DE102014100131A1 - Surgical instruments and procedures - Google Patents

Surgical instruments and procedures

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Publication number
DE102014100131A1
DE102014100131A1 DE102014100131.1A DE102014100131A DE102014100131A1 DE 102014100131 A1 DE102014100131 A1 DE 102014100131A1 DE 102014100131 A DE102014100131 A DE 102014100131A DE 102014100131 A1 DE102014100131 A1 DE 102014100131A1
Authority
DE
Germany
Prior art keywords
holding
device
force
characterized
object
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
DE102014100131.1A
Other languages
German (de)
Inventor
Tobias Pfeifer
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aesculap AG
Original Assignee
Aesculap AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap AG filed Critical Aesculap AG
Priority to DE102014100131.1A priority Critical patent/DE102014100131A1/en
Publication of DE102014100131A1 publication Critical patent/DE102014100131A1/en
Application status is Pending legal-status Critical

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50Supports for surgical instruments, e.g. articulated arms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2059Mechanical position encoders
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/064Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0807Indication means
    • A61B2090/0811Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0807Indication means
    • A61B2090/0811Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
    • A61B2090/0812Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument indicating loosening or shifting of parts of an instrument, signaling maladjustment of parts

Abstract

The invention relates to a surgical instrument, comprising a holding device (50) with a holding element (74) for holding an object to be processed (15), in particular a bone. In order to provide such a surgical instrumentation with which the processing of the article can be assisted with the least possible invasiveness, it is proposed according to the invention that the retaining element (74) comprises or forms a sensing element (78) via which the object (15) has a holding force that the instrumentation (10, 100, 150) comprises a force measuring device (80) with at least one force sensor (82), with which a change in the holding force on the probe element (78) can be detected, and in that the instrumentation (10, 100; 150) comprises a computing unit (40) with which a position change of the object (15) can be detected as a function of a relevant signal of the force measuring device (80). Moreover, the invention relates to a method for operating a surgical instrument.

Description

  • The invention relates to a surgical instrument, comprising a holding device with a holding element for holding an object to be processed, in particular a bone.
  • In addition, the invention relates to a method for operating a surgical instrument, which comprises a holding device with a holding element for holding an object to be processed, in particular a bone.
  • A holding device of the instrument of the type mentioned can be used in the context of surgery, for example in a knee surgery, such as the implantation of an artificial knee joint. The object to be processed, for example a bone such as the femur or the tibia, can be held with the holding element of the holding device. This serves to keep the location of the machining, for example sawing, milling or drilling, constant in order to make the machining easier for the surgeon. It is known to form the holding device as an invasive clamping device, which is firmly connected to the object (in particular femur or tibia). Not originating from the actual procedure, this causes unwanted trauma to the patient. Further, in knee surgery, in practice, for reasonable tensioning of the femur or tibia, it must be prepared sufficiently freely such that the retainer is of considerable invasiveness. In addition, the holding device arranged in the operating field can hinder the surgeon during the actual processing.
  • A different approach to ensure that the processing of the article can be tracked and maintained at the intended location is the use of a surgical navigation device. In this case, a surgical marking device is firmly connected to the object, so that upon movement of the object, the movement of the marking device based thereon can be detected by means of an optical detection system and a change in position of the object can be determined. The operator can receive an indication of the movement of the object from the navigation device. However, the disadvantage here is also the invasive connection of the marking device with the object, in particular the fixation on the femur or the tibia with bicortical bone screws.
  • The object of the present invention is to provide a generic surgical instrumentation and a generic method, with which or by its use, the processing of the article can be supported with the least possible invasiveness.
  • This object is achieved in an instrument of the type mentioned according to the invention that the holding element comprises or forms a sensing element, via which the object can be acted upon by a holding force, that the instrumentation comprises a force measuring device with at least one force sensor, with a change in the holding force can be detected on the probe element and that the instrumentation comprises a computing unit with which a position change of the object can be detected as a function of a relevant signal of the force measuring device.
