CN103561667A - 机器人手术器械中的夹持力控制 - Google Patents
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Abstract
公开了控制组织夹持力的手术组件、器械和相关方法。手术组件包括包含可操作以夹持病人组织的夹钳的末端执行器和弹簧组件。所述弹簧组件包括与所述夹钳驱动地耦合的输出连杆、驱动地耦合到铰接源的输入连杆和与所述输入和输出连杆耦合以将铰接力从所述输入连杆传递到所述输出连杆的弹簧。所述弹簧被预载，以在所转移的铰接力低于预定水平时抑制所述输入连杆和所述输出连杆之间的相对运动，和以便在所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动。
Description
相关申请的交叉参考
本申请要求2011年5月31日提交的题为“机器人手术器械中的夹持力控制”的美国临时申请第61/491,804号的权益，其全部内容通过引用并入本文。
发明背景
微创手术技术目的是减少在诊断或手术期间损坏的体外组织的量，从而减少病人恢复时间、不适和有害的副作用。因此，标准手术住院期的平均长度可以通过采用微创手术技术而大大缩短。此外，采用微创手术也可以减少病人恢复时间、病人不适、手术副作用和离开工作的时间。
微创手术的一种常见形式是内窥镜检查术，而内窥镜检查术的一种常见形式是腹腔镜检查术，其是腹腔内的微创检查和手术。在标准腹腔镜检查手术中，病人腹部被充入气体，然后插管套管通过小的（约半英寸或更小）切口来为腹腔镜检查器械提供入口。
腹腔镜检查手术器械一般包括用于查看手术区的内窥镜（例如，腹腔镜）和在手术部位操作的工具。操作工具通常类似于传统（开放式）手术中使用的那些，除了每个工具的操作端或末端执行器通过伸缩管（也称为，例如，器械轴或主轴）与其手柄隔开。所述末端执行器可以包括例如，夹钳、抓紧器、剪刀、吻合器（stapler）、烧灼工具、线切削器（linear cutter）或持针器。
为了进行手术操作，外科医生通过插管套管将操作工具传递到内部手术部位，并从腹部外面操纵它们。外科医生从显示由内窥镜拍下的手术部位的图像的监视器查看操作。例如，在关节镜检查术、后腹腔镜检查术、盆腔镜检查术、肾镜检查术、膀胱镜检查术、脑池镜检查术（cisternoscopy）、窦镜检查术、子宫镜检查术、尿道镜检查术等中采用类似的内窥镜技术。
正在开发微创遥控手术机器人系统（minimally invasive telesurgicalrobotic systems），以增加外科医生在内部手术部位上操作时的灵巧，以及允许外科医生从（在无菌区以外的）远程位置在病人身上做手术。在遥控手术系统中，常常在操作台向外科医生提供手术部位的图像。当在适当查看器或显示器上查看该手术部位的三维图像时，外科医生通过操纵该操作台的主输入或控制设备在病人身上进行手术操作。每个所述主输入设备控制伺服机械致动/铰接的手术器械的运动。在手术操作过程中，遥控手术系统可以为外科医生提供具有执行各种功能的末端执行器的多种手术器械或工具的机械致动和控制，例如，响应于主输入设备的操纵，夹持或驱动针、抓住血管、解剖组织等。
在许多不同的手术操作中已经采用了非机器人直线夹紧、切割和吻合设备。例如，这样的设备可以用来切除胃肠道的癌组织或异常组织。许多已知手术设备，包括已知的直线夹紧、切割和吻合设备，往往具有用来操纵病人组织的对置夹钳。
对于具有对置夹钳的已知设备，大量的机械动力必须传送到末端执行器，以有效地例如，夹紧组织、吻合组织、切割组织等。必要量的机械动力的传送可以涉及具有高机械优点的机构，以将高运动低力致动输入转换成高夹紧力。这样的机构通常是相对刚性的，且能够产生过量的夹紧力。因此，这样的高机械优点机构的使用可能在一些情况下导致损坏被夹紧组织的过大夹紧力的施加。
因此，认为需要一种以可控的方式可操作产生夹紧力的手术组件。
发明内容
公开了控制组织夹持力的手术组件、器械和相关方法。所公开的组件、器械和相关方法采用具有预载弹簧的机构，所述预载弹簧在传送到夹紧机构的力/转矩低于预定水平时使该机构的构件（components）一起偏置和在所传送的力/转矩高于预定水平时允许构件之间的分离。所公开的组件、器械和方法可以用于任何适合的应用。例如，本文所公开的手术组件、器械和/或方法可以在用于开放式或微创（单端口或多端口）操作的手动或电动、手持式或机器人式、直接控制或遥控操作的其他手术器械中使用。当在微创机器人手术组件、器械和操作中采用时，所公开的组件、器械和方法可以是特别有利的。
因此，在第一个方面，提供微创机器人手术组件。所述手术组件包括包含可操作以夹持病人组织的夹钳的末端执行器和弹簧组件。所述弹簧组件包括与所述夹钳驱动地耦合的输出连杆、驱动地耦合到铰接源的输入连杆和与所述输入和输出连杆耦合以将铰接力从所述输入连杆转移到所述输出连杆的弹簧。所述弹簧被预载，以便当所转移的铰接力低于预定水平时抑制所述输入连杆和所述输出连杆之间的相对运动，和以便当所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动。
