly kit of FIG. 1 and the obturator of FIG. 2 is partly or fully in an assembled state.
[0225] FIG. 2 is a schematic view of an embodiment of a cannula assembly kit, where the shaft portion of the cannula comprises a mounting through hole through which the projector has been mounted.
[0226] FIG. 3 is a schematic view of an embodiment of a cannula assembly kit comprising a sleeve.
[0227] FIG. 4 is a schematic view of an embodiment of a cannula assembly kit with a relatively large flange portion for comprising the pattern light source.
[0228] FIG. 5 is a schematic view of a distal end portion of an assembled trocar assembly kit, where the obturator comprises a projector protection arrangement.
[0229] FIG. 6 is a schematic view of an embodiment of a cannula assembly kit during use in a surgical procedure seen from outside the body cavity.
[0230] FIG. 7 is a schematic view of an embodiment of a cannula assembly kit during use in a surgical procedure seen in a cross-sectional view through the body cavity.
[0231] FIG. 8 is a schematic view of an embodiment of a cannula assembly kit configured for emitting a bullseye shaped pattern.
[0232] FIG. 9 is a schematic view of an embodiment of a cannula assembly kit with a bent cannula shaft portion.
[0233] FIG. 10 is a schematic view of an embodiment of a cannula assembly kit where the cannula comprises two cannula shaft portions and one cannula flange portion.
[0234] FIG. 11 is a schematic view of another cannula assembly kit where the cannula comprises two cannula shaft portions and one cannula flange portion.
[0235] FIG. 12 is a schematic view of an embodiment of a cannula assembly kit where the cannula comprises two cannula flange portions and one cannula shaft portion.
[0236] FIG. 13 is a schematic illustration of an embodiment of a minimally invasive surgery system of the invention where the projected light pattern comprises a coded structured light configuration comprising a plurality of light dots with different sizes.
[0237] FIG. 14 is a schematic illustration of an embodiment of a minimally invasive surgery system where the projected light pattern comprises a coded structured light configuration comprising a plurality of light dots with different shapes and sizes.
[0238] FIG. 15 is a schematic illustration of an embodiment of a minimally invasive surgery system where the projected light pattern comprises a crosshatched pattern
[0239] FIG. 16 is a schematic illustration of an embodiment of a minimally invasive surgery system where the projected light pattern comprises a plurality of parallel lines.
[0240] FIG. 17a illustrates a part of a minimally invasive surgery system.
[0241] FIG. 17b illustrates a procedure performed using the minimally invasive surgery system of FIG. 17a.
[0242] FIG. 18a illustrates a part of the minimally invasive surgery system of FIG. 17a.
[0243] FIG. 18b illustrates a part of minimally invasive surgery system of FIG. 18a and a procedure performed using the minimal invasive system of FIG. 17a.
[0244] FIG. 19 illustrates a procedure performed by a minimally invasive surgery system involving a number of sub-procedures.
[0245] FIGS. 20a and 20b illustrate an operation of a surgical tool of a minimally invasive surgery system.
[0246] The figures are schematic and are not drawn to scale and may be simplified for clarity. Throughout, the same reference numerals are used for identical or corresponding parts.
[0247] FIG. 1a illustrates an embodiment of a cannula assembly which may form part of a minimally invasive surgery system. The cannula assembly kit comprises a cannula 1 and a pattern generating member wherein only the projector 2 is shown. The cannula has a distal end D and a proximal end P and comprises a flange portion 4 at its proximal end and an elongate cannula shaft portion 3 extending from the flange portion 4 to its distal D end and an access port A through the flange portion 4 and the elongate cannula shaft portion 3, such that a surgical tool of a surgical instrument can be inserted through the access port. The pattern generating member comprises a not shown pattern light source and a projector 2 at least temporarily fixed to the cannula shaft portion 3 of the cannula. The cannula flange portion 4 comprises an insufflation port 5 for insufflating the body cavity.
[0248] The obturator and the cannula assembly kit of FIG. 1 are correlated to each other. The obturator 9 shown in FIG. 1b has a distal end D and a proximal end P and comprises a head portion 6 at its proximal end, a tip portion 8 at its distal end and a rigid obturator shaft portion 7 extending between said head portion 6 and said tip portion 8. The tip portion can be bladed or non-bladed.
