SURGICAL ROBOT/INSTRUMENT SYSTEM
20170281286 ยท 2017-10-05
Inventors
Cpc classification
A61B18/1445
HUMAN NECESSITIES
A61B2034/305
HUMAN NECESSITIES
A61B17/3462
HUMAN NECESSITIES
A61B17/16
HUMAN NECESSITIES
A61B18/1482
HUMAN NECESSITIES
A61B46/10
HUMAN NECESSITIES
A61B90/50
HUMAN NECESSITIES
A61B2090/0813
HUMAN NECESSITIES
International classification
Abstract
A surgical robot/instrument system comprising a holding arm whose distal end portion has a gripping or holding device arranged thereon, the latter being designed to hold a trocar or a surgical instrument in an exchangeable fashion, and a surgical instrument with a minimally invasive design comprising an instrument shaft whose distal end portion supports an instrument tip via a joint, said instrument tip supporting an effector of the surgical instrument. The surgical robot/instrument system comprises drives by means of which functions such as actuating the effector, inclining or bending of the effector at its joint to the instrument shaft, rotating the effector around its longitudinal axis and/or rotating the instrument shaft, moving the instrument shaft in its shaft direction as well as moving the instrument shaft transverse to the shaft direction can be effected. The drives for effecting at least the instrument-internal functions, such as actuating the effector, inclining or bending the effector at its joint to the instrument shaft and rotating the effector around its longitudinal axis are provided internally on or in the surgical instrument. The drives for effecting the instrument-external functions, such as moving the instrument shaft transverse to the shaft direction, are provided externally on/in the holding arm.
Claims
1. A surgical robot/instrument system, comprising: a trocar; and a holding arm having a distal end portion; a gripping or holding device arranged on the distal end portion of the holding arm, the latter being designed to hold exclusively the trocar in an exchangeable fashion, and a surgical instrument preferably with a minimally invasive design and comprising an instrument shaft whose distal end portion supports an instrument tip via a joint, said instrument tip supporting or forming an effector of the surgical instrument, wherein the surgical robot/instrument system comprises a number of drives or drive units by means of which at least the following functions can be effected: an actuation of the effector, an inclination or bending of the effector preferably at its joint to the instrument shaft, a rotation of the effector around its longitudinal axis and/or a rotation of the instrument shaft, a movement of the instrument shaft in its shaft direction as well as moving the instrument shaft transverse to the shaft direction, whereas, the drives for effecting at least the instrument-internal functions, preferably an actuation of the effector, an inclination or bending of the effector preferably at its joint to the instrument shaft (10) and a rotation of the effector around its longitudinal axis are provided as instrument-internal drives preferably on/in the surgical instrument, whereas the drives for effecting the instrument-external functions, preferably moving the instrument shaft (10) transverse to the shaft direction are provided as instrument-external drives preferably on/in the holding arm.
2. The surgical robot/instrument system according to claim 1, wherein the trocar is designed to receive the surgical instrument so as to be rotatable around its instrument shaft and/or so as to be movable along its instrument shaft.
3. The surgical robot/instrument system according to claim 2, wherein the trocar is provided with trocar-internal drives which are designed to effect the movements of the surgical instrument within the trocar.
4. The surgical robot/instrument system according to claim 1, wherein the gripping or holding device is mounted on the holding arm in such a manner that it can be bent with respect to the holding arm and preferably can be extended and retracted relative to the holding arm in a telescopic manner.
5. The surgical robot/instrument system according to claim 4, wherein the bending movement and the telescopic movement are effected by the instrument-external drives.
6. The surgical robot/instrument system according to claim 1, wherein the instrument-internal drives are connected to the instrument shaft in a fixed or detachable manner and effect the instrument-internal functions via power transmission trains arranged preferably within the instrument shaft.
7. The surgical robot/instrument system according to claim 1, wherein an at least two-part instrument shaft comprising a distal and a proximal shaft portion which are coupled to each other so as to be rotatable relative to each other around the shaft axis and/or shiftable in the direction of the shaft axis, and the drive units for effecting instrument-internal functions, preferably any movement(s) of the distal shaft portion relative to the proximal shaft portion, an actuation of the effector, an inclination or bending of the effector preferably at its joint to the instrument shaft and a rotation of the effector around its longitudinal axis being directly arranged in/on the instrument.
8. The surgical instrument according to claim 7, wherein the instrument-internal drives are mounted on the proximal end portion of the instrument shaft in a fixed or detachable manner.
Description
DESCRIPTION OF THE FIGURES
[0042] The invention will be explained in more detail below on the basis of a preferred exemplary embodiment with reference to the attached drawings.
[0043]
[0044]
[0045]
[0046]
[0047] The surgical instrument shown in
[0048] In the present example, the surgical instrument having a minimally invasive design comprises an instrument shaft 10 (flexible or rigid) at whose distal end an instrument tip 12 is articulated in such a manner that the instrument tip 12 can bend like a hinge with respect to the shaft axis 10. In the following, this bending function forms according to
[0049] As shown in
[0050] Further, provision may be made that the distal shaft portion, in addition to or as an alternative to the previously described rotational support, is supported in/around/on the proximal shaft portion even so as to be movable in the longitudinal direction (in a telescopic manner).