在所述手术组件的许多实施例中，所转移的铰接力诱导所述夹钳的夹持力。当所转移的铰接力处于或高于所述预定水平时进一步关闭所述夹钳的所述输入连杆的运动诱导与所述输入连杆和所述输出连杆之间的相对运动相关联的弹簧的变形，以便当变形弹簧将所述铰接力从所述输入连杆转移到所述输出连杆时控制转移的铰接力的增加。
所述弹簧组件的弹簧可以是拉伸弹簧。所述输出连杆相对于所述末端执行器的直线运动可以用来诱导所述夹钳的铰接。
在所述手术组件的许多实施例中，所述弹簧组件的弹簧包括扭力弹簧。并且，所述输出连杆相对于所述末端执行器的旋转运动可以用来诱导所述夹钳的铰接。所述输入和输出连杆可以旋转地安装到底座，以围绕共同旋转轴线旋转。例如，所述输出连杆可以固定地连接到中心轴，和所述输入连杆可以旋转地安装到该中心轴。可选择地，所述输入连杆可以固定地连接到中心轴，和所述输出连杆可以旋转地安装到该中心轴。当所述弹簧包括扭力弹簧时，所述扭力弹簧可以由所述输入连杆的外表面或所述输出连杆的外表面中的至少一个容纳和约束。
在所述手术组件的许多实施例中，所述弹簧组件进一步包括旋转地安装到所述底座以围绕共同旋转轴线旋转的一个或多个接合元件。所述一个或多个接合元件和所述弹簧的组合在所转移的铰接力低于所述预定水平时抑制所述输入连杆和所述输出连杆之间的相对运动，和在所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动。所述一个或多个接合元件中的至少一个可以具有凸部，其被定形以在所转移的铰接力低于所述预定水平时与所述输入连杆或所述输出连杆中至少一个的互补定形的凸部接合。
在另一方面，提供了一种控制机器人手术器械中的夹持力的方法。该方法包括：致动弹簧组件的输入连杆；将致动力从所述输入连杆转移到所述弹簧组件的输出连杆；当所转移的致动力低于所述弹簧组件的预载弹簧的预定水平时，抑制所述输入连杆和所述输出连杆之间的相对运动；当所转移的致动力增加至高于所述预定水平时，通过使所述弹簧组件的预载弹簧变形，相对于所述输出连杆移动所述输入连杆；和经由所述输出连杆致动夹持机构，以便夹持病人组织。
该方法的动作可以以各种合适的方式完成。例如，所述输入连杆的致动可以包括相对于所述夹持机构平移所述输入连杆。所述输入连杆的致动可以包括相对于所述夹持机构旋转所述输入连杆。所述致动力的转移可以包括通过预载弹簧转移所述输入连杆和所述输出连杆之间的力。所述输入连杆和所述输出连杆之间的相对运动的抑制可以包括用预载弹簧使输入和输出弹簧相对于彼此约束。并且，所述输入连杆和所述输出连杆之间的相对运动的抑制可以包括接合所述输入连杆与接合连杆及接合所述接合连杆与所述输出连杆，所述输入和输出连杆通过预载弹簧与所述接合连杆保持接触。所述输入连杆、所述输出连杆和所述接合连杆可以被约束以围绕共同旋转轴线旋转。所述预载弹簧可以包括在所述输入连杆和所述输出连杆之间耦合的扭力弹簧。
在另一方面，提供了一种与微创手术系统的机器人机械手（manipulator）一起使用的手术器械，所述机器人机械手具有夹具。所述手术器械包括：在远端和近端之间延伸的器械轴；由所述远端支撑并包括可操作以夹持病人组织的夹钳的末端执行器；与所述夹钳驱动地耦合的驱动元件；和设置在所述近端处的底架。所述底架包括支撑所述器械轴的框架、弹簧组件和输入耦合器。所述弹簧组件包括：与所述驱动元件驱动地耦合的输出连杆；输入连杆；和与所述输入和输出连杆耦合以将铰接力从所述输入连杆转移到所述输出连杆的弹簧。所述弹簧被预载，以便当所转移的铰接力低于预定水平时抑制所述输入连杆和输出连杆之间的相对运动，和以便当所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动。所述输入耦合器是与所述输入连杆驱动地耦合，并经配置与所述机器人机械手的相应输出耦合器驱动地接合。
在所述手术器械的许多实施例中，所转移的铰接力诱导所述夹钳的夹持力。并且，当所转移的铰接力处于或高于所述预定水平时进一步关闭所述夹钳的输入连杆的运动诱导与所述输入连杆和所述输出连杆之间的相对运动相关联的弹簧的变形，以便当变形弹簧将所述铰接力从所述输入连杆转移到所述输出连杆时控制转移的铰接力的增加。
在所述手术器械的许多实施例中，所述驱动元件包括与所述夹持机构旋转地耦合的驱动轴。所述输入连杆和所述输出连杆可以旋转地安装到所述框架，以围绕共同旋转轴线旋转。并且，所述预载弹簧可以包括扭力弹簧。
在所述手术器械的许多实施例中，所述弹簧组件进一步包括旋转地安装到所述底座以围绕共同旋转轴线旋转的一个或多个接合元件。所述一个或多个接合元件和所述弹簧的组合在所转移的铰接力低于所述预定水平时抑制所述输入连杆和所述输出连杆之间的相对运动，和在所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动。所述一个或多个接合元件中的至少一个可以具有凸部，其被定形以在所转移的铰接力低于所述预定水平时与所述输入连杆或所述输出连杆中至少一个的互补定形的凸部接合。
为了更完全地理解本发明的性质和优点，应该参考随后的详细描述和附图。从下面的附图和详细描述看，本发明的其他方面、目的和优点将是明显的。
附图说明
图1是根据许多实施例的用来进行手术的微创机器人手术系统的平面图。
图2是根据许多实施例的用于机器人手术系统的外科医生的操作台的透视图。
图3是根据许多实施例的机器人手术系统电子推车的透视图。
图4示意地示出了根据许多实施例的机器人手术系统。
