U.S. patent application number 13/828008 was filed with the patent office on 2014-06-26 for mounting and positioning device of a surgical instrument and.or an endoscope for minimally invasive surgery and asurgical robot system.
This patent application is currently assigned to avateramedical GmBH. The applicant listed for this patent is avateramedical GmBH. Invention is credited to Andreas Karguth, Marcel Seeber, Christian Trommer.
Application Number | 20140180309 13/828008 |
Document ID | / |
Family ID | 50878754 |
Filed Date | 2014-06-26 |
United States Patent
Application |
20140180309 |
Kind Code |
A1 |
Seeber; Marcel ; et
al. |
June 26, 2014 |
MOUNTING AND POSITIONING DEVICE OF A SURGICAL INSTRUMENT AND.OR AN
ENDOSCOPE FOR MINIMALLY INVASIVE SURGERY AND ASURGICAL ROBOT
SYSTEM
Abstract
The invention describes a mounting and positioning device of a
surgical instrument and/or an endoscope for minimally-invasive
surgery, in particular for use within a surgical robot system,
comprising a first axis of rotation (3), around which a support
element (4) is rotatably arranged, wherein the first axis of
rotation (3) intersects with the longitudinal axis (11) of at least
one surgical instrument (9; 17A, 17b) and/or an endoscope (9; 17A,
17b) in a pivot point (13), as the result of a deviation drive (5)
being fixed on the support element (4), said deviation drive
arranging an instrument drive unit (15) in rotatable fashion around
a pivot point (13), and wherein a telescopic device (8) is provided
at an instrument drive unit (15), which allows for the translatory
movement of the surgical instrument (9; 17A, 17b) and/or the
endoscope (9; 17A, 17B) into the body, along its longitudinal axis
(11) using a guide device (10, 10s) in such fashion that the
longitudinal axis (11) of the surgical instrument (9; 17A, 17b)
and/or the endoscope (9; 17A, 17b) is variably adjustable in
relation to the telescopic device (8).
Inventors: |
Seeber; Marcel; (Jena,
DE) ; Karguth; Andreas; (Tuttleben, DE) ;
Trommer; Christian; (Wipfratal/Schmerfeld, DE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
avateramedical GmBH |
Jena |
|
DE |
|
|
Assignee: |
avateramedical GmBH
Jena
DE
|
Family ID: |
50878754 |
Appl. No.: |
13/828008 |
Filed: |
March 14, 2013 |
Current U.S.
Class: |
606/130 |
Current CPC
Class: |
A61B 2034/302 20160201;
A61B 90/11 20160201; B25J 18/007 20130101; A61B 90/50 20160201;
A61B 34/30 20160201; A61B 2034/305 20160201; A61B 2034/301
20160201 |
Class at
Publication: |
606/130 |
International
Class: |
A61B 19/00 20060101
A61B019/00 |
Foreign Application Data
Date |
Code |
Application Number |
Dec 20, 2012 |
DE |
10 2012 025 099.1 |
Claims
1. Mounting and positioning device of a surgical instrument and/or
an endoscope for minimally invasive surgery, in particular for use
within a surgical robot system, comprising a first axis of rotation
(3), around which a support element (4) is rotatably arranged,
wherein the first axis of rotation (3) intersects with the
longitudinal axis (11) of at least one surgical instrument (9; 17A,
17b) and/or an endoscope (9; 17A, 17b) in a pivot point (13), as
the result of a deviation drive (5) being fixed on the support
element (4), said deviation drive arranging an instrument drive
unit (15) in rotatable fashion around a pivot point (13), and
wherein a telescopic device (8) is provided at an instrument drive
unit (15), which allows for the translatory movement of the
surgical instrument (9; 17A, 17b) and/or the endoscope (9; 17A,
17B) into the body, along its longitudinal axis (11) using a guide
device (10, 10s) in such fashion that the longitudinal axis (11) of
the surgical instrument (9; 17A, 17b) and/or the endoscope (9; 17A,
17b) is variably adjustable in relation to the telescopic device
(8).
2. Mounting and positioning device according to claim 1,
characterized in that the instrument drive unit (15) on the
telescopic device (8) by means of an instrument pivot point (56) is
pivoted so that the longitudinal axis of the telescope (58) of the
telescopic device (8) is variable in relation to the longitudinal
axis (11) of the surgical instrument (9; 17A, 17b) and/or the
endoscope (9; 17A, 17b) in dependence on the deviation drive
(5).
3. Mounting and positioning device according to claim 1 or 2,
characterized in that the telescopic device (8) comprises several
telescope elements (8U, 8V, 8W), wherein the instrument pivot point
(56) is arranged on the telescope element (8W) with the largest
range of telescopic adjustment.
