DE102010021037A1 - Operating theater-service robot arrangement for use in health care system during surgical operation, has robot formed to pick up and hand over instruments stored in storage area on tray to users based on request - Google Patents

Abstract

The arrangement has a tray (121) i.e. fresh instrument tray, positionable in a range of an operating theater (OP)-service robot (110). The tray has a preset storage area i.e. trough, in which certain OP-instruments (211-21 5) e.g. knife, shears, forceps, clamps, needle with threads, cloths and swabs, are stored, where a position of the storage area is known to the robot. The robot is formed to pick up and hand over the instruments stored in the storage area on the tray to users (40, 50, 60) based on a request, where shape of the storage area is adapted to shape of the instruments. The users are operating-and assistant surgeons.

Description

The invention relates to an arrangement which replaces the surgical assistants required for a surgical operation, for example an operating theater nurse.

In the healthcare system, cost containment and reduction measures are playing an increasingly important role, especially in hospitals. With increasing technical progress in medical technology and an increasing life expectancy of the population, for example, due to physically lighter activities, better nutrition and hygiene and better medical care, the health costs can only be controlled if the increasing use of technology, especially automation technology, in the hospital in addition to a higher quality of treatment and at the same time promises a cost reduction per treatment case. This cost reduction can be achieved by saving medical staff.

• – dem Chirurgen Instrumente wie Messer, Scheren, Pinzetten, Klemmen, Nadeln mit Faden etc. oder Tücher, Tupfer und andere Verbrauchsgegenstände anzureichen,
• – Instrumente und Verbrauchsgegenstände vom Chirurgen entgegenzunehmen und/oder
• – Instrumente und Verbrauchsgegenstände abzuzählen, um so sicherzustellen, dass kein Material im Patienten verbleibt.

Especially in the operating theater (OP), surgical assistants are active, for example

• - to provide the surgeon with instruments such as knives, scissors, tweezers, clamps, needles with thread etc. or cloths, swabs and other consumables,
• - Receive instruments and consumables from the surgeon and / or
• - Count instruments and consumables to ensure that no material remains in the patient.

As part of the effort to save medical staff, for example, in the article "Future Trends in the Design and Application of Surgical Robots." By Richard M. Satava in Surgical Innovation 2004 11: 129-135 proposed to replace the operating room staff with a robot.

In the US 7164968 B2 In addition, an OR service robot is described which, upon request by the surgeon, searches, locates and / or identifies the requested instrument or consumable by means of a characteristic feature. This requires a complex system with a complex programming and signal processing, etc., so that the robot with the system behind it is correspondingly expensive. Very high demands are placed on the reliability and speed of such a system, especially in situations during the operation in which the surgeon relies on the robot responding quickly to a request and reaching the requested instrument. Due to the necessary complexity of in US 7164968 B2 In particular, due to the system's ability to independently search and identify requested instruments, etc., it can not be ruled out that such an urgent request can not be timely served if the robot does not find the requested instrument fast enough.

It is therefore the object of the present invention to provide a way to provide a reliable replacement or reliable support for the operating room assistant.

This object is achieved by the inventions specified in the independent claims. Advantageous embodiments emerge from the dependent claims.

The object is achieved by an arrangement with an OP service robot, an electronics unit and at least one positionable within reach of the OP service robot first shelf, especially a fresh instruments tray, which has at least one predetermined storage location, in particular a trough at a particular surgical instrument can be stored and whose position is known to the surgical service robot. The OP service robot is designed to receive and submit to an operator on request the surgical instrument placed on the first storage area at the predetermined storage location.

The OP service robot is in particular voice-controlled, wherein the request is adjustable by at least one command word and the request is processed by voice recognition.

The storage location of the first storage is designed such that only a specific surgical instrument, in particular only a specific surgical instrument type, can be deposited there.

In particular, the shape of the storage location of the first storage compartment is adapted to the shape of the particular surgical instrument that can be stored there.

In addition, a second tray, in particular a second-hand tablet, is provided on which at least one surgical instrument can be placed.

The surgical service robot is designed to additionally take back an operating instrument from the operator on request. In addition, the surgical service robot is designed to place the returned surgical instrument on the second shelf.