图5A是根据许多实施例的机器人手术系统的病人侧推车（手术机器人）的前视图。
图5B是根据许多实施例的机器人手术工具的前视图。
图6A是根据许多实施例的包括具有对置夹钳的末端执行器的机器人手术工具的透视图。
图6B是图6A的末端执行器的特写透视图。
图7是图6A的末端执行器的分解透视图，其示出用来将驱动轴的旋转运动转换成对置夹钳的铰接的机构。
图8A和图8B是根据许多实施例的具有对置夹钳的末端执行器和用来将驱动轴的旋转运动转换成对置夹钳的铰接的机构的透视图。
图9是示出根据许多实施例的控制手术器械中的夹紧力的方法的简化示意图。
图10以图表形式示出根据许多实施例的控制手术器械中的夹紧力的方法。
图11以图表形式示出根据许多实施例的在控制手术器械中的夹紧力的方法中使用的拉伸弹簧的工作范围。
图12A是根据许多实施例的用来控制手术器械中的夹紧力的旋转机构的横截面视图。
图12B是简化示意图，其示出当通过旋转机构传送的转矩小于预定水平时图12A的旋转机构的构件的配置。
图12C是简化示意图，其示出当通过旋转机构传送的转矩大于预定水平时图12A的旋转机构的构件的配置。
图13以图表形式示出根据许多实施例的在控制手术器械中的夹紧力的方法中使用的扭力弹簧的工作范围。
图14是机器人手术工具的近端底架的透视图，其示出根据许多实施例的用于控制转移到用来致动末端执行器的夹钳的驱动轴的转矩的旋转机构。
图15A是根据许多实施例的用于控制转移到用来致动末端执行器的夹钳的驱动轴的转矩的旋转机构的透视图。
图15B是图15A的旋转机构的分解透视图。
图15C示出在图15A的旋转机构中用于将扭力弹簧耦合到输入连杆的输入连杆的细节。
图16示出根据许多实施例的控制手术器械中的夹持力的方法的动作。
具体实施方式
在下列描述中，将描述本发明的各种实施例。为了说明的目的，阐释具体配置和细节，以便提供对实施例的完全理解。然而，对本领域技术人员也将明显的是，本发明可以在无具体细节的情况下实践。此外，可能省略或简化熟知的特征，以便不遮掩正在描述的实施例。
微创机器人手术
现在参考附图，其中贯穿若干视图，相同参考标号表示相同部件，图1是示出微创机器人手术（MIRS）系统10的平面图，该系统通常用于对躺在手术台14上的病人12进行微创诊断或手术操作。该系统可以包括由外科医生18在操作过程中使用的外科医生的操作台16。一个或多个助手20也可以参与操作。所述MIRS系统10可以进一步包括病人侧推车22（手术机器人）和电子推车24。当外科医生18通过操作台16查看手术部位时，病人侧推车22可以通过病人12的身体内的微创切口操纵至少一个可拆卸耦合的工具组件26（以下简称为“工具”）。手术部位的图像可以由内窥镜28如立体内窥镜获得，可以由病人侧推车22操纵以便定向内窥镜28。电子推车24可以用来处理随后通过外科医生的操作台16显示给外科医生18的手术部位的图像。同时使用的手术工具26的数量一般将取决于诊断或手术操作以及手术室内的空间限制及其他因素。如果有必要改变在操作过程中使用的一个或多个所述工具26，助手20可以从病人侧推车22移除工具26，并用手术室中来自托盘30的另一工具26将其替换。
图2是外科医生的操作台16的透视图。外科医生的操作台16包括用于给外科医生18呈现能够深度感知的手术部位的协调立体图的左眼显示器32和右眼显示器34。所述操作台16进一步包括一个或多个输入控制设备36，其进而导致（图1中所示的）病人侧推车22操纵一个或多个工具。所述输入控制设备36可以提供与（图1中所示的）其关联工具26相同的自由度，以便向外科医生提供远程监控或者所述输入控制设备36与所述工具26是一个整体的感知，这样外科医生具有直接控制所述工具26的强烈感觉。为此，可以采用位置、力和触觉反馈传感器（未示出），以通过所述输入控制设备36将位置、力和触觉感受从所述工具26传送回到外科医生的双手。
外科医生的操作台16通常位于与病人相同的房间内，以便外科医生可以直接监控操作，如果有必要亲自到场，并直接而不是通过电话或其他通信媒介对助手讲话。然而，外科医生可以位于不同的房间、完全不同的建筑物或允许远程手术操作的远离病人的其他位置。
图3是电子推车24的透视图。所述电子推车24可以与所述内窥镜28耦合，并可以包括处理器，以处理随后显示的捕获图像，如在外科医生的操作台上或在本地和/或远程位置的另一合适显示器上随后显示给外科医生的捕获图像。例如，在使用立体内窥镜的情况下，电子推车24可以处理捕获的图像，以便向外科医生呈现手术部位的协调立体图。这样的协调可以包括对置图像之间的对准，且可以包括调整所述立体内窥镜的立体工作距离。作为另一示例，图像处理可以包括先前确定的摄像机校准参数的使用，以便补偿该图像捕获设备的成像误差，如光学像差。
图4示意地示出机器人手术系统50（如图1的MIRS系统10）。如上面所讨论的，外科医生的操作台52（如图1中的外科医生的操作台16）可以由外科医生使用来在微创手术操作过程中控制病人侧推车（手术机器人）54（如图1中的病人侧推车22）。所述病人侧推车54可以使用成像设备，如立体内窥镜，以捕获操作部位的图像，并输出捕获的图像到电子推车56（如图1中的电子推车24）。如上面所讨论的，所述电子推车56可以在任何随后显示之前以各种方式处理捕获的图像。例如，所述电子推车56可以在经由外科医生的操作台52显示组合的图像给外科医生之前用虚拟控制界面覆盖捕获的图像。所述病人侧推车54可以输出用于在电子推车56的外面处理的捕获图像。例如，所述病人侧推车54可以输出捕获的图像到处理器58，处理器58可以用来处理捕获的图像。所述图像也可以由电子推车56和处理器58的组合加以处理，所述电子推车56和处理器58可以耦合在一起，以便共同地、相继地和/或其组合地处理捕获的图像。一个或多个单独的显示器60也可以与所述处理器58和/或所述电子推车56耦合，用于图像的本地和/或远程显示，如手术操作部位的图像或其他相关图像。