4. Mounting and positioning device according to one of the
preceding claims 1 to 3, characterized in that the guide device
(10, 10s) comprises at least one instrument guide (10s), through
which the shaft of the surgical instrument (9; 17A, 17b) and/or the
endoscope (9; 17A, 17b) extends.
5. Mounting and positioning device according to one of the
preceding claims 1 to 4, characterized in that the deviation drive
(5) is arranged on the telescopic device (8) by means of a
deviation drive position point (55), in such fashion that the
rotation of the instrument drive unit (15) around the pivot point
(13) is the result of a coupling device (6, 7) comprising a
coupling pivot point (6) which is firmly connected with the support
element (4).
6. Mounting and positioning device according to one of the
preceding claims 1 to 5, characterized in that the instrument drive
unit (15) moves the surgical instrument (9; 17A, 17b) and/or the
endoscope (9; 17A, 17B) in several degrees of freedom, wherein the
activation of the instrument drive unit (15) is controlled by the
surgeon with a control unit (44), by means of control and supply
lines, which are guided through the support element (4) and the
deviation drive (5).
7. Mounting and positioning device according to one of the
preceding claims 1 to 6, characterized in that the first axis of
rotation (3) is formed in that a drive unit (1) is provided that
can be mounted on a robotic arm, wherein a pivot joint (2) is
provided between the drive unit (1) and the support element
(4).
8. Mounting and positioning device according to one of the
preceding claims 1 to 7, characterized in that a coupling element
(12) is arranged on support element (4), which is rotatably
connected at the distal end at the pivot point (13) with the
instrument guide (10s).
9. Mounting and positioning device according to one of the
preceding claims 1 to 8, characterized in that several surgical
instruments (17a, 17b) are guided through a single trocar (18) into
the body, wherein a separate instrument drive unit (15a, 15b) is
provided for each surgical instrument (17a, 17b), and wherein in
particular the surgical instruments (17a, 17b) are curved in a
longitudinal direction.
10. Mounting and positioning device according to one of the
preceding claims 1 to 9, characterized in that the support element
(4) and/or the drive unit (1) can be adjusted by means of a
pre-positioning device in its starting position, wherein the
pre-positioning device comprises one or more pre-positioning
elements (30, 32, 34, 37), the position of which is adjustable in
at least one axis, wherein in particular four pre-positioning
elements (30, 32, 34, 37) can be preset with positions that are in
series and variable in relation to one another.
11. Surgical robot system with multiple mounting and positioning
devices according to one of the claims 1 to 10, wherein at least
two mounting and positioning devices are arranged on a mounting
support system (19, 20, 21, 22, 23, 24) that essentially runs
transversely to the mounting and positioning devices, wherein the
mounting support system (19, 20, 21, 22, 23, 24) is constructed
from one coupling point (22a-d) for each mounting and positioning
device, and wherein the coupling points (22a-d) are connected
rigidly or via joints (23, 24) with each other.
12. Surgical Robot System according to claim 11, characterized in
that the mounting support system (19, 20, 21, 22, 23, 24) by means
of a coupling support connection is connected to an essentially
vertically running main support device (39, 40), for support in
relation to a fixed bearing (42), which is movably arranged or
predefined in relation to a fixed or movable operating table
(48).
13. Surgical Robot System according to claim 11 or 12,
characterized in that a central control unit (46) is provided,
which is connected with each of the mounting and positioning
devices with the appropriate surgical instruments (9; 17A, 17b)
and/or endoscopes (9; 17A, 17b) and is coupled with a control panel
(44) for entering commands in the form of control data provided by
a surgeon, which by means of a visualization unit (53) provides
image data from one or multiple endoscopes (9; 17A, 17b).
14. Surgical Robot system according to one of the claims 11 to 13,
characterized in that the control unit (46) and the control panel
(44) are coupled with a movable operating table (48), wherein both
the image data as well as the control data are processed in
dependence of the given positions of the mounting and positioning
device and the operating table (48).
Description
[0001] The present invention relates to a mounting and positioning
device of a surgical instrument and a surgical robot system or
telemanipulator for minimally invasive surgery and in particular
laparoscopy.
[0002] Robot systems or telemanipulators for minimally invasive
surgery, particularly for laparoscopic surgery, replace the
surgical instruments usually operated manually by the surgeon, e.g.
surgical instruments, endoscopes, or camera, with a motorized
positioning mechanism. The surgical instruments to be used are
guided inside a patient's body via one or several trocars. A trocar
refers to an instrument used by the surgeon in minimally invasive
surgery to gain access to the patient's body cavity (usually the
abdomen or thorax), whereby the port is kept open by a tube, a
so-called tubus. The movement mechanics and control logic of
retainers provided in the robot system enables the movement of the
surgical instruments about a pivot point in 2 degrees of freedom
(x, y) and a translational movement of the surgical instruments
along the axis of the instrument (z). The pivot point refers to the
invariant point of the motion in 2 degrees of freedom (x, y). This
pivot point is ideally located at the point where the trocar
penetrates the patient's abdominal wall. The control logic of a
robot system must know the pivot point or the pivot point must be
defined by the moving mechanism's design, to limit the surgical
instrument's movement in a way that keeps the biomechanical stress
acting on the tissue around the trocar at a minimum.