• – die Anzahl der von der ersten Ablage genommenen OP-Instrumente sowie die Anzahl der auf der zweiten Ablage abgelegten OP-Instrumente detektiert und/oder
• – die Anzahl der vom OP-Service-Roboter von der ersten Ablage genommenen OP-Instrumente sowie die Anzahl der vom OP-Service-Roboter auf der zweiten Ablage abgelegten OP-Instrumente detektiert.

The electronics unit is equipped with a counting function for surgical instruments, the

• - detects and / or detects the number of surgical instruments taken from the first tray and the number of surgical instruments stored on the second tray
• - Detects the number of surgical instruments taken by the OR service robot from the first shelf and the number of OP instruments stored by the OR service robot on the second shelf.

In this case, the electronic unit is designed to compare the numbers detected with the counting function with one another and to output a message if the numbers do not coincide with one another.

The first tray has at least one further predetermined storage location at which a particular consumable item can be stored and whose position is known to the OP service robot, wherein the OP service robot is designed to request the operator on request to pick up and submit the specified consumed item.

Alternatively or additionally, a further tray, in particular a consumable tray, is provided which has at least one further predetermined storage location at which a certain consumable item can be stored and whose position is known to the OP service robot, the OP service robot being formed is to pick up and submit on request by the operator the particular consumable deposited at the designated storage location.

Furthermore, a consumable container for disposing of a used consumable is provided, wherein the electronic unit is provided with a further counting function for consumables stored in the consumable container, the number of consumables taken from the first and / or from the further storage and the number of stored in the consumables container Consumables detected.

The electronic unit is designed to compare the numbers detected with the further counting function with one another and to output an indication if the numbers do not coincide with one another.

• – in die der OP-Service-Roboter ein angefragtes OP-Instrument oder einen angefragten Verbrauchsgegenstand anreicht oder
• – in der eine Haltevorrichtung des OP-Service-Roboters positionierbar ist, um vom Bediener ein OP-Instrument oder einen Verbrauchsgegenstand zurück zu nehmen.

Advantageously, at least one target position is predetermined,

• - in which the OP service robot reaches a requested surgical instrument or a requested consumable item or
• - In which a holding device of the OP service robot can be positioned to take back from the operator an operating instrument or a consumable item.

This target position can be individually specified by the operator and stored in the OP service robot.

• – Personaleinsparung,
• – Programmierbarkeit/Adaptierbarkeit auf die Präferenzen beispielsweise des operierenden Chirurgen,
• – höhere Zuverlässigkeit (insbesondere bei der Zählfunktion)
• – permanente Verfügbarkeit,
• – keine emotionalen/menschlichen Beeinträchtigungen (Reizbarkeit, Unkonzentriertheit)
• – automatische Dokumentation.

An OR service robot has the following advantages:

• - personnel savings,
• Programmability / adaptability to the preferences of, for example, the operating surgeon,
• - higher reliability (especially with the counting function)
• - permanent availability,
• - no emotional / human impairments (irritability, lack of concentration)
• - automatic documentation.

In addition, the surgical service robot according to the invention additionally has, for example, the advantages that, on the one hand, a simple technical realization is possible by the use of command words and by dispensing with the complex automatic realization of, for example, the surgical instruments. The automatic optical instrument recognition is difficult not only because of the variety of surgical instruments, but also because the instruments after use no longer look the same as before use, for example because of pollution. Furthermore, given by the special design of a disposal and a counting function of consumables such as swabs and / or towels.

Further advantages, features and details of the invention will become apparent from the embodiment described below and with reference to the drawings.

It shows

1 a plan view of an operating room with the inventive arrangement,

2 an operating room service robot.

In the figures, identical or corresponding areas, components, component groups or method steps are identified by the same reference numerals.

The 1 shows an example of a plan view of an operating room (OP). Shown are the operating table 10 on which a patient is 20 is an anesthesiologist 30 , an operating surgeon 40 as well as a first 50 and a second assistant surgeon 60 ,

Furthermore, the arrangement according to the invention 100 shown. This includes a surgical service robot 110 , a frame 120 on which a fresh-ingredients tray 121 , a used instruments tray 122 and a consumable tray 123 are stored, and a consumable container 130 , For example, a consumable catch basin with a container arranged underneath or a collecting funnel with suction o. Ä.

