CN109480967B

CN109480967B - Operation puncture actuating mechanism and operation mechanical arm adopting same

Info

Publication number: CN109480967B
Application number: CN201710821639.XA
Authority: CN
Inventors: 孙志伟
Original assignee: Surgnova Healthcare Technologies (zhejiang) Co ltd
Current assignee: Surgnova Healthcare Technologies (zhejiang) Co ltd
Priority date: 2017-09-12
Filing date: 2017-09-12
Publication date: 2021-02-19
Anticipated expiration: 2037-09-12
Also published as: CN109480967A

Abstract

An operation puncture actuating mechanism and an operation mechanical arm adopting the same. The puncture executing mechanism can clamp surgical instruments (such as a puncture needle and an ablation needle) so that a doctor can remotely control the mechanical arm to adjust the puncture track of the instrument and push the puncture track to reach a target depth along the target puncture track, the control mechanism can provide a certain free movement space for the puncture instrument in an operation, the surgical instrument can move along with tissues along with respiration when reaching a target point to perform subsequent actions (such as laser ablation), track deviation, puncture point damage and the like caused by rigid fixation of the mechanical arm to the end part of the surgical instrument are eliminated, the rapid release of the surgical instrument under emergency conditions (such as fracture danger caused by excessive bending of the surgical instrument) can be met, meanwhile, the mechanism can restore the surgical instrument to a clamped state, and the surgical instrument restores the relative position to the mechanical arm so as to perform another puncture track adjustment.

Description

Operation puncture actuating mechanism and operation mechanical arm adopting same

Technical Field

The invention relates to the technical field of medical instruments, in particular to a surgical puncture executing mechanism and a surgical mechanical arm adopting the same.

Background

Needle penetration is a relatively common technique in modern surgery, particularly in the field of minimally invasive surgery. Under the guidance of images and other sensors, the puncture needle pierces into the focus target of soft tissue to complete the operations of preventing medicine, biopsy, local anesthesia, radiation, ablation, etc. The needle puncture is widely applied to diagnosis and treatment of organ tissues such as prostate, lung, liver, kidney, spine and the like.

With the development of interventional guidance tools and robot assistance technologies and the field of medical treatment, multiple scanning verification, long operation time, high requirements on doctor technical level, poor repeatability and the like in the traditional puncture surgery and a plurality of problems that doctors are directly exposed to rays and the operation space is limited under real-time CT scanning are gradually solved.

However, the existing puncture needle is rigidly connected with the mechanical arm and cannot move along with breathing; or, when breathing is considered, there may still be a tear in the skin at the puncture site, with high equipment costs.

Disclosure of Invention

In view of the above, the main objective of the present invention is to provide a surgical puncture actuator to solve at least one of the above technical problems.

In order to achieve the above object, as one aspect of the present invention, there is provided a surgical puncture actuator including:

the clamp is used for clamping a surgical instrument to be operated and can drive the surgical instrument to execute a puncture action or withdraw from the puncture action under the driving of external input power;

a limiting unit comprising one or more limiting elements for defining spatial positions of the surgical instrument in several directions during surgery and for de-defining during non-surgery;

the clamping and the opening of the clamp are linked with the limiting and the releasing actions of the limiting unit.

As another aspect of the present invention, the present invention also provides a surgical robot, comprising a robot trolley, a passive robot, a posture adjustment mechanism, and the surgical puncture execution mechanism as described above; wherein:

the passive mechanical arm is supported by the mechanical arm trolley, and the posture and the position of the passive mechanical arm can be manually adjusted;

the posture adjusting mechanism is arranged on the driven mechanical arm, comprises a plurality of connecting rods hinged into a space parallelogram structure and is used for adjusting the posture of the surgical puncture executing mechanism arranged on the posture adjusting mechanism.