[0003] Robot systems known from prior art are based on robot arms
with an active movement of a surgical instrument, which on one hand
require a large installation space and on the other hand, due to
the typical embodiments, make it difficult to avoid collisions
caused by the movements of the robot arms.
[0004] During a minimally invasive surgical procedure a minimum of
two, usually three to four surgical instruments, such as gripper,
scissors, needle holder, dissector), as well as a camera or an
endoscope are used, which are each inserted into the patient's body
via a separate trocar. This means that there is a robot arm for
each employed surgical instrument, controlling the positions of the
robot arms and active moving of the instrument.
[0005] The disadvantage of the prior art solutions lies in the fact
that due to the space required by the construct the positioning of
the instruments is limited and the surgical staff, e.g. the
assisting doctor and the surgical nurse, has limited access to the
patient.
[0006] A further disadvantage is that the invariant point in known
systems is always necessarily given by a mechanical coupling
between trocar and robot arm.
[0007] It is therefore the object of the present invention to
provide a manipulator arm for positioning a surgical instrument and
a surgical robot system that provides high variability and requires
only a small installation space or is of a smaller and lighter
embodiment, and optionally allows for the mechanical coupling of
the trocar with the manipulator arm or manages without this
mechanical coupling of the trocar with the manipulator arm.
[0008] It is a further object of the present invention to provide a
robot system that allows for a larger range of prepositioning for a
support structure of a manipulator arm. This enables more flexible
positioning relative to each other when two or more support
structures for manipulator arms are used.
[0009] These objects are achieved by the present invention, in
accordance with the features of claim 1, by a mounting and
positioning device for a surgical instrument and/or an endoscope
for minimally invasive surgery, and in particular for use within a
surgical robot system, which [0010] comprises a first axis of
rotation, around which a support element is rotatably arranged,
wherein the first axis of rotation always intersects with the
longitudinal axis of at least one surgical instrument and/or an
endoscope in a pivot point, as the result of a feeding drive being
fixed on the support element, said feeding drive arranging an
instrument drive unit in rotatable fashion around a pivot point,
[0011] and wherein a telescopic device is provided at an instrument
drive unit, which allows for the translatory movement of the
surgical instrument and/or the endoscope into the body, along its
longitudinal axis using a guide device in such fashion that the
longitudinal axis of the surgical instrument and/or the endoscope
is variably adjustable in relation to the telescopic device.
[0012] In addition, the objects are achieved by the present
invention, in accordance with the features of claim 11 by a
surgical robot system with multiple robot arms, on which at least a
surgical instrument and/or an endoscope for the minimally invasive
surgery can be arranged, at least two mounting and positioning
devices are arranged on a mounting support system that essentially
runs transversely to the mounting and positioning devices, wherein
the mounting support system is constructed from one coupling point
for each mounting and positioning device, and wherein the coupling
points are connected rigidly or via joints with each other.
[0013] Further advantageous embodiments of the invention and the
surgical robot system according to the invention arise from the
subclaims analogous to the manipulator arm for active positioning
of a surgical instrument. This is a result in particular of the
fact that the manipulator arm for active positioning of a surgical
instrument according to the invention can be combined or
retrofitted with a robot system. According to the invention, the
terms robot system and telemanipulator be used synonymously.
[0014] It is advantageous if the instrument drive unit on the
telescopic device is pivoted by means of an instrument pivot point
so that the longitudinal axis of the telescope of the telescopic
device is variable in relation to the longitudinal axis of the
surgical instrument and/or the endoscope in dependence on the
feeding drive.
[0015] A further embodiment of the invention is formed and arranged
in a manner such that a telescopic device comprises several
telescope elements, wherein the instrument pivot point is arranged
on the telescope element with the largest range of adjustment.
[0016] In a preferred embodiment the guide device comprises at
least one instrument guide, through which the shaft of the surgical
instrument and/or the endoscope extends.
[0017] It is especially advantageous that the feeding drive is
arranged on the telescopic device by means of a feeding drive
position point, in such fashion that the rotation of the instrument
drive unit around the pivot point is the result of a coupling
device comprising a coupling pivot point which is firmly connected
with the support element.
[0018] The rotation of the instrument drive unit with the
instruments and/or an endoscope around the pivot point as well as
the coupling pivot point allows for the essentially fixed
arrangement of the support element in relation top the pivot
point.