  • The instrument of the invention is given the opportunity to keep the object with low invasiveness. This can be done by using a feeler element as the holding element, which is acted upon by a holding force directed at the object. This makes it possible, in particular, to fix the object with a comparatively small holding force, for example a pretensioning force in the direction of a support for the object. The held object exerts a holding force counter to the opposing force on the probe element. When the position of the object changes, the opposing force acting on the probe element changes. Thereby, a change in the holding force on the probe element can be detected with the force measuring device. One or more force sensors of the force measuring device can provide the arithmetic unit with a signal in this regard which the arithmetic unit can evaluate to determine the change in position. The use of the probe element makes it possible in particular to detect a change in position with only little invasiveness. The probe element can act on the object with the holding force by being applied to this. A solid mechanical connection, in particular by screwing, clamping or bonding is not required. A separate incision for the probe over the required for the actual surgery incision can be saved. As a result, the trauma to the patient can be significantly reduced.
  • In the invention, the idea flows in that it can be dispensed with by a rigid support of the object during processing, if via the computing unit an indication or signal can be provided that changes the position of the object. The use of the "holding device" therefore does not require in the present case to hold the object to fix him immobile in particular. For example, a corresponding indication can be issued to an operator, so that he pointed to a change in the position of the object to be processed can be. A signal of the arithmetic unit may also be supplied to a surgical processing device, which processes the object with a processing member, which will be discussed below.
  • It is favorable if a change in the size and / or direction of the holding force can be detected with the at least one force sensor and if the position change of the object in space can be determined with the arithmetic unit. During a movement of the object changes, as mentioned, the force exerted by this on the probe element counterforce in direction and amount. Accordingly, a force and / or moment change as a result of the changing size and / or direction of the holding force, which can be detected by the force-measuring device, can occur on the feeler element. Based on their signal, the arithmetic unit can determine how the position of the object has changed. This gives, in particular, the opportunity to track the movement of the object in space.
  • The instrumentation can thereby provide a mechanical tracking device for contact-laden tracking of the object with at the same time the least possible invasiveness.
  • Preferably, the probe element is an elongated projection on the holding device or comprises such a projection. As a result, only relatively little space is required by the feeler element, so that an impairment of the surgeon or a processing device at the point of processing can be minimized. The projection is for example finger-shaped or tongue-shaped and can act on the object with the holding force with a first end, for example with a front side. An opposite second end may be fixed to the fixture.
  • The force measuring device and the at least one force sensor can be designed in many ways. Preferably, as mentioned, the force measuring device allows a change in the size and / or the direction of the holding force and, accordingly, to detect a force and / or torque change on the probe element.
  • For example, it can be provided that the at least one force sensor determines the force change via displacement measurement, pressure measurement, resistance measurement, via a magnetoelastic effect, an electroelastic effect, by means of piezoelectricity and / or according to the vibrating string principle. Corresponding embodiments of the at least one force sensor that are familiar to the person skilled in the art can be provided in the holding device. It is conceivable that more than one of the measuring principles mentioned above is used. It is also conceivable that identical or different measuring principles are used in the presence of two or more force sensors.
  • The force measuring device preferably has two or more force sensors. A change in the holding force is detectable with the two or more force sensors, preferably in three degrees of freedom of translation and three degrees of freedom of rotation.
  • Advantageously, the holding device comprises two or more holding device segments which are each movably connected to one another at a joint. For example, the holding device comprises or forms a holding arm with hingedly connected holding device segments. The joint or joints may be hinges and / or push joints.
  • It is favorable if at least one force sensor is arranged on or integrated in a joint, in particular if in each case a force sensor is arranged on or integrated in a joint. As a result, for example, a compact design of the holding device can be achieved.
  • Alternatively or additionally, it can be provided that at least one force sensor is arranged on a contact surface of the probe element for contacting the object. Such a force sensor can be acted upon by the object directly with the force acting on the probe element counterforce, so that at the same time a change in the holding force can be detected.
  • It can be provided that the holding device has a rigid configuration in which the holding element, once set for applying the object with the holding force, is not movable.
  • In a different preferred embodiment of the instrumentation, it is advantageous if the holding device has a coupled to the arithmetic unit drive means with which the probe element is movable in space, and if the movement of the probe element is controlled and / or regulated depending on the signal of the force measuring device for Maintaining the relative position of the probe element and the object and / or maintaining the holding force on the object. This gives, in particular, the possibility that the feeler element can be tracked by the drive device during a movement of the object. Accordingly, the holding device may comprise a tracking device, which is formed by the drive device. The arithmetic unit can signal the drive device so that it can move the probe element in space so that its position on the object and / or the holding force acting on the object is kept constant depending on a determined change in the position of the object.
