CN103654960A - Robot for minimally invasive orthopedic surgery - Google Patents
Robot for minimally invasive orthopedic surgery Download PDFInfo
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- CN103654960A CN103654960A CN201310495949.9A CN201310495949A CN103654960A CN 103654960 A CN103654960 A CN 103654960A CN 201310495949 A CN201310495949 A CN 201310495949A CN 103654960 A CN103654960 A CN 103654960A
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Abstract
The invention provides a robot for minimally invasive orthopedic surgery. The robot is characterized in that the robot for the minimally invasive orthopedic surgery is composed of a robot body, X-ray perspective equipment, a master control system, a ray registration device, a cross-shaped registration device, a double-implantation mechanical hand and a single-implantation mechanical hand, the master control system is composed of a control table, a computer, a manual controller, an external scene display system and a motor driver, a liquid crystal displayer is adopted as the displayer of the external scene display system, registration is carried out on virtual labels arranged in the human vertebrae and same virtual labels on an extracorporal registration device through X-rays, and transpedicular implantation or puncturing is guided.
Description
Technical field
The present invention relates to orthopedic medical device technical field, particularly a kind of minimal access bone robot.
Background technology
Although it is varied that the therapeutic modality of spinal operation has, as fixing in fixing in spinal fracture pedicle nail, spondylolishesis pedicle nail, orthopedic surgery of scoliosis, vertebroplasty etc., but great majority all will be inserted fixing in screw or puncture by this approach of pedicle of vertebral arch and can be realized.So-called pedicle of vertebral arch is exactly to connect people vertebra vertebral body and vertebral arch bone structure narrower, that be irregular roundness column, half hollow, left and right sides respectively has one, from lumbar vertebra to cervical vertebra, its width and reducing highly gradually, it is around the vital tissues such as spinal cord, blood vessel and internal organs.Certainly, pedicle is inserted fixing in screw or puncture and is had certain risk, penetrates its cortical bone i.e. likely injured nerve, blood vessel and internal organs, causes the catastrophic effects such as paralysis.Therefore, pedicle is inserted at field of spinal surgery tool and is of great significance accurately.At present the most conventional pedicle approach method for posting is manually to insert, adopt x-ray just, side position guide of fluoroscopy, feel is adjusted angle, precision is poor, its fault rate of bibliographical information can reach 6-41%.In recent years, many diverse ways are applied to improve the accuracy that pedicle approach is inserted, as bring out Evoked EMG in current potential (SEP), art and monitor (EMG), electrical impedance, computer assisted navigation (computer aided surgery navigation system, CASNS), individuation guiding die plate or Digitalized guiding template, electromagnetic navigation (EM), operating robot etc.SEP, EMG, electrical impedance etc. are that the mode giving the alarm when by Gonna breakthrough pedicle of vertebral arch cortical bone reminds patient to adjust placing direction, and the deficiency of this class technology is may be late while finding error.Individuation guiding die plate or Digitalized guiding template are to utilize reverse-engineering principle to make three-dimensional template and guiding tube, and after template coordinates with vertebra rear surface, guiding pedicle of vertebral arch is inserted.CASNS, EM etc. are stored in " virtual world coordinate space " by data after the preoperative SCT obtaining, MRI 3-dimensional reconstruction, Intraoperative position device is based upon the locus of targeted vertebra and operating theater instruments in " real-world coordinates system " in real time, by the coupling guiding pedicle of these two coordinate spaces, inserts.Different according to the mode of image collection, CASNS can be divided into two kinds: (1) navigation system based on CT.The preoperative scanning of operative site SCT the three-dimensional reconstruction of carrying out.Patient selects suitable entry point by reformatting and dimensional measurement, reduces the blindness of operation in art according to the guiding of system.