CN105125289A - Minimally-invasive medical robot system - Google Patents
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- CN105125289A CN105125289A CN201510623072.6A CN201510623072A CN105125289A CN 105125289 A CN105125289 A CN 105125289A CN 201510623072 A CN201510623072 A CN 201510623072A CN 105125289 A CN105125289 A CN 105125289A
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Abstract
The invention relates to a minimally-invasive medical robot system, an application of the system and a method for positioning interventional equipment. The minimally-invasive medical robot system comprises a working mechanism (3), an adjusting mechanism (4), a control mechanism (5) and a human-computer interaction mechanism (1), wherein the working mechanism (3) comprises a double-pore type protective positioning pore plate (31) and a guide syringe (34). The guide syringe (34) of the working mechanism (3) can be positioned, so that the guide syringe (34) falls onto a straight line determined by an objective sampling point and a pore of the double-pore type protective positioning pore plate (31). With the adoption of the minimally-invasive medical robot system, the prostatic cancer can be diagnosed and treated accurately under the guidance of images.
Description
Technical field
The present invention relates to a kind of minimally invasive medical robot system, particularly relate to a kind of medical robotic system that can increase recall rate, improve operation safety, avoid the Clinics and Practices for such as carcinoma of prostate of medical cross infection.
The invention still further relates to the using method of minimally invasive medical robot system, comprise its embody rule field and apply it to locate the method for intervening equipment.
Background technology
Carcinoma of prostate is mainly in male genitourinary system, is a kind of malignant tumor, and often asymptomatic in early days, incubation period is long, and incidence and mortality is in ascendant trend year by year.How early diagnosis treat carcinoma of prostate, has important clinical meaning.At present, the sextant Transrectal puncture biopsy collocation puncture template under the real-time 2D Transrectal Ultrasound guiding of clinical many employings carries out examination and diagnosis.
Chinese invention patent application CN104720853A discloses a kind of ultrasonic guidance automatic prostate biopsy seeds implanted system and acupuncture treatment method.Support platform is fixed with locating module and image capture module, and the front end of support platform is provided with horizontal Needle localization plate.Adjustment locating module makes cell taking gun be that horizontal level is placed, and samples one by one according to the space of location-plate.
But the conventional mould method puncture method be similar to disclosed in above patent document has following problem.
1. template helical pitch is short, and deviation is large: first, and relative to the length of clinical cell taking gun/particle implanting gun used, the pilot hole length of template is shorter, easily causes cell taking gun/particle implanting gun deviations; Secondly, pilot hole position, the distance between borehole of template cannot adjust, the point of puncture limiting cell taking gun is chosen, diameter is less than to the focus of 5mm, possibly cannot completely sample, cause loss, false negative rate to raise, or the Path selection of restriction particle implanting gun, cause implant the radiation dose distribution of particle and target inconsistent; 3rd, when cell taking gun or particle implanting gun run into pubis stop time, the tissue samples of (cancer district occurred frequently) is difficult to gather near pubis, or is difficult to by radioactive prospecting instrument to estimating position, limitation and blindness higher.Therefore, template may affect pathological examination result, or causes the actual radiation dose distribution implanting particle to produce deviation with plan, affects radiotherapeutic effect.
2. lack self-detection mechanism before getting involved, lack monitoring in real time in intervention: first, when the position adjustment of locating module is complete, namely biopsy needle is inserted, there is no checking procedure, cannot judge the on position of cell taking gun or attitude whether accurate, if due to the reason such as software, hardware, cause locating module and/or cell taking gun attitude extremely, before cell taking gun arrives at operation receiveing person's skin surface, system cannot detect, and may accidentally injure operation receiveing person, such as prick into urethra, lead to complications, before namely getting involved, lack self-detection mechanism; Secondly, existing imaging technique mostly is the 2D sequence that all scanning completed through reconstruct modeling, obtain static 3D image to guide as in art, lose real-time, when cell taking gun/particle implanting gun enters after in body, be difficult to the information such as its degree of depth of Obtaining Accurate, angle, track, largely upper experience and the level of skill relying on patient, maloperation, accidentally injure other organ probabilities and increase, in namely getting involved, lack in real time monitoring.
3. maintenance cost is high: in existing equipment, and due to the inherent characteristics of its structure, the blood of operation receiveing person may flow backwards into equipment and pollute, and increases the maintenance cost of hospital, even affects functions of the equipments and procedure.
Summary of the invention
In view of this, technical problem to be solved by this invention be overcome in aforementioned drawback one or more.
According to an aspect of the present invention, a kind of minimally invasive medical robot system is provided.This minimally invasive medical robot system comprises: operating mechanism, guiding mechanism, controlling organization and man-machine interaction mechanism.Operating mechanism is positioned on guiding mechanism, and guiding mechanism is positioned on controlling organization.Operating mechanism comprises further: ditrysian type protection location orifice plate, guiding syringe, ultrasonic probe, motion of ultrasound probe mechanism, pedestal and guiding syringe motion control mechanism.Guiding syringe motion control mechanism is slidably mounted on pedestal.Ditrysian type protection location orifice plate is removably mounted on the anterior bent plate of pedestal, and motion of ultrasound probe mechanism is slidably mounted on the upper support board of pedestal, and ultrasonic probe can be held in described motion of ultrasound probe mechanism.Guiding mechanism is set to adjust the horizontal level of operating mechanism, vertical position and/or luffing angle according to the position of patient and/or the position of operating-table.Man-machine interaction mechanism is configured to the real-time imaging that display operating mechanism gathers, and receives outside input, and is configured to and controlling organization communication, thus controlled the assembly in operating mechanism by controlling organization.
According to an embodiment of the invention, guiding syringe motion control mechanism can comprise the guide pin cylinder base for installing guiding syringe.At least one end of guide pin cylinder base can be connected with universal joint, for the adjustment of the attitude of auxiliary guiding syringe.
