CN101340852A - 机器人外科系统的器械对接装置 - Google Patents

机器人外科系统的器械对接装置 Download PDF

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CN101340852A
CN101340852A CNA2006800473174A CN200680047317A CN101340852A CN 101340852 A CN101340852 A CN 101340852A CN A2006800473174 A CNA2006800473174 A CN A2006800473174A CN 200680047317 A CN200680047317 A CN 200680047317A CN 101340852 A CN101340852 A CN 101340852A
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docking facilities
manipulator
sterile adapter
spring
surgical
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CN101340852B (zh
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R·L·德文根佐
T·G·库珀
J·P·奥尔班三世
B·舍纳
A·罗
C·S·安德森
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Intuitive Surgical Operations Inc
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Intuitive Surgical Inc
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    • B—PERFORMING OPERATIONS; TRANSPORTING
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    • B25J9/10—Programme-controlled manipulators characterised by positioning means for manipulator elements
    • B25J9/104—Programme-controlled manipulators characterised by positioning means for manipulator elements with cables, chains or ribbons
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    • B25J15/04—Gripping heads and other end effectors with provision for the remote detachment or exchange of the head or parts thereof
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    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
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    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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Abstract

提供了机器人操纵器的器械对接装置和包括该器械对接装置的外科系统。在一个实施例中，器械对接装置包括用于将轴向载荷和扭矩提供给能够可操作地联结器械的无菌适配器的弹簧加载输入。在另一个实施例中，机器人外科操纵器系统包括操纵器组件，该操纵器组件包括可操作地联结到操作臂远端的基部连杆以及沿纵轴可移动地联结到基部连杆的滑架连杆，该滑架连杆包括集成的器械对接装置。该系统进一步包括通过器械对接装置可操作地联结到滑架连杆的器械，以及可操作地联结到操纵器组件用于检测器械存在与否的处理器。

Description

机器人外科系统的器械对接装置
相关申请的交叉引用
【0001】本申请要求2005年12月20日提交的序号为60/752,755的美国临时申请的权益，该申请的全部公开(包括其中通过参考并入的所有参考文献)通过参考合并于此以用于各种用途。
【0002】本申请是在2005年12月20日提交的名称为“Sterile SurgicalAdaptor”的序号为11/314,040的未决的美国专利申请的部分继续申请，序号为11/314,040的申请是在2004年8月19日提交的序号为10/922,346的未决的美国专利申请的部分继续申请，序号为10/922,346的申请是在2001年10月30日提交的序号为10/004,399的美国专利申请的继续申请，序号为10/004,399的申请是在1999年9月28日提交的序号为09/406,360而现在的美国专利号为6,346,072的美国专利申请的继续申请，序号为6,346,072的申请是在1997年12月21日提交的序号为08/975,617而现在的美国专利序号为6,132,368的美国专利申请的继续申请，序号为6,132,368的申请要求1996年12月12日提交的序号为60/033,321的美国临时申请的优先权，以上申请的全部公开通过参考合并于此以用于各种用途。