  • The above embodiment makes it possible to provide with the instrumentation a particularly advantageous mechanical tracking device for contact-driven tracking of the article with low invasiveness. A movement change of the object is "felt" by the feeler element. The probe element can be tracked via the drive device and thereby follow the object.
  • The drive device is preferably designed such that the probe element has six degrees of freedom and, accordingly, is translationally movable in three spatial directions and rotationally movable in three spatial directions.
  • In an implementation of the instrumentation in practice, it is advantageous if the holding device comprises two or more each at a joint movably interconnected Haltevorrichtungssegmente and if the drive means comprises drive units, wherein at a joint in each case a drive unit is arranged, is integrated in the joint or forming the joint. As a result, for example, a compact design of the holding device can be achieved.
  • A respective force sensor may be integrated in a drive unit or may be included in the drive unit.
  • To implement the instrument in practice, for example, it is provided that the holding device comprises a robot arm or is designed as such, at the working end of the probe element is arranged. The arithmetic unit is preferably integrated in the robot arm. However, it can also be separated from this and connected to this signal effectively.
  • Preferably, the instrumentation comprises a processing device which comprises a surgical processing element with a processing tool for processing the article. The processing member may be manually guided by the operator or by a drive device, it will be discussed below, led out.
  • The processing member is, for example, a surgical sawing member, a milling member or a drilling member. Accordingly, the machining tool may be a surgical saw tool, a milling tool or a drilling tool.
  • It is advantageous if the processing device has a drive unit coupled to the computing unit, with which the processing tool is movable in space, and if the movement of the processing tool is controllable and / or controllable depending on the signal of the force measuring device for maintaining the relative position of the processing tool and the object. This gives in particular the possibility to track the tool, so that the processing device also has a tracking device, for the purpose of which the drive device can move the tool in space so that the position of the machining of the object is maintained. Depending on the signal of the force measuring device, the machining tool can be held in constant relative orientation to the moving object, wherein a movement of the object can be detected by means of the probe element and the force measuring device as a result of a change in the holding force. When using this instrument, the surgeon can pay close attention to the treatment of the object. He remains spared in particular to move the processing member itself or to drive the drive means for moving the machining tool. This happens rather under the control of the arithmetic unit.
  • In the above-mentioned advantageous embodiment, in particular, a template, for example for sawing, milling or drilling, on which the machining tool is to be aligned, can be saved. In addition, a holder for a template saved and thereby the invasiveness can be further reduced.
  • Conveniently, the machining device comprises two or more machining device segments movably connected to one another at a joint, and the drive device preferably comprises drive units, a drive unit each being arranged on one joint, being integrated into the joint or forming the joint. This makes it possible to achieve a compact design of the processing device. For example, the machining device has or forms a machining arm in which machining device segments which are movably connected to one another are present and at whose working end the machining element is arranged.
  • The joints may be pivots and / or push joints.
  • Preferably, the drive device is designed such that the machining tool has six degrees of freedom and, accordingly, is translationally movable in three spatial directions and rotationally movable in three spatial directions.
  • It is particularly advantageous if the instrumentation comprises an integrated holding and processing device which comprises the feeler element and the processing member. In the present case, this can be understood in particular to mean that the holding device and the processing device are integrated in a combined device comprising the probe element and the processing element. Furthermore, this may in particular mean that the processing device comprises or forms the holding device or vice versa. This makes it possible to achieve a structurally particularly simple embodiment of the instrument. It can be saved separate holding and processing devices. For example, an integrated holding and processing device with hingedly interconnected segments is used, which are at the same time holding device segments and processing device segments of the integrated holding and processing device. Only one drive device can be used, with which a movement of the feeler element and a movement of the machining tool in space can be performed depending on the signal of the arithmetic unit. As a result, a change in position of the object can be tracked at the same time and the location of processing on the object can be maintained. Relative position of probe element and object on the one hand and machining tool and object on the other hand can be kept constant.