According to an embodiment of the invention, guiding syringe motion control mechanism can comprise left controlling organization and right controlling organization.Inner and/or in the region that left controlling organization and right controlling organization limit, be provided with the assembly of location of the syringe that controls to lead at left controlling organization and right controlling organization.The control of left controlling organization and right controlling organization can be separate with motion, to realize, to the location of guiding syringe, can comprising the adjustment to himself attitude and locus.
Further, lead that the location of syringe comprises in the following motion of guide pin cylinder one or more: elevating movement, elevating movement, left and right translational motion, horizontal revolving motion and seesaw.
In one embodiment, guiding syringe motion control mechanism can comprise such as Lead screw transmission structure or hydraulic-driven structure, for controlling the location of guiding syringe.Guiding syringe motion control mechanism can be configured to elevating movement, elevating movement, left and right translational motion, the horizontal revolving motion of control guiding syringe and/or seesaw, and the motion on these 5 degree of freedom can be separate.Seesaw, the direction of left and right translational motion and elevating movement can be orthogonal.
According to an embodiment of the invention, described minimally invasive medical robot system can also comprise the adapter be arranged on pedestal, for power supply and the communication of operating mechanism.
According to an embodiment of the invention, the outer upper of ditrysian type protection location orifice plate can be outstanding structure, comprises two through locating holes.
According to an embodiment of the invention, the bottom of the outstanding structure of ditrysian type protection location orifice plate can have blood groove.
According to an embodiment of the invention, described minimally invasive medical robot system can also comprise external command flip flop equipment, can be configured to send signal, the location of guiding syringe is switched and is enabled.
Further, external command flip flop equipment may be implemented as the pedal being arranged on controlling organization bottom.
According to an embodiment of the invention, man-machine interaction mechanism is removably mounted on controlling organization or independent setting.
According to an embodiment of the invention, described minimally invasive medical robot system can also comprise pushing hands and/or universal wheel.Pushing hands and/or universal wheel can be configured to the transfer of auxiliary minimally invasive medical robot system and/or fix.
According to an embodiment of the invention, controlling organization can comprise the space being applicable to hold man-machine interaction mechanism and operating mechanism.
According to an embodiment of the invention, operating mechanism can coordinate cell taking gun or bar radioactive particle implanting gun to use.
According to another aspect of the present invention, aforementioned minimally invasive medical robot system is applied in the field such as prostate biopsy or radioactive prospecting instrument.For this reason, described operating mechanism can be combined with the cell taking gun or bar radioactive particle implanting gun use that are applicable to prostate cancer diagnosis or treatment.Thus, provide a kind of minimally invasive surgery system can gathering prostate cancer diagnosis and treatment function.
According to a further aspect of the invention, a kind of method of locating intervening equipment is provided.The method comprises: position the guiding syringe of aforementioned operation mechanism, and the syringe that makes to lead drops on target sample point and ditrysian type and protect on the determined straight line in hole of locating in orifice plate, and intervening equipment can pass the syringe that leads act on target sample point; Or the location of adjustment guiding syringe, make guiding syringe drop on radioactive particle target and implant on the determined straight line in path, intervening equipment can act on target through guiding syringe and implant path.In above two kinds of situations, the intervention degree of depth of intervening equipment can be limited by the position of guiding syringe.That is, the locus of guiding syringe, the especially position of its rear end, can limit the intervention degree of depth of intervening equipment, without the need to extra intervening equipment depth control features.This design simplify the structure of system, avoid depth control features is set and/or drive it to move motor spatially with the conflicting of miscellaneous part in system.Such as, in the preoperative process of self-test of system or in the location of guiding syringe, the depth control features being arranged on syringe rear and/or the motor driving it to move, may be blocked by miscellaneous part, cause guiding syringe cannot adjust to target location, attitude, also may bump against system miscellaneous part, as ultrasonic probe, cause the displacement of probe even to damage.
According to an embodiment of the invention, intervening equipment can be cell taking gun or bar radioactive particle implanting gun.
According to the embodiment of the present invention, propose a kind of location orifice plate that protects and to combine the method for locate with guiding syringe, can under image-guided, precisely enforcement biopsy samples.If make a mistake in the location of guiding syringe, the syringe that then leads does not drop on the determined straight line of destination path, so the intervening equipment passed along guiding syringe, the through locating hole on the orifice plate of protection location cannot be arrived at according to plan, but blocked by protection location orifice plate, cannot through locating hole be passed and arrive at operation receiveing person's skin, thus achieve the process of self-test of intervening equipment before getting involved human body, avoid the injury to operation receiveing person that causes of guiding syringe Wrong localization because the fault such as hardware, software causes, improve the safety of system, reliability.Embodiments of the present invention make operation technique visual, improve recall rate, reduce operation receiveing person's wound surface, avoid medical cross infection, and reduce patient's labor intensity.
According to the following detailed description of this description by reference to the accompanying drawings, these and other advantages of the various embodiment of the present invention and feature all will become more obvious.
Accompanying drawing explanation
Fig. 1 is the overall structure schematic diagram of the minimally invasive medical robot system illustrated according to one embodiment of the present invention;
Fig. 2 illustrates according to the operating mechanism of the minimally invasive medical robot system of one embodiment of the present invention relative to the position of patient's perineum and the point of puncture at its perineum place;
Fig. 3 diagram is according to the structure of the operating mechanism of one embodiment of the present invention;
Fig. 4 diagram is according to the motion of the fore-and-aft direction of the guiding syringe of one embodiment of the present invention;
Fig. 5 diagram is according to the motion of the pitching of the guiding syringe of one embodiment of the present invention, lifting, left and right translation and horizontal rotatio direction;
Fig. 6 diagram is according to the structure of the ditrysian type protection location orifice plate of one embodiment of the present invention;
Fig. 7 diagram is according to the schematic diagram of the accurate locate mode of " locating hole+guiding syringe " of one embodiment of the present invention; And
Fig. 8 illustrates the software control flow chart of the minimally invasive medical robot system according to one embodiment of the present invention.