In the present invention, it is assumed that an instrument set belonging to the OP 210 with a variety of surgical instrument types, such as knives 211 , Scissors 212 , Tweezers 213 , Clamps 214 and needles 215 , on the fresh-ingredients tray 121 At the beginning, there are several instruments of each type of instrument, and each instrument of the instrument set 210 on the tray 121 on a given and the robot 110 known position or storage location on the fresh instruments tray 121 lies. Ideally, a storage location for a surgical instrument is a well whose position is the surgical service robot 110 is known and which has a unique size and shape to the instrument type (not shown). It is therefore ideally not possible, for example, to lay a knife in a trough for a tweezers and vice versa.

Next to the tray full at the beginning of the operation 121 with surgical instruments, there is also a used instruments tray that is empty at the beginning of the OP 122 to disposal. The used instruments tray 122 and the fresh instruments tray 121 may be identical, ie both trays have, for example, wells for the respective instruments.

On the consumables tray 123 are at the surgery service robot 110 known items or filing fresh consumables 220 for example, abdominal tissues 221 and swabs 222 , filed.

The surgery service robot 110 is equipped with a voice recognition functionality with which the robot is controllable by an operator such as the operating surgeon and / or one of the assisting surgeons. The operator gives the OP service robot 110 for example, by a first command word such as "give" to understand that an object 210 . 220 from the fresh instruments tray 121 or from the consumables tray 123 should be submitted, the subject being an OP instrument 210 or a consumable 220 can act. Following this first command word, the operator calls a second command word representing the name of the item to be submitted.

As the surgical service robot 110 It is known at which position on the fresh-instruments tray 121 the requested surgical instrument 210 or on the supplies tray 123 the requested consumable 220 is located, he can specifically approach this position, the object with a holding device 117 , For example, a gripper o. Ä., Record and bring him to a predeterminable by the operator target position so that it can take the operator comfortably. The surgery service robot 110 registers and stores that the requested item has been taken from the appropriate tray and from the default position. This storage can, for example, be realized in such a way that the position assigned to the already enriched object in the temporary memory of the OP service robot 110 is deleted, so the robot 110 in a renewed request for this item or the corresponding instrument type anfährt another position at which another instrument of the requested type is stored.

In the case of enrichment of a surgical instrument, the robot thus engages in the appropriate recess of the fresh-instruments tablet 121 and moves the instrument to a position (target position) from which the instrument can be conveniently grasped by the operating surgeon. The target position, including the reach of the instrument, can be adjusted by the surgeon according to his individual preferences.

In the case of accumulating a consumable, the robot grasps the requested item from the consumable tray 123 and moves the object to the target position at the target enrichment angle, from where it is taken over by the surgeon (eg, by means of previously submitted tweezers).

As already indicated, it can be assumed that certain objects, such as tweezers or clamps, are present several times on the respective tray, the OP service robot 110 For each individual object present an individual position or storage location on the tablet known, ie in a memory of the robot 110 is stored. An exception could be, for example, sheets placed on top of each other o. Ä., All of which are in the same position. Now, if the same object, such as another pair of tweezers, is requested again, the OP service robot does not approach the same position that he approached on the last request for a pair of tweezers, but the individual one, another fresh pair of tweezers assigned position. This ensures that the robot does not fall into the void, for example, when requesting an instrument type that has already been requested and submitted.

If the operator wishes to return an item, he will name, for example, "take" as the first command word, and again the name of the item to be accepted by the OP service robot as the second command word. The surgery service robot 110 then moves his gripper 117 at a predetermined angle in the predetermined target position and receives the object against, finally to him in a likewise predetermined position on the Gebrauchtinstrumente-tray 122 or in the consumables container 130 store.

In a special embodiment of the surgical service robot 110 this is designed as a so-called "pick-and-place" robot, the surgical instruments 210 and consumables 220 sufficient and in particular surgical instruments 210 also takes back. The pick-and-place robot 110 takes surgical instruments 210 back, possibly also consumables 220 , The latter option, however, is an exception because, for. B. the delivery of tweezers with a belly cloth is more difficult than just the transfer of tweezers. The process in which the surgeon z. B. with the tweezers the abdomen removed from the patient, the abdomen in the consumables container 130 is then faster and technically easier to implement than a variant in which the surgeon transfers the tweezers with abdominal tissue to the surgical service robot and the operating room service provider delivers the tweezers to the surgical service robot. Robot then the belly cloth into the consumables container 130 Throws and finally the tweezers on the used instruments tray 122 stores. Furthermore, an orderly storage used Verbauchsmaterialien does not make sense, because they are thrown away anyway.