[0249] The obturator of FIG. 1b and the cannula assembly kit of FIG. 1 are correlated to each other such that the obturator can be inserted into the access port A of the cannula 1. In FIG. 1c the obturator 9 is partly inserted into the access port A of the cannula 1. In FIG. 1d the obturator 9 is fully inserted into the access port A of the cannula 1 to thereby assemble the trocar assembly kit.
[0250] The cannula assembly kit shown in FIG. 2 comprises a cannula and a pattern generating member wherein only the projector 12 is shown. The cannula comprises a flange portion 14 and an elongate cannula shaft portion 13 extending from the flange portion 14 to its distal end and an access port A. At its distal end the cannula shaft portion 13 has an access port exit 13a and comprises an end edge 13b in the vicinity of said distal access port exit 13a.
[0251] The shaft portion 13 of the cannula comprises a mounting through hole 12a indicated on the drawing with dotted lines. The projector 12 has been mounted via the mounting through hole 12a and a not shown optical fiber extends through the mounting through hole 12a for transmitting light to the projector 12.
[0252] The cannula assembly kit shown in FIG. 3 comprises a cannula and a pattern generating member wherein only the projector 22 is shown. The cannula comprises a flange portion 24 and an elongate cannula shaft portion 23 extending from the flange portion 24 to its distal end and an access port A.
[0253] The shaft portion 23 and the flange portion 24 are covered by a sleeve 26 which is mounted to the cannula. The projector 22 is mounted to or integrated in the sleeve 26 and the sleeve also comprises a fiber covering line 22a comprising a not shown optical fiber arranged for transmitting light to the projector 22.
[0254] The cannula assembly kits shown in FIG. 4 comprises a flange portion 34 and an elongate cannula shaft portion 33 extending from the flange portion 34 to its distal end and an access port A. The cannula assembly kit also comprises a not shown pattern generating member. The rays R indicate that the not shown projector is positioned at the distal end of the cannula shaft portion 33. The cannula flange portion 34 is relatively large such that a not shown light source and/or battery can be incorporated into the cannula flange portion 34.
[0255] The distal end portion of an assembled trocar assembly kit shown in FIG. 5 comprises distal end portions of the correlated cannula assembly kit and obturator. The cannula assembly kit comprises a cannula shaft portion 43 and a projector 42 arranged for projecting a light pattern. The obturator comprises a rigid obturator shaft portion 47 and a tip portion 48. The obturator further comprises a projector protection arrangement 47a correlated with the projector 42 of the cannula assembly kit to at least partly cover the projector 42, such that the projector is at least partly projected during the insertion during surgery. In a not shown modified embodiment the projector protection arrangement is shaped to align with the shape of the tip portion of the obturator such that there will be a more gradually increase of the diameter of the assembled trocar assembly kit from the tip portion of the obturator to the cannula shaft portion of the cannula assembly kit.
[0256] When the obturator is withdrawn from the access port of the cannula assembly kit, the projector protection arrangement 47a will at least partly be passed into a cavity of the obturator, such that the projector protection arrangement 47a is not blocking for the withdrawal. The projector protection arrangement 47a may for example be pivotally folded into a cavity of the obturator, by folding towards the tip portion 48.
[0257] FIG. 6 and FIG. 7 show a cannula assembly kit in use during a surgical procedure. The figures show a body part of a patient in surgery, where an incision I is made through the skin 50 of the patient, the cannula assembly kit comprises a shaft portion 53 and a flange portion 54, and the shaft portion 53 is inserted through the incision I. The cannula assembly kit comprises a pattern generating member comprising a projector from where a light pattern P in the form of rays R of light is emitted.
[0258] A surgical instrument comprising a handle portion 56, a body portion 57 and a surgical tool 58 is inserted through the access port of the cannula assembly kit and the pattern P is projected onto a surgical site 60.
[0259] It can be seen that when the surgical tool 58 of surgical instrument is subjected to a lateral movement and/or tilting movement the pattern will be moved in a correlated way, thereby providing information to the operator.
[0260] The pattern may for example be recorded by an image recorder on a scope inserted via the same or another incision through the skin.