Detailed description of the invention
More completely describe present disclosure hereinafter with reference to accompanying drawing, wherein show the embodiment of present disclosure in the accompanying drawings.But these embodiments multi-formly can realize and should not be construed as limited to embodiment as herein described with many.On the contrary, provide these examples will to be thorough and complete to make present disclosure, and the scope of present disclosure will be expressed all sidedly to those skilled in the art.
Fig. 1 illustrates the composition of the minimally invasive medical robot system according to one embodiment of the present invention with structural representation.This minimally invasive medical robot system comprises: operating mechanism 3, guiding mechanism 4, controlling organization 5 and man-machine interaction mechanism 1.Operating mechanism 3 is positioned on guiding mechanism 4, and guiding mechanism 4 is positioned on controlling organization 5.As shown in Figure 1, man-machine interaction mechanism 1 is removably mounted on the column that is fixed on controlling organization 5.Should be appreciated that man-machine interaction mechanism 1 also can independently be arranged.
As shown in Figure 1, this minimally invasive medical robot system can also comprise external command flip flop equipment 6.Controlling organization 5 bottom is shaped with external command flip flop equipment 6.In this embodiment, external command flip flop equipment 6 is implemented as pedal.
As can be seen from Figure 1, pushing hands 2 and 4 universal wheels 7 can also be comprised according to the minimally invasive medical robot system of this embodiment.As shown in Figure 1, pushing hands 2 is installed on the end face of controlling organization 5 regularly, and 4 universal wheels 7 are arranged on below controlling organization 5.Should be appreciated that in other embodiments, also pushing hands 2 directly can be installed on the column on controlling organization 5, or the side of controlling organization 5.
Operating mechanism 3 can be used for the Perineal approach aspiration biopsy realizing prostata tissue, and the implanted treatment of radioactive particle.When operating mechanism 3 is for realizing the Perineal approach aspiration biopsy of prostata tissue, can use cell taking gun, specifically the hand-held cell taking gun of patient is through the guiding syringe (as mentioned below) of operating mechanism 3, and handles cell taking gun and complete biopsy sampling.When operating mechanism 3 is for realizing the implanted treatment of the radioactive particle of prostata tissue, protection location orifice plate (as mentioned below) can be pulled down, use particle implanting gun, specifically the hand-held particle implanting gun of patient is through the guiding syringe (as mentioned below) of operating mechanism 3, and manipulation of particles implanting gun completes seeds implanted.
As shown in Figure 2, that schematically shows the point of puncture 8 at patient's perineum place, and when using minimally invasive medical robot system to carry out operation operating mechanism 3 relative to the position of human body.
Fig. 3 illustrates in greater detail the structure of the operating mechanism 3 according to one embodiment of the present invention.Operating mechanism 3 can comprise ditrysian type protection location orifice plate 31, guiding syringe 34, ultrasonic probe 33, motion of ultrasound probe mechanism 32, pedestal 53 and guiding syringe motion control mechanism 37.Guiding syringe motion control mechanism 37 is slidably mounted on pedestal 53, left controlling organization and right controlling organization can be comprised, can be provided with the assembly of the location of the syringe 34 that controls to lead in the region that the inner and left and right controlling organization of left controlling organization and right controlling organization limits, wherein the location of guiding syringe 34 can comprise its locus and attitude.Alternatively, the connecting plate of auxiliary fixation can also be set between left controlling organization and right controlling organization, such as, be arranged on the top between left controlling organization and right controlling organization or middle part.
Ditrysian type protection location orifice plate 31 is removably mounted on the anterior bent plate of pedestal 53, and motion of ultrasound probe mechanism 32 is slidably mounted on the upper support board of pedestal 53, and ultrasonic probe 33 can be held in motion of ultrasound probe mechanism 32.
According to an embodiment of the invention, as shown in Figure 4, guiding syringe motion control mechanism 37 is slidably mounted on pedestal 53, can be configured to control guiding syringe seesawing relative to pedestal 53, as shown in the dotted arrow in Fig. 4.
According to an embodiment of the invention, as shown in Figure 5, guiding syringe motion control mechanism 37 comprises the assembly of the location controlling guiding syringe 34, as Lead screw transmission structure, the elevating movement of control guiding syringe 34, elevating movement, left and right translational motion and/or horizontal revolving motion can be configured to, as shown in the dotted arrow in Fig. 5.
Therefore, guiding movement controlling organization 37 can realize the motion of aforementioned 5 degree of freedom of the location controlling guiding syringe 34, i.e. elevating movement, elevating movement, left and right translational motion, horizontal revolving motion and seesaw, and can be separate.Left and right translational motion, elevating movement, the direction that seesaws can be orthogonal.
Figure 5 shows that the Local map of structure controlling the guiding elevating movement of syringe, elevating movement, left and right translational motion, horizontal revolving motion.The left and right controlling organization that the vertical leading screw 63 of first vertical leading screw 61, second vertically, is rotatably arranged at guiding syringe controlling organization 37 is respectively inner, described vertical leading screw is respectively equipped with 1 screw, and is fixed with the first vertical motion part 62 and the second vertical motion part 64 in screw outside respectively.First horizontal screw lead 71 flatly, is rotatably arranged at inside the first vertical motion part 62, second horizontal screw lead 73 flatly, is rotatably arranged at inside the second vertical motion part 64, one end do not contacted with the first vertical motion part 62, second vertical motion part 64 of first horizontal screw lead 71, second horizontal screw lead 73, has been respectively equipped with the bearing (not shown) of support, turning effort.Described horizontal screw lead is respectively equipped with 1 screw, and is fixed with the first horizontal movement part 72 and the second horizontal movement part 74 in screw outside respectively.According to the principle that leading screw coordinates with screw, the rotary motion of described leading screw can be converted into the respective rectilinear motion along place leading screw of described first vertical motion part 62, second vertical motion part 64, first horizontal movement part 72, second horizontal movement part 74.