[0051] Furthermore, the instrument shaft 10 can be inclined/tilted in an X-plane as well as in a Y-plane (perpendicular to the X-plane), in the following corresponding to the 3rd and 4th degree of freedom of the surgical instrument. Finally, the instrument tip 12 forms or comprises an effector of the surgical instrument, in the present case consisting of a jaw part comprising preferably two branches 16, 18 from which at least one branch 16 is pivotally supported on the effector in order to enlarge or reduce a gripping/clamping gap between the branches. This pivoting movement of the at least one branch 16 represents in the following the 6th degree of freedom of the surgical instrument.
[0052] Here, it is referred to the fact that in the case of a surgical instrument realized in some other design, such as a mechanical cutting knife, for example, the 6th degree of freedom would relate to extending or retracting the knife from or into the instrument tip, or in the case of a drill/milling cutter would relate to the rotation of the milling/drilling head, etc. It would also be conceivable to move an HF electrode or similar tool with respect to the effector.
[0053] The 5th and 6th degrees of freedom or movement possibilities defined in this way are achieved in the present exemplary embodiment preferably by mechanical ways and means, in fact preferably by means of independent power transmission trains (not shown in further detail) which may be arranged as instrument-internal trains within the instrument shaft 10.
[0054] As illustrated in
[0055]
[0056] Here, it is referred to the fact that the stand 26 may be immovably mounted or in turn may be arranged on the distal end of a further, preceding movement mechanism (and hence in a movable manner). In the latter case, the stand 26 may simply be a swivel pin where the holding arm 24 is pivotally or immovably supported/held.
[0057] It may also be provided to support the holding arm on the stand only so as to be able to pivot, but not so as to be able to extend in telescopic manner, with the option that the holding arm can also be extended in a telescopic manner.
[0058] According to the present preferred exemplary embodiment, the holding arm 24 has its distal end portion provided with a gripper or coupling piece 28 which is connected to the holding arm 24 preferably by means of a joint or hinge 30. It is preferred that the gripper 28 can be exchanged depending on the surgical instrument to be used in each case or is designed as a universal gripper (and hence in a not exchangeable manner) which is adapted to be coupled to a freely selected surgical instrument.
[0059] The robotic structure is thus designed such that it is capable of moving the gripper 28 arranged on the distal end of the holding arm 24 according to the previously mentioned 3rd and 4th degree of freedom.
[0060] Stated in other words, in the case of application of the surgical robot/instrument system according to the invention it is understood that the surgical instrument is inserted directly or through a trocar 32 into a patient cavity, e.g. through the abdominal wall. In this case, the patient's tissue (e.g. abdominal wall) representing the penetration site serves as an abutment against any movements in the tissue plane. If the gripper 24 is moved in an X- and Y-direction transverse to the shaft axis, the instrument shaft 10 and/or the trocar 32 perform a corresponding pivoting movement around the penetration site as an imaginary pivot point. In this way, the instrument shaft/trocar may describe a sort of funnel in the course of its pivoting movement, with the penetration site as the tip of the funnel, as indicated in
[0061] As an alternative or in addition to this, the abdominal wall may also be supplemented or replaced by an elastic membrane defining the imaginary pivot point. Finally, it is also possible to give the gripper a corresponding rotation by a motorized unit in order to produce a funnel-shaped pivoting movement of the instrument/trocar in superposition with the circular movement of the holding arm; in this case, the abdominal wall and/or membrane serving as the abutment would not be required any more.
[0062] In this connection, the drive unit(s) 20 is/are located with respect to the gripper 24 on an end side of the surgical instrument remote from the penetration site, so that the view onto the penetration site remains unobstructed and is slightly limited merely by the preferably filigree gripper 24 (which is constructed as a framework).
[0063] In the present exemplary embodiment of the invention, it is not the surgical instrument itself which is mounted on the gripper 24, but a trocar 32 is exchangeably mounted.
[0064] A trocar is a surgical introduction aid at least comprising a tubular shaft having a distal front edge preferably realized as a blade and an insertion funnel on the proximal end of the tubular shaft for the insertion of a surgical instrument having the previously mentioned structure.
[0065] As a general rule, the trocar is realized so as to have a smooth surface at the inner side of the shaft, preferably with a sealing edge for preventing any uncontrolled outflow of blood or for preventing an air leak in the event of pressurizing the patient cavity with air for deploying it.
[0066] In the present exemplary embodiment, however, the trocar 32 is (optionally) provided with an internal drive/drive unit (not shown in further detail) by means of which the inserted surgical instrument can be (optionally) shifted in its longitudinal axis and, if applicable, can also be (optionally) rotated around its longitudinal axis. By way of example, the trocar-internal drive may consist of a number of friction wheels which act on the instrument shaft.
[0067] Further, the trocar-internal drive may also be designed such that it acts in one direction only, for instance in a direction toward the patient for advancing the surgical instrument into the patient body, whereas a movement of the surgical instrument in the opposite direction (out of the patient body) can be achieved for instance by a helical compression spring 34 which is supported on the trocar 32 as well as on the drive unit 20 of the surgical instrument, as is likewise shown in
[0068] The operating principle of the surgical robot/instrument system according to the invention can be explained preferably on the basis of
[0069] Here, a patient is illustrated symbolically, which is penetrated at at least two points spaced apart from each other by one trocar in each case. The two trocars are each held on one holding arm 24 (or gripper) in the previously mentioned sense, in fact in such a way that the two trocars are able to perform a pivoting movement (in a funnel shape) around the respective penetration site, as has been described above. In addition, a camera is inserted into the patient body at a third penetration site.
[0070] As can be seen in this case, the pivoting movement of each of the trocars is achieved in that the gripper 28 is swiveled back and forth around its joint to the holding arm 24 in a first plane (e.g. X-plane according to