【0003】本申请涉及2006年12月20日提交的名称为“Cable Tensioning InA Robotic Surgical System”的序号为______(代理人案号M-16315-1US)的美国申请、2006年12月20日提交的名称为“Telescoping Insertion Axis Of ARobotic Surgical System”的序号为______(代理人案号M-16315-2US)的美国申请、2006年12月3日提交的名称为“Indicator For Tool State andCommunication In a Muti-Arm Robotic Telesurgery”的序号为11/556,484的美国申请、2006年12月20日提交的名称为“Wireless Communication In ARobotic Surgical System”的序号为______(代理人案号M-16315-5US)的美国申请以及2006年3月31日提交的名称为“Sterile Surgical Adaptor”的序号为11/395,418的美国申请，以上申请的全部公开(包括其中通过参考并入的所有参考文献)通过参考合并于此以用于各种用途。
技术领域
【0004】本发明一般涉及医疗的和/或机器人的装置、系统和方法。
背景技术
【0005】微创医疗技术旨在减小在诊断或者外科手术期间损伤的体外组织的程度，因此减小病人的康复时间、不适感以及有害的副作用。例如，微创医疗技术的一个作用可能是缩短手术后的住院康复时间。因为标准手术的平均住院时间一般比类似的微创手术的平均住院时间长很多，所以增加使用微创技术能够节省每年用于住院花费的几百万美元。虽然每年在美国执行的许多手术能够潜在地以微创的方式执行，但是由于微创手术器械的限制和掌控它们所需的附加外科训练，仅现代外科治疗的一部分使用这些有利的技术。
【0006】已经开发出微创机器人外科或者遥控外科手术系统，从而增加外科医生的灵活性并且避免传统微创技术的一些限制。在遥控外科手术中，外科医生使用如伺服机构等一些遥控控制形式来操纵外科器械的运动，而不是直接手持和移动器械。在遥控外科手术系统中，能够在外科工作台为外科医生提供外科部位的图象。在观察显示器上的外科部位的二维或者三维图象的同时，外科医生通过操纵主控制装置执行外科程序，主控制装置反过来控制被以伺服机构方式操作的器械的运动。
【0007】在机器人辅助外科手术中，外科医生典型地在远离病人的位置(例如，在手术室的对面、在不同的房间或者在与病人完全不同的建筑物内)操作主控制器以控制外科器械在外科部位的运动。主控制器通常包括一个或者多于一个手输入装置，例如手持式腕关节万向节、操纵杆、外骨骼手套等，这些装置可操作地联结到外科器械上，所述外科器械可释放地联结到病人侧的外科操纵器(“从动装置”)。主控制器控制器械的位置、方向和在外科部位的关节联接。从动装置是包括连接在一起支撑和控制外科器械的多个臂、关节、连杆、伺服电机等的电-机械组件。在外科程序中，外科器械(包括内诊镜)可以直接引入到敞开的外科部位中或者更典型地通过套管针套进入身体内腔。根据外科程序，存在可利用的多种外科器械，例如组织抓取器、测针驱动器、电外科烧灼探针等等，以便执行外科手术的各种功能，例如，保持或者驱动测针、缝合、抓取血管、或者解剖、烧灼或者凝结组织。
【0008】外科操纵器组件被认为可以分为包括有菌驱动和控制部件、可消毒的末端受动器或者外科工具/器械以及中间的连接器部件三个主要部件。中间的连接器部件包括用于将外科工具与驱动和控制部件联结并且将运动从驱动部件传递到外科工具的机械元件。
【0009】对遥控机器人外科系统的挑战是在手术期间外科医生一般将利用很多不同的外科器械/工具。由于空间的限制和成本，操作臂的数量是有限的，所以在手术期间这些外科器械中有许多将被连接到操作臂和从操作臂上拆卸很多次。
【0010】虽然已经证明遥控外科系统、装置以及方法具有很高的效率和优势，但希望有更进一步的改良。一般而言，希望提供在操作臂上的改良器械对接装置从而最小化在外科手术期间器械交换的时间和难度。
发明内容
【0011】根据本发明的实施例，提供机器人操纵器的器械对接装置，该器械对接装置包括用于将轴向载荷和扭矩提供给能够可操作地联结器械的无菌适配器的弹簧加载输入。该器械对接装置可以进一步包括弹簧塞和弹簧加载释放杆。
【0012】根据本发明的另一个实施例，提供机器人外科操纵器系统，该系统包含操纵器组件，该操纵器组件包括可操作地联结到操作臂远端的基部连杆和沿纵轴可移动地联结到基部连杆的滑架连杆，该滑架连杆包括上述器械对接装置。该系统进一步包括通过器械对接装置可操作地联结到滑架连杆的器械，以及可操作地联结到操纵器组件以便感测器械和/或无菌适配器的处理器。
【0013】有利的是，本发明提供器械无菌适配器(ISA)的简单和有效的装卸和/或啮合，同时使ISA和无菌屏障能够有成本效益且易处理的设计。提供了本发明的其他优点。
【0014】发明的范围由权利要求限定，这些权利要求通过参考并入这一部分。通过下面的一个或者多个实施例的详细阐述将使本领域的技术人员获得对本发明实施例的更完整的理解和对其中附加的优点的认识。将参考那些将首先简要阐述的附图。