First horizontal movement part 72 bottom is provided with connector 82, and the second horizontal movement part 74 bottom is provided with universal joint 81.For ensureing the attitude stabilization of guiding syringe 34 in operation, be shaped with guide pin cylinder base 83, for installing guiding syringe 34, its front portion is connected with universal joint 81, and rear portion is connected with bearing with connector 82.
The design of universal joint and coupled structure, makes the rotary movement of the guiding syringe in usual embodiment be optimized.Under normal circumstances, what take the rotation of target element is all be fixed on another rotatable parts, as rotatable axle, target rotary components is connected at a place with this rotatable part, by the rotation to these parts (such as rotatable axle), drive this target rotary components integral-rotation, be the rotary motion under single-point connection (control).
And the rotation mode adopted in the present invention, for arranging junction point (or control point) respectively in the front end of target rotary components and rear end, by control two junction points (or control point) respectively in the change of vertical direction, horizontal direction relative bearing, control the rotation of guiding syringe, the rotary motion namely under two point control.Rotary motion under controlling relative to single-point, more flexibly, and simplifies frame for movement.
In embodiments of the present invention, the connected mode of guide pin cylinder base and horizontal movement part is front end universal joint, rear end bearing.Wherein, bearing is selected in rear end, can ensure the stable of guide pin cylinder base rear end (guide pin tube rear end) position in space, thus guarantee that syringe can not produce slip in the longitudinal direction, and guarantee that syringe can not skid off universal joint.
Alternatively, also can be that connector is set in the second horizontal movement part 74 bottom, the connector that front portion and this of guide pin cylinder base 83 are located at the second horizontal movement part 74 bottom is connected with bearing, arrange universal joint in the first horizontal movement part 72 bottom, the universal joint that rear portion and this of guide pin cylinder base 83 are located at the first horizontal movement part 72 bottom is connected; Or in other reasonably design, the two ends of guide pin cylinder base 83 can be set to be connected with universal joint respectively.
Except existing ball-type universal joint, can also be the parts such as Hooks coupling universal coupling in force.
When the first vertical leading screw 61 and the second vertical leading screw 63 at the same rate, same direction rotate time, first vertical motion part 62 and the second vertical motion part 64 also at the same rate, same direction along place leading screw up or down synchronous linear move, drive the first horizontal screw lead 71 and the second horizontal screw lead 73 synchronization lifting, thus realize the elevating movement of guiding syringe 34.
When the first vertical leading screw 61 and the second vertical leading screw 63 rotate with friction speed and/or different directions, first vertical motion part 62 and the second vertical motion part 64 are also with friction speed and/or to different directions along place leading screw asynchronous rectilinear motion up or down, drive the first horizontal screw lead 71 and the second horizontal screw lead 73 to carry out nonsynchronous elevating movement, thus realize the elevating movement of guiding syringe 34.
When the first horizontal screw lead 71 and the second horizontal screw lead 73 at the same rate, same direction rotate time, first horizontal movement part 72 and the second horizontal movement part 74 also at the same rate, same direction along place screw synchronous rectilinear motion to the left or to the right, thus realize guiding syringe 34 left and right translational motion.
When the first horizontal screw lead 71 and the second horizontal screw lead 73 rotate with friction speed and/or different directions, first horizontal movement part 72 and the second horizontal movement part 74 also with friction speed and/or to different directions along place leading screw asynchronous rectilinear motion to the left or to the right, thus realize the horizontal revolving motion of guiding syringe 34.
More than for the process of the location from guiding syringe describes, if describe from the result of the location of guiding syringe, from the principle of lead screw transmission, distance=revolution * pitch, namely leading screw often turns around, and namely the screw (movement parts) on leading screw advances along leading screw the distance of a pitch, and the number of turns of screw turns is different, the distance of screw (movement parts) movement is also different, thus can realize the location of guiding syringe (guide pin cylinder base).
If guiding syringe is before and after location, the displacement of each movement parts on the leading screw of place (comprising size and the direction of distance) is:
First vertical motion part 62:A; Second vertical motion part 64:B;
First horizontal movement part 72:C; Second horizontal movement part 74:D.
If A and B is identical, then achieves the translation of guiding syringe in the vertical direction, be the elevating movement of guiding syringe;
If A and B is different, then achieves the rotation of guiding syringe in the vertical direction, be the elevating movement of guiding syringe;
If C and D is identical, then achieves the translation in the horizontal direction of guiding syringe, be the side-to-side movement of guiding syringe;
If C and D is different, then achieves the rotation in the horizontal direction of guiding syringe, be the horizontal revolving motion of guiding syringe.
The motion of aforementioned various degree of freedom can be driven by built-in motor, and can be independent mutually.
The lead assembly of location of syringe 34 of the aforementioned control be provided with in the region that left controlling organization and right controlling organization are inner and left and right controlling organization limits is Lead screw transmission structure, but it should be noted that inventor has been susceptible to can also arrange other forms of assembly or drive mechanism and to control to lead the location of syringe 34.
In another embodiment, the syringe motion control mechanism 37 that leads can comprise first direction motion-control module, second direction motion-control module and third direction motion-control module.As the alternative of lead screw transmission, each control module can adopt hydraulic linear actuator telecontrol equipment, utilize compression pump to the pressure oil pressurization in pipeline and executor or blood pressure lowering, the press rods promoting executor is stretched, thus be rectilinear motion by the converting rotary motion of motor, realize the location of guiding syringe.First direction motion-control module can be configured to control the translational motion on the vertical direction of guiding syringe 34 and rotary motion, second direction motion-control module can be configured to control the translational motion in the horizontal direction of guiding syringe 34 and rotary motion, and third direction motion-control module can be configured to the translational motion on the linear movement direction of motion of ultrasound probe mechanism 32 controlling guiding syringe 34.Translational motion on aforementioned three directions can be mutually vertical and separate.