For the disposal of consumables 220 is located at the operating table 10 within reach of the operating surgeon 40 the consumables container 130 , If the operating surgeon 40 for example, a pair of tweezers 213 with a blood-soaked swab 222 first he has to tweezer over the consumables container 130 hold and the swab 222 discard. Then he can, for example, by a command sequence "take forceps" o. Ä. The OP service robot 110 instruct him to bring his gripper at a predetermined angle to a target position where the surgeon can conveniently deliver the forceps to the robot.

In another embodiment, for the return of an item by the surgical service robot 110 a command sequence consisting of only a single command word is used, for example "take". The surgery service robot 110 then moves his gripper at a predetermined angle to the target position and takes over the object from the surgeon, but without information about what type of object or surgical instrument it is. The item would then not in a special trough on the used instrument tray 122 stored. Alternatively, however, could be integrated, for example, in the gripper, a sensor that detects the received object.

In the case of returning a surgical instrument that is no longer needed, the pick-and-place robot stops 110 his claw 117 at a predeterminable angle in the predefinable target position, this target position including the angle in turn being adaptable to the preferences of the operator. The surgeon pushes the instrument into the gripper, the gripper recognizes at least that an instrument is in the gripper, possibly even what type of instrument it is, and attacks the instrument.

The OP service robot according to the invention 110 is in the 2 shown in more detail. In the embodiment shown there is a one-armed robot 110 with a swivel 111 For example, a disc or planar joint that is on a separate foot 119 is attached. In the hinge 111 is a stand 112 rotatably mounted, the top of another rotary joint 114/1 is completed. The height of the stand 112 ie the distance between the hinges 111 and 114/1 , is adjustable with an electromechanical, pneumatic or hydraulic adjusting device (not shown). The swivel joint 114/1 connects the stand 112 with a first arm piece 115/1 , at the end of which another rotary joint 114/2 located. The swivel joints 114/1 and 114/2 can also be designed as planar or ball joints. The swivel joint 114/2 connects the first arm piece 115/1 with another arm piece 115/2 , At the end of the arm piece 115/2 is a hinge 116 , For example, an axial pivot, possibly combined with another planar or ball joint mounted. In this hinge 116 is a gripper 117 axially rotatably mounted. Possibly. is the gripper 117 not directly on the hinge 116 attached, but a another arm piece or intermediate piece (not shown) is located in between.

• – Wenn dem Bediener also ein Gegenstand angereicht werden soll, d. h. das erste Befehlswort ist beispielsweise ”give”, ist die Zielposition diejenige Position des Greifers 117 im Raum, die der Greifer mit dem angefragten Gegenstand anfährt.
• – Wenn der Bediener einen Gegenstand abgeben will, d. h. das erste Befehlswort ist beispielsweise ”take”, ist die Zielposition diejenige Position des Greifers im Raum, die der Greifer anfährt, um den abzugebenden Gegenstand entgegen zu nehmen.

Due to the various hinges, it is possible to maneuver the gripper in the predetermined target position, if necessary, including a predetermined angle. The term "target position" basically refers to the position of the gripper 117 of the surgical service robot 110 into which the robot grips 117 brings when the operator makes a request:

• If an object is to be presented to the operator, ie the first command word is for example "give", the target position is the position of the gripper 117 in the room, which the gripper approaches with the requested object.
• - When the operator wants to deliver an item, ie the first command word is for example "take", the target position is the position of the gripper in the space that the gripper moves to accept the item to be dispensed.

Depending on the object, the target position may include both the 3D coordinates, for example Cartesian coordinates, and the enrichment angle. Normally, the target position will be 6-dimensional and will contain the 3D coordinates as well as the angles. Especially the reaching-in angle can play an essential role, for example, when applying a knife. If a knife is placed at the correct angle, the operator or the surgeon can ideally grasp the knife blind and assume that it is immediately right in the hand, so that, for example, the blade points in the right direction. This feature saves a lot of time.