  • Preferably, the probe element is fixed to the processing element, whereby a structurally simple design can be achieved.
  • In a particularly simple constructive embodiment can be provided that the processing member or that the machining tool forms the probe element. This makes it possible to save a separate probe element. For example, the machining tool which processes the object can at the same time be the feeler element and act on the object with a holding force. During a movement of the object, a corresponding change in the holding force as described above can be detected by means of the force-measuring device. This makes it possible to determine the change in position of the object and to move the machining tool for tracking in space.
  • In another advantageous embodiment of the instrumentation, it is favorable if the processing device is a separate device from the holding device.
  • The processing device may for example comprise a robot arm or be configured as such, at the working end of which the processing member is arranged. The arithmetic unit may be integrated into the robot arm or separated from it and connected to the robot arm signal effective.
  • The object stated in the introduction is achieved in a generic method according to the invention in that a probe element is used as the holding element, via which the object is subjected to a holding force, that detects a change in the holding force on the probe element with a force measuring device having at least one force sensor and a computing unit depending on a relevant signal of the force measuring device, a change in position of the object is detected.
  • The advantages already mentioned in connection with the explanation of the instrumentation according to the invention can also be achieved by practicing the method. It can therefore be made in this regard to the above explanations.
  • In a corresponding manner, with regard to possible advantageous embodiments of the method, reference may be made to the above explanations on advantageous embodiments of the instrumentation according to the invention. Their features can serve to form advantageous embodiments of the method.
  • In particular, it is expedient for the instrumentation to have a processing device which comprises a surgical processing element with a machining tool for processing the object, the movement of the machining tool being controlled and / or regulated in dependence on the signal of the force measuring device in order to maintain the relative position of the tool Machining tool and the object.
  • The following description of advantageous embodiments of the invention is used in conjunction with the drawings for a more detailed explanation of the invention. Show it:
  • 1 a schematic representation of a first advantageous embodiment of an instrument according to the invention;
  • 2 a schematic representation of a second advantageous embodiment of an instrument according to the invention;
  • 3 FIG. 2: a schematic partial representation of a third advantageous embodiment of an instrumentation according to the invention, FIG.

    being with the instruments according to the 1 to 3 in each case an inventive method is feasible.
  • 1 shows a schematic representation of a reference numeral 10 proven advantageous embodiment of a device according to the invention. In addition, a detail is also schematically a leg 12 represented by a patient, especially with a femur 13 , Knee joint 14 and tibia 15 , The leg 12 is in an angled condition on a surface 16 arranged, for example, a surgical table. An incision 18 is at the knee joint 14 present, allowing access to a proximal portion of the tibia 15 exists to work on them. In the present case, the processing is done by means of a processing organ, which is not hand-held by the surgeon, but part of one of the instruments 10 included processing device 20 is.
  • The processing device 20 includes a plurality of processing device segments 22 to 29 , which are connected in a polygonal or chain link manner. There are eight processing device segments here 22 to 29 available. The processing device 20 however, could also have fewer or more segments.
  • Adjacent segments are at a respective joint 30 rotatable about a respective axis of rotation 32 connected with each other. Adjacent segments 22 to 29 can be pivoted relative to each other.
  • At the segments 24 and 25 and the segments 27 and 28 interconnecting joints 30 are the axes of rotation 32 in the longitudinal direction of the segments 24 . 25 respectively. 27 . 28 aligned so that they can be pivoted about their longitudinal axis to each other. For the other joints 30 become adjacent segments 22 to 29 pivoted transversely to a respective longitudinal axis relative to each other.
  • This arrangement of the segments 22 to 29 and joints 30 however, is only an example and may be different. Similarly, about the number of segments 22 to 29 In addition, their respective lengths may be different. Instead of swivel joints 30 can the processing device 20 also have push joints.
  • The processing device 20 is configured according to the embodiment described above as a processing arm 34 with the relatively movable segments 22 to 29 ,
  • The processing device 20 includes a drive device 36 , The drive device 36 points into a respective joint 30 integrated drive units 38 on. This is simplistic in the drawing by the on the respective joint 30 referring reference line of the reference 38 shown.