As shown in Figure 3, Figure 4, operating mechanism 3 also comprises setting adapter 51 on the base 53, for power supply and the communication of operating mechanism 3, the frame for movement of its inside can be driven to realize the motion of aforementioned 5 degree of freedom of guiding syringe 34, i.e. pitching, lifting, left and right translation, horizontally rotate, front and back.The location of guiding syringe 34 can be carried out according to the program preset.
Alternatively or additionally, the motion of aforementioned 5 degree of freedom of guiding syringe 34, namely the adjustment (location of guiding syringe) of himself attitude and locus, also can manually realize.Alternatively or additionally, adapter 51 can also be arranged on the appropriate location of guiding syringe motion control mechanism 37, as the side lower of guiding syringe motion control mechanism 37.
It should be noted that, Fig. 4 is from protection location orifice plate 31 to the view in certain angular field of view the direction of guiding syringe motion control mechanism 37, and Fig. 5 is from guiding syringe motion control mechanism 37 to the view in certain angular field of view orifice plate 31 direction, protection location, therefore the drafting direction of Fig. 5 have rotated about 90 degree relative to Fig. 4." front and back " direction herein can be understood from the direction of motion of the ultrasonic probe straight ahead Fig. 4 or retrogressing, and " left and right " direction is the direction perpendicular with " front and back " direction, but be to be understood that, " front and back " direction is relative concept with " left and right " direction, and " front and back " direction in a width view may become " left and right " direction in another width view.
When operation element mechanism 3, utilize motion of ultrasound probe mechanism 32 that ultrasonic probe 33 is pushed operation receiveing person's rectum, need first at the outside installed protection device of ultrasonic probe in some cases, to improve image quality, as ultrasonic probe protective sleeve.For obtaining fan-shaped ultrasonic scanning image figure, manipulation motion of ultrasound probe mechanism 32 makes to stretch into the intrarectal ultrasonic probe 33 of operation receiveing person and rotates in certain angle.The track envelope of the relative two place's points of puncture 8 of guiding syringe 34 is all tapered, guarantees that, when left and right prostate punctures sampling respectively, double-cone type puncture sampling can avoid operation receiveing person's urethra, reduces injury and complication.
Guiding mechanism 4 is set to adjust the horizontal level of operating mechanism 3, vertical position and/or luffing angle according to the position of the position of patient and/or operating-table.In the embodiment shown in Fig. 1, can be operated by position adjustments knob.
The real-time imaging that man-machine interaction mechanism 1 gathers for showing operating mechanism 3, is received outside input, and is configured to and controlling organization 5 communication, thus controlled each assembly in operating mechanism 3 by controlling organization 5.As shown in Figure 1, man-machine interaction mechanism 1 is removably mounted on described controlling organization 5.In the embodiment of figure 1, man-machine interaction mechanism 1 comprises a notebook computer, inside is mounted with the scanning imagery and software for calculation that aim at described system development, for the reading of real-time imaging, modeling, fusion, registration, display, and the calculating in responsible biopsy sample point, seeds implanted path, display and adjustment are that patient obtains the main source of operation information and completes the main guide of operation technique; It is as host computer, and transmitting control commands to controlling organization 5, thus controls each assembly in operating mechanism 3.It will be appreciated by those skilled in the art that and according to actual needs notebook computer can be replaced with other electronic equipments (include but not limited to desktop computer, panel computer and aim at the electronic control unit, remote control equipment etc. of described system design).
Should be appreciated that the program that positioning and guiding syringe 34 can be set by man-machine interaction mechanism 1.External command flip flop equipment 6 is configured to send signal to man-machine interaction mechanism 1, makes can be enabled by the control of each assembly in controlling organization 5 pairs of operating mechanisms 3, thus the location switching of guiding syringe is enabled.
In the embodiment shown in Fig. 3, external command flip flop equipment 6 is implemented as the pedal being arranged on controlling organization 5 bottom.When pedal is operated, signal is sent to man-machine interaction mechanism 1 by controlling organization 5, if and only if, and man-machine interaction mechanism receives this signal, the control of each assembly in operating mechanism 3 is just enabled, thus the location switching of guiding syringe 34 is enabled, sampling location or seeds implanted location can start next time.Such control model is the protection to patient, avoids intervening equipment in human body, produce uncontrollable displacement, causes malpractice.
Controlling organization 5 includes hardware circuit, and interconnect with man-machine interaction mechanism 1, the order of man-machine interaction means 1 can be received, maybe send the command signal of the external command flip flop equipment 6 received to man-machine interaction mechanism 1, thus control each assembly in operating mechanism 3.
Further, controlling organization 5 inside can also comprise the space that can be held operating mechanism 3, man-machine interaction mechanism 1, when equipment does not use, for the preservation of operating mechanism 3, man-machine interaction mechanism 1, associated cable etc.
Should be appreciated that the syringe 34 that leads be located through that manually adjustment realizes time, the function in aforementioned man-machine interaction mechanism 1 except image shows and external command flip flop equipment 6 are optional mechanism or function.It is also understood that external command flip flop equipment 6 also can be configured to send signal to guiding syringe motion control mechanism, make to be enabled to the control of each assembly in operating mechanism 3, thus the location switching of guiding syringe 34 is enabled.