(2) navigation system based on C shape arm X-ray machine perspective.Without preoperative CT scan, during operation, data collection ring is installed to image amplifier scan-data and collects annular space image, then with reference to frame, be connected to and need the spinal column position of operation to start scanning.Select and activation graph picture, the operating theater instruments position that patient shows according to multiple image, the path of simulated surgical operation, is the real-time navigation of the real meaning of spinal surgery.Though CASNS has significantly improved the accuracy of inserting, but still there is 6% fault rate, also exist image easily to drift about (drift incidence rate is 66%), tracing system is easily disturbed, complex operation is time-consuming, localization method has wound, the dynamic deficiency such as Real-Time Monitoring.Since nineteen ninety-five, several robots of inserting for pedicle of vertebral arch been have in succession have been researched and developed abroad, as a kind of robot etc. of the SPINEBOT of the spinal column assistant of Israel (Spineass iant), Korea S and Germany, all will depend on above-mentioned CASNS and position and attitude control, the deficiency of CASNS all may have embodiment with it at them like this.The operating robot that comprises CASNS, not only formation is more complicated, inserts precision and is also difficult to further raising.In sum, although the method form that these guiding are inserted is totally different, without exception all will with reference to or rely on the anatomic landmark of vertebral surface.During due to spinal surgery, the anatomic landmark of vertebral surface may be destroyed, organize also can deform (as laminectomy for decompression spinal dura mater bulge), they can depart from the determined position of preoperative image reconstruction like this, depart from scope and sometimes even can reach several centimetres, make preoperative registration and merge the data that form in art, to occur deviation, can affect so undoubtedly the precision of navigation.And correct the best approach that this metaplasia produces error, be exactly in art, to apply CT and MRI Real Time Imaging Technology in real-time ultrasound, art, real-time update location image, find in time and correction of deviation.This will make whole surgery systems more complicated undoubtedly, operate also more loaded down with trivial details time-consumingly, be difficult to clinically apply.
Summary of the invention
For this reason, the present invention proposes a kind of minimal access bone robot, can eliminate fully one or more problems that restriction and defect due to prior art cause.
Additional advantages of the present invention, object and characteristic, a part will be elucidated in the following description, and another part will be significantly or be acquired from enforcement of the present invention by the investigation of the explanation to below for those of ordinary skill in the art.By the structure of pointing out especially in the description at word and claims and accompanying drawing, can realize and obtain the object of the invention and advantage.
The invention provides a kind of minimal access bone robot, it is characterized in that, described minimal access bone robot is by robot body, X-ray examination equipment, master control system, line aligner, cross aligner, two insert robot arm and singly insert robot arm partly form, described master control system is by control station, computer, hand controller, outer scene display system and motor driver form, the display of described outer scene display system adopts liquid crystal display, wherein, by being set in same virtual identifying in virtual identifying in people's vertebra and external aligner, by x-ray, carry out registration, guiding pedicle is inserted or punctures.
Preferably, virtual identifying can be dummy line section or other virtual forms.
Preferably, robot body comprises operation chassis and two six degree of freedom mobile units, can make respectively robot body adapter and X-ray examination equipment move and rotate along X, Y, Z direction.
Preferably, robot body adapter left and right respectively has one, facilitates robot arm to peg graft.
Preferably, the positioning sliding block of line aligner can become various shapes, and its external diameter is greater than the external diameter of the locating rod of localizer.
2 of preferably, choosing on the distance between two locating rod tips and cantle arc bone line are equal in length.
Preferably, cross aligner metal registration ball also can be made for material other various shapes, radiopaque.
Preferably, two locating rods of inserting robot arm localizer are two or more.
The present invention has the following advantages: positioning precision is high, does not need multi-coordinate mutually to mate, easy and simple to handle, can reduce doctor's working strength, can carry out remote operation, is applicable to multiple spinal operation.
Accompanying drawing explanation
Fig. 1 is according to the front view embodiment of the present invention, minimal access bone robot.
Fig. 2 is according to the top view embodiment of the present invention, minimal access bone robot.
Fig. 3 is according to the side view embodiment of the present invention, minimal access bone robot.
Fig. 4 is according to the schematic diagram embodiment of the present invention, line aligner.
Fig. 5 is according to the schematic diagram embodiment of the present invention, cross aligner.
Fig. 6 is according to the top views of the inserting robot arm embodiment of the present invention, two.
the specific embodiment
Below in conjunction with accompanying drawing, the specific embodiment of the present invention is described further.