In addition to the 6D target position for the collection and return of instruments and / or consumables, the positioning of the OP service robot relative to the operating table for the operator, ie the operating surgeon, can also be adjusted. At a surgical service robot whose foot 119 is firmly anchored on or in the floor of the operating room, the positioning of the surgical service robot relative to the operating table is only possible via a corresponding positioning and alignment of the operating table. Alternatively, the foot can 119 of the surgical service robot with wheels and releasable locking devices. When unlocking locking devices of the OP service robot is displaced and possibly also rotatable. The releasable locking device may be configured to cause locking of the surgical service robot on the floor of the operating room or on the patient table. Thus, both a bottom locking device and a patient table locking device of the surgical service robot are conceivable.

The surgery service robot 110 furthermore has a cleaning device 118 near the gripper 117 is mounted such that via a nozzle of the cleaning device 118 optionally cleaning and / or disinfecting liquid can be sprayed, for example, for cleaning and / or air, for example, for drying on the object, the gripper 117 just stops. Also the gripper 117 even with this device 118 be cleaned or dried. The gripper 117 For example, you will be showered either flat rate after each withdrawal of an instrument or on command, for example, by the command word "rinse".

In addition, the inventive arrangement has 100 via a counting function for all issued and withdrawn surgical instruments. In one embodiment, with the aid of the electronics unit 140 monitors how many times the robot 110 the operator has an OP instrument of a certain type and how often the robot retracts an instrument of the same type. With the help of this function can be controlled accordingly, whether all requested by the operator and the robot 110 have been withdrawn in order to ultimately ensure that no instruments remain in or on the patient's body after the end of the operation.

The counting function can additionally monitor the number of accumulated and returned consumables. In the event that the surgery service robot 110 is designed to take back even consumables, the counting function can easily monitor how often the robot 110 the user reaches a consumable and how often the robot takes back a consumable. For the special training as a "pick-and-place" robot or in the event that the robot 110 Consumables does not take back, so that the operator, for example, the operating surgeon, as described above, the consumable item manually in the consumables container 130 there must be the consumables container 130 Provide information about the number of consumables placed in it. This information is then sent to the electronics unit 140 transmitted and there with the number of the robot 110 compared consumed consumables. With the help of this additional counting function can be controlled accordingly, whether all requested by the operator and the robot 110 enriched consumables are taken back or in the consumables container 130 to ultimately ensure that no consumables remain in or on the patient's body after completing the operation.

The result of the counts is on a monitor 150 shown with the electronics unit 140 connected is. For example, the data may be sorted into a table with several columns "Name Instrument / Consumable Item", "Number Issued", "Number Withdrawn", "Number In Use" or the like, the table being constantly updated during the operation Monitor is displayed. Of course, at the end of the operation, only zeros may appear in the last column "number in use".

The comparison of detected with the counting function numbers in the electronics unit 140 may lead to a hint to the user if the numbers do not match. The indication may include, for example, an audible or visual warning signal by means of a corresponding signaling device. Alternatively or additionally, an optical warning signal on the monitor 150 displayed, for example, a warning window, a warning message and / or, for example, color-coded and / or flashing non-zeros in the "number in use" column in the instrument and consumables table.

The comparison of the numbers of issued and returned items preferably takes place in real time, but at the latest after completion of the OP, for example when the operating surgeon manually or also by voice command the OP service robot or the control unit gives a corresponding command. Alternatively, it could also be on the monitor constantly or on request during the surgery 150 display whether the numbers match each other.

The surgery service robot 110 is also with a camera 113 equipped with the movement area of the robot 110 is monitored. Corresponding image processing software, in conjunction with the robot motion control electronics and software, ensures that moving parts of the robot can not touch persons or devices in the movement area due to their own movement.

The surgery service robot 110 was described above using the example of a "pick-and-place" robot, which may be surgical instruments 210 and consumables 220 sufficient, but only surgical instruments 210 withdraws, but no consumables 220 , Basically, it is of course not excluded that the surgical service robot 110 also consumables 220 returns and in the consumables container 130 stores. In this case, the above-described cleaning device is 118 almost obligatory, since the gripper 117 after depositing a consumable 220 in the consumables container 130 before recording and submitting a new surgical instrument 210 should be cleaned first. In principle, however, this also applies to the withdrawal of the instruments, as these are usually also bloody.