附图说明
【0015】图1是图示说明机器人外科系统的一部分手术室的示意性平面图，该机器人外科系统包括用于输入外科程序的主外科医生控制台或者工作台以及用于通过在病人内的外科部位以机器人的方式移动外科器械的机器人操纵器系统。
【0016】图2A和2B分别图示说明操纵器系统的实施例的透视图和正视图，该操纵器系统的实施例包括定位连杆装置或者构建关节，这些构建关节允许为外科手术预先配置病人侧机器人操纵器和/或内诊镜或者照相机机器人操纵器。
【0017】图3是用于图1系统的外科器械的实例的透视图。
【0018】图4是包括多个定位连杆装置的替代性操纵器系统的俯视透视图，每个定位连杆装置支撑一个操作臂。
【0019】图5A-5E和5B1-5E1是根据本发明的实施例包括伸缩插入轴的操纵器的透视图和各自的侧视图。
【0020】图6A-6E图示说明根据本发明的实施例的滑架连杆的器械对接装置构件的不同视图。
【0021】图7A-7D图示说明根据本发明的实施例的滑架连杆的内部的不同视图。
【0022】图8A-8B图示说明根据本发明实施例的无菌适配器啮合杆的运动。
【0023】图9A-9E是根据本发明的实施例的分离器械输入的不同视图。
【0024】图10A-10B是根据本发明的实施例的器械输入的截面图。
【0025】图11A-11B是根据本发明的实施例的弹簧塞的侧视图。
【0026】图12A-12C分别图示说明根据本发明实施例的无菌适配器的俯视透视图、仰视透视图以及截面图。
【0027】图13图示说明根据本发明的实施例的无菌适配器的电触点的放大截面图。
【0028】图14A和14B分别图示说明根据本发明的实施例的无菌适配器的圆盘的放大俯视透视图和放大仰视透视图。
【0029】图15A和15B图示说明根据本发明的实施例的无菌适配器的顶部牵引板的俯视透视图和仰视透视图。
【0030】图16A-16F示出根据本发明实施例无菌适配器安装/啮合到器械对接装置、外科器械安装/啮合到无菌适配器以及外科器械从无菌适配器移除。
【0031】通过参考下面的详细阐述可以很好地理解本发明的实施例和它们的优点。应该认识到在一个或者多于一个的图中相同的参考数字用于表示相同的元件。也应该认识到这些图不是必须按比例绘制的。
具体实施方式
【0032】本发明一般地提供用于插入器械的改良的机器人插入轴、系统以及方法，并且特别地包括用于提供更大刚度和强度、更大运动范围以及外科手术区域的改良的可见度的伸缩插入轴。
【0033】本发明作为允许外科医生在远离病人的位置通过伺服机构操作外科器械的遥控机器人外科系统的一部分是非常有用的。机器人外科系统的一个实例是从加利福尼亚州桑尼维尔(Sunnyvale)的Intuitive Surgical公司可获得的da Vinci
Figure A20068004731700091
STH外科系统。Da Vinci
Figure A20068004731700092
STH外科系统的用户手册可以从Intuitive Surgical公司获得，并且在此通过参考并入以用于各种用途。
【0034】图1-3图示说明用于执行微创机器人外科手术的机器人外科系统1的部件。系统1与在序号为6,246,200的美国专利中更详细阐述的系统相似，该专利的全部公开通过参考合并于此。系统操作者O(通常是外科医生)对躺在手术台T上的病人P执行微创外科程序。系统操作者O观察由显示器12呈现的图象并且在外科医生控制台3上操纵一个或者多于一个输入装置或者主控器2。响应外科医生的输入指令，控制台3的计算机处理器4通过病人侧机器人操纵器系统6(在这个实例中是基于手推车的系统)指挥外科器械或者工具5的运动，并影响器械的伺服机构的运动，病人侧机器人操纵器系统6包括关节、连杆装置以及操纵臂，每个操纵臂具有一个伸缩插入轴。在一个实施例中，处理器4与工具5的末端受动器的运动相关联，从而末端受动器的动作遵循系统操作者O手中的输入装置的运动。
【0035】处理器4将典型地包括数据处理硬件和软件，其中软件典型地包含机器可读代码。机器可读代码将嵌入软件编程指令从而执行在此阐述的一些或者全部的方法。虽然处理器4在图1的简化示意图中显示为单个方框，但是处理器可以包含多个数据处理电路，其中处理过程的至少一部分优选地接近输入装置执行，一部分接近操纵器执行，等等。可以利用多种集中式和分散式数据处理架构中的任何一种。类似地，编程代码可以作为多个独立的程序或者子程序执行或者可以集成到在此阐述的机器人系统的多个其他的方面。
【0036】在一个实例中，操纵器系统6包括至少四个机器人操纵器组件。三个连杆装置7(在这个实例中安装在手推车的侧面)支持和定位操纵器8，其中在外科程序的至少一部分期间连杆装置7通常在固定的位置支撑操纵器8的基部。操纵器8移动外科工具5以便以实现组织的机器人操纵。一个附加的连杆装置9(在这个实施例中安装在手推车的中心)支持和定位操纵器10，操纵器10控制内诊镜/照相机探针11的运动从而获取内部外科部位的图象(优选立体图像)。病人侧系统的定位连杆装置7、9的可固定部分在此有时称作“构建臂”。
【0037】在一个实施例中，内部外科部位的图象通过外科医生控制台3中的立体显示器12展示给操作者O。内部外科部位同时通过辅助显示器14展示给助手A。
【0038】助手A使用构建连杆装置臂7、9帮助相对病人P预先定位操纵器组件8和10；帮助从一个或者多于一个的外科操纵器上用替代性外科工具或者器械5’替换工具5；帮助操作相关的非机器人医疗器械和设备；帮助手动地移动操纵器组件以便相关工具穿过不同的开孔进入内部的外科部位，等等。