Both pushing hands 2 and universal wheel 7 can coordinate the transfer, fixing for medical robot equipment.Be to be understood that, pushing hands 2 can change to other forms of pulling device according to actual needs, universal wheel 7 also can change to and be applicable to other specifications of operative site environment or the load-carrying members of form or mobile device, the such as lifting support of adjustable for height bottom belt wheel.
As shown in Fig. 3, Fig. 4 and Fig. 6, in a preferred embodiment, ditrysian type protection location orifice plate 31 is removably mounted on the anterior bent plate of pedestal 53, and its outer upper is outstanding structure, comprises two through locating holes 311.Outstanding structure (comprising locating hole 311) can be symmetrical structure.Two place's points of puncture 8 corresponding two through locating holes protecting location orifice plate 31 respectively at the patient's perineum place shown in Fig. 2.
Should be appreciated that in figs. 3 and 4, what anterior bent plate pedestal being used for install protection location orifice plate is depicted as pedestal front end directly stretches out structure, but other forms of bending and to stretch out structure be also feasible, such as, along first stretching out forward on the front end-plate of pedestal, and then upwards bend.
Different from classical matrix formula mechanical template method, two described in the embodiment of the present invention through locating holes 311 left prostate of corresponding operation receiveing person and the prostatic point of puncture in the right side respectively.Meanwhile, have blood groove 312 in the bottom of the outstanding structure of this protection location orifice plate 31, for retaining the operation receiveing person's blood in operation process, avoiding it to flow backwards into equipment and polluting, affecting procedure, even cause cross infection.
Fig. 7 illustrates the principle of the accurate locate mode of " locating hole+guiding syringe " according to one embodiment of the present invention.When trigger external instruction triggers device 6 (such as, step on pedal), man-machine interaction mechanism 1 locator data that calculating samples next time or seeds implanted is corresponding automatically, correspondingly control operating mechanism 3, namely seesawed by the entirety on the base 53 of guiding syringe motion control mechanism 37, to control the guiding front and back position of syringe 34 on ultrasonic probe linear movement direction (locus) thus to realize the restriction to the intervention degree of depth of intervening equipment; Simultaneously by controlling guiding syringe motion control mechanism 37 assembly as shown in Figure 5,4 degree of freedom realize the control to the location of guiding syringe in vertical and horizontal direction.By the adjustment of above 5 degree of freedom, i.e. self attitude of adjustable guide pin cylinder 34 and locus, guiding syringe 34 is dropped on target sample point and the determined straight line of some locating holes 311, coordinates the control of the intervention degree of depth to intervening equipment, accurate location can be realized.This structure makes system in principle, overcome the shortcoming of conventional template method, improves positioning precision.Patient only needs hand-held cell taking gun, thrusts operation receiveing person's prostate, handle cell taking gun and complete sampling along guiding syringe 34 track according to designated depth.According to other embodiment, when not using protection location orifice plate, can by the location of adjustment guiding syringe 34, making guiding syringe drop on radioactive particle target with certain position implants on the determined straight line in path, and patient holds particle implanting gun and acts on target implantation path through guiding syringe.
Should be appreciated that, because plot space and ability limit, above structure chart or other schematic diagrams only represent system structure and the operation principle of embodiment of the present invention, do not represent its actual size, also not exclusively represent the true form of each parts.
Above comparatively detailed description is done to the overall structure of embodiment of the present invention, below for the further exemplary elaboration of its work process.
Operation receiveing person gets calculi position, and medical personnel complete the preparations such as sterilization.Hold pushing hands 2, described system is moved near operating-table, determine its position and lock universal wheel 7, according to the position adjustments knob in operative space, operation receiveing person's position turn guiding mechanism 4, adjusting the horizontal level of operating mechanism 3, vertical position and/or luffing angle.Start, equipment self-inspection and initialization.
Fig. 8 illustrates the software control flow chart of the minimally invasive medical robot system according to one embodiment of the present invention.As shown in Fig. 8 flow process, self-inspection, initialized laggard enter main menu, need to select " prostate biopsy " or " radioactive prospecting instrument " according to operation, and input operation receiveing person's data, create case history.
Handle motion of ultrasound probe mechanism 32 and ultrasonic probe 33 is pushed operation receiveing person's rectum, and suitably movable or rotary ultrasonic pops one's head in 33 to realize sector scanning imaging, man-machine interaction mechanism 1 shows imaging results, and patient can adjust the scope in sampling/radioactive prospecting instrument region according to actual needs.
3D modeling, image co-registration and registration is carried out, as shown in Fig. 8 flow process by software.The display screen of man-machine interaction mechanism 1 shows pre-sample point (puncture sampling planning), patient according to actual needs and operation receiveing person's physiological situation, Reasonable adjustment sample point position and number.If radioactive prospecting instrument, then this step can adjust the position in seeds implanted path and number (seeds implanted is planned).
Come into effect puncture sampling subsequently.The display screen of man-machine interaction mechanism 1 starts to point out sample point successively.The hand-held cell taking gun 35 of patient is through guiding syringe 34, it is made accurately to thrust prostate according to angle, track and the degree of depth that system is pre-set from the point of puncture of perineum, switch on driving handle, one fritter prostata tissue can be taken off and be locked in syringe needle, namely complete a single-point sampling.When trigger external instruction triggers device 6 (such as stepping on pedal), man-machine interaction mechanism 1 locator data that calculating samples next time or seeds implanted is corresponding automatically, correspondingly control operating mechanism 3, and seesawed by the entirety on the base 53 of guiding syringe motion control mechanism 37, to control the front and back position of guiding syringe 34 on ultrasonic probe linear movement direction; Simultaneously by controlling guiding syringe motion control mechanism 37 part-structure as shown in Figure 5,4 degree of freedom realize the location to guiding syringe.By the adjustment of above 5 degree of freedom, locus and self attitude of guiding syringe 34 can be adjusted, guiding syringe 34 is dropped on target sample point and the determined straight line of some locating holes 311, coordinates the control of the intervention degree of depth to intervening equipment, accurate location can be realized.This structure makes system in principle, overcome the shortcoming of conventional template method, improves positioning precision.Patient only needs hand-held cell taking gun, thrusts operation receiveing person's prostate, handle cell taking gun and complete sampling along guiding syringe 34 track according to designated depth.According to system suggestion, and coordinate the signal of external command flip flop equipment 6, traversal gross sample point, namely prostate biopsy process completes.Similarly, if radioactive prospecting instrument, then fibrous root shields the seeds implanted path of prompting according to the show and coordinates the signal of external command flip flop equipment 6, implant path until traversal is all pre-and implants point, complete radioactive prospecting instrument, and the postoperative positional accuracy without the need to check checking seeds implanted and dose distribution.In whole process, the system that all depends on is followed the tracks of the real-time imaging of intervening equipment, and operation visualization and risk control ability are strengthened greatly.