• 1. Beginnend von der Roboterarm-Grundstellung Heranfahren des leeren Greifers in die Zielposition zur Instrumenten-Rücknahme;
• 2. Rücknahme eines Gebrauchtinstruments durch den Roboter;
• 3. Ablegen des Gebrauchtinstruments auf dem Gebrauchtinstrumente-Tablett 122;
• 4. ggf. Reinigung des Greifers;
• 5. Aufnahme des Frischinstruments vom Frischinstrumente-Tablett 121;
• 6. Anreichen des Frischinstruments;
• 7. Übergabe des Frischinstruments;
• 8. Rückführung des Roboterarms in die Grundstellung, ggf. nach Reinigung des Greifers.

Instead of the one arm OP service robot explained above 110 It is also possible to use a robot with two or more arms. This multi-arm robot does not differ in its basic functionality from the one-arm robot. For example, in a two-armed surgical service robot, one hand could be responsible for handing over and the other arm for taking instruments back. As a result, these two work steps can take place simultaneously, which is not possible with the one-armed robot. This represents a significant advantage of the two-armed surgical service robot over the one-armed surgical service robot, because the time saved is likely to be significant. For a one-armed surgical service robot, the order would typically be:

• 1. Starting from the robot arm home position, move the empty grab to the target position for instrument withdrawal;
• 2. Return of a used instrument by the robot;
• 3. Place the used instrument on the used instruments tray 122 ;
• 4. if necessary, cleaning the gripper;
• 5. Recording the fresh instrument from the fresh instruments tray 121 ;
• 6. presentation of the fresh instrument;
• 7. handover of the fresh instrument;
• 8. Return of the robot arm to the basic position, if necessary after cleaning the gripper.

With two- and multi-arm surgical service robots, there is always at least one arm available for retrieval and one arm for attachment. Steps 1 to 4 can then be performed with one robot arm simultaneously with steps 5 to 8 with another robot arm.

As a rule, no anticipatory actions are expected from an OR nurse or from the OP service robot, ie an action takes place only after instruction by the operating surgeon. However, to speed up the collection and return operation by the OP service robot, it may make sense for the robot to "know" what its next action is likely to be. These are in the electronics unit 140 from each individual action carried the timestamp and the action taken. In a simple embodiment, this could be done, for example, in the form "A1 = Pouring Tweezers" as the name of the action taken and "t1 = 100" as the time stamp (here in arbitrary unit) for the action taken. The next action could be for example, in the form of "A2 = withdrawal tweezers" and "t2 = 250" are stored.

Each such logged operation is stored in a filing system, e.g. A database stored with respect to the operator and the OP class, where an OP class is, for example, an appendectomy. In a new operation, the logged operation sequences, ie the actions performed or their order, from the same OP class and the same operator of the electronic unit 140 evaluated by the time beams with the timestamps t1, t2, ... of the logged operations with each other and with the timeline of the current operation as far as possible be brought into coincidence. If it follows from the comparison of the time journals of the logged operations that the next action was always the same in all the logged operations, starting from the action last performed in the current operation, then the OP service robot closes that also in the current one Operation the next action will be the one that followed in the stored operations. For example, if this action was to infuse a fresh instrument, the surgical service robot will already place its gripper over the trough of that instrument, or the gripper will already grasp that instrument in its trough before the surgeon issues the appropriate instruction.

The in the 1 separately represented electronic unit 140 Of course, the monitor may as well as possibly 150 as part of the surgical service robot 110 be formed, ie the surgical service robot 110 , the electronics unit 140 and / or the monitor 150 can form a unity. For example, the electronics unit 140 at the same time the control of the robot 110 include.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 7164968 B2 [0005, 0005]

Cited non-patent literature

• "Future Trends in the Design and Application of Surgical Robots." By Richard M. Satava in Surgical Innovation 2004 11: 129-135 [0004]

Claims (18)