【0039】总体来说，连杆装置7，9主要在病人侧系统6的构建期间使用，并且典型地在外科手术的至少一部分期间保持固定的构形。每个操纵器8、10包含在外科医生控制台3的指挥下主动用关节相连的驱动连杆装置。虽然可以选择性地驱动和以机器人方式控制构建臂的一个或者多于一个关节，但是至少一些构建臂关节可以被配置为由助手A手动定位。
【0040】根据本发明的实施例，一些操纵器包括伸缩插入轴100，尽管在其他的实施例中，所有的操纵器都可以包括伸缩插入轴100。伸缩插入轴100允许通过三个可操作地联结的连杆使安装的器械5运动，且与以前的设计相比(除其他的优点外)具有改良的刚度和强度、更大的运动范围以及改良的动态性能和对于系统使用者接近外科手术区域的可见度，这在下面会进行更详细的描述。
【0041】为了方便起见，如支撑用于操纵组织的外科工具的操纵器8之类的操纵器有时称作病人侧操纵器(PSM)，而控制如内诊镜11之类的图象获取或数据收集装置的操纵器10可以称作内诊镜-照相机操纵器(ECM)。操纵器可以随意地驱使、操控和控制多种器械或者工具、图象获取装置以及对外科手术有用的类似装置。
【0042】当为外科程序构建时、当为不同阶段的外科程序重新配置操纵器系统6时、当移动器械和用替代性器械5’替换器械时，等等，可以手动地定位器械5和内诊镜11。在这样由助手A手动重新配置操纵器组件期间，可以以不同的模式安置操纵器组件而不采用在主/从遥控外科手术期间使用的模式，其中手动可重新定位模式有时称作离合模式。操纵器组件可以响应例如按下按钮或者接通操纵器8(例如，图6A-6C中的离合按钮/开关103)或者操纵器组件上的一些其他部件的输入而在组织操纵模式和离合模式之间改变，因此允许助手A改变操纵器模式。
【0043】从图1和2A-2B可以看出，可以将指示器20设置于操纵器组件上。在这个实施例中，将指示器20设置于靠近操纵器和它们的安装的工具5之间的对接装置的操纵器8上。在替代性实施例中，取而代之可以将指示器20设置于构建关节7、9上，工具5上，其他的操纵器8、10上，等等。在2006年12月3日提交的序号为11/556,484的美国申请中公开了指示器的一个实例，该申请的全部公开(包括其中通过参考并入的所有参考)通过参考合并于此以用于各种用途。
【0044】图3图示说明用关节连接的外科工具或者器械5的透视图。器械5具有与操纵器的工具夹持器或者器械对接装置接触的近端外壳24，通常通过无菌适配器或者对接装置提供快速释放的安装啮合，在2005年12月20日提交的序号为11/314,040的美国专利申请中和在2006年3月31日提交的序号为11/395,418的美国专利申请中公开了它的一个实例，这些申请的全部公开通过参考合并于此以用于各种用途。工具5包括支撑与近端外壳24相对的末端受动器28的细长轴23。近端外壳24接收并且传送驱动信号并且驱动操纵器8与末端受动器28之间的运动。用关节连接的腕关节29可以提供末端受动器28和轴23之间的两个自由度的运动，并且该轴可以相对近端外壳24绕轴的轴线旋转从而在病人的体内给末端受动器28提供三个方向的自由度。
【0045】外科工具可以包括各种各样的用关节连接的末端受动器，例如可以由电线、偏心凸轮、推杆或者其他机构驱动的夹钳、剪刀、抓紧器、测针夹持器、微型解剖器、U形钉施夹钳、缝合器、抽吸灌注工具以及血管夹施夹钳等。另外，外科工具可以包括非关节连接的器械，例如切割刀片、探针、灌注器、导尿管或者抽吸口等。作为替代，外科工具可以包含用于融化、切除、切割或者凝结组织的电外科探针。在序号为6,331,181、6,491,701和6,770,081的美国专利中阐述了可应用的适配器、工具或者器械以及附件的实例，这些专利的全部公开(包括其中通过参考并入的所有参考)通过参考合并于此以用于各种用途。市场上也可买到来自加利福尼亚州桑尼维尔的Intuitive Surgical公司的可应用外科器械。
【0046】现在参考图4，图示说明了可以安装到手术室天花板上的替代性组合操纵器支撑组件30的透视图。组合操纵器支撑30对准并支撑与病人体内的一组期望的外科切开部位相对的机器人操纵器系统。组合操纵器支撑组件30通常包括定向平台36和多个可以联结到该定向平台的可配置构建连杆装置臂38、40、42、44。每个臂可移动地支撑相关操纵器32、34，操纵器32、34进一步可移动地支撑相关工具或者图象获取装置。定向平台36也支撑辅助显示器104，辅助显示器104可用于构建、器械更换、观察程序，等等。组合操纵器支撑组件30的任何构件的结构和使用与上面阐述的有关操纵器6的内容相似，并且在2005年1月24日提交的序号为11/043,688并且题目为“Modular Manipulator Support ForRobotic Surgery”的共同待决的美国专利申请中更全面地进行了阐述，该申请的全部公开通过参考合并于此以用于各种用途。如上面总体所述，组合操纵器支撑30的每个操纵器32、34也可以包括插入轴100。
【0047】现在参考图5A-5E1，根据本发明的实施例更详细地展示了包括伸缩插入轴100的操纵器8。在一个实例中，本发明的插入轴由包括三个连杆的三级伸缩线性轴构成，这三个连杆通过轴承、轨道、滑轮以及电缆彼此可移动地联结，其中从近端连杆朝向远端连杆移动时连杆宽度或形状因子逐渐变窄。有利的是，本发明提供了单手的端口和单手的器械离合、更大的运动范围、更窄的插入臂和更大的插入轴刚度和强度以及作为插入深度的函数的减小的惯性，因此有助于使能具有单一机构的两象限外科手术(例如，结肠直肠的外科手术)，并且提供更大的空间和靠近外科手术区域的可见度。