[0019] In a preferred embodiment the mounting and positioning
device is arranged in a manner such that the instrument drive unit
moves the surgical instrument and/or the endoscope in several
degrees of freedom, wherein the activation of the instrument drive
unit is controlled by the surgeon with a control unit, by means of
control and supply lines, which are guided through the support
element and the feeding drive.
[0020] The first axis of rotation is in particular formed in that a
drive unit is provided that controls the surgical instrument and/or
endoscope, wherein the drive unit can be mounted on a robotic arm
and a pivot joint is provided between the drive unit and the
support element.
[0021] A further embodiment is arranged in a manner such that a
coupling element is arranged on the support element, which is
rotatably connected at the distal end at the pivot point with the
instrument guide. Hereby the pivot point is mechanically predefined
in relation to the support element, which allows for an additional
fixing of the pivot point.
[0022] Furthermore, the present invention can be expanded in that
several surgical instruments are guided through a single trocar
into the body, wherein a separate instrument drive unit is provided
for each surgical instrument, and wherein in particular the
surgical instruments are curved in a longitudinal direction.
[0023] If the support element can be adjusted in its starting
position by means of a prepositioning device, wherein the
prepositioning device comprises one or more prepositioning
elements, the position of which is adjustable in at least one axis,
wherein in particular four prepositioning elements can be preset
with positions that are in series and variable in relation to one
another, then the mounting and positioning device can be preset to
a desired position.
[0024] The surgical robot system according to the invention may
also expanded in such a manner that the mounting support system by
means of a coupling support connection is connected to an
essentially vertically running main support device, for support in
relation to a fixed bearing, which is movably arranged or
predefined in relation to a fixed or movable operating table.
[0025] In another embodiment the invention the surgical robot
system according comprises a central control unit, which is
connected with each of the mounting and positioning devices with
the appropriate surgical instruments and/or endoscopes and is
coupled with a control panel for entering commands in the form of
control data provided by a surgeon, which by means of a
visualization unit provides image data from one or multiple
endoscopes.
[0026] It is furthermore advantageous that the control unit and the
control panel are coupled with a movable operating table, wherein
both the image data as well as the control data are processed in
dependence of the given positions of the mounting and positioning
device and the operating table.
[0027] The present invention is realized in purely exemplary manner
by the attached figures. Shown are:
[0028] FIG. 1a shows a schematic view of the manipulator arm
according to the invention for active positioning of a surgical
instrument which is connected to a telescopic jib by means of a
pivotably mounted drive unit, including a coupling element between
the guide device for inserting a surgical instrument and the
constructive device for achieving the second axis of rotation;
[0029] FIG. 1b shows a schematic view of the manipulator arm
according to the invention for active positioning of a surgical
instrument which is connected to a telescopic jib by means of a
pivotably mounted drive unit, including a coupling element between
the guide device for inserting a surgical instrument and the
constructive device for achieving the second axis of rotation;
[0030] FIG. 2a shows a further schematic view of the manipulator
arm according to the invention for active positioning of a surgical
instrument which is connected to a telescopic jib by means of a
pivotably mounted drive unit, including a coupling element between
the guide device for inserting a surgical instrument and the
constructive device for achieving the second axis of rotation,
which illustrates the sliding motion that creates the rotational
movement about the second axis of rotation by means of a coupling
joint;
[0031] FIG. 2b shows a further schematic view of the manipulator
arm according to the invention for active positioning of a surgical
instrument which is connected to a telescopic jib by means of a
pivotably mounted drive unit, including a coupling element between
the guide device for inserting a surgical instrument and the
constructive device for achieving the second axis of rotation,
which illustrates the sliding motion that creates the rotational
movement about the second axis of rotation by means of a coupling
joint;
[0032] FIG. 3a shows a schematic view of the manipulator arm
according to the invention for active positioning of a surgical
instrument which is connected to a telescopic jib by means of a
pivotably mounted drive unit, without the coupling element
according to Figure la;
[0033] FIG. 3a shows a schematic view of the manipulator arm
according to the invention for active positioning of a surgical
instrument which is connected to a telescopic jib by means of a
pivotably mounted drive unit, without the coupling element
according to FIG. 13;
[0034] FIG. 4 shows a schematic view of the manipulator arm
according to the invention for active positioning of a surgical
instrument without the coupling element according to FIG. 1, which
illustrates the sliding motion that creates the rotational movement
about the second axis of rotation by means of a coupling joint and
the coupling of the instrument drive unit;
[0035] FIG. 5a shows a top view of an embodiment of the manipulator
arm according to the invention for active positioning of a surgical
instrument, which comprises a telescopic arm on the right side;
[0036] FIG. 5b shows a top view of an embodiment of the manipulator
arm according to the invention for active positioning of a surgical
instrument, which comprises a telescopic arm on the left side;
[0037] FIG. 6 shows a schematic view of embodiments of the
manipulator arm according to the invention for active positioning
of a surgical instrument, which comprise telescopic arm on the
right side and telescopic arm on the left side for mutual use with
a single port trocar;
[0038] FIG. 7 shows a schematic view of the flexibly adjustable
support structure according to the invention;
[0039] FIG. 8 shows a schematic view of the prepositioning device
according to the invention;
[0040] FIG. 9 shows a schematic view of the flexibly adjustable
support structure according to the invention with a connected
prepositioning device according to the invention on which a
manipulator arm according to the invention for active positioning
of a surgical instrument is arranged;
[0041] FIG. 10 shows a schematic side view of a superordinate
carrying system, on which the flexibly adjustable support structure
according to the invention is arranged with four connected
prepositioning devices according to the invention on each of which
a manipulator arm according to the invention for active positioning
of a surgical instrument is arranged;
[0042] FIG. 11 shows a schematic front view of a superordinate
carrying system, on which the flexibly adjustable support structure
according to the invention is arranged with four connected
prepositioning devices according to the invention on each of which
a manipulator arm according to the invention for active positioning
of a surgical instrument is arranged;
[0043] FIG. 12 shows a schematic view of the use of the
superordinate carrying system in a surgical robot system for use in
minimally invasive surgery, like e.g. laparoscopy.