Arrangement with an OP service robot ( 110 ), an electronics unit ( 140 ) and at least one within reach of the OP service robot ( 110 ) positionable first tray ( 121 ), in particular a fresh-instruments tray, which has at least one predetermined deposit location, in particular a depression, at which a specific surgical instrument ( 211 - 215 ) and whose position is assigned to the surgical service robot ( 110 ), the OP service robot ( 110 ) is adapted to an operator ( 40 . 50 . 60 ) on request at the designated storage location on the first shelf ( 121 ) record and submit the surgical instrument. Arrangement according to claim 1, characterized in that the OP service robot ( 110 ) is voice-controlled, wherein the request is adjustable by at least one command word and the request is processed by speech recognition. Arrangement according to one of the preceding claims, characterized in that the individual storage locations of the first storage ( 121 ) are designed such that at each deposition site only a specific surgical instrument ( 211 - 215 ), in particular only a specific type of surgical instrument, can be stored. Arrangement according to claim 3, characterized in that the shape of the deposit location of the first tray to the shape of there can be stored, certain surgical instrument ( 211 - 215 ) is adjusted. Arrangement according to one of the preceding claims, characterized in that a second tray ( 122 ), in particular a second-hand instrument tray, on which at least one surgical instrument can be placed. Arrangement according to one of the preceding claims, that the surgical service robot ( 110 ) is designed to provide on request a surgical instrument from the operator ( 40 . 50 . 60 ) to take back. Arrangement according to claim 5 and 6, characterized in that the surgical service robot ( 110 ) is adapted to the withdrawn surgical instrument on the second tray ( 122 ). Arrangement according to one of claims 5 to 7, characterized in that the electronic unit ( 140 ) is equipped with a counting function for surgical instruments which - the number of 121 ), as well as the number of copies on the second shelf ( 122 ) and / or - the number of OP-service robots ( 110 ) from the first shelf ( 121 ) and the number of OR service robots ( 110 ) on the second shelf ( 122 ) detected surgical instruments detected. Arrangement according to claim 8, characterized in that the electronic unit ( 140 ) is adapted to compare the numbers detected with the counting function with each other and to issue an indication if the numbers do not coincide with each other. Arrangement according to one of the preceding claims, characterized in that the first tray ( 121 ) has at least one further predetermined deposit location at which a particular consumable item ( 221 . 222 ) and whose position is assigned to the surgical service robot ( 110 ), the OP service robot ( 110 ) is designed to be requested by the operator ( 40 . 50 . 60 ) the particular consumable deposited at the further predetermined storage location ( 221 . 222 ) record and submit. Arrangement according to one of the preceding claims, characterized in that a further tray ( 123 ), in particular consumable tray, is provided, which has at least one further predetermined storage location at which a certain consumable item ( 221 . 222 ) and whose position is assigned to the surgical service robot ( 110 ), the OP service robot ( 110 ) is designed to be requested by the operator ( 40 . 50 . 60 ) the specific consumable deposited at the designated depository ( 221 . 222 ) record and submit. Arrangement according to claim 10 or 11, characterized in that a consumable container ( 130 ) for disposing of a used consumable ( 221 . 222 ) is provided, wherein the electronic unit ( 140 ) with another counting function for in the consumables container ( 130 ) stored consumables ( 221 . 222 ), which is the number of the first ( 121 ) and / or from the further storage ( 123 consumables ( 221 . 222 ) as well as the number of in the consumables container ( 130 ) consumables ( 221 . 222 ) detected. Arrangement according to claim 12, characterized in that the electronic unit ( 140 ) is configured to compare the numbers detected with the further counting function with each other and to output an indication if the numbers do not coincide with each other. Arrangement according to one of the preceding claims, characterized in that at least one target position is predetermined, into which the OP service robot ( 110 ) a requested surgical instrument or a requested consumable article reaches or - in which a holding device ( 117 ) of the surgical service robot ( 110 ) is positionable by the operator ( 40 . 50 . 60 ) to take back a surgical instrument or a consumable. Arrangement according to claim 14, characterized in that the target position of the operator ( 40 . 50 . 60 ) and can be specified individually in the operating room service robot ( 110 ) is storable. Arrangement according to one of the preceding claims, characterized in that the position of the surgical service robot ( 110 ) is individually predetermined by the operator relative to an operating table. Arrangement according to one of the preceding claims, characterized in that the electronic unit ( 140 ) is adapted to the individual actions of the surgical service robot ( 110 ) during an operation to log and save. Arrangement according to claim 16, characterized in that the electronic unit ( 140 ) is adapted, in a new operation, to compare the course of the operation with the logged operation sequences of previous operations of the same operation class, wherein, if it results from the comparison, starting from the action last performed in the current, new operation, the next action in It is automatically concluded, even in the current new operation, that the next action will be that which followed in the stored operations.

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