【0048】图5A-5E和5B1-5E1图示说明根据本发明的实施例的操纵器8的透视图和各自的侧视图，操纵器8包括操纵器臂50和可操作地联结到臂50的远端的伸缩插入轴100。伸缩插入轴100包括第一连杆或者基部连杆102、可操作地联结到基部连杆102的第二连杆或者空载连杆104以及可操作地联结到空载连杆104的第三连杆或者滑架连杆106。
【0049】基部连杆102可操作地联结到操纵器臂50的远端，并且在一个实例中具有连接到基部连杆102的远端的附件夹具108。附件110(例如套管)可以安装在附件夹具108上。在2005年9月30日提交的序号为11/240,087的待决的美国申请中公开了可应用的附件夹具和附件的实例，该申请的全部公开通过参考合并于此以用于各种用途。在2005年12月20日提交的序号为11/314,040的美国申请中和2006年3月31日提交的序号为11/395,418的美国申请中公开了可应用的无菌适配器和器械外壳的实例，该申请的全部公开通过参考合并于此以用于各种用途。
【0050】滑架连杆106包括用于可操作地联结到器械无菌适配器(ISA)109的器械对接装置101，器械无菌适配器(ISA)109能够可操作地联结到器械的外壳(例如，图3和图5的外壳24)，并控制在病人内部的器械的深度。在一个实施例中，无菌适配器与可能遮盖着机器人外科系统特别是操纵器系统的遮盖件集成在一起，从而在外科程序的有菌PSM臂和无菌区域之间建立无菌屏障。在2005年9月30日提交的序号为11/240,113的待决的美国申请中公开了可应用的遮盖件和适配器的实例，该申请的全部公开通过参考合并于此以用于各种用途。
【0051】空载连杆104可移动地联结在基部连杆102和滑架连杆106之间从而允许连杆102、104和106以伸缩的方式沿纵向轴(例如，轴C)相对于彼此移动。在一个实施例中，连杆102具有比连杆104更窄的形状因子，并且连杆104具有比连杆106更窄的形状因子，因此提供了靠近外科手术区域的更大的可见度。
【0052】如图5A和5A1所示，根据本发明由至少在近端和远端连杆之间延伸的电缆提供操纵器8中沿轴C-G的运动。随后机器人臂能够控制可操作地联结到该臂的工具和器械。电缆是传送系统的部件，该传送系统还包括由电动机驱动的驱动滑轮、绞盘、空载滑轮和/或输出滑轮。滑轮槽或斜坡位于基部连杆102的下侧，用于在操纵器系统6的插入轴100和操纵器臂50之间传递电缆和电线。除其他的元件之外，也可以提供多个运动进给构件用于传送运动。
【0053】驱动组件可以进一步包括多个联结到臂用于随其旋转的驱动电机。偏航和俯仰电机分别控制臂绕轴A和轴B(图5A)的运动，而驱动电机控制腕关节单元的运动和插入位置。在一个实施例中，将四个驱动电机邻近地安装于臂上从而控制安装在臂的远端的工具的四个自由度(D、E、F和G轴)。同时，邻近地安装的电机控制在臂的远端的工具的插入位置(沿C轴)。驱动电机将优选地联结到编码器和电位器(未示出)上从而使能伺服机构。例如在序号为6,331,181、6,491,701和6,770,081的美国专利中阐述了驱动组件、臂和其他的可应用零件的实施例，这些专利的全部公开(包括其中通过参考并入的公开)通过参考合并于此以用于各种用途。操纵器臂和驱动组件也可以与宽范围的定位装置一起使用。对遥控中心定位装置更完整的说明可以在1995年7月20日提交的序号为08/504,301而现在的美国专利号为5,931,832的美国专利申请中找到，该专利的全部公开通过参考合并于此以用于各种用途。
【0054】现在参考图6A-6E，根据本发明的实施例图示说明了用于装纳器械无菌适配器的滑架连杆106的器械对接装置101和最终器械(例如，器械5)的透视图。器械对接装置101包括隔离电触点510(例如，避免意外的接触)的覆盖件502、用于给ISA圆盘提供预加载的弹簧加载输入504、用于提供预加载到ISA的牵引板的弹簧塞506、用于将ISA 109保持在适当位置的托架508、用于加固/释放ISA的杆511以及同样用于相对于机器人操纵器固定无菌适配器的位置的基准512，其中每个弹簧加载输入具有用于将扭矩传送到外科器械的凸起部505。在一个实例中，器械对接装置101包括四个弹簧加载输入504、四个弹簧塞506以及七个电触点510，其中每个弹簧加载输入具有两个凸起部505。
【0055】现在参考图7A-7D，根据本发明的实施例图示说明了滑架连杆和与滑架连杆的剩余部分分离的器械对接装置盖101a。本发明提供了有效地在外科机器人的输出端封装器械对接装置部件的紧凑设备和方法。这些构件包括但不限于电路板、电缆传送元件、传感器以及水平仪。图7A图示说明了滑架连杆106的器械对接装置盖101a和内部器械对接装置构件101b。盖101a包括基准512、覆盖件502、安装托架508、用于容纳杆511的开口520、用于容纳弹簧塞506的开口524以及用于容纳弹簧加载输入504的开口526，其中覆盖件502包括用于容纳电触点510的开口522。器械对接装置的这个“蛤壳”或者盖的设计允许当必要时很容易接触内部的机械装置、电路板以及插入轴的电缆传送元件。