Minimal access bone robot by robot body, X-ray examination equipment, master control system, line aligner, cross aligner, twoly insert robot arm, singly insert robot arm etc. and partly form.Robot body comprises operation chassis 1 and two six degree of freedom mobile units, can make respectively robot body adapter 2 and X-ray examination equipment move and rotate along directions X (referring to operating-table long axis direction), Y-direction (referring to operating-table short-axis direction), Z (referring to and operating-table vertical direction) direction.X-ray examination equipment comprises panadaptor 3, bulb 4.Robot body adapter 2 left and right respectively have one, so that two or single robot arm is pegged graft.Master control system is comprised of control station, computer, hand controller, outer scene display system, motor driver, control software etc., and the display of described outer scene display system adopts liquid crystal display.Line aligner comprises holder 5, rule 6, positioning sliding block 7 etc.Holder 5 can be fixed on line aligner on panadaptor 3.Cross aligner comprises the saturating x-ray graduated tile of holder 8, four 9, four metal registration balls 10 and distance adjustment locking device 11 etc.Holder 8 can be fixed on line aligner on panadaptor 3 equally.Two robot arms of inserting comprise that localizer 12, two guide pins 13 and distance adjusting mechanism are (by threaded rod 14,15 and the composition such as handle 16), angle-adjusting mechanism (being formed by graduated disc 17, rotating shaft 18, locking nut 19), rotation descending mechanism (by motor 20, Timing Belt 21, belt wheel 22, bearing 23, base 24 form) and joint pin 25.The leading portion outside of guide pin 13 is screw thread, is installed in the screwed hole 26 of base 24, and back segment is square, and afterbody has a groove.Belt wheel 22 inside are square, and its rotation can make guide pin 13 rotations decline.The groove 42 of afterbody is so that artificial rotation departs from guide pin 13 and robot arm.Localizer 12 comprises two locating rods 27, signaling switch 28, back-moving spring 29, distance adjustment threaded rod and handle 30 etc.The distance that turning handle 30 scalable two locating rod is 27.Singly insert robot arm and comprise a guide pin 31, rotary lifting mechanism (comprising motor 32, Timing Belt 33, belt wheel 34, bearing 35, base 36, radioparent collet 37, roll tube 38) and joint pin 39.Roll tube 38 leading portions are outward screw thread, and back segment is outward square structure, and in it, hollow can see through ray.Radioparent collet 37 is installed in the hole 40 of roll tube 38 bottoms.In belt wheel 34, be also square structure, its rotation can make guide pin 31 rotations decline.The back segment outside of guide pin 31 is screw thread, and afterbody has a groove 41 so that artificial rotation makes it to throw off with robot arm.Owing to inserting the most difficulty with the pedicle of vertebral arch of cervical vertebra and upper thoracic vertebra clinically, take respectively atlas and first thoracic vertebra below to insert process as example illustrates the pedicle of vertebral arch of this robot.(1) atlas " pedicle of vertebral arch " is inserted: atlas is bent by front and back two and two lateral mass are interconnected into mutually, in the form of a ring.Anterior arch front, center has anterior tubercle, and cantle rear portion tuberosity is posterior tubercle.In anatomy, atlas there is no pedicle of vertebral arch structure, and two lateral mass is equivalent to the pedicle of vertebral arch of other vertebras.Preoperative end to end to waiting on the CT scan section of minute atlas, carry out following mensuration: a little 43 spacing are inserted in (1) left and right " pedicle of vertebral arch ".(2) angle of left and right " pedicle of vertebral arch " central axis 44 (end to end to the axis with the equal decile pedicle of vertebral arch of introversion and extroversion) and atlas median line.(3) on atlas median line both sides, cantle arc bone line, choose 2 points, it equates apart from cutting the horizontal vertical dimension in tuberosity solstics later.Measure this spacing of 2, its on line is i.e. the first virtual line segment 45 of a virtual identifying; Measure at 2 to cutting the length of the vertical line that horizontal line is done in tuberosity solstics later, it is also i.e. the second virtual line segment 46 of a virtual identifying.In art, set that (1) localizer two locating rods 27 are parallel to each other and throw according to line vertically with the center of X-ray examination equipment all the time, the most advanced and sophisticated projection of two locating rods 27 is just positioned at this center and throws according on line.(2) make 2 of choosing on distance between two locating rod 27 tips and cantle arc bone line equal in length.On line between two locating rod 27 tips is i.e. the 3rd virtual line segment 47 of a virtual identifying.(3) line aligner is fixed on the equipment panadaptor 3 of X-ray examination, the distal-most end shadow of rule 6 is just positioned at the center of X-ray examination equipment and throws according on line.