CN101730506B - 带有触觉反馈的微创外科工具 - Google Patents

带有触觉反馈的微创外科工具 Download PDF

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CN101730506B
CN101730506B CN2008800239439A CN200880023943A CN101730506B CN 101730506 B CN101730506 B CN 101730506B CN 2008800239439 A CN2008800239439 A CN 2008800239439A CN 200880023943 A CN200880023943 A CN 200880023943A CN 101730506 B CN101730506 B CN 101730506B
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minimally invasive
invasive surgical
surgical tools
tools according
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C·拉姆斯泰恩
C·J·乌尔里克
A·德吉斯特
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Immersion Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00106—Sensing or detecting at the treatment site ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure

Abstract

一种微创外科工具包括响应与微创外科工具的相互作用生成信号的传感器。所述微创外科工具还包括响应所述信号生成触觉效应的触觉反馈系统。

Description

带有触觉反馈的微创外科工具
相关申请
本申请要求2007年7月9日提交的美国临时专利申请No.60/948,616的权益。
技术领域
一个实施例涉及外科工具。尤其是，一个实施例涉及微创外科工具。
背景技术
微创手术在不形成大切口或开口的情况下执行，这使得患者创伤减小并且产生明显的成本节约。这些由更短的住院时间和减少的治疗要求产生。微创手术的其他益处包括更少的疼痛、更少需要术后止痛用药、更小的疤痕和与切口有关的并发症的更小可能性。
基于手术过程(例如，小切口)或结果(例如，减小的手术并发症或成本)定义微创手术。然而，微创手术不同于小手术。一些“微创”过程例如冠状动脉旁路手术仍然是需要住院的大手术。
在微创手术中，微型照相机典型地通过小切口被引入身体中。照相机将图像传输到视频监视器，允许医生诊断，并且必要时治处理各种状况。为此，医生通过一个或多个附加小切口插入外科器械和辅助装置(统称为“微创外科工具”)例如灌洗和引流装置。这样的外科器械可以用于腹腔镜手术、导管插入或内窥镜检查，以及用于允许远程手术和遥测。然而与开放式手术相比，微创手术在视觉和触觉方面具有限制，而且构成了对该类手术的挑战。主要的忧虑之一是可能由力的不当使用导致的组织损伤的可能性。
基于上述内容，需要一种改进的微创外科工具。
发明内容
一个实施例是一种微创外科工具，其包括响应与所述微创外科工具的相互作用生成信号的传感器。所述微创外科工具还包括响应所述信号生成触觉效应的触觉反馈系统。
附图说明
图1示出了根据一个实施例的微创外科工具。
图2是根据一个实施例的触觉反馈系统的框图。
图3示出了根据另一个实施例的微创外科工具。
图4示出了根据另一个实施例的微创外科工具和相应套管针。
具体实施方式
一个实施例是一种微创外科工具，其包括在工具尖端处或附近的传感器，并且生成触觉效应以将相关反馈提供给正在操作工具的用户。
图1示出了根据一个实施例的微创外科工具10。微创外科工具10是用于腹腔镜手术的夹紧工具，但是可以是任何类型的微创外科工具，其包括专门设计成通过与身体的相互作用提供触觉反馈的工具。微创外科工具10包括在所示实施例中为夹钳部分12的工具尖端、外壳14和手柄16。手柄16的运动通过从手柄16延伸到夹钳部分12的内部金属线或线束21打开和关闭夹钳部分12。总体上类似于微创外科工具10，腹腔镜工具通常为5mm-10mm的细器械，每个器械具有不同功能(例如夹钳、剪刀、夹子施用器等)并且可以通过套管针由外科医生引入腹部或身体的其他区域中，所述套管针是带有橡胶密封件以防止CO2泄露的中空管。
当使用现有技术的夹紧工具时，外科医生将通常用夹钳部分12戳组织或以其它方式与该组织相互作用，并且依靠手柄16上的柔和感觉来确定组织的硬度。然而，该技术不是很精确并且当错误组织被切割或夹紧时会导致潜在的致命错误。所以，在一个实施例中，外壳14包括挠性和包封应变计15。在一个实施例中通过去掉外壳14的一部分并且更换应变计15来安装应变计15。在一个实施例中，应变计15安装在微创外科工具10的尖端附近。
微创外科工具10还包括连接到手柄16或微创外科工具10的某个其他部分上的触觉反馈系统17，使得当执行程序时用户接触触觉反馈系统17的一部分。在一个实施例中，触觉反馈系统17是生成用于触觉反馈的振动的振动触觉装置。在其他实施例中，其他类型的触觉反馈被生成并且被提供给用户，例如动觉反馈(例如动力和阻力反馈)和/或除了振动以外的其他类型的触觉反馈(例如组织质地和热)。在一个实施例中触觉反馈系统17在微创外科工具10内部连接到应变计15。