图5A和图5B分别示出病人侧推车22和手术工具62。所述手术工具62是手术工具26的一个示例。所示的病人侧推车22提供了三个手术工具26和一个成像设备28的操纵，该成像设备28如用于操作部位的图像捕获的立体内窥镜。由具有多个机器人接头的机器人机构提供操纵。所述成像设备28和所述手术工具26可以通过病人的切口被定位和操纵，以便运动远程中心保持在该切口处以最小化该切口的大小。该手术部位的图像可以包括当位于所述成像设备28的视场内时所述手术工具26的远端图像。
组织夹持末端执行器
图6A示出了手术工具70，其包括近侧底架72、器械轴74和具有可以铰接以夹持病人组织的夹钳78的远端执行器76。所述近侧底架包括经配置与病人侧推车22的输出耦合器接合并由其驱动的输入耦合器。所述输入耦合器与弹簧组件80的输入连杆驱动地耦合。所述弹簧组件80安装到所述近侧底架72的框架82，并包括与设置在所述器械轴74内的驱动轴驱动地耦合的输出连杆。所述驱动轴与所述夹钳78驱动地耦合。图6B提供所述末端执行器76的夹钳78的特写视图。
图7是图6A的末端执行器76的分解透视图，其示出用来将驱动轴84的旋转运动转换成所述末端执行器76的对置夹钳的铰接的夹紧机构。所述末端执行器包括上夹钳86、下夹钳88、框架90、用于枢转地安装上夹钳86和下夹钳88到框架90的销92和与所述驱动轴84驱动地耦合的导螺杆机构94。所述导螺杆机构94包括导螺杆96和经由所述导螺杆96的旋转沿所述框架90内的狭槽100推进和缩回的配合移动螺母98。所述移动螺母98包括与在上夹钳86中的狭槽102和下夹钳88中的狭槽104接合的相对延伸的凸部，从而导致在所述移动螺母98沿所述狭槽100推进或缩回时上夹钳86和下夹钳88围绕所述销92的铰接。
图8A和图8B示出与图7的夹紧机构类似的一个夹紧机构的操作。在所示的方向上旋转所述驱动轴84导致移动螺母98向枢轴销92进行远侧推进，所述下夹钳88和所述上夹钳86通过该枢轴销92枢转地安装到末端执行器的框架90。如图8B中所示，移动螺母98的凸部啮合在所述上夹钳86中的狭槽102。所述移动螺母98向所述枢轴销92的远侧推进导致所述上夹钳在所示的方向上旋转，并导致所述下夹钳88在相反方向上旋转，从而打开该夹钳。同样地，所述移动螺母98远离所述枢轴销92的近侧推进导致该夹钳关闭。因此，该夹钳可以铰接以夹持病人组织。
图7、图8A和图8B中显示的导螺杆型的夹紧机构提供显著的机械优势，其将由所述驱动轴传送的相对低的转矩转换成相对高的夹紧力。为了避免经由具有这样的显著机械优势的机构使组织遭受过大夹紧力，可以控制由所述驱动轴传送到所述夹紧机构的转矩。
致动力/转矩的控制
图9示意地示出用于控制传送到末端执行器的夹钳的夹紧力的量的弹簧组件110。所述弹簧组件110包括由输入耦合器（也称为“针盘传动滑轮（dog）”）驱动的输入连杆112、与所述末端执行器夹钳驱动地耦合的输出连杆114和在所述输入连杆112和所述输出连杆114之间耦合的预载拉伸弹簧116。参照图9，当所述输入连杆112由所述输入耦合器向右驱动时，所述拉伸弹簧116向右拉动所述输出连杆114，从而导致所述末端执行器的夹钳关闭。随着该夹钳开始夹持组织，进一步关闭该夹钳所需的力开始增加。为了进一步关闭该夹钳，传送到该夹钳的夹紧力增加。随着该夹钳继续关闭，传送到该夹钳的渐增的夹紧力到达等于所述预载拉伸弹簧116中的力的水平。在该点处，所述输入连杆112的进一步向右运动导致所述预载拉伸弹簧116开始拉伸，从而允许所述输入连杆和所述输出连杆开始分离。此后，所产生的传送到该夹钳的夹紧力受所述弹簧刚度（spring rate）和所述拉伸弹簧116的总挠度（deflection）的组合限制。
图10示意地示出随着所述输入耦合器从其中所述夹钳不夹持组织的初始位置（P(i)）移动到其中所述夹钳开始夹持组织的接触位置（P(c)），再移动到其中通过所述弹簧组件110传送的力到达其中所述预载拉伸弹簧116开始拉伸的点的中间位置（P(sep)），以及最后移动到最终位置（P(f)），通过所述弹簧组件110传送到所述末端执行器夹钳的夹紧力（也称为“夹持力”）。当所述输入耦合器在初始位置（P(i)）至接触位置（P(c)）之间移动时，通过所述弹簧组件110传送的力118保持为低，因为所述末端执行器夹钳尚未开始夹持组织。一旦所述末端执行器夹钳开始夹持组织（当所述输入耦合器到达接触位置（P(c)）时），所述输入耦合器的进一步向右运动导致通过所述弹簧组件110传送的力118以取决于由夹持的组织提供的阻力的速率增加。当通过所述弹簧组件传送的力到达预定水平（G_F(i)）时，所述预载拉伸弹簧116开始拉伸，从而随着所述输入耦合器在中间位置（P(sep)）和最终位置（P(f)）之间继续向右移动，控制通过所述弹簧组件110传送的力118的量。在没有弹簧组件110的情况下，所述输入耦合器在中间位置（P(sep)）和最终位置（P(f)）之间的进一步运动将产生未受控制的夹紧力120，其超过在所述输入耦合器到达最终位置（P(f)）时通过所述弹簧组件110传送的最大控制夹紧力（G_F(f)）。