[0044] The present invention is described below in exemplary manner
in detail with reference to the figures described below:
[0045] FIG. 1a, FIG. 2a, FIG. 1b and FIG. 2b show a manipulator arm
according to the invention for active positioning of a surgical
instrument, including a coupling element 12 between the guide
device 10 for inserting a surgical instrument 9 and the
constructive device 4 for achieving the second axis of rotation.
Generally 4 surgical instruments are use during a minimally
invasive, laparoscopic surgery, of which 3 are surgical instruments
and 1 is a camera or endoscope, controlled by the surgeon by means
of the telemanipulator system. Thus, according to the invention,
the system comprises preferably 4 versions of a manipulator arm.
However, it goes without saying that also embodiments with 1 to 3
or more than 4 manipulator arms in accordance with the present
invention may be provided, with each manipulator arm comprising at
least a mounting and positioning device according to the
invention.
[0046] Each manipulator arm has the degree of freedom 3 required
for realization of a pivoting motion of an instrument 9 coupled via
an instrument drive unit 15 in x- and y-direction, and for a
translational movement in z-direction. To this end, each
manipulator arm comprises a first drive unit 1, which enables a
rotational movement of .+-.120.degree. about the axis of rotation 3
via pivot joint 2, starting from the zero point position. This
rotational movement about the axis 3 results in a tilting of the
coupled constructive device consisting of the elements 4, 5, 6, 7,
8, 12 about an invariant point 13, the so-called pivot point. The
support element 4 carries a feeding drive 5, which realizes a
second rotational movement about a second pivot point 6,
orthogonally to axis of rotation 3. The coupling element 12 between
the support element 4 and the grommet 10 for a surgical instrument
9 is connected at the pivot point 13 with the grommet 10 in a
manner such that the axis of rotation 3 extends through this pivot
point 13 and the grommet 10, being forcibly actuated around the
axis of rotation 3, implements the tilting. The grommet 10
implements the access for a surgical instrument 9 through the
abdominal wall 14 of a patient. By means of a feeding drive 5 a
force transmission to a coupling guide 7 in pivot point 55 is
achieved, which realizes a rotation of the coupling guide 7 about
the pivot point 6 of at least .+-.60.degree.. The grommet 10 serves
in particular as guide device for the surgical instrument 9 and has
a guide shaft 10s that serves to guide instrument 9 and preferably
is formed in one piece with grommet 10.
[0047] A telescopic jib 8 is arranged on the coupling guide 7. The
telescopic jib 8 comprises an actuating drive 81. The supply and
control lines for the actuating drive 81 of the telescopic jib 8
are guided along the feeding drive 5 through the support element 4
and the drive unit 1. The supply and control lines for the feeding
drive 5 are guided through the support element 4 and the drive unit
1.
[0048] An instrument drive unit 15 is rotatably arranged on the
telescopic jib 8, as shown in FIG. 2a or 2b. The instrument drive
unit 15 serves for the realization of the degree of freedom 4 of an
instrument 9 coupled with it. For this purpose an instrument drive
unit 15 is equipped with the respective actuating drives. The
supply and control lines for the actuating drives of the instrument
drive unit 15 are guided via the telescopic jib 8 along the feeding
drive 5 through the support element 4 and the drive unit 1.