It should be noted that embodiment of the present invention can be applied in the field such as prostate biopsy or radioactive prospecting instrument, such as, operating mechanism 3 can coordinate be applicable to prostate biopsy or treatment cell taking gun, bar radioactive particle implanting gun use.Such as, but it should also be appreciated that the present invention and embodiment can also be improved and be applied in conjunction with other medical procedures, locate other Medical Equipmentes etc., operating mechanism 3 also can be combined with freezing rifle and use.
Embodiment of the present invention proposes a kind of location orifice plate that protects and to combine the method for locating with the syringe that leads, namely protection location orifice plate is front, guiding syringe is rear, can not with operation receiveing person's contact skin, self attitude and the position of guiding syringe are adjustable, and one of them locating hole on the orifice plate of protection location overlaps with the straight line of the determined straight line of impact point with guiding syringe place, length due to the syringe that leads is greater than the pilot hole length of traditional mechanical template, and the locating hole that can be combined with on the orifice plate of protection location is implemented to get involved, if make a mistake in the location of guiding syringe, the syringe that then leads does not drop on the determined straight line of destination path, so the intervening equipment passed along guiding syringe, the through locating hole on the orifice plate of protection location cannot be arrived at according to plan, but blocked by protection location orifice plate, cannot through locating hole be passed and arrive at operation receiveing person's skin, thus achieve the process of self-test of intervening equipment before getting involved human body, avoid due to hardware, the injury to operation receiveing person that the guiding syringe Wrong localization that the faults such as software cause causes, improve the safety of system, reliability, the deviations of conventional template method is eliminated from principle, overcome conventional template method surgical wound surface many, restriction is large, without the deficiency of process of self-test, improve puncture accuracy rate, guarantee cell taking gun, particle implanting gun accurately arrives at precalculated position, within error can be controlled in 1.0mm, improve operation reliability.
On this basis, some embodiments of the present invention devise blood groove on the orifice plate of protection location, for retaining operation receiveing person's blood, simultaneously device interior may be infected with the parts such as the guiding syringe of operation receiveing person's blood and hetero-organization thereof and be all disposable, substantially stop the possibility of medical cross infection, reduce the maintenance cost of hospital simultaneously.At an embodiment, blood groove can be a seam having one fixed width, blood flow to time here, owing to locating the structure of orifice plate and action of gravity, can flow down along location orifice plate outer surface and can not access arrangement inner.At another embodiment, blood groove can be many seam be arranged in juxtaposition structure.According to the embodiment of the present invention, blood groove can be lateral arrangement, also can be longitudinally to arrange.
According to certain embodiments of the present invention, motion of ultrasound probe mechanism not only can make ultrasonic probe seesaw at internal rectum, and comprise a kind of rotating mechanism, ultrasonic probe can be made to rotate in certain angle at operation receiveing person's internal rectum, expand scanning imagery scope, switch imaging section, the positional information such as the degree of depth, angle, track of Real-time Obtaining intervening equipment, improve operation reliability.
According to certain embodiments of the present invention, the rigidity of the control software design of the minimally invasive medical robot system NMR (Nuclear Magnetic Resonance)-imaging (MRI) that can realize preoperative collection and real-time ultrasonography, elasticity merge and image registration.On the basis of rigidity fusion of imaging, utilize the nonlinear characteristic of elasticity fusion of imaging, by software, the lesion information that nuclear magnetic resonance image provides accurately is merged with ultrasonic image, no matter intervening equipment is horizontal or the intervention of oblique cutting shape, system can both show the track of intervening equipment in real time, especially the positional information of needle point, improve the tracking accuracy of cell taking gun/bar radioactive particle implanting gun, auxiliary patient carries out biopsy/seeds implantation more accurately, namely the whole process achieving intervention procedure is monitored in real time, reduce maloperation risk, improve operation reliability.
In addition, in the treatment of carcinoma of prostate, radioactive prospecting instrument method is because of its simple operation, wound surface is little, and conformal degree is high, and relapse rate is low, compare few intercurrent disease with outer photograph with operation, radiological dose is easy to the advantages such as control, has become the treatment means of standard at Systems in Certain Developed Countries.In the embodiment that guiding self attitude of syringe and locus can control according to the program preset, can greatly raise the efficiency, safety, simplicity and reliability.
According to certain embodiments of the present invention, medical robotic system is decomposed into the relevant compound movement of location intervening equipment the lead straight line of syringe on 5 degree of freedom or rotary motion, make it can be independent mutually, reduce operation easier, expand the operative space between operation receiveing person two lower limb simultaneously, be convenient to patient's operation.
According to certain embodiments of the present invention, the Clinics and Practices of carcinoma of prostate is integrated in same system.Wherein, seeds implanted function under image-guided, make the position accurately controlling each radioactive particle, and real-time monitor particle position becomes possibility in ultrasonoscopy, implant position and the dose distribution of particle without the need to postoperative check inspection, save the energy of patient and operation receiveing person.