在操作中，当微创外科工具10的尖端(例如夹钳部分12)与骨和在人和其他动物体中发现的各种类型的组织相互作用并且在应变计15中产生变形时，由应变计15生成信号。从应变计15接收的信号可以通过转换为相应触觉反馈被“放大”，使得执行操作的用户对他/她正在导航通过和围绕的组织和骨具有“增强”感觉。该增强感觉(在使用(即，切割、导管插入等)期间施加到装置的外科尖端的力的放大效果)为用户提供更好的控制和灵敏性以有效地、高效地且对患者造成极小创伤地使用微创外科工具。此外，在触诊期间，在工具尖端感测到的力被转换为触觉反馈，以便放大或突出了工具尖端与身体的内部相互作用。
在一个实施例中触觉反馈可以是振动触觉，其基于硬度或变形的变化水平而变化或者是“动态的”。该变化可以是幅度、频率、持续时间等的变化。其他类型的触觉反馈可以包括使用：螺线管，以改变手柄16的硬度/阻尼的动觉反馈；改变手柄16的尺寸的小气囊；或形状变化的材料。在另一个实施例中，用户可以戴上包括多个力输出性能的力反馈网络手套(cyber golves)。所有实施例可以包括不同类型触觉反馈的组合，或者触觉反馈和非触觉反馈的组合(例如音频/视觉反馈)。
图2是根据一个实施例的触觉反馈系统17的框图。触觉反馈系统17包括连接到存储器30的处理器22和连接到振动致动器28的致动器驱动电路26。处理器22可以是任何类型的通用处理器，或者可以是专门设计成提供触觉效应的处理器，例如特定用途集成电路(“ASIC”)。处理器22可以基于高水平参数和响应从应变计15接收的信号确定将显现什么样的触觉效应以及在哪里显现该效应。通常，限定特定触觉效应的高水平参数包括幅度、频率和持续时间。低水平参数例如传输中的电机指令也可以用于确定特定触觉效应。
处理器22将控制信号输出到驱动电路26，所述驱动电路包括用于为振动致动器28供应所需电流和电压以产生预期触觉效应的电子部件和电路。振动致动器28是在手柄16上生成振动的触觉装置。振动致动器28可以包括能够将振动触觉力施加到微创外科工具10的用户的一个或多个施力机构。振动致动器28例如可以是电磁致动器、其中偏心质量由电机移动的偏心旋转质量(“ERM”)、其中附连到弹簧的质量被往复驱动的线性共振致动器(“LRA”)、或诸如压电、电活化聚合物或形状记忆合金这样的“智能材料”。
存储装置30可以是任何类型的存储装置或计算机可读介质，例如随机存取存储器(“RAM”)或只读存储器(“ROM”)。存储器30存储由处理器22执行的指令。存储器30也可以位于处理器22内部、或者内部和外部存储器的任何组合中。
图3示出了根据另一个实施例的微创外科工具40。在微创外科工具40中，线束21的一部分由沿其长度的内嵌式压电应变计42替换。应变计42输出信号，该信号与手柄16正被挤压的强度成比例，其反映夹钳正被夹紧的强度。这允许信号例如指示夹钳12是否正接触骨、组织或血管，甚至指示所接触的血管是否正在脉动。所以，用户可以更容易地使用微创外科工具40进行探查。来自应变计42的信号通过线路43传输到触觉系统17，在那里它被转换为可以由用户察觉的触觉反馈。
在所有实施例中，工具尖端与身体之间的相互作用可以是物理力(例如尖端接触骨)或某个其他类型的相互作用。相互作用的其他例子可以通过将传感器连接到工具尖端上实现。在一个实施例中，感测声振动的压电换能器安装在工具尖端上，并且相互作用是通过换能器感测声振动，这又生成由触觉反馈系统接收的信号。可以连接到工具尖端的传感器的另外例子包括压力换能器、对生物材料敏感的硅片、超声探头、电磁场传感器等。
图4示出了根据另一个实施例的微创外科工具55和相应套管针50。套管针50包括在它的内圆周周围的多个辊51，而不是像现有技术的套管针中的被动橡胶密封件。现有技术的橡胶密封件并不提供变化摩擦，并且过滤了用户原本会在手柄16接收到的许多反馈或感觉。辊51包括允许改变辊51在外壳14的外部上的滚动阻力的致动器或其他结构。线或其他相互作用件将致动器连接到位于手柄16上的压力传感器54。用户可以通过改变施加到压力传感器54的压力改变由辊51所施加的阻力的大小。例如，用户抓握手柄16越紧，辊51施加的阻力就越大。
可以以多种方式利用套管针50以增强工具55的使用。例如，辊51的阻力可以被最大化，使得外壳14可以在套管针50内“卡”在适当位置。此外，辊51的阻力可以被最小化，使得外壳14不费力地并且几乎无摩擦地滑动通过套管针50，因此当探查时增强在手柄16处提供给用户的“反馈”。在一个实施例中，套管针50被认为是工具55的一部分。
在一个实施例中，工具中的传感器和/或致动器是一次性物品。典型地，在体内诸如腹腔镜工具这样的装置需要在每次使用之前被消毒。工具的可去除且一次性的部分不是必须被消毒的，原因是它们刚被替换。在一个实施例中，带有致动器的手柄可以被旋下并替换。在其他实施例中，传感器也可以是一次性的。
在本文中具体示出和/或描述了几个实施例。然而，应当理解修改和变化由以上教导涵盖并且在附带权利要求的范围内而不脱离本发明的精神和预期范围。
例如，尽管公开的实施例是用于腹腔镜手术的工具，其他实施例可以用于非腹腔镜手术，例如导管插入，其中或工具尖端上的超声成像和其他机械传感器可以与通信传回到导管手柄。此外，对于内窥镜检查过程，挠性内窥镜上的机械传感器可以与局部组织性质例如机械阻抗通信。其他实施例可以用于远程手术或遥测以便例如由远程医生执行常规外部检查。