  • For driving the drive device 36 includes the instruments 10 an arithmetic unit 40 in the present case separate from the processing device 20 is formed, but can also be integrated into this. The arithmetic unit 40 is over a line 42 with the processing device 20 connected. The drive units 38 can from the arithmetic unit 40 be controlled separately from each other.
  • The processing device 20 has a positioning element 44 for placement on a surface such as the surface 16 , The positioning element 44 may comprise or form a connection device, whereby the processing device 20 can be set on the surface.
  • At the the Aufstellelement 44 opposite end forms the segment 29 a working end of the processing device 20 , At the segment 29 is a processing organ 46 with a machining tool 48 arranged. With the editing tool 48 The object to be processed can be processed, in the example of the drawing, the tibia 15 , In the editing tool 48 For example, it is a sawing tool, a milling tool or a drilling tool. Accordingly, it may be in the processing member 46 to act a sawing organ, a milling member or a drilling member. A drive for the machining tool 48 is for example in the segment 29 integrated.
  • The processing device 20 is designed so that the editing tool 48 has six degrees of freedom. Under control by the arithmetic unit 40 can the editing tool 48 thereby under the restriction of the reach of the processing device 20 be brought into any spatial position.
  • The processing device 20 is configured for example by a robot arm, at the end of which the processing member 46 is arranged or includes this.
  • The instrumentation 10 further comprises a holding device 50 , The holding device 50 is designed largely identical to the processing device 20 Apart from, among other things, the processing organ 46 , For simplicity's sake, it can therefore be mentioned that the holding device 50 Holder segments 52 to 59 has, these interconnecting joints 60 , which axes of rotation 62 define. The holding device 50 accordingly forms a support arm 64 , And it includes a drive device 66 with separately controllable drive units 68 , The drive device 66 is with the arithmetic unit 40 via a bidirectional line 70 connected. The holding device 50 includes a positioning element 72 which may also comprise a connection device.
  • The number of the respective segments 22 to 29 respectively. 52 to 59 , Type, training and alignment of the joints 30 respectively. 60 can at the processing device 20 and the holding device 50 be different and differ from the actual implementation shown in the drawing.
  • At a free working end of the holding device 50 is at the segment 59 a holding element 74 established. With the retaining element 74 can the object to be processed, here the tibia 15 to be kept during processing. This is done here by the tibia 15 is subjected to a holding force. The retaining element acts here 74 in an in 1 schematically by an arrow 76 illustrated direction on the tibia 15 one. The holding element 74 contacts the tibia 15 without being connected to it. In particular, the retaining element 74 not with the tibia 15 screwed, clamped or glued. A force is applied to the holding force only by conditioning the holding element 74 on the tibia 15 ,
  • The holding element 74 In the present case, it is elongated, for example finger-shaped, and lies with one end face on the tibia 15 at.
  • The of the holding device 50 held tibia 15 exercises on the retaining element 74 a counterforce, which is opposite to the holding force. Moves the tibia 15 in the room and thus changes the processed object its position, this leads to a change in the opposing force. This change in the counterforce can from the holding element 74 be felt, so this is a tactile element 78 forms. On the probe element 78 occurs a change in size and / or the direction of the counterforce. Due to the application of force by means of the holding device 50 This also has a change in the size and / or the direction of the holding force result. Due to the movement of the tibia 15 can thereby a force and / or a torque change on the probe element 78 occur.
  • The holding device 50 has a force measuring device 80 on. The force measuring device 80 includes a plurality of force sensors 82 , with which a force and / or a torque change on the probe element 78 is detectable. The force sensors 82 are present preferably in the joints 60 integrated and with the computing unit 40 over the line 70 signal effectively connected. A force and / or a moment change on the probe element 78 can therefore from the force sensors 82 via a signal from the arithmetic unit 40 be signaled.
  • The arithmetic unit 40 may find, depending on the signal, that a change in position of the tibia 15 has resulted. In particular, it is possible to change the position of the tibia 15 due to the force and / or a torque change on the probe element 78 to investigate. This allows the tibia 15 to track in the room. This is through the instruments 10 a mechanical tracking device provided, with the contact-related via the probe element 78 the tibia 15 can be tracked.