图11示意地示出在所述输入耦合器在初始位置（P(i)）和最终位置（P(f)）之间的运动过程中所述预载拉伸弹簧116中的力。在所述拉伸弹簧116的零挠度（L(0)）处，所述拉伸弹簧产生零弹簧力。在所述弹簧组件110中，所述拉伸弹簧116处于预载状态，从而由于传送的转矩小于和等于所述预定水平而将所述输入连杆和所述输出连杆偏置在一起。因此，在所述输入耦合器在初始位置（P(i)）和中间位置（P(sep)）之间的运动过程中，未发生所述拉伸弹簧116的拉伸（即所述弹簧挠度保持恒定L(i)）和所产生的弹簧力在F(i)处保持恒定）。随着所述输入耦合器从中间位置（P(sep)）移动到最终位置（P(f)），所述拉伸弹簧116的弹簧挠度从L(i)增加到L(f)，从而导致所述弹簧力从F(i)增加到F(f)。因此，当所述输入耦合器从中间位置（P(sep)）移动到最终位置（P(f)）时传送到所述夹钳的力是弹簧预载力（F(i)）、拉伸弹簧116的弹簧刚度和拉伸弹簧116从L(i)到L(f)的挠曲量的函数。
图12A示意地示出用于控制传送到末端执行器的夹钳的夹紧力的量的扭力弹簧组件130。所述扭力弹簧组件130包括：与输入耦合器（也称为“针盘传动滑轮”）旋转地耦合的输入连杆132；与驱动轴旋转地耦合的输出连杆134，所述驱动轴与所述末端执行器夹钳驱动地耦合；接合元件136；和在所述输入连杆132和所述输出连杆134之间耦合的扭力弹簧138。所述输出连杆134固定地连接到中心轴140（或与中心轴140是整体）。所述扭力弹簧组件130经由轴承142旋转地安装到所述近端底架72的框架82。所述输入连杆132和所述接合元件136经安装以围绕所述中心轴140的中心轴线144旋转。在所述输入连杆132和所述输出连杆134之间耦合的扭力弹簧138处于预载状态。
在操作中，所述扭力弹簧组件130将转矩从所述输入连杆132传送到所述输出连杆134。参照图12B，当传送的转矩146低于预定水平（即所述扭力弹簧138中预载的转矩）时，所述扭力弹簧138中的预载水平足以偏置所述输出连杆134以与所述接合元件136接触，所述接合元件136进而被偏置以与所述输入连杆132接触。参照图12C，当传送的转矩146超过所述预定水平时，所述扭力弹簧138中的预载水平不足以保持在所述输出连杆134、所述接合元件136和所述输入连杆132之间的接触，因此发生所述扭力弹簧138的额外旋转变形。并且，当传送的转矩146超过所述预定水平时，通过所述扭力弹簧组件130传送的转矩是通过所述扭力弹簧138传送的。
所述接合元件136用于若干目的。对于小于所述预定水平的通过所述扭力弹簧组件130传送的转矩，所述接合元件136和所述输入和输出连杆132、134之间的接触保持所述输入连杆132和所述输出连杆134之间的相对成角定向。对于超过所述预定水平的通过扭力弹簧组件130传送的转矩，所述接合元件136也用于增加可以发生在所述输入连杆132和所述输出连杆134之间的可能角偏转量。例如，通过将所述输入和输出连杆配置有提供类似于由所述接合元件（例如，所述接合元件136可以与所述输入连杆132制成整体，或所述接合元件136可以与所述输出连杆134制成整体）提供的接触的输入和输出连杆之间的直接接触的特征，可以配置没有接合元件的所述扭力弹簧组件130。在没有接合元件136的这种实施例中，可以存在于所述输入连杆132和所述输出连杆134之间的可能角偏转量可限于略小于360度（例如，约345度）。在具有可以围绕所述中心轴线144旋转的接合元件136的情况下，可以存在于所述输入连杆132和所述输出连杆134之间的可能角偏转量可以较大（例如，约690度）。可以使用任何合适数量的接合元件136（例如，0、1、2、3或更多个等），适用于所述输入连杆132和所述输出连杆134之间所需的可能角偏转量。
所述扭力弹簧组件130，如同所述拉伸弹簧组件110，经配置以控制在一个方向（即在对应于所述末端执行夹钳关闭的方向）传送的转矩/力的量。对于在对应于所述末端执行器夹钳打开的方向传送的转矩/力，所传送的转矩/力的方向进一步增加至预载弹簧力，防止所述输入连杆132和所述输出连杆134之间的相对运动。为了实现双向控制，可以与所述扭力弹簧组件130串联地添加相对配置的扭力弹簧组件（即控制在对应于所述末端执行器夹钳打开的方向的转矩的扭力弹簧组件）。
返回参照图10和相关讨论，图13示意地示出在初始角定向（对应于图10中的P(i)）和最终角定向（对应于图10中的P(f)）之间的输入耦合器旋转过程中所述扭力弹簧138的转矩。在所述扭力弹簧138的零角挠度（角度(O)）处，所述扭力弹簧产生零弹簧转矩。在所述扭力弹簧组件130中，所述扭力弹簧138处于预载状态，从而对于小于和等于预定水平的传送转矩而言将所述输入连杆和所述输出连杆偏置在一起。因此，在初始角定向和中间角定向（对应于图10中的P(sep)）之间的输入耦合器旋转过程中，未发生所述扭力弹簧138的角偏转（即所述弹簧角挠度保持恒定角度(i)，且所产生的弹簧转矩在T(i)保持恒定）。随着所述输入耦合器从中间角定向移动到最终角定向（对应于图10中的P(f)），所述扭力弹簧138的角挠度从角度(i)增加到角度(f)，从而将所述弹簧转矩从T(i)增加到T(f)。因此，当所述输入耦合器从中间位置移动到最终位置时传送到所述夹钳的转矩是弹簧预载转矩（T(i)）、扭力弹簧138的弹簧刚度和从角度(i)到角度(f)的扭力弹簧138的角偏转量的函数。