Based on the technical scheme, the surgical puncture executing mechanism has the following beneficial technical effects: the control mechanism can provide a certain free movement space for the puncture instrument in the operation, so that the puncture instrument can move along with the tissues along with respiration when reaching a target point to perform subsequent actions (such as laser ablation), the track deviation and puncture point damage caused by rigid fixation of the mechanical arm to the end part of the puncture instrument are eliminated, the rapid release of the puncture instrument under emergency conditions (such as fracture danger caused by over-bending of the puncture instrument) can be met, and meanwhile, the mechanism can restore the puncture instrument to a clamped state, so that the relative position of the puncture instrument to the mechanical arm is restored, and the puncture track can be adjusted again; the mechanical arm can be remotely controlled to adjust the puncture track of a surgical instrument (such as a puncture needle and an ablation needle) under the guidance of a real-time CT image, and guide the surgical instrument to advance into a target depth along the target puncture track.

Drawings

FIG. 1 is an isometric view of one embodiment of the surgical penetration actuator of the present invention in a clamped state;

FIG. 2 is an exploded view of one embodiment of the surgical penetration actuator of the present invention in a clamped state;

FIG. 3 is an isometric view of one particular embodiment of the surgical penetration actuator of the present invention in a free state;

FIG. 4 is a schematic illustration of the installation process of the surgical penetration actuator as one embodiment of the present invention;

FIG. 5 is a schematic view of the internal structure of the components in a fully clamped state as one embodiment of the present invention;

FIG. 6 is a front view of an action trigger as one embodiment of the invention;

FIG. 7 is a diagram of the structure and critical dimension relationships of various motion receivers that is an embodiment of the present invention;

FIG. 8A is a schematic view showing an internal structure of a roller in an opened state as an embodiment of the present invention;

FIG. 8B is a schematic diagram of the internal structure of the lateral clamp in a fully open position as an embodiment of the present invention;

FIG. 8C is a schematic internal view of the components in a fully expanded state as an embodiment of the present invention;

FIG. 9 is a schematic view of the application scenario of the present invention installed on the RCM mechanism;

fig. 10 is a schematic view of an application scenario of the present invention applied to a real-time CT guided surgery.

In the above figures, the reference numerals have the following meanings:

10-a puncture mechanism, wherein the puncture mechanism is provided with a puncture needle,

20-two-degree-of-freedom RCM puncture posture adjusting mechanism,

30-a passive mechanical arm, wherein the passive mechanical arm is arranged on the base,

40- -O-arm CT.

Detailed Description

In order that the objects, technical solutions and advantages of the present invention will become more apparent, the present invention will be further described in detail with reference to the accompanying drawings in conjunction with the following specific embodiments. Various directional terms in the present invention, such as "front", "rear", "left", "right", "up", "down", etc., are used for convenience of description, and are used to describe relative positions of various components, but not to limit the present invention, and different product placement modes of the present invention may cause changes in description of various directions.

The invention discloses a tail end puncture executing mechanism which is adapted to a remote motion center mechanism of an RCM (remote center of motion) as a far-end driven mechanical arm of a puncture instrument posture adjusting device in a master-slave control medical robot system, the mechanism not only can clamp surgical instruments (such as puncture needles and ablation needles) so that doctors can remotely control the mechanical arm to adjust the puncture track of the instruments and push the puncture track to reach a target depth along the target puncture track, but also can control the mechanism to provide a certain free motion space for the puncture instruments in an operation so that the surgical instruments can move along with tissues along with respiration when reaching a target point to perform subsequent actions (such as laser ablation), track deviation, puncture point damage and the like caused by rigid fixation of the mechanical arm to the end part of the surgical instruments are eliminated, and emergency situations (such as fracture danger caused by over-bending of the surgical instruments) can be met, the surgical instrument is quickly released, and meanwhile, the mechanism can enable the surgical instrument to be restored to a clamped state, so that the surgical instrument is restored to the relative position with the mechanical arm, and further, the puncture track can be adjusted again.

Specifically, the invention discloses a surgical puncture executing mechanism, which comprises:

The clamp is two rollers, wherein one roller can rotate in the forward direction or the reverse direction under the driving of external input power so as to drive the surgical instrument to perform corresponding actions.

Wherein, two rollers of anchor clamps link to each other with an axle at the centre of a circle respectively, and two rollers can open with the angle that the diaxon contained angle is more than or equal to 45.