  • Tracking a change in position of the tibia 15 in the room is possible in a particularly patient-friendly non-invasive way. As mentioned, the holding device requires 50 no fixed connection of the probe element 78 with the tibia 15 , A separate incision on the leg 12 about tibia editing 15 In addition, required incision 18 not necessary. Trauma to the patient may be by using the holding device 50 be kept low.
  • The application of force via the probe element 78 can be comparatively low.
  • Accordingly, "holding device" in the case of the present invention does not necessarily mean a holding device. A movement of the object to be processed, here the tibia 15 , can and should preferably be possible.
  • Depending on the signal of the force sensors 82 can the arithmetic unit 40 a movement of the machining tool 48 control and / or regulate. The editing tool 48 is moved in space so that its relative position and / or orientation to the tibia 15 is preserved in the room. During their movement, accordingly, the machining tool 48 by means of the processing device 20 be tracked.
  • This results in the advantage that the place of processing of the tibia 15 is kept constant, even if the position of the tibia 15 in the room changes.
  • The surgeon can direct his attention to the progress of the processing and needs the processing element 46 not manually track.
  • About the line 70 can also drive the device 66 be controlled, the probe element 78 with a movement of the tibia 15 to track. This is done by a movement of the probe element 78 in the room. It is particularly possible, the relative position and / or orientation relative to the tibia 15 to keep constant. Likewise, the size and the direction of the holding force of the probe element 78 on the tibia 15 kept constant.
  • Also the drive device 66 is designed so that the probe element 78 has six degrees of freedom. Provided the reach of the holding device 50 can the feeler element 78 be aligned in any position and orientation in space.
  • 2 shows one with the reference numeral 100 occupied second advantageous embodiment of a device according to the invention. For the same or equivalent features and components of the instruments 10 and 100 identical reference numerals are used. The ones with the instruments 10 achievable benefits can be achieved with the instrumentation 100 can also be achieved, so that reference can be made in this regard to the above statements.
  • While at the instrumentarium 10 the processing device 20 and the holding device 50 are separate devices comes in the instrumentation 100 only a common integrated holding and processing device 110 for use. The processing device 20 at the same time forms the holding device 50 off and vice versa, so that the processing arm 34 equal to the holding arm 64 is. The force measuring device 80 with the force sensors 82 is at the device 110 like the holding arm 64 of the instruments 10 in the respective joints 30 integrated. In the device 110 is at the segment 29 via the editing tool 48 in addition, this is the feeler element 78 forming retaining element 74 established.
  • According to the integration of the processing device 20 and the holding device 50 at the device 110 it is possible to work on the tibia 15 over the retaining element 78 on the segment 29 to apply a holding force. A change in position of the tibia 15 can due to the changing reaction force on the probe element 78 be recorded. A signal due to the on the probe element 78 occurring force and / or a torque change of the force measuring device 80 can from the arithmetic unit 40 be evaluated.
  • The arithmetic unit 40 is in the device 110 integrated. Depends on one of the arithmetic unit 40 ascertainable change in position of the tibia 15 in the room, the drive device 36 be controlled to position and / or orientation of the processing element 48 relative to the tibia 15 maintain. As the probe element 78 also on the segment 29 is fixed, can also be the location and / or orientation of the probe element 78 relative to the tibia 15 to be kept. As in the case of the instrument 10 it is possible, even the tibia 15 holding power to hold constant.
  • 3 shows in sections one with the reference numeral 150 proven advantageous embodiment of a device according to the invention. The with the instruments 10 and 100 achievable benefits can also be achieved with the instrumentation 150 be achieved. For identical or equivalent features or components identical reference numerals are used in this case.
  • At the instrumentarium 150 also comes an integrated holding and processing device (reference numeral 160 ) used by the device 110 at the instrumentarium 100 equivalent. The peculiarity of the instrumentation 150 exists opposite the instruments 100 in that the editing tool 48 the holding element 74 and thus at the same time the probe element 78 formed. The tibia to be treated 15 can with the editing tool 48 be acted upon and processed at the same time with the holding force. Changes the position of the tibia 15 , Their position change based on the signal of the force measuring device 80 as a result of the machining tool 48 resulting force and / or torque change can be determined. The editing tool 48 can by appropriate control of the drive device 36 from the arithmetic unit 40 be moved in the room and tracked. In a similar way, that of the machining tool 48 formed probe element 78 tracked. The holding force can be kept constant.