[0261] The cannula assembly kit 61 shown in FIG. 8 comprises a not shown projector operatively connected to a light source and configured for emitting light rays R arranged to form a bullseye shaped pattern P. The various rings of the bullseye shaped pattern P could for example have different wavelength profile.
[0262] The cannula assembly kit shown in FIG. 9 comprises a cannula and a pattern generating member wherein only the projector 72 is shown. The cannula comprises a flange portion 74 and an elongate cannula shaft portion 73 extending from the flange portion 74 to its distal end and an access port A. The cannula shaft portion 73 is bent in a soft curve to thereby make is easier for an operator to insert the cannula shaft portion 73 through an incision of a patient. The cannula shaft portion 73 is for example pre-bent to the shown bending curve and is further bendable or flexible i.e. in unloaded condition the cannula shaft portion 73 is bent. In another embodiment the cannula shaft portion 73 is substantially rigid in the bent position.
[0263] At its distal end the cannula shaft portion 73 comprises an end edge 73b and the projector 72 is mounted at the end edge 73b and a not shown optical fiber is arranged to guide light along a channel 72a in the wall of the cannula shaft portion 73.
[0264] The cannula assembly kit shown in FIG. 10 comprises a cannula and at least one pattern generating member wherein only the two projectors 82 are shown. The two projectors 82 can be of a common pattern generating member or they can be of separate pattern generating members.
[0265] The cannula comprises a flange portion 84 and a double cannula shaft portion 83, 83a, 83b. The double cannula shaft portion 83, 83a, 83b comprises a common shaft portion section 83 and two branch shaft portion sections 83a and 83b each comprising a distal access port section A, such that the cannula has a common access port section through the flange portion 84 and through the common shaft portion section 83 and two separate distal access port sections through said respective branch shaft portion sections 83a and 83b.
[0266] The cannula assembly kit shown in FIG. 11 comprises a cannula and at least one pattern generating member wherein only the two projectors 92 are shown. The two projectors 92 can be of a common pattern generating member or they can be of separate pattern generating members.
[0267] The cannula comprises a flange portion 94 and two cannula shaft portions 93a, 93b providing two access ports through the cannula flange portion 94.
[0268] The cannula assembly kit shown in FIG. 12 comprises a cannula and at least one pattern generating member wherein only the projector 102 is shown.
[0269] The cannula comprises two flange portions 104a, 104b and a double cannula shaft portion 104, 104a, 104b. The double cannula shaft portion 104, 104a, 104b comprises a common shaft portion section 104 and two branch shaft portion sections 104a and 104b. The respective branch shaft portion sections 104a and 104b are connected to the respective flange portions 104a, 104b and are merged in the common shaft portion section 104 in the distal end section of the cannula.
[0270] The minimally invasive surgery system shown in the respective FIGS. 13, 14, 15 and 16 comprises a cannula assembly kit 110, a surgical instrument 115, a camera 116 and a computer system 118.
[0271] The cannula assembly kit 110 comprises a flange portion 114, an elongate cannula shaft portion 117 and a projector 112 for projecting a light pattern at its distal end. An access port is provided via the cannula shaft portion 117.
[0272] The surgical instrument 115 comprises its actual operation tool 115a at its distal end. The distal end comprising the operation tool 115a is inserted through the access port of the cannula assembly kit 110.
[0273] The projector 112 projects a light pattern towards a distally arranged surface 111 and the reflected light pattern 113 is recorded by the camera 116. In use this distally arranged surface 111 will be a surgery site which may be very uneven as described above.
[0274] As the surgical instrument 115 is moved the cannula assembly kit will be moved accordingly and thereby also the projector 112 will be moved and the reflected pattern 113 will change accordingly at least when the surgical instrument 115 is subjected to tilting movements.
[0275] The camera records the reflected light and generates recorded image data. The recorded image data is transmitted to the computer system 118.
[0276] In the shown embodiment the computer system comprises a calibration unit for calibration of the camera, a processing unit comprising algorithms for 3D data set generation and decoding of the recorded and calibrated image data, a processing unit for determine topography data in real time and a PC for storing and/or displaying the determined topography data. The various units of the computer system 118 may be integrated in a common hardware box.
[0277] As described above the surgical instrument 115 may advantageously form part of a robot for performing the minimally invasive surgery and the computer system may provide feedback to the robot and/or at least a part of the computer system may be an integrated part of the robot.