Wherein, the spacing unit comprises spacing elements which are positioned in a plane vertical to the surgical instrument clamped by the clamp and in the front-back direction and the left-right direction. In one embodiment, the front-back and left-right limiting elements are a first limiting rod capable of moving back and forth and two second limiting rods capable of moving left and right and being clamped and opened respectively.

The linkage of the clamp and the limiting unit is realized by driving an action trigger piece through external input power and driving the clamp and the limiting unit respectively at different parts on the action trigger piece.

In one embodiment, the action trigger is provided with protrusions at different positions, and the protrusions are matched with a track, a deformation gear (comprising a ratchet wheel) or a spring trigger mechanism and the like to push different components to perform corresponding actions. The deformation gear comprises a groove forming deformation gear which is formed on a disc and is inwards sunken in a specific shape, and a protrusion is matched with the groove to push the deformation gear to rotate in a specific mode so as to drive a corresponding limiting unit to act; examples of the spring trigger mechanism include, for example, a spring to clamp the position-limiting unit, and the movement of the protrusion counteracts the thrust of the spring to open the position-limiting unit, and when the protrusion retreats, the position-limiting unit clamps again under the action of the spring; examples of tracks include, for example, protrusions that engage a track on a cylinder (wheel) so that movement of the protrusions causes movement of the cylinder. In a preferred embodiment, the motion trigger moves up and down along a vertical rod at a constant speed, and three protrusions are formed on the motion trigger and are respectively coupled with the three rails, so that the three corresponding parts are respectively driven by setting the tracks of the corresponding rails. Wherein the track can be arranged on a cylinder (rotating wheel) or a driving plate, the rotating wheel is driven by the projection to rotate, and the driving plate is translated.

Wherein, the external input power drives a screw rod through a pair of bevel gears to enable the action trigger piece to vertically move up and down under the action of the thread.

The invention also discloses a surgical mechanical arm, which comprises a mechanical arm trolley, a driven mechanical arm, a posture adjusting mechanism and the surgical puncture executing mechanism; wherein:

the passive mechanical arm is supported by the mechanical arm trolley and can manually adjust the posture and the position of the passive mechanical arm;

the posture adjusting mechanism is arranged on the driven mechanical arm, comprises a plurality of connecting rods hinged into a space parallelogram structure and is used for adjusting the posture of the operation puncture executing mechanism arranged on the posture adjusting mechanism.

The passive mechanical arm and the attitude adjusting mechanism may be electrically controlled remotely, thereby constituting a so-called remote center of motion (rcm) mechanism.

The mechanical arm trolley and the operating bed can be fixedly connected or arranged on a positioning mounting seat with casters; preferably, the mechanical arm trolley can be fixedly connected with the operating table through a sliding rail.

In one embodiment, the power device for driving the surgical instrument to feed is arranged on the passive mechanical arm, and the posture adjusting mechanism comprises a mechanism for transmitting power.

In one embodiment, the surgical puncture executing mechanism is detachably connected with the posture adjusting mechanism; it is further preferred that the surgical penetration actuating mechanism is disposable, so that the sanitation and cleanliness of the operation can be better ensured.

In one embodiment, the outer surface of the posture adjustment mechanism may be covered with a plastic film or waterproof coating to facilitate post-operative cleaning.

In a preferred embodiment, the surgical penetration actuator is mounted to be positioned at the distal end of the RCM mechanism. Determining that two rotating shafts are hinged with the tail end of the two-degree-of-freedom RCM mechanism by using the axis position (related to the RCM structure parameters), and obtaining the adjusted puncture pose; and the power is obtained through the remote transmission mechanism so as to obtain the power required by the action of the puncture mechanism under the condition of not influencing CT imaging.

2 groups of movable components in non-parallel directions, which can perform expansion and contraction actions sequentially, comprise transverse clamping rods and longitudinal clamping rods. The purpose of the expansion and contraction action is to provide a range of motion for the penetrating instrument and re-grip the instrument to restore the determined relative position; the purpose of the sequential execution sequence is to minimize the clamping length after clamping on the premise of meeting the free movement space of the given puncture instrument, so that the clamping piece cannot interfere with the body of a patient, and the sufficient safety and the adjustment range are ensured.