(4) adjust positioning sliding block 7, make its equal in length to the distance of rule 6 distal-most end and the second virtual line segment 46 bottom, positioning sliding block 7 bottom and rule the on line between 6 far-ends be a virtual identifying, i.e. the 4th virtual line segment 48.(5) with X-ray examination equipment, atlas is carried out to lateral projection, left and right pedicle of vertebral arch projection is overlapped.(6) by hand controller, inciting somebody to action two robot arms of inserting moves to directly over arch of posterior atlas, lower two locating rods 27 of adjusting of perspective, make minute atlas " pedicle of vertebral arch " such as its central shaft the end of a thread Caudad, the projection of two locating rods 27 overlaps completely, and arch of posterior atlas surface of bone is pressed at its tip, on the two, move to connection signal switch 28.(7) fine setting is two inserts robot arm and X-ray examination equipment, and positioning sliding block 7 projection bottom is just contacted with the projection in tuberculum posterius atlantis solstics.The external diameter of positioning sliding block 7 must be greater than the external diameter of two locating rods 27, otherwise cannot observe the projection of the lower edge of slide block.When (5), (6), (7) three states meet simultaneously, the 3rd virtual line segment 47 and the virtual line segment 46 of the first virtual line segment 48 second of virtual line segment the 45, the 4th realize accurate registration.Because the 4 48 and second virtual line segment 46 spatially has distance quite far away, the position of atlas or robot and X-ray examination equipment slightly changes, positioning sliding block 7 projection bottom will depart from the projection in tuberculum posterius atlantis solstics, and so the precision of registration is just very high.(4) adjust the two distances of inserting robot arm two guide pin central axis of order and left and right " pedicle of vertebral arch " and insert that spacing a little equates, two guide pin 13 central axis equate with the angle of atlas median line with left and right " pedicle of vertebral arch " central axis with mesien angle.(5) starter motor 20 screws in guide pins 13 real-time dynamic monitorings, and in inserting process, fluoroscopic observation keeps above-mentioned (5), (6), (7) three states constant, and guide pin 13 can accurately be inserted along pedicle of vertebral arch central axis.First thoracic vertebra pedicle of vertebral arch is inserted: the narrowest part of pedicle of vertebral arch is pedicle isthmus, and as thrown photograph along central axis from pedicle of vertebral arch standard axle position, the medial border of pedicle isthmus bone wall must be projected as the inner edge of pedicle of vertebral arch projection.Preoperative (1) to waiting on the CT scan section of minute atlas, measures geodesic length between the inside and outside sidewall inner face of pedicle isthmus, vertical with pedicle of vertebral arch central axis end to end, and this line is the first virtual line segment 49.(2) on the CT scan section of minute atlas such as introversion and extroversion, measure geodesic length between pedicle isthmus head, tail side wall inner surface, vertical with pedicle of vertebral arch central axis, this line is the second virtual line segment 50.First and second virtual line segment is mutually vertical, has formed i.e. the first virtual cross sign 51 of a virtual cross sign.In art, (1) keeps the center throwing of X-ray examination equipment to overlap all the time with the central axis of singly inserting the guide pin 31 of robot arm according to line.(2) cross aligner is fixed on to the panadaptor 3 of X-ray examination equipment, four outer intermarginal distances of metal registration ball 10 are by inside and outside and end to end to adjusting and above-mentioned the one 49 and second virtual line segment 50 equal in length, these two virtual line segments are mutually vertical, and just outside four metal registration balls, another virtual cross sign of intermarginal formation is the second virtual cross sign 52.(3) with X-ray examination equipment, from axle position to first thoracic vertebra pedicle of vertebral arch, throw and shine, adjust X-ray examination equipment and singly insert robot arm, make the outer rim of four metal registration balls, 10 projections just touch inner edge inside and outside and head, the projection of tail sidewall, so just realized the registration of the 2 52 and first virtual cross sign 51.Because the 2 52 and first virtual cross sign 51 spatially has distance quite far away, first thoracic vertebra X-ray examination equipment slightly changes with the position of singly inserting robot arm, the outer rim of four metal registration balls, 10 projections can depart from inner edge inside and outside and head, the projection of tail sidewall, and so the precision of registration is just very high.(4) starter motor 32 screws in guide pin 31 real-time dynamic monitoring, remains that the outer rim of four metal registration balls, 10 projections is touched inner edge inside and outside and head, the projection of tail sidewall just, and guide pin can accurately be inserted along pedicle of vertebral arch central axis like this.