Claims (22)

  1. Surgical instrumentation comprising a holding device ( 50 ) with a holding element ( 74 ) for holding an object to be processed ( 15 ), in particular a bone, characterized in that the retaining element ( 74 ) a probe element ( 78 ), over which the object ( 15 ) can be acted upon by a holding force that the instruments ( 10 ; 100 ; 150 ) a force measuring device ( 80 ) comprises at least one force sensor ( 82 ), with which a change in the holding force on the probe element ( 78 ) and that the instruments ( 10 ; 100 ; 150 ) a computing unit ( 40 ), dependent on a respective signal of the force measuring device ( 80 ) a change in position of the object ( 15 ) is detectable.
  2. Instrumentarium according to claim 1, characterized in that with the at least one force sensor ( 82 ) a change in the size and / or the direction of the holding force can be detected and that with the arithmetic unit ( 40 ) the position change of the object ( 15 ) can be determined in the room.
  3. Instrumentarium according to claim 1 or 2, characterized in that the feeler element ( 78 ) an elongated projection on the holding device ( 50 ) or comprises such a projection.
  4. Instrumentarium according to one of the preceding claims, characterized in that the at least one force sensor ( 82 ) determines the force change via displacement measurement, pressure measurement, resistance measurement, a magnetoelastic effect, an electro-elastic effect, by means of piezoelectricity and / or according to the vibrating string principle.
  5. Instrumentarium according to one of the preceding claims, characterized in that the force measuring device ( 80 ) two or more force sensors ( 82 ).
  6. Instrumentarium according to one of the preceding claims, characterized in that the holding device ( 50 ) two or more each at a joint ( 30 . 60 ) movably interconnected retainer segments ( 22 - 29 . 52 - 59 ).
  7. Instrumentarium according to claim 6, characterized in that the at least one force sensor ( 82 ) at a joint ( 30 . 60 ) is arranged or integrated in such, in particular that in each case at a joint ( 30 . 60 ) a force sensor ( 82 ) are arranged or integrated in such.
  8. Instrumentarium according to one of the preceding claims, characterized in that at least one force sensor ( 82 ) at a contact surface of the probe element ( 78 ) for contacting the object ( 15 ) is arranged.
  9. Instrumentarium according to one of the preceding claims, characterized in that the holding device ( 50 ) one with the arithmetic unit ( 40 ) coupled drive device ( 36 . 66 ), with which the feeler element ( 78 ) is movable in space, and that the movement of the probe element ( 78 ) depending on the signal of the force measuring device ( 80 ) is controllable and / or controllable in order to maintain the relative position of the feeler element ( 78 ) and the object ( 15 ) and / or maintaining the holding force on the object ( 15 ).
  10. Instrumentarium according to claim 9, characterized in that the holding device ( 50 ) two or more each at a joint ( 30 . 60 ) movably interconnected retainer segments ( 22 - 29 . 52 - 59 ) and that the drive device ( 36 . 66 ) Drive units ( 38 . 68 ), wherein at a joint ( 30 . 60 ) each have a drive unit ( 38 . 68 ) is arranged in the joint ( 30 . 60 ) or the joint ( 30 . 60 ) trains.
  11. Instrumentarium according to one of the preceding claims, characterized in that the holding device ( 50 ) comprises a robot arm or is designed as such, at the end of which the feeler element ( 78 ) is arranged.
  12. Instrumentarium according to one of the preceding claims, characterized in that the instruments ( 10 ; 100 ; 150 ) a processing device ( 20 ), which is a surgical processor ( 46 ) with a processing tool ( 48 ) for editing the article ( 15 ).
  13. Instrumentarium according to claim 12, characterized in that the processing member is a ( 46 ) Surgical saw, milling or drilling member is.
  14. Instrumentarium according to claim 12 or 13, characterized in that the processing device ( 20 ) one with the arithmetic unit ( 40 ) coupled drive device ( 36 ), with which the processing tool ( 48 ) is movable in space, and that the movement of the machining tool ( 48 ) depending on the signal of the force measuring device ( 80 ) is controllable and / or controllable in order to maintain the relative position of the machining tool ( 48 ) and the object ( 15 ).