The rotary roller capable of yielding and resetting comprises a driving roller and a driven roller. The purpose of the roller abdicating action is not to cause interference on the free movement of the puncture instrument and the subsequent reclamping action; after the resetting action of the rollers is executed, the two rollers can clamp the puncture instrument, the driving roller receives power from the rotating shaft, and the puncture instrument executes the feeding action by utilizing the friction force.

The implementation mode of the motion sequence execution of the clamping bars and the giving and resetting actions of the rollers is characterized in that the execution part comprises an action trigger part, a roller opening and closing receiving part, a transverse clamping bar opening and closing receiving part and a longitudinal clamping bar opening and closing receiving part. The target action is realized through the movement of the action trigger piece and the structural matching of the action trigger piece and the opening and closing receiving piece, and the reliable clamping is provided by limiting the movement after the action is finished, and the power of the action trigger piece is transmitted by the rotating shaft.

The puncture instrument is mounted and dismounted relative to the puncture mechanism or the mechanical arm. Comprises a rigid body mark which is convenient to install and remove, and an outer side longitudinal clamping rod which is movably connected with the longitudinal opening and closing executive component by a hinge joint and a buckle. Under the condition that the traditional operation process is not influenced (namely, the puncture instrument is inserted into a certain depth through a puncture point), a mark with a determined distance (related to the size parameter of the RCM mechanism) from the skin puncture point is marked on the puncture instrument, the rigid body mark is arranged at the position overlapped with the mark, the mechanical arm and the RCM mechanism are pulled and adjusted to ensure that the lower surface of the rigid body mark is overlapped with the upper surface of the transverse clamping rod group, the outer longitudinal clamping rod is closed through a buckle, the puncture mechanism is used for determining and clamping the puncture instrument, the puncture point on the skin is the far-end central point adjusted by the mechanical arm, the roller is driven to reset to provide reliable transverse clamping, and the rigid body mark is removed to perform subsequent actions of the instrument; the detachable outer longitudinal clamping rod is also utilized, and after the roller abdicating action is executed, the mechanical arm can be dragged to separate the instrument from the puncture mechanism without influencing the state of the instrument.

An embodiment of the invention is further illustrated with reference to the accompanying drawings.

As shown in fig. 1 and 9, the shaft segments 101R1, 102R2 of the

rotating shafts

101, 102 of the puncture mechanism are hinged with the moving link of the RCM mechanism to output the puncture pose adjustment result provided by the RCM mechanism; the shaft segments 101R2, 102R2 act as pulleys for a belt to obtain the power of a remotely located motor to provide the power for the mechanism to achieve the target action.

The target actions of the present invention include:

the clamping state shown in fig. 1 is obtained, so that the mechanical arm can adjust the pose of the puncture instrument and can provide the feeding action of the instrument at the moment;

the largest enveloping space of the clamping part in the figure 3 is obtained, so that the puncture instrument can freely move along with respiration;

in the case of fig. 4, the position and state of each component is given. Fig. 4 shows the state of each movable part of the puncture mechanism when the puncture device is installed, wherein the

rollers

107 and 108 are in the abdicating state, the transverse clamping parts 103 and 104 (namely, the limiting units) are in the clamping state, the buckles of the opening and closing executing part 114 connected with the outer longitudinal clamping part 106 (namely, the limiting units) are opened, and the longitudinal clamping part is in the clamping state when the opening and closing executing part 114 is positioned to close the outer longitudinal clamping part 106, so that the puncture device is ensured to be positioned after being installed and is not interfered by the rollers when being installed.

In addition to the above 3 states, in order to minimize the clamping length after clamping and prevent the clamping member from interfering with the body of the patient on the premise of satisfying the free movement space of the given puncture device, the puncture mechanism further includes longitudinal clamping rods 105b and 106 (i.e. limiting units) which are completely clamped, and then the

transverse clamping rods

103 and 104 move from the completely opened state to the clamping state.