[0049] A tilting of the coupling element 7 leads to a tilting
motion of the telescopic jib 8 attached thereto about the axis 6
and thus to a tilting of the instrument drive unit 15 and surgical
instrument 9 coupled with it. This leads to a tilting motion of the
grommet 10 in an orthogonal axis to the axis of rotation 3 about
the pivot point 13 (see FIG. 2a). The resulting position of the
longitudinal axis of the instrument 11 corresponds to the axis
between an instrument pivot point 56 of the instrument drive unit
15 on the telescopic jib 8 and the pivot point 13. The surgical
instrument 9 is forcibly guided along the longitudinal axis of the
instrument 11 by means of the grommet 10 in a manner such that by
means of the drives 1 and 5 a pivotal tilting motion of the
surgical instrument 9 about the pivot point 13 is realized in axes
orthogonally to each other. A telescopic jib 8 is arranged on the
coupling guide 7 such that the surgical instrument 9 is mounted on
the telescopic jib 8 by means of the instrument drive unit 15 can
be moved along the longitudinal axis of the instrument 11 and
through the grommet 10 and thereby be moved in relation to
abdominal wall 14. The entire design can be implemented in
extremely compact manner. Surgical Instruments 9 typically have a
diameter of 5 to 10 mm and a length of 250 to 300 mm. The
embodiment according to the invention of the telescopic jib 8 is
designed in a way that a surgical instrument 9 can be moved by
preferably at least 250 mm along its axis of the instrument 11 in
relation to the grommet 10 and that, in the case of the maximum
penetration depth of the surgical instrument 9 into the grommet 10
the telescopic jib 8 is at its minimal length, i.e. extends only
marginally beyond the proximal end of the surgical instrument 9,
and thus the risk of collision between different surgical
instruments 9 or telescopic jibs 8 of manipulator arms arranged
side-by-side resulting from the necessary pivoting motions is
minimized. The entire design has a significantly minimized
installation space, compared to prior art. The full construction
length 16 of a manipulator arm according to the invention as
measured from the drive unit 1 to the pivot point 13 is preferably
less than 500 mm. The embodiment with the coupling element 12 for
forcibly guiding the pivot point 13 at the grommet 10 allows for
the use of the manipulator arm according to the invention also in
case of open, non-minimally invasive operations.
[0050] FIG. 3a, FIG. 3b and FIG. 4 show a manipulator arm according
to the invention for active positioning of a surgical instrument 9
without mechanical coupling between the guide device 10 for
insertion of a surgical instrument and the constructive device 4
for realization of the second axis of rotation. In accordance with
this embodiment the tilting movements about the axes of rotation 3
and 6 produced by drive units 1 and 5 are not mechanically
transferred to the pivot point 13. In this embodiment the grommet
10 acts as floating bearing within the abdominal wall 14, as is the
case in manual laparoscopy with hand-held instruments. In this
embodiment the orientation of the axis of the instrument between
the pivot point 56 of the instrument drive unit 15 and the pivot
point of the guide device 10 results in the abdominal wall 14. The
pivot point 13 in or on the abdominal wall 14 eventuates from the
resulting force between torque impressed from the outside and reset
or holding torque of the abdominal wall. This puts less stress on
the tissue of the abdominal wall, in particular if more than one
instrument 9 is used, each in its own guide device 10, because
there is no direct fixed mechanically coupled force exerted by the
coupling element 12 acting on guide device 10 and thus the
abdominal wall 14.
[0051] The telescopic jib 8 is used to move the instrument 9
through the guide device 10 along the axis of the instrument. The
sliding motion results from moving at least 2, preferably 3
telescope elements 8u, 8v, 8w in relation to each other by means of
an actuating drive 81 and actuating elements 82, 83, preferably
formed as toothed belts. The Instrument 9 is mounted on the
outermost telescope element 8w in pivotable manner, by means of the
instrument drive unit 15 in instrument pivot point 56.
[0052] The resulting axis of the instrument 11 of the instrument 9
is not identical with the longitudinal axis of the telescope 58,
due to the force transmission point 55 of the feeding device 5 on
the telescopic jib. Due to the pivotable arrangement of the
instrument drive unit 15 on the outmost telescopic jib 8w and the
resulting possible pivoting or compensating movement about the
instrument pivot point 56, neither the force transmission point 55
nor the pivot point 6 of the coupling element 7 have to be on the
longitudinal axis of the instrument 11. In particular, the
pivotable arrangement of the instrument drive unit 15 about the
instrument pivot point 56 makes it possible that the longitudinal
axis of the instrument 11 and the longitudinal axis of the
telescope 58 are variable to each other, wherein the force
transmission point 55 and the instrument pivot point 56 are
different and affect each other.
[0053] Omitting the coupling element 12 allows for guiding two
surgical instruments 9 through a common grommet 10 by means of two
manipulator arms according to the invention and represents a
substantial improvement and increased flexibility in comparison to
prior art.