[0278] In FIG. 17 the projected light pattern comprises a coded structured light configuration comprising a plurality of light dots with different sizes.
[0279] In FIG. 14 the projected light pattern comprises a coded structured light configuration comprising a plurality of light dots with different shapes and sizes.
[0280] In FIG. 15 the projected light pattern comprises crosshatched pattern
[0281] In FIG. 16 the projected light pattern comprises a plurality of parallel lines.
[0282] The minimally invasive surgery system shown in FIGS. 17a and 17b comprises a robot where only one robot arm is shown. The robot may comprise several arms. The robot arm comprises a number of joints J for bending, rotating, twisting and generally moving the robot arm. At its outermost section a surgical instrument and a cannula assembly is mounted. The surgical instrument is mounted to the robot arm via its mounting portion and the mounting portion can be displaced in a direction parallel to (coincident with) the axis of the cannula and the axis of the straight body portion of the surgical instrument. The cannula of the cannula assembly is inserted through an incision in the skin of a patient. The cannula assembly comprises a projector projecting a light pattern, which is reflected by the surgical surface as illustrated with the cross hatched pattern. A camera e.g. of an endoscope captures images of the reflected pattern and transmit image date to the computer system as illustrated in FIG. 17b. The image data is processed by the computer system using software algorithms for determining spatial position and orientation of the projector relative to the surgical surface e.g. distance B. Advantageously this determination is performed as real-time determinations monitoring the distance B during at least a part of a surgical procedure.
[0283] Top image of FIG. 18b is a close up illustration of the instrument and cannula assembly and it shows that the cannula is inserted through an incision in the skin of a patient.
[0284] Bottom image of FIG. 18b is a close up illustration of the surgical tool as it passes through the cannula and the distance A between the surgical tool tip and the cannula is indicated.
[0285] FIG. 18b further illustrates a procedure comprising 1) mounting the cannula assembly to the robot arm, 2) mounting the surgical instrument to the robot arm, 3) calibrating the displacement between the cannula and the distal surgical tool tip, 4) determining movements of the surgical tool e.g. by one or more sensors at the tool and/or by the computer system (where and if the computer system is configured for operating the surgical tool) and 5) continuously determining the distance A between the projector of the cannula and the distal tip of the surgical tool based on the displacement calibration and the data from the motion sensor
[0286] FIG. 19 illustrated a procedure performed by a minimally invasive surgery system involving a number of sub-procedures. A first sub-procedure is illustrated from image I to image II. Based on calibration data the computer calculate the relative position between the projector of the cannula assembly and the distal tip of the surgical tool—(distance A). This first sub-procedure corresponds to the procedure illustrated in FIG. 18b. A second sub-procedure is illustrated from image III to image IV. Based on camera images the computer calculates the position of the projector of the cannula assembly—(distance B). This first sub-procedure corresponds to the procedure illustrated in FIG. 18a.
[0287] A third sub-procedure is illustrated from image V to image VI. Pair wise time correlated A and B distance determinations are combined. The computer calculates the distance between the surgical surface and the distal tip of the surgical tool (distance C). Thereby all distances A, B and C may be determined in real-time (B−A=C).
[0288] FIG. 20a illustrates an operation of a surgical tool of a minimally invasive surgery system. Only cannula assembly and parts of the surgical tool are shown. In the left hand image, the distance (c) between the distal tip of the surgical tool and the surgical surface is determined. In the right hand image it is illustrated that the distance (c) is updated in real-time based on acquired motion data representing the movement of the surgical tool.
[0289] The distance C between the distal tip and the surgical surface is determined as the distance B between the projector of the cannula assembly minus the distance A between the distal tool tip and the projector of the cannula.
[0290] In an embodiment The computer system is further configured for determining the orientation of the surgical instrument and/or surgical tool.
[0291] In a procedure as indicated in FIG. 20b, encoders and/or other sensors are applied to sense movements of the tool tip. Data representing the tool tip movements are transmitted to the computer system. The computer calculates the change in distances A, B, C (see FIG. 19) and orientation of the tool and/or pointing direction of the tip. The computer process the data and update in real-time at least the distance C between the distal tip of the surgical tool and the surgical surface.