图14示出所述机器人手术工具70的近侧底架72。所述近侧底架72包括所述框架82和与图5A中所示的手术机器人的相应输出耦合器驱动地接合的输入耦合器（未示出）。安装到所述框架82的是控制经传送以致动所述末端执行器夹钳的转矩的量的扭力弹簧组件150。所述扭力弹簧组件150经由与相应的一个所述输入耦合器驱动地耦合的输入驱动轴152接收输入转矩，和经由输出小齿轮154传送输出转矩，该输出小齿轮154与所述末端执行器夹钳经由与支撑所述末端执行器76的器械轴74的管腔一起设置的内驱动轴驱动地耦合。
图15A单独地示出所述扭力弹簧组件150。并且，图15B示出所述扭力弹簧组件150的构件的分解视图。所述扭力弹簧组件150包括安装到所述近侧底架72的所述框架82的壳体156。所述壳体156支撑所述扭力弹簧组件150的子组件，包括输入小齿轮子组件158和转矩控制子组件160。
所述输入小齿轮子组件158包括将从所述输入驱动轴152接收的转矩转移到所述转矩控制子组件160的输入小齿轮162。所述输入小齿轮162由销164支撑。所述销164具有扁平外部166，和所述输入小齿轮162具有被定形以与所述销164和该销的扁平外部166接合的孔168，以便与所述销164一起旋转。所述销164经由轴承170、172安装到所述壳体。
所述转矩控制子组件160包括输入连杆174、接合元件176、输出连杆178、支撑轴180、扭力弹簧182、支撑轴承184、186、188和输出小齿轮190。所述支撑轴180被安装，以经由所述轴承184、188相对于所述壳体156旋转。所述输出小齿轮190由所述支撑轴180支撑，且包括其被定形以防止所述输入小齿轮190相对于所述支撑轴180旋转的孔192，从而使得所述输出小齿轮190与所述支撑轴180一起旋转。所述输出连杆178由所述支撑轴180支撑。所述支撑轴180具有凸状部分194。所述输出连杆178具有孔196，其被定形以与所述支撑轴180及其凸状部分194接合，以便与所述支撑轴180一起旋转。所述输出连杆178具有圆柱形外表面198，其被设定尺寸以容纳和支撑所述扭力弹簧182。所述输出连杆178也具有四个凸部200，其经配置以与所述扭力弹簧182的端部202接合，以旋转地耦合所述扭力弹簧182和所述输出连杆178。所述输入连杆174由所述支撑轴180支撑，以相对于所述支撑轴180旋转。所述输入连杆174具有圆柱形外表面204，其被设定尺寸以容纳和支撑所述扭力弹簧182。所述接合元件176由所述支撑轴180支撑，以相对于所述支撑轴180旋转。所述接合元件176包括与所述输入和输出连杆的内部突出部分接合的纵向凸部208。所述扭力弹簧182以预载配置安装，从而当通过所述转矩控制子组件160传送的转矩小于所述扭力弹簧182的预载转矩时旋转地偏置所述输入和输出连杆以与所述接合元件176的纵向凸部208接触。
图15C示出所述输入连杆174如何经配置以与所述扭力弹簧182耦合。如截面C-C中所示，所述输入连杆174具有孔206，其接收所述扭力弹簧182的弯曲端，从而耦合所述扭力弹簧182的该端与所述输入连杆174。
在操作中，所述转矩控制组件160通过采用图12A、12B和12C的扭力弹簧组件130所用的相同方法经由所述输出小齿轮190控制转移到所述末端执行器夹钳的转矩水平。例如，对于小于所述扭力弹簧182的预载转矩的传送转矩，所述输出连杆178以与所述输入连杆174相同的速率旋转。当传送转矩超过所述扭力弹簧182的预载转矩时，传送转矩的任何额外增加导致所述扭力弹簧182的额外角偏转，这允许所述输出连杆178以比所述输入连杆174更慢的速率旋转，从而控制传送到所述末端执行器夹钳的转矩量，进而控制所述末端执行器夹钳的夹持力的量。
应用
本文公开的手术组件和器械可以在任何合适的应用中使用。例如，本文公开的手术组件可以在用于开放式或微创（单端口或多端口）操作的手动或电动、手持式或机器人式、直接控制或遥控操作的其他手术器械中使用。
控制手术器械中的夹持力的方法
图16示出根据许多实施例的用于控制手术器械中的夹持力的方法210的动作。方法210可以例如通过使用本文公开的手术组件和器械中的任何一个进行实践。
方法210包括致动弹簧组件的输入连杆（动作212）。例如，输入连杆的致动可以包括相对于手术器械的夹持机构平移所述输入连杆。作为另一示例，输入连杆的致动可以包括相对于手术器械的夹持机构旋转所述输入连杆。
方法210进一步包括将致动力从所述输入连杆转移到所述弹簧组件的输出连杆（动作214）。所述致动力的转移可以包括通过所述弹簧组件的预载弹簧转移所述输入连杆和所述输出连杆之间的力。