  15. Instrumentarium according to claim 14, characterized in that the processing device ( 20 ) two or more each at a joint ( 30 ) movably interconnected processing device segments ( 22 - 29 ) and that the drive device ( 36 ) Drive units ( 38 ), wherein at a joint ( 30 ) each have a drive unit ( 38 ) is arranged in the joint ( 30 ) or the joint ( 30 ) trains.
  16. Instrumentarium according to one of claims 12 to 15, characterized in that the instrumentation ( 10 ; 100 ; 150 ) an integrated holding and processing device ( 110 ; 160 ) comprising the tactile element ( 78 ) and the processing member ( 46 ).
  17. Instrumentarium according to claim 16, characterized in that the feeler element ( 78 ) on the machining element ( 46 ).
  18. Instrumentarium according to claim 16, characterized in that the processing member ( 46 ) or the editing tool ( 48 ) the feeler element ( 78 ) trains.
  19. Instrumentarium according to one of claims 12 to 15, characterized in that the processing device ( 20 ) one of the holding device ( 50 ) is separate device.
  20. Instrumentarium according to one of claims 12 to 19, characterized in that the processing device ( 20 ) comprises a robot arm or is designed as such, at the end of which the processing member ( 46 ) is arranged.
  21. A method for operating a surgical instrument, comprising a holding device with a holding element for holding an object to be processed, in particular a bone, characterized in that a probe element is used as a holding element, via which the object is subjected to a holding force that with a Force measuring device with at least one force sensor detected a change in the holding force on the probe element and a position change of the object is determined by a computing unit depending on a relevant signal of the force measuring device.
  22. A method according to claim 21, characterized in that the instrumentation comprises a processing device comprising a surgical processing member with a movable means of a driving tool for machining the article, wherein the movement of the machining tool is controlled and / or regulated depending on the signal of the force measuring device to maintain the relative position of the machining tool and the object.
DE102014100131.1A 2014-01-08 2014-01-08 Surgical instruments and procedures Pending DE102014100131A1 (en)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2825436A1 (en) * 1978-06-09 1979-12-13 Schmidt Ramsin Eckhard Dr Med Surface pressure measuring element - is used in patella-femoral joint and includes pressurised line attached to hollow probe
US4534364A (en) * 1983-09-19 1985-08-13 Lamoreux Larry W Sagittal knee test apparatus
DE102004025612A1 (en) * 2004-04-22 2005-11-10 Plus Endoprothetik Ag Means for detecting a force-displacement characteristic of one or more bands, as well as methods for detecting the characteristic
DE102007024708A1 (en) * 2007-05-25 2008-11-27 Rheinisch-Westfälisch-Technische Hochschule Aachen Device and method for determining the mechanical leg axis of a femur
DE602005003943T2 (en) * 2004-06-15 2008-12-04 Zimmer Gmbh Imageless robot device for guiding a surgical tool
US20120130687A1 (en) * 2008-09-19 2012-05-24 Smith & Nephew, Inc. Tuning Implants For Increased Performance

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2825436A1 (en) * 1978-06-09 1979-12-13 Schmidt Ramsin Eckhard Dr Med Surface pressure measuring element - is used in patella-femoral joint and includes pressurised line attached to hollow probe
US4534364A (en) * 1983-09-19 1985-08-13 Lamoreux Larry W Sagittal knee test apparatus
DE102004025612A1 (en) * 2004-04-22 2005-11-10 Plus Endoprothetik Ag Means for detecting a force-displacement characteristic of one or more bands, as well as methods for detecting the characteristic
DE602005003943T2 (en) * 2004-06-15 2008-12-04 Zimmer Gmbh Imageless robot device for guiding a surgical tool
DE102007024708A1 (en) * 2007-05-25 2008-11-27 Rheinisch-Westfälisch-Technische Hochschule Aachen Device and method for determining the mechanical leg axis of a femur
US20120130687A1 (en) * 2008-09-19 2012-05-24 Smith & Nephew, Inc. Tuning Implants For Increased Performance

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