Above content is only preferred embodiment of the present invention, for those of ordinary skill in the art, according to thought of the present invention, all will change in specific embodiments and applications, and this description should not be construed as limitation of the present invention.
Claims (8)
1.Yi Zhong minimal access bone robot, it is characterized in that, described minimal access bone robot is by robot body, X-ray examination equipment, master control system, line aligner, cross aligner, two insert robot arm and singly insert robot arm partly form, described master control system is by control station, computer, hand controller, outer scene display system and motor driver form, the display of described outer scene display system adopts liquid crystal display, wherein, by being set in same virtual identifying in virtual identifying in people's vertebra and external aligner, by x-ray, carry out registration, guiding pedicle is inserted or punctures.
2. minimal access bone according to claim 1 robot, is characterized in that, virtual identifying can be dummy line section or other virtual forms.
3. minimal access bone according to claim 1 robot, is characterized in that, robot body comprises operation chassis and two six degree of freedom mobile units, can make respectively robot body adapter and X-ray examination equipment move and rotate along X, Y, Z direction.
4. minimal access bone according to claim 1 robot, is characterized in that, robot body adapter left and right respectively has one, facilitates robot arm to peg graft.
5. minimal access bone according to claim 1 robot, is characterized in that, the positioning sliding block of line aligner can become various shapes, and its external diameter is greater than the external diameter of the locating rod of localizer.
6. minimal access bone according to claim 5 robot, is characterized in that, 2 of choosing on the distance between two locating rod tips and cantle arc bone line are equal in length.
7. minimal access bone according to claim 1 robot, is characterized in that, cross aligner metal registration ball also can be made for material other various shapes, radiopaque.
8. minimal access bone according to claim 1 robot, is characterized in that, two locating rods of inserting robot arm localizer are two or more.
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| CN201310495949.9A CN103654960A (en) | 2013-10-18 | 2013-10-18 | Robot for minimally invasive orthopedic surgery |
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| CN201310495949.9A CN103654960A (en) | 2013-10-18 | 2013-10-18 | Robot for minimally invasive orthopedic surgery |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN105476713A (en) * | 2015-12-28 | 2016-04-13 | 苏州点合医疗科技有限公司 | Orthopedic operation robot based on collet receding sleeve type anti-twining minimally-invasive decompression mechanical hand |
| CN106031635A (en) * | 2015-03-19 | 2016-10-19 | 上海市第六人民医院 | Cantilever type laser optical path calibrating device |
| CN112674882A (en) * | 2019-03-16 | 2021-04-20 | 韩志勇 | Deviation direction judgment method for surface projection axis adjustment of minimally invasive surgery |
| CN113509270A (en) * | 2021-07-09 | 2021-10-19 | 武汉联影智融医疗科技有限公司 | End tool motion guiding method and system and surgical robot |
| CN113855244A (en) * | 2021-09-08 | 2021-12-31 | 江苏集奥医工交叉科技有限公司 | Surgical robot for treating pain |
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Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106031635A (en) * | 2015-03-19 | 2016-10-19 | 上海市第六人民医院 | Cantilever type laser optical path calibrating device |
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| CN112674882A (en) * | 2019-03-16 | 2021-04-20 | 韩志勇 | Deviation direction judgment method for surface projection axis adjustment of minimally invasive surgery |
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| CN113509270A (en) * | 2021-07-09 | 2021-10-19 | 武汉联影智融医疗科技有限公司 | End tool motion guiding method and system and surgical robot |
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| CN113855244A (en) * | 2021-09-08 | 2021-12-31 | 江苏集奥医工交叉科技有限公司 | Surgical robot for treating pain |
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Application publication date: 20140326 |