方法210进一步包括当所转移的致动力低于所述弹簧组件的预载弹簧的预定水平时，抑制所述输入连杆和所述输出连杆之间的相对运动（动作216）。所述相对运动的抑制可以包括用预载弹簧使所述输入连杆和所述输出连杆相对于彼此约束。并且，所述相对运动的抑制可以包括接合所述输入连杆与接合连杆以及接合所述接合连杆与所述输出连杆，所述输入和输出连杆通过所述预载弹簧与所述接合连杆保持接触。在许多实施例中，所述输入连杆、所述输出连杆和所述接合连杆被约束以围绕共同旋转轴线旋转，并且所述预载弹簧包括在所述输入连杆和所述输出连杆之间耦合的扭力弹簧。
方法210进一步包括当所转移的致动力增加至高于所述预定水平时通过使所述预载弹簧变形而相对于所述输出连杆移动所述输入连杆（动作218）。并且，方法210进一步包括经由所述输出连杆致动夹持机构（动作220）。在许多实施例中，致动所述夹持机构，以便夹持病人组织。
方法应用
本文公开的方法可以在任何合适的应用中使用。例如，本文公开的方法可以在用于开放式或微创（单端口或多端口）操作的手动或电动、手持式或机器人式、直接控制或遥控操作的手术器械中使用。这样的手术器械的示例包括微创机器人手术器械，如本文所公开的那些。
其他变化是在本发明的精神内。因此，虽然本发明可以容许各种修改和替代结构，但某些其示出的实施例在附图中显示且已在上文详细地描述。然而，应该理解的是，无意图将本发明限制到具体形式或所公开的形式，但相反，意图是涵盖落入本发明的精神和范围内的所有修改、替代结构和等同物，如在所附权利要求书中所限定的那样。
术语“力”被解释为包括力和转矩（特别是在所附权利要求书的背景下），除非本文另有说明外，或与上下文明显相矛盾。术语“一（a）”和“一个（an）”和“该（the）”及在描述本发明的背景下（特别是在所附权利要求书的背景下）的类似指代被解释为涵盖单数和复数，除非本文另有说明或与上下明显相矛盾。术语“包含”、“具有”、“包括”和“含有”被解释为开放式术语（即，指“包括但不限于”），除非另有说明。术语“连接”被解释为部分或全部被包含在其中、附着于其或结合在一起，即使有一些事物介于其间。本文中的各值的范围的叙述仅意图充当分别指代落在该范围内的每个单独值的简化方法，除非本文另有明确指出，并且每个单独的值包含在本说明书内，如同其被本文单独叙述。本文描述的所有方法可以以任何合适的顺序执行，除非本文另有明确指出或与上下文明显相矛盾。本文提供的任何和所有示例或示例性语言（例如，“如”）的使用仅意图更好地阐明本发明的实施例，并不限制本发明的范围，除非另有要求。本说明书中的语言不应被解释为将任何非要求的元件指示是对本发明的实践必不可少的。
本文描述了本发明的优选实施例，包括用于实施本发明的发明人已知的最佳方式。在阅读上述说明时，对于本领域的普通技术人员来说那些优选实施例的变化可能变得明显。本发明人预期熟练的技术人员适当地采用这样的变化，且本发明人意图在本文具体描述以外实践本发明。因此，本发明包括适用法律所允许的所附权利要求书中叙述的主题的所有修改和等同物。此外，本发明包含上述元件在其所有可能变化中的任何组合，除非本文另有明确指出或与上下文明显相矛盾。
本文引用的所有参考文献，包括出版物、专利申请和专利，通过引用并入本文，达到与如果每个参考文献单独地和特别地指出通过引用而并入以及在本文中全部阐述的相同的程度。
Claims (22)
1.一种微创机器人手术组件，包括：
末端执行器，其包括可操作以夹持病人组织的夹钳；和
弹簧组件，其包括与所述夹钳驱动地耦合的输出连杆、与铰接源驱动地耦合的输入连杆和与所述输入和输出连杆耦合以将铰接力从所述输入连杆转移到所述输出连杆的弹簧，所述弹簧被预载，以在所转移的铰接力低于预定水平时抑制所述输入连杆和所述输出连杆之间的相对运动，和在所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆的相对运动。
2.根据权利要求1所述的手术组件，其中：
所述所转移的铰接力导致所述夹钳的夹持力；和
当所述所转移的铰接力处于或高于所述预定水平时进一步关闭所述夹钳的所述输入连杆的运动诱导与所述输入连杆和所述输出连杆之间的相对运动相关联的所述弹簧的变形，以便当变形的弹簧将所述铰接力从所述输入连杆转移到所述输出连杆时控制所转移的铰接力的增加。
3.根据权利要求1所述的手术组件，其中所述输出连杆相对于所述末端执行器的直线运动诱导所述夹钳的铰接。
4.根据权利要求1所述的手术组件，其中所述输出连杆相对于所述末端执行器的旋转运动诱导所述夹钳的铰接。
5.根据权利要求4所述的手术组件，其中所述输入和输出连杆旋转地安装到底座，以围绕共同旋转轴线旋转。
6.根据权利要求5所述的手术组件，其中所述输出连杆固定地连接于中心轴，和所述输入连杆旋转地安装到所述中心轴。
7.根据权利要求5所述的手术组件，其中所述输入连杆固定地连接于中心轴，和所述输出连杆旋转地安装到所述中心轴。
8.根据权利要求5所述的手术组件，其中所述弹簧包括扭力弹簧，其由所述输入连杆的外表面或所述输出连杆的外表面中的至少一个容纳和约束。
9.根据权利要求5所述的手术组件，其中所述弹簧组件进一步包括旋转地安装到所述底座以围绕共同旋转轴线旋转的接合元件，所述接合元件和所述弹簧的组合在所转移的铰接力低于所述预定水平时抑制所述输入连杆和所述输出连杆之间的相对运动，和在所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动。