In the present embodiment, the torque from the rotating shaft 101 is transmitted to the roller rotating shaft 123 to effect rotation of the roller 107 in the meshing state of the bevel gear sets 121, 122 (at this time, the roller is in the returning state). The rotation from the rotating shaft 102 provides power for the yielding and resetting actions of the roller and the clamping and expanding actions of each clamping component, and the power is transmitted to a screw rod combination consisting of an action trigger 109, a threaded rod 130 and a guide rod 131 through bevel gear sets 127 and 128 in fig. 5, so that the action trigger 109 moves up and down along the guide rod 131. The working trigger is shown in fig. 6, and 3 cylindrical protrusions 109t1, 109t2 and 109t3 are respectively matched with the sliding chutes of the roller opening and closing receiving piece 110, the transverse clamping bar opening and closing receiving piece 111 and the longitudinal clamping bar opening and closing receiving piece 112, and sliding chute conducting wires on the outer cylindrical surfaces of the roller opening and closing receiving piece 110 and the longitudinal clamping bar opening and closing receiving piece 112 are a combination of a spiral line and a vertical line; the runner wire on the plane of the lateral clamp bar opening and closing receiver 111 is a combination of diagonal and vertical lines. Fig. 7 shows the relationship between the sliding groove conductors on the receiving members, and the dashed lines 0 and 3 in the figure represent the two extreme positions of the bit line in the action trigger 109.

The specific implementation and procedure will now be described in terms of the state and procedure that the lancing mechanism needs to achieve during the surgical procedure when installing the instrument.

When the instrument is installed, the external moving parts of the mechanism appear as in fig. 4, with the motion trigger 109 in position 1 of fig. 7. Then, the action trigger 109 moves to position 0 to drive the roller opening and closing receiving member 110 and the driven roller steering shaft 125 fixedly connected with the roller opening and closing receiving member to rotate with the opening and closing driving gear 132 on the roller opening and closing receiving member, and the driven roller rotating shaft 124 is supported by the driven roller steering shaft 125 and can rotate relative to the mounting hole, namely the driven roller rotates inwards; meanwhile, an opening and closing driven gear 133 engaged with the opening and closing driving gear 132 rotates, a driving roller steering shaft fixedly connected with the opening and closing driven gear drives a driving roller to rotate inwards, the roller resets and clamps the puncture instrument, and process diagrams are shown in fig. 8A to fig. 5.

And (II) when the puncture mechanism is converted from the clamping state of each part to the fully-expanded state of each part, the action trigger piece moves from the 0 position to the 3 position.

Wherein the movement from the 0 position to the 1 position is the reverse of the movement, the steering shaft rotates reversely, and the roller gives way. The process diagrams are fig. 5 to 8A;

in the S2 displacement from the 1 position to the 2 position, only the sliding track of the transverse opening and closing receiving member 111 is a non-vertical line segment (fig. 7), the transverse opening and closing receiving member 111 is in moving pair fit with the middle plate 116 of the mounting base thereof and is hinged with the opening and closing connecting rods (fig. 8B)134 and 135 respectively through the rotating shaft 111R fixedly connected thereon, and the opening and

closing connecting rods

134 and 135 are hinged with the

transverse clamping rods

103 and 104 respectively, and the transverse clamping rods are also in moving pair fit with the middle plate 116 of the mounting base to form two parallel 1-degree-of-freedom mechanisms driven by the transverse opening and closing receiving member 111, so that the action trigger 109 moves upwards to drive the transverse opening and closing receiving member 111 to move forwards, the transverse clamping rods are fully opened, and the process diagram is as shown in fig. 8A to.

In the displacement from the 2-position to the 3-position element S3, only the sliding track of the longitudinal opening and closing receiving element 112 is a non-vertical line segment (fig. 7), that is, only the longitudinal opening and closing receiving element 112 moves to drive the gear 129 fixedly connected to the shaft 112R thereof to rotate, and then drive the longitudinal opening and closing actuator 113 capable of moving freely on the installation base plate to move forward, and the process diagrams are fig. 8B to 8C.