【0056】图7A-7C也图示说明了电触点510和可操作地安装到印刷电路组件(PCA)516的霍尔效应传感器514。电触点510提供接口从而在ISA109和PCA之间传递电信号，并且在一个实例中可以包括“弹簧单高跷引脚(pogo pins)”。在一个实施例中，遥控PCA 516可以具有用于供电和/或与发光二极管(LED)、霍尔效应传感器、无菌适配器、器械以及用户界面按钮(例如，用于离合操作)通信的输入和输出。遥控PCA 516也可以包括用于接收电能的输入和用于与主PCA(例如，图1的处理器4)通信的输入/输出。在一个实施例中，主PCA可以具有用于供电和/或通过串行通信总线与电机(例如，主PCA将位置控制传送到电机并处理电位和编码信号)、传感器、用户界面按钮、遥控PCA以及在病人侧手推车系统上的其他印刷电路板通信的输入和输出。在2006年12月20日提交的名称为“Wireless Communication In A Robotic Surgical System”的序号为______(代理人案号M-16315-5US)的美国专利中阐述了可应用的PCA的输入和输出的实例，该申请完整的公开已经在前面通过参考合并于此以用于各种用途。在一个实例中，遥控PCA可以包括器械对接装置的嵌入式串化器(ESII)PCA，而主PCA在一个实例中可以包括嵌入式串化器病人操纵器(ESPM)PCA，两者都可从加利福尼亚州桑尼维尔的Intuitive Surgical公司获得。
【0057】霍尔效应传感器514用于提供坚固的装备和方法来探测安装在ISA 109上的器械存在与否。需要霍尔效应传感器是因为它是不带有移动构件的固态装置。图7A和7C图示说明了没有保护盖的霍尔效应传感器514，而图7B图示说明了带有保护盖的霍尔效应传感器514的侧视图。在一个实施例中，在器械底盘中有磁体的情况下，两个邻近的霍尔效应传感器可以用于改变状态。当器械磁体很接近霍尔效应传感器时，传感器的电输出状态改变。PCA 516探测传感器的状态改变并通知系统安装了器械。PCA 516通过现有探测电路也能够探测其他系统部件(例如ISA或者器械)存在与否。
【0058】在另一个实例中，除霍尔效应传感器之外，安装了第三个输入，系统可能需要该输入来识别器械。霍尔效应传感器514的输出可以与在器械存在时闭合的电路(例如，回环电路)结合使用，因此提供冗余存在的确认。PCA 516也探测这个电路的闭合。图7D图示说明了用于加固/释放ISA的杆511。杆511包括杆主体511a和用于安装轴511c的安装螺钉511b，杆主体511a可以绕轴511c旋转。扭转弹簧511e和硬挡块511d致使当安装上ISA时杠杆主体511a处于静止的“向上”位置，而在安装或者移去ISA的过程中杆主体511a处于旋转的位置。杆主体511a可以从水平线向下旋转大约25度。图8A和8B分别图示说明了处于静止位置和处于旋转位置的杆511。
【0059】图9A-9E是分离的器械输入504的不同视图，而图10A-10B是根据本发明的实施例的器械输入的截面图。图9A、9B和9D图示说明了处于静止(伸长)位置的输入504，而图9C和9E展示了处于缩回位置的输入504a。输入504包括弹簧504a、径向滚珠轴承504b、输出滑轮504c、线性滚珠花键滑动单元504d、滚珠花键轴504e、螺杆504f以及包括凸起部505的输入杆504g。其他的装备也可以用于实现线性运动和扭矩传递，例如线性滑块、V形滚轮、滑套、滚珠螺杆等等。
【0060】弹簧504a提供了在轴504e的轴向方向的弹簧力(轴向载荷)(如图9D的双向箭头所示)，因此允许输入杆504g沿轴向方向线性地平移。径向滚珠轴承504b使组件能够绕轴504e的纵向(或者径向)轴作旋转运动，并且滚珠花键滑动单元504d支撑组件的旋转运动，特别地支撑轴504e的旋转运动并因此支撑输入杆504g的旋转运动，这允许通过ISA圆盘304(图12A)将扭矩从输出滑轮504c传递到器械。在一个实例中，滚珠花键滑动单元504d被装夹到输出滑轮并且包括用作在花键轴504e的运动方向上的滚动元件的两排循环滚珠。输出滑轮504c由电缆驱动，如在2006年12月20日提交的名称为“Cable Tensioning In ARobotic Surgical System”的序号为______(代理人案号M-16315-1US)的美国专利中所公开，该申请的全部公开(包括其中通过参考并入的所有参考文献)已经在前面通过参考合并于此以用于各种用途。在一个实例中，花键轴504e包括沿它的长度方向的两个凹槽，循环滚珠进入这些凹槽内。将螺杆504f拧入花键轴504e内从而提供在轴向方向上的硬档块。在一个实例中，输入杆504g被压入到花键轴504e上，并提供与无菌适配器圆盘中的孔啮合的凸起部505。
【0061】图11A-11B是根据本发明的实施例的弹簧塞的侧视图。图11B图示说明了处于静止(伸长)位置的弹簧塞506，而图11C图示说明了当提供对ISA 109的牵引板的偏压力时处于缩回位置的弹簧塞506。
【0062】弹簧加载输入504、弹簧塞506以及杆511提供了在操纵器上的弹簧元件，因此允许ISA和无菌屏障用后即可丢弃的设计。有利的是，操纵器和ISA的安装和啮合更容易使用、更可靠并需要更少的作用力，同时使能ISA和无菌障碍遮盖件的划算且易处理的设计。
【0063】现在参考图12A、12B以及12C，根据本发明的实施例分别图示说明了ISA 109的俯视透视图、仰视透视图以及截面图。ISA 109包括外壳302、圆盘304、顶部牵引板306、外壳302的器械阻挡特征308、外壳302的轨道特征301、触点310以及底部牵引板312。顶部牵引板306和底部牵引板312形成相对于外壳302移动的牵引板组件313。圆盘304陷入牵引板组件313内并且相对于牵引板组件移动。