10.根据权利要求9所述的手术组件，其中所述接合元件具有凸部，其被定形以在所转移的铰接力低于所述预定水平时与所述输入和输出连杆的互补定形的凸部接合。
11.根据权利要求5所述的手术组件，其中所述弹簧组件进一步包括旋转地安装到所述底座以围绕共同旋转轴线旋转的多个接合元件，所述接合元件和所述弹簧的组合在所转移的铰接力低于所述预定水平时抑制所述输入连杆和所述输出连杆之间的相对运动，和在所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动。
12.一种控制机器人手术器械中的夹持力的方法，所述方法包括：
致动弹簧组件的输入连杆；
将致动力从所述输入连杆转移到所述弹簧组件的输出连杆；
当所转移的致动力低于所述弹簧组件的预载弹簧的预定水平时，抑制所述输入连杆和所述输出连杆之间的相对运动；
当所转移的致动力增加至高于所述预定水平时，通过使所述预载弹簧变形，相对于所述输出连杆移动所述输入连杆；和
经由所述输出连杆致动夹持机构，以便夹持病人组织。
13.根据权利要求12所述的方法，其中所述致动输入连杆包括相对于所述夹持机构平移所述输入连杆。
14.根据权利要求12所述的方法，其中所述致动输入连杆包括相对于所述夹持机构旋转所述输入连杆。
15.根据权利要求12所述的方法，其中所述转移致动力包括通过预载弹簧转移所述输入连杆和所述输出连杆之间的力。
16.根据权利要求15所述的方法，其中所述抑制相对运动包括用预载弹簧使所述输入和输出连杆相对于彼此约束。
17.根据权利要求16所述的方法，其中所述抑制相对运动包括接合所述输入连杆与接合连杆以及接合所述接合连杆与所述输出连杆，所述输入和输出连杆通过预载弹簧与所述接合连杆保持接触。
18.根据权利要求17所述的方法，其中：
所述输入连杆、所述输出连杆和所述接合连杆被约束以围绕共同旋转轴线旋转；和
所述预载弹簧包括在所述输入连杆和所述输出连杆之间耦合的扭力弹簧。
19.一种与微创手术系统的机器人机械手一起使用的手术器械，所述机器人机械手具有夹具，所述手术器械包括：
在远端和近端之间延伸的器械轴；
由所述远端支撑的并包括可操作以夹持病人组织的夹钳的末端执行器；
与所述夹钳驱动地耦合的驱动元件；
设置在所述近端处的底架，所述底架包括：
支撑器械轴的框架，
弹簧组件，其包括与所述驱动元件驱动地耦合的输出连杆、输入连杆和与所述输入和输出连杆耦合以将铰接力从所述输入连杆转移到所述输出连杆的弹簧，所述弹簧被预载，以便当所转移的铰接力低于预定水平时抑制所述输入连杆和所述输出连杆之间的相对运动，和以便当所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动，和
输入耦合器，其与所述输入连杆驱动地耦合并经配置以与所述机器人机械手的相应输出耦合器驱动地接合。
20.根据权利要求19所述的手术器械，其中：
所转移的铰接力诱导所述夹钳的夹持力；和
当所转移的铰接力处于或高于所述预定水平时进一步关闭所述夹钳的所述输入连杆的运动诱导与所述输入连杆和所述输出连杆之间的相对运动相关联的弹簧的变形，以便当所述变形的弹簧将铰接力从所述输入连杆转移到所述输出连杆时控制转移的铰接力的增加。
21.根据权利要求19所述的手术器械，其中：
所述驱动元件包括与所述夹持机构旋转地耦合的驱动轴；
所述输入连杆和所述输出连杆旋转地安装到所述框架，以围绕共同旋转轴线旋转；和
所述弹簧包括扭力弹簧。
22.根据权利要求21所述的手术器械，其中所述弹簧组件进一步包括旋转地安装到所述框架以围绕共同旋转轴线旋转的接合元件，所述接合元件和所述弹簧的组合在所转移的铰接力低于所述预定水平时抑制所述输入和输出连杆之间的相对运动，和在所转移的铰接力高于所述预定水平时允许所述输入连杆和所述输出连杆之间的相对运动。
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Also Published As
| Publication number | Publication date |
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| KR102012698B1 (ko) | 2019-08-21 |
| US9913694B2 (en) | 2018-03-13 |
| US20120310256A1 (en) | 2012-12-06 |
| EP2713910A1 (en) | 2014-04-09 |
| US11344375B2 (en) | 2022-05-31 |
| CN103561667B (zh) | 2016-08-17 |
| CN106109017B (zh) | 2019-01-04 |
| WO2012166806A1 (en) | 2012-12-06 |
| CN106109017A (zh) | 2016-11-16 |
| KR20140035389A (ko) | 2014-03-21 |
| EP2713910B1 (en) | 2022-06-22 |
| US20180140365A1 (en) | 2018-05-24 |
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