The those skilled in the art benefiting from the instruction provided in aforementioned specification and associated drawings will easily expect many improvement and other embodiments of present disclosure.Therefore, be appreciated that and these are only preferred embodiment of the present invention, not in order to limit the present invention, within the spirit and principles in the present invention all, any amendment done, equivalent replacement etc., all should be included within protection scope of the present invention.
Claims (12)
1. a minimally invasive medical robot system, it is characterized in that, comprise: operating mechanism (3), guiding mechanism (4), controlling organization (5) and man-machine interaction mechanism (1), wherein, described operating mechanism (3) is positioned on described guiding mechanism (4), and described guiding mechanism (4) is positioned on described controlling organization (5)
Described operating mechanism (3) comprising: ditrysian type protection location orifice plate (31), guiding syringe (34), ultrasonic probe (33), motion of ultrasound probe mechanism (32), pedestal (53) and guiding syringe motion control mechanism (37), described guiding syringe motion control mechanism (37) is slidably mounted on pedestal, described ditrysian type protection location orifice plate (31) is removably mounted on the anterior bent plate of described pedestal (53), described motion of ultrasound probe mechanism (32) is slidably mounted on the upper support board of pedestal (53), described ultrasonic probe (33) is held in described motion of ultrasound probe mechanism,
Described guiding mechanism (4) is set to adjust the horizontal level of described operating mechanism (3), vertical position and/or luffing angle according to the position of patient and/or the position of operating-table;
Described man-machine interaction mechanism (1) is configured to show the real-time imaging that described operating mechanism (3) gathers, receive outside input, and be configured to and described controlling organization (5) communication, thus by described controlling organization (5), the assembly in described operating mechanism (3) is controlled.
2. minimally invasive medical robot system according to claim 1, it is characterized in that, described guiding syringe motion control mechanism (37) comprises the guide pin cylinder base (83) for installing guiding syringe (34), at least one end of wherein said guide pin cylinder base (83) is connected with universal joint (81), for the adjustment of the attitude of auxiliary described guide pin cylinder (34).
3. minimally invasive medical robot system according to claim 2, it is characterized in that, described guiding syringe motion control mechanism (37) comprises left controlling organization and right controlling organization, described left controlling organization and described right controlling organization inner and/or in the region that described left controlling organization and described right controlling organization limit, be provided with the assembly of the location controlling described guiding syringe (34), such as, the assembly of the location of the described guiding syringe (34) of described control is Lead screw transmission structure.
4. minimally invasive medical robot system according to claim 3, it is characterized in that, the location of described guiding syringe (34) comprise in the following motion of described guiding syringe (34) one or more: elevating movement, elevating movement, left and right translational motion, horizontal revolving motion and seesaw.
5. minimally invasive medical robot system according to claim 1, is characterized in that, the outer upper of described ditrysian type protection location orifice plate (31) is outstanding structure, comprises two through locating holes (311).
6. minimally invasive medical robot system according to claim 5, is characterized in that, the bottom of the described outstanding structure of described ditrysian type protection location orifice plate (31) has blood groove (312).
7. the minimally invasive medical robot system according to any one of claim 1-6, it is characterized in that, also comprise external command flip flop equipment (6), described external command flip flop equipment (6) is configured to send signal, the location of guiding syringe (34) is switched be enabled, as preferably, described external command flip flop equipment (6) is implemented as the pedal being arranged on described controlling organization (5) bottom.
8. the minimally invasive medical robot system according to any one of claim 1-7, is characterized in that, described man-machine interaction mechanism (1) is removably mounted on described controlling organization (5) and above or independently arranges.
9. the minimally invasive medical robot system according to any one of claim 1-8, it is characterized in that, also comprise pushing hands (2) and/or universal wheel (7), described pushing hands (2) and/or universal wheel (7) are configured to the transfer of auxiliary described minimally invasive medical robot system and/or fix.
10. the minimally invasive medical robot system according to any one of claim 1-9, it is characterized in that, described controlling organization (5) comprises the space being applicable to hold described man-machine interaction mechanism (1) and described operating mechanism (3).
11. application of minimally invasive medical robot system in prostate biopsy or radioactive prospecting instrument according to claim 1-10.
12. 1 kinds of methods of locating intervening equipment, is characterized in that, comprising:
The guiding syringe (34) of the operating mechanism (3) according to claim 1-10 is positioned, making described guiding syringe (34) drop on target sample point and described ditrysian type protects on the determined straight line in hole of locating in orifice plate (31), or make described guiding syringe (34) drop on radioactive particle target to implant on the determined straight line in path
Wherein said intervening equipment to the control getting involved the degree of depth, acts on described target sample point or radioactive particle target implantation path through described guiding syringe according to described guiding syringe (34).
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| CN201510623072.6A CN105125289B (en) | 2015-09-25 | 2015-09-25 | minimally invasive medical robot system |
| PCT/CN2016/099359 WO2017050201A1 (en) | 2015-09-25 | 2016-09-19 | Minimally invasive medical robot system |
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| CN201510623072.6A CN105125289B (en) | 2015-09-25 | 2015-09-25 | minimally invasive medical robot system |
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| CN110960318A (en) * | 2018-09-30 | 2020-04-07 | 赛诺微医疗科技（浙江）有限公司 | CT guided ablation system and ablation positioning method |
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| CN113413219B (en) * | 2021-06-16 | 2022-10-14 | 拜斯特医疗科技(北京)有限公司 | Surgical instrument positioning and supporting device |
| CN113786220B (en) * | 2021-09-08 | 2023-03-10 | 中国科学院长春光学精密机械与物理研究所 | Throat swab sampling system and sampling method |
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Also Published As
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| WO2017050201A1 (en) | 2017-03-30 |
| CN105125289B (en) | 2018-01-02 |
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