When the puncture mechanism is shifted from the state in which the respective members are completely spread to the state in which the respective members are clamped, the operation trigger 109 moves from the 3 position to the 1 position. The reverse motion of the aforementioned (second) motion, the opening and closing motion design shown in fig. 7, at the 2 position, is the motion critical point of the longitudinal opening and closing receiving part 112 and the transverse opening and closing receiving part 111, ensuring that the instrument does not fall outside the clamping range.

When the trigger piece reaches the minimum limit position, the projections on the trigger piece limit the movement of the receiving pieces, and the components are in a completely clamped state, as shown in fig. 5.

The housing components of the puncture mechanism comprise a mounting top plate 115, a mounting base middle plate 116, a mounting bottom plate 117, a right side mounting plate 118, a left side mounting plate 119, a front side cover plate 105 and a rear side cover plate 120, which provide a determined mounting position for internal parts, so that the action is realized, and meanwhile, an inner longitudinal clamping rod 105b is fixedly connected to the front side cover plate 105, so that the longitudinal opening and closing action is simplified.

Fig. 9 and 10 are schematic diagrams of an application scenario of the present invention installed in an RCM mechanism and an application scenario of the present invention applied to a real-time CT guided surgery, respectively.

The above-mentioned embodiments are intended to illustrate the objects, technical solutions and advantages of the present invention in further detail, and it should be understood that the above-mentioned embodiments are only exemplary embodiments of the present invention and are not intended to limit the present invention, and any modifications, equivalents, improvements and the like made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A surgical penetration actuator comprising:

the clamping and the opening of the clamp are linked with the limiting and the removing actions of the limiting unit;

the linkage of the clamp and the limiting unit is realized by driving an action trigger piece through external input power, and driving the clamp and the limiting unit respectively at different parts on the action trigger piece.

2. The surgical penetration actuator of claim 1, wherein said clamp is two rollers, one of which is rotatable upon actuation of an external input power to actuate the surgical instrument to perform the corresponding action.

3. The surgical penetration actuator of claim 2 wherein said clamp has two rollers each connected to a shaft, said rollers being capable of opening at an angle of 45 ° or greater to each other.

4. The surgical penetration actuator of claim 1, wherein said stop unit includes stop elements in a fore-aft direction and a left-right direction in a plane perpendicular to the surgical instrument held by said clamp.

5. The surgical puncture actuator of claim 4, wherein the front and rear and left and right limiting elements are a first limiting rod capable of moving forward and backward and two second limiting rods capable of moving left and right and being opened and closed by clamping.

6. The surgical penetration actuator of claim 1 wherein said actuation trigger has projections formed at different locations thereon, whereby said projections cooperate with a track, ratchet or spring trigger mechanism to urge different components to perform corresponding actions.

7. The surgical puncture actuator of claim 6, wherein the motion trigger moves up and down along a vertical rod at a constant speed, and three protrusions are formed on the motion trigger and are respectively coupled to the three rails, so that the corresponding parts are respectively driven by setting the tracks of the corresponding rails.

8. The surgical penetration actuator of claim 7 wherein said track is provided on a wheel or a drive plate, said wheel being rotated by a projection to translate said drive plate.

9. The surgical penetration actuator of claim 7 wherein said external input power drives a lead screw through a pair of bevel gears to move said motion trigger vertically up and down under the influence of a screw thread.

10. A surgical robotic arm comprising a robotic trolley, a passive robotic arm, a pose adjustment mechanism, and a surgical penetration actuation mechanism according to any of claims 1 to 9; wherein:

11. A surgical robotic arm as claimed in claim 10, wherein the robotic arm trolley is fixedly attached to the operating table or mounted on a positioning mount having castors.

12. The surgical robotic arm of claim 11, wherein said robotic arm trolley is fixedly connected to the operating table by a slide rail.

13. A surgical robotic arm as claimed in claim 11, wherein power means for driving the advancement of a surgical instrument are provided on the passive robotic arm, and the attitude adjustment mechanism comprises a power transmission mechanism.

14. The surgical robotic arm of claim 10, wherein said surgical penetration actuator and said attitude adjustment mechanism are removably connected;

the surgical puncture executing mechanism is disposable;

the outer surface of the posture adjusting mechanism is covered with a plastic film or a waterproof coating.