[0054] FIGS. 5a and 5b show a top view of two different embodiments
of the manipulator arm according to the invention for active
positioning of a surgical instrument. The design can preferably be
used in a "right-sided" or "left-sided" embodiment. Starting from
the first drive unit 1a, 1b with the pivot joint 2a, 2b, the second
drive unit 4a can be to the right of the axis of rotation
3a--right-sided embodiment--or the second drive unit 4b can be to
the left of the axis of rotation 3a--left-sided embodiment. The
rotation movement, which is orthogonal to the axis of rotation 3a,
3b is created by the drive unit 5a, 5b. The movement of the
surgical instrument 9a, 9b along its longitudinal axis of the
instrument through the grommet 10a, 10b is carried out by the
telescopic jib 8a, 8b. The surgical instrument 9a, 9b itself is
mechanically connected with the telescopic jib 8a, 8b, by means of
an instrument drive unit 15a, 15b.
[0055] FIG. 6 shows the use of two manipulator arms according to
the invention for active positioning of a surgical instrument in
the "left-handed" and "right-handed" embodiments for mutual use
with a single port trocar 18 with the grommets 18a, 18b, 18c. In
this configuration it is preferable that curved instruments 17a,
17b are used in combination with a left-sided manipulator arm 1b,
4b, 8b and a right-sided manipulator arm 1a, 4a, 8a, with the
advantage that the surgical instruments 17a, 17b can be used
through a mutual trocar 18--which enables access through the
abdominal wall 14 of the patient--and respectively separate
grommets 18a, 18b of the mutual trocar 18. The separate grommets
18a, 18b, and 18c of the mutual trocar 18 are mounted in movable
pivotable fashion relative to the trocar 18 by means of an elastic
material 60. The option of using the manipulator arm according to
the invention without the mechanical coupling 12 between the
support element 4 on the manipulator arm and the pivot point 13
(see FIG. 1a), makes the use of only one trocar 18 with at least
two grommets 18a, 18b possible. Through the use of a left-sided
manipulator arm 1b, 4b, 8b according to the invention and a
right-sided manipulator arm invention 1a, 4a, 8a according to the
invention the danger of the manipulator arms colliding as a result
from the pivotal tilting motion can be minimized.
[0056] Due to the preferable use of curved instruments 17a and 17b
in a single port trocar 18, a relative motion 62a, 62b of the two
instruments leads towards each other, e.g. in order to connect
tissue by means of a seam stitching in the surgical area, whereas a
relative motion 61a, 61b of the two manipulator arms outside of the
patient leads away from each other. This ensures that the
manipulator arms cannot collide with each other.
[0057] The use of crossover instruments in the single port surgical
technique is known from prior art. In contrast, the present
embodiment as a matter of principle holds the advantage of
collision avoidance while moving the instrument tips inside the
body of the patient towards or away from each other.
[0058] FIG. 7 shows the design of a flexible carrier system or
mounting support system 19-26 for preferably up to 4 prepositioning
devices and manipulator arms. The flexible carrier system can be
mounted to a superordinate carrying system via a coupling point 19
in such a manner that the position of the flexible carrier system
about the axis of rotation 20 can be optimally adjusted by at least
.+-.90.degree.. The flexible carrier system consists of preferably
4 coupling points 22a, 22d for the adaptation of up to four
prepositioning devices. The outer coupling points 22a, 22d are
connected with the coupling points 22b, 22c through the joints 23,
24 in a manner such that they can be pivoted by up to 30.degree. in
relation to the axis 20. The entire design is kept to an optimized
minimal installation space 25, 26 of approximately 415 mm or 350 mm
as an exemplary design and can preferably be formed so that, for
example, the width of the flexible carrier system can be a maximum
of 700 mm.
[0059] FIG. 8 shows a prepositioning device 29 . . . 38 according
to the invention for adapting a flexible carrier system (FIG. 7)
and mounting a manipulator arm according to the invention (FIG. 1 .
. . 4). The prepositioning device is arranged on a coupling point
(e.g. 22d) of the flexible carrier system by means of a coupling
joint 29 and allows for the twisting of a first prepositioning
element 30 by preferably .+-.90.degree. in relation to the flexible
carrier system or the coupling point. A second prepositioning
element 32 is arranged so that it can be rotated by further
.+-.90.degree. in relation to the first prepositioning element 30,
by means of a further joint 31. The axes of rotation of the
coupling point 29 and the joint 31 are preferably arranged
orthogonally to each other. The second prepositioning element 32 is
connected with a third prepositioning element 34 by means of a
further joint 33 in such a manner that the third prepositioning
element 34 is pivoted by .+-.90.degree. in relation to the second
prepositioning element 32. The third prepositioning element 34 is
connected with a fourth prepositioning element 37 by means of a
pivot joint 35. In this regard the axis of rotation 36 is
preferably orthogonal to the axis of rotation of the joints 31 and
33 respectively and allows rotational movement of .+-.90.degree..