Claims (14)

1.一种微创外科工具，其包括：
响应与所述微创外科工具的相互作用生成信号的传感器；以及
响应所述信号生成触觉效应的触觉反馈系统；
所述微创外科工具还包括具有多个辊的套管针，所述触觉效应是所述辊的滚动阻力的变化。
2.根据权利要求1所述的微创外科工具，其中所述相互作用是施加到所述微创外科工具的力。
3.根据权利要求1所述的微创外科工具，其中所述触觉反馈系统包括致动器，并且所述触觉效应是振动触觉。
4.根据权利要求1所述的微创外科工具，其中所述传感器是应变计。
5.根据权利要求4所述的微创外科工具，还包括外壳，所述应变计连接到所述外壳。
6.根据权利要求4所述的微创外科工具，还包括线束，其中所述线束连接到所述应变计。
7.根据权利要求1所述的微创外科工具，其中所述触觉效应是动态的。
8.根据权利要求1所述的微创外科工具，其中所述传感器是换能器。
9.根据权利要求1所述的微创外科工具，其中所述传感器是对生物材料敏感的装置。
10.根据权利要求1所述的微创外科工具，其中所述传感器是超声探头。
11.根据权利要求1所述的微创外科工具，其中所述传感器是电磁场传感器。
12.根据权利要求1所述的微创外科工具，还包括：
手柄；
主体；以及
工具尖端；
其中所述套管针包括连接到所述多个辊的至少一个致动器；
线将所述该致动器连接到位于手柄上的所述传感器。
13.根据权利要求12所述的微创外科工具，其中所述致动器适于改变所述多个辊的滚动阻力和提供触觉效应。
14.根据权利要求13所述的微创外科工具，其中所述滚动阻力基于施加到所述手柄的压力的大小而变化。
CN2008800239439A 2007-07-09 2008-05-14 带有触觉反馈的微创外科工具 Expired - Fee Related CN101730506B (zh)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US94861607P 2007-07-09 2007-07-09
US60/948,616 2007-07-09
US11/955,563 US20110046659A1 (en) 2007-07-09 2007-12-13 Minimally Invasive Surgical Tools With Haptic Feedback
US11/955,563 2007-12-13
PCT/US2008/063561 WO2009009220A2 (en) 2007-07-09 2008-05-14 Minimally invasive surgical tools with haptic feedback

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