【0064】图13图示说明了触点310的放大截面图，在一个实施例中该触点被插入模压到外壳内。
【0065】图14A和14B根据本发明的实施例分别图示说明了圆盘304的放大俯视透视图和放大仰视透视图，圆盘304包括在圆盘304的基部的齿314、在圆盘304的主体上用于装纳外科器械5(见图16D和16E)的销253的孔316、在圆盘304的底部用于装纳弹簧加载输入504(见图9和10)的凸起部505的孔317以及用于将圆盘304移到死区外的突出件315。在这个实施例中，ISA 109包括四个圆盘304，每个圆盘304包括四个齿314和两个孔316。在一个实施例中，四个齿314彼此相隔90度放置。注意在其他的实施例中，更多或更少的圆盘、齿以及切口是可能的，但需要可操作地联结到在操纵器和外科器械上的适配器装纳部分。
【0066】图15A和15B根据本发明的实施例图示说明了顶部牵引板306的俯视透视图和仰视透视图。顶部牵引板306包括用于与器械底盘24啮合的横杆318和用于根据相对位置与圆盘304的齿314紧密配合的齿319。如图所示，顶部牵引板306包括与四个圆盘304相应的四个开孔307。
【0067】现在参考图16A至16F，根据本发明的实施例图示说明了器械无菌适配器(ISA)109安装/啮合到器械对接装置101(图16A)、外科器械5安装/啮合到ISA 109(图16B-16E)以及从ISA 109移除外科器械5(图16F)。
【0068】图16A展示了安装和啮合到操纵器8的适配器装纳部分101的ISA 109。ISA触点310联结到操纵器触点510，圆盘304与弹簧加载输入504啮合，底部牵引板312与弹簧塞506啮合，并且凸缘特性305(图16A和16F)与托架508紧密配合。器械阻挡特征308允许当器械安装到ISA上时如果用户滑离了轨道301阻止住器械(为了病人的安全)。当安装上器械时器械完全被顶部牵引板306上的横杆318阻止。在安装之前，弹簧加载输入504和弹簧塞506处于它们的最大伸长位置，而ISA的圆盘304在牵引板组件内能够自由旋转到任何随机位置。在一个实施例中，为了将ISA 109安装到对接装置101的适配器装纳部分上，用户将ISA外壳的凸缘放置于托架内并向下敲击后端，因此使杠杆/锁销511啮合。
【0069】在这个安装而预啮合的位置上，弹簧加载输入504向上挤压圆盘304以抵顶顶部牵引板306，并且弹簧加载输入504和弹簧塞506向上挤压牵引板组件313。在每个圆盘位置(牵引板306的开孔307)，在牵引板306上有一个与圆盘304的齿314相啮合的齿319。齿构形具有多重功能，其中之一是将圆盘304推出“死区”，死区是指在圆盘304的底部的孔317处于可能未与弹簧加载输入504的凸起部505紧密配合位置的角度方向，因为这些孔未旋转完整的360度。齿构形的另一个功能是在无菌适配器啮合步骤期间防止圆盘304旋转超过90度。
【0070】在啮合步骤期间，当弹簧加载输入504被驱使以通过凸起部505和圆盘304的底部表面之间的摩擦和与突出件315的接触促使圆盘304运动的时候，圆盘齿314与牵引板齿319相啮合。当弹簧加载输入504转换旋转方向时，四个齿314的存在阻止圆盘304的这种旋转运动，并且允许当弹簧加载输入504相对圆盘304旋转的时候凸起部505对准圆盘304的孔317。当在圆盘304的底部的孔317与弹簧加载输入504的凸起部505对齐的时候，圆盘304落至弹簧加载输入504上。在这一点上，当圆盘304落下时顶部牵引板306的齿319错过圆盘304的齿314，因此允许圆盘304相对于牵引板306自由地转动。当圆盘304啮合到弹簧加载输入504上时，ISA 109与适配器装纳部分101啮合。
【0071】在一个实施例中，在ISA 109安装到适配器装纳部分101之后的几毫秒内啮合步骤发生。当将ISA 109敲入适当的位置时，电触点310啮合电触点510(例如，弹簧单高跷引脚(pogo pins))，这样在操纵器8上的初始断开的电路被闭合，以此激发ISA啮合步骤。应该注意在外壳302中的插入模压触点310可能具有多个电通路(通孔)，这些电通路与适配器装纳部分101上的电触点啮合，并且还被用于通过器械的电触点255(图16C和16D)建立与外科器械5的通信。
【0072】图16B示出了局部安装的外科器械5，而图16C示出了完全安装并与ISA 109啮合的外科器械5。初始，当用户将外科器械5安装到ISA 109上时，随着与中心横杆318啮合的器械5压下顶部牵引板306，牵引板组件313被向下推向适配器装纳部分101。在器械5和ISA 109之间电啮合之前，横杆318上的倒角啮合器械5的底部上的倒角，并且当这两个倒角对准时，由于弹簧加载输入和弹簧塞的弹簧力，器械被拉入到它的收容位置中。当器械被拉入到它的收容位置中时，牵引板组件313开始升起到外科器械中，并且在几乎同一运动中，器械5的电触点255开始与ISA 109的电触点310接触。当器械5被安装到ISA 109上时，顶部牵引板306被压在器械的底部上并且横杆38位于器械外壳的间隙狭缝内。在器械啮合之前，因为在器械上的输入不与圆盘304顶部上的孔316啮合，所以圆盘304和弹簧加载输入504被推离器械。