The fourth prepositioning element 37 has a coupling point, which
allows for a rotational movement about the axis of rotation 38
orthogonal to the axis of rotation 36. The coupling of the
manipulator arm according to the invention is made at the axis of
rotation 38, as shown in the FIGS. 1, 2, 3, 4, 5a and 5b.
[0060] FIG. 9 shows a preferable embodiment for the connection of
the flexible mounting and carrier system 19-26 with a
prepositioning device according to the invention 29-38 with an
exemplary manipulator arm according to the invention 1, 2, 3, 4, 8,
10, 15 coupled thereto. The drive unit 1 is of the manipulator arm
is connected at the fourth prepositioning element 37 of the
prepositioning device in the axis of rotation 38. The design is
formed in a manner such that either a left-sided or right-sided
embodiment of the manipulator according to the invention can be
connected to the axis of rotation 38 of the prepositioning
device.
[0061] FIG. 10 and FIG. 11 shows a design of the surgical robot
system according to the invention and in particular of the
superordinate carrier system 39-43 to which the flexibly adjustable
carrier system 22a-22d is coupled by means of the coupling point or
coupling support connection 19. The superordinate carrier system
allows for the optimal prepositioning of the flexible carrier
system 22a-22d by means of a horizontal alignment of the preferably
mobile base carrier or fixed bearing 42 in relation to the surgical
table 48 (see FIG. 12) and a vertical alignment by setting the
optimal angle between assembly 39 and 40 by means of the adjusting
element 41. The prepositioning device according to the invention
29d . . . 38d is connected to the flexible carrier system by means
of the coupling point 29d and mounts the manipulator arms according
to the invention at the coupling point 38d. The entire design
distinguishes itself from prior art in that all robot components
are concentrated in the manipulator arm and thus the entire design
requires significantly less installation space when compared to
prior art, especially having a mere height 43 of exemplary 1447
mm.
[0062] FIG. 12 shows a schematic general view of the use of the
superordinate carrier system 39 . . . 42 in a surgical robot system
for use in minimally invasive surgery, such as e.g. laparoscopy. By
means of an operating unit 44, the user can transmit control
commands for the actuators of the manipulator arm according to the
invention to a control unit 46 via a suitable data connection 45.
Said control unit is connected with the superordinate carrier
system 39 . . . 42 via a further data line 49 and, when equipped
with a support arm or main support device 39, 40, a flexible
carrier system 39, 40 connected by means of the coupling point 19
can be prepositioned according to the position of the patient on
the surgical table 48 by means of a coupling point 19 so that the
flexible carrier system in conjunction with the prepositioning
devices allows for an optimal positioning of the manipulator
arms.
[0063] If a manipulator arm according to the invention is fitted
with e.g. an endoscopic camera the image signals can be transmitted
to a processing unit 51 via the appropriate data connections 49,
45, 50, which processes the image data for presentation and feeds
it back to a visualization unit 53 via a further data connection
53. The visualization unit 53 can display both 2D and 3D image
data, for example separately but also combined in a single image or
a single series of pictures. The control of how image data is
displayed is performed by the control unit 44, according to the
wish of the operator or surgeon respectively. The control commands
produced by the control unit 44 for this purpose are transmitted to
processing unit 51 via data connection 51.
[0064] The present invention therefore relates on the one hand to a
mounting and positioning device of a surgical instrument and/or an
endoscope, wherein one or more such mounting and positioning
devices according to the invention are arranged on a surgical robot
system above coupling points respectively, wherein these coupling
points are connected to each other respectively, so that the
required installation space of the surgical robot system
advantageous is only very small. The particularly compact
construction is furthermore the results of the especially light and
compact practicability of the mounting and positioning device
according to the invention, wherein this can furthermore be
retrofitted in an existing robot system.
[0065] In a preferred embodiment the guide device for insertion of
a surgical instrument is rigidly connected via a coupling element
with the constructive device for realization of the second axis of
rotation. The rotation movement of the axis of rotation 1 thus
leads to a forced movement of the guide device for insertion of a
surgical instrument about the invariant point in a direction x.
[0066] In a further preferred embodiment the guide device for
insertion of a surgical instrument is not rigidly connected with
the constructive device for realization of the second axis of
rotation. Thus the guide device for insertion of a surgical
instrument acts as floating bearing in the abdominal wall, as is
normal for manual laparoscopy.
[0067] In a further preferred embodiment the surgical instrument is
coupled with the telescopic device by means of an instrument drive
that comprises a rotational actuator, through which the shaft of
the surgical instrument is rotatably varied about the z-direction
in relation to the starting position. Preferably, the instrument
drive unit comprises three instrument actuators, through which the
active component mounted on the distal end of the surgical
instrument can be varied in three additional degrees of freedom. It
is particularly preferred that the instrument drive unit is
arranged by means of a holding device at the proximal end of the
telescopic mechanism.
* * * * *