【0073】图16D和16E图示说明了圆盘314与器械5的啮合步骤。在图16D中，圆盘304直到圆盘304旋转到对准器械圆盘251的位置才与器械5啮合，圆盘304初始时处于随机位置。如关于ISA 109和适配器装纳部分101之间的啮合步骤前面提到的，当器械的电触点啮合ISA 109的电触点310时，ESII印刷电路板和器械之间的常开电路通过ISA闭合从而激发器械啮合步骤。弹簧加载输入504和圆盘304作为一个组件一起旋转直到圆盘304的孔316与器械圆板251的销253啮合。当孔对准销时，允许圆盘304和弹簧加载输入504向上移动。图16E示出了具有与圆盘304的孔316啮合的销253的器械圆板251，在这一点上，认为器械5与ISA 109啮合。应该注意在ISA 109上的其他电触点可以在外科系统和器械“可重复放置的工具对接装置”(RTI)板之间传送电信号。
【0074】当器械完全安装上时，它被保持在沿它的外壳的三点位置上。两个点位于沿器械的边侧的轨道特征301处，第三个点位于沿器械的前侧中心的中心压制突出部309处。有利的是，通过在三个位置压制器械，器械不会被过度限制且安装和移除变得更容易。
【0075】图16F图示说明了从ISA 109移除器械5(未示出)。当用户想要移除器械时，压下在器械底盘任一侧的杆，器械将从ISA中被向后拉出。在器械上的杆作用于顶部牵引板的中心横杆318，牵引板的中心横杆318进一步下推牵引板使其远离器械。当牵引板移动越来越远时，圆盘304脱离器械的销从而允许器械的移除。
【0076】上述实施例图示说明而不限制本发明。也应该理解，根据本发明的实施例许多的修改和变化是可能的。例如，系统不限于四个机器人操纵器组件，而在其他的实例中可以包括两个或者多于两个机器人操纵器组件。因此，发明的范围仅由附属的权利要求限定。

Claims (22)

1.一种机器人操纵器的集成的器械对接装置，其包含：
用于将轴向载荷和扭矩提供给能够可操作地联结器械的无菌适配器的弹簧加载输入。
2.如权利要求1所述的器械对接装置，其中所述弹簧加载输入包括联结到轴的输入杆，所述轴可操作地联结到输出滑轮。
3.如权利要求2所述的器械对接装置，其中所述输入杆包括用于啮合所述无菌适配器的凸起部。
4.如权利要求1所述的器械对接装置，进一步包含用于可操作地啮合所述无菌适配器的多个弹簧加载输入。
5.如权利要求1所述的器械对接装置，进一步包含用于连接或者释放所述无菌适配器的弹簧加载释放杆。
6.如权利要求5所述的器械对接装置，其中所述释放杆包括用于偏压杆主体的扭矩弹簧。
7.如权利要求1所述的器械对接装置，进一步包含用于探测所述器械的存在的霍尔效应传感器。
8.如权利要求7所述的器械对接装置，其中所述霍尔效应传感器能够感测安装在所述器械内的磁体。
9.如权利要求1所述的器械对接装置，进一步包含用于相对于所述机器人操纵器的位置固定所述无菌适配器的基准。
10.如权利要求1所述的器械对接装置，进一步包含用于提供轴向力对抗所述无菌适配器的弹簧塞。
11.如权利要求1所述的器械对接装置，进一步包含无菌适配器安装托架。
12.如权利要求1所述的器械对接装置，进一步包含用于在所述无菌适配器和印刷电路组件之间对接的电接口。
13.如权利要求12所述的器械对接装置，进一步包含围绕所述电接口的保护性遮盖件。
14.如权利要求1所述的器械对接装置，其中所述器械选自于由夹钳、剪刀、抓紧器、测针夹持器、微型解剖器、U形钉施夹钳、缝合器、抽吸灌注工具、血管夹施夹钳、切割刀片、烧灼探测器、灌注器、导尿管以及抽吸口组成的组。
15.一种机器人外科操纵器系统，其包含：
操纵器组件，其包括：
可操作地联结到操作臂远端的基部连杆；以及
沿纵轴可移动地联结到所述基部连杆的滑架连杆，所述滑架连杆包括具有弹簧加载输入的集成的器械对接装置，所述弹簧加载输入用于将轴向载荷和扭矩提供给能够可操作地联结器械的无菌适配器；
通过所述器械对接装置可操作地联结到所述滑架连杆的器械；以及
可操作地联结到所述操纵器组件用于感测所述器械的存在的处理器。
16.如权利要求15所述的系统，其中所述弹簧加载输入包括联结到轴的输入杆，所述轴可操作地联结到输出滑轮。
17.如权利要求15所述的系统，其中所述器械对接装置进一步包括用于可操作地啮合所述无菌适配器的多个弹簧加载输入。
18.如权利要求15所述的系统，其中所述器械对接装置进一步包括用于感测所述器械的存在的霍尔效应传感器。
19.如权利要求18所述的系统，其中所述霍尔效应传感器能够感测安装在所述器械内的磁体。
20.如权利要求15所述的系统，其中所述器械选自于由夹钳、剪刀、抓紧器、测针夹持器、微型解剖器、U形钉施夹钳、缝合器、抽吸灌注工具、血管夹施夹钳、切割刀片、烧灼探测器、灌注器、导尿管以及抽吸口组成的组。
21.如权利要求15所述的系统，其中所述无菌适配器与无菌遮盖件结合以便使所述机器人外科系统的一部分与外科手术区域隔离。
22.如权利要求15所述的系统，其中所述器械对接装置进一步包括用于连接或者释放所述无菌适配器的弹簧加载释放杆。
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JP5101519B2 (ja) 2012-12-19
JP2009520573A (ja) 2009-05-28
ATE547059T1 (de) 2012-03-15
KR101337278B1 (ko) 2013-12-09
CN101340852B (zh) 2011-12-28
EP1962711A1 (en) 2008-09-03

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