JP2014111080A - 多構成テレプレゼンスシステムおよびその方法 - Google Patents
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B46/10—Surgical drapes specially adapted for instruments, e.g. microscopes
- A61B46/13—Surgical drapes specially adapted for instruments, e.g. microscopes the drapes entering the patient's body
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/35—Surgical robots for telesurgery
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B34/37—Master-slave robots
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/71—Manipulators operated by drive cable mechanisms
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/76—Manipulators having means for providing feel, e.g. force or tactile feedback
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
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- A61B2034/305—Details of wrist mechanisms at distal ends of robotic arms
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0803—Counting the number of times an instrument is used
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- A—HUMAN NECESSITIES
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- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0814—Preventing re-use
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
- A61B2090/506—Supports for surgical instruments, e.g. articulated arms using a parallelogram linkage, e.g. panthograph
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/361—Image-producing devices, e.g. surgical cameras
Abstract
【解決手段】無菌フィールド内で処置手順を実施するためのロボット外科手術システムであって、外科手術機材と、近位端部および遠位端部を有するマニピュレータアームを含むマニピュレータアッセンブリ4と、少なくともマニピュレータアームを覆い、無菌フィールドからマニピュレータアームを遮断する無菌ドレープ70と、該マニピュレータアームの遠位端部を外科手術機材と連結させ、マニピュレータアッセンブリからこの機材まで、少なくとも2次の運動を伝達するためのアダプタ52と、上記機材を収容し、患者体内で経皮貫入による接近を提供するための内側管腔を規定するカニューレ66と、上記ドレープを通して延び、かつ、カニューレをマニピュレータアームの遠位端部に連結する滅菌可能カニューレアダプタ64とを備える。
【選択図】図3A
Description
この出願は、1996年12月12日に出願された、米国暫定特許出願番号第60/033,321号の継続であり、かつそれからの優先権の特権を主張し、その十分な開示は、本明細書中で参考により援用される。
本発明は、ロボット支援式外科手術マニピュレータに関するものであり、より特定すると、外科手術部位に物理的に存在しているような知覚を外科医に与えながら、患者に遠隔ロボット外科手術手順を実施するシステムおよび方法に関連する。
本発明は、外科手術部位に物理的に存在している知覚(すなわち、遠隔存在感)を外科医に与えながら、患者に遠隔ロボット支援外科手術処置手順を実施するためのシステムおよびその方法を提供する。特に、非滅菌の駆動および制御構成要素、滅菌可能端部作動体または外科手術機材、および、駆動および制御構成要素と外科手術機材を連結するための、かつ駆動構成要素から外科手術機材へ運動を伝達するための中間コネクタ構成要素を含む、3構成要素外科手術システムが提供される。駆動および制御構成要素は無菌外科手術部位から遮断され、外科手術機材は滅菌処理可能および廃棄処理可能で、中間コネクタは滅菌可能および再使用可能である。この態様で、中間コネクタは、ロボットシステムの駆動および制御構成要素内部のモータまたは電気接続機器に損傷を与えることなく、外科手術処置手順後に滅菌できる。
装着される。リストユニットは迅速かつ容易にマニピュレータアッセンブリに連結され、かつそこから連結解除され、処置手順期間中に機器の取り替えを促進する。或る具体的実施態様では、リストユニットは休止可能で、同ユニットのそれ以上の使用を阻止するように、リストユニットが使用された回数を計数する機構を含む。
外科手術機材と、
近位端部および遠位端部を有するマニピュレータアームを含むマニピュレータアッセンブリと、
上記マニピュレータアッセンブリの少なくとも上記マニピュレータアームを覆い、上記無菌フィールドから上記マニピュレータアームを遮断する無菌ドレープと、
上記マニピュレータアームの上記遠位端部を上記外科手術機材と連結させ、かつ、上記マニピュレータアッセンブリから上記機材まで、少なくとも2次の運動を伝達するためのアダプタであって、上記アダプタが上記無菌ドレープを通って延びる、アダプタとを備える、システム。
ットに連結される軸方向移動可能キャリッジを有する、項目5に記載のシステム。
近位端部および遠位端部を有するマニピュレータアームを含むマニピュレータアッセンブリ、
上記マニピュレータアッセンブリの少なくとも上記マニピュレータアームを覆い、上記無菌フィールドから上記マニピュレータアームを遮断する無菌ドレープと、
上記マニピュレータアームの上記遠位端部を上記外科手術機材と連結し、かつ上記マニピュレータアッセンブリから上記機材まで少なくとも2次の運動を伝達するアダプタであって、上記アダプタは上記無菌ドレープを通して延びる、アダプタと、
上記マニピュレータアッセンブリから遠隔の位置に配置されるコントローラと、
上記マニピュレータアームの遠隔制御のために、上記コントローラを上記マニピュレータアームに連結するサーボ機構とを備える、遠隔ロボットシステム。
マニピュレータアームの部分を無菌ドレープで覆い、上記無菌フィールドから上記アームを遮断する工程と、
上記無菌ドレープを通して無菌アダプタを上記マニピュレータアームの遠位端部に装着する工程と、
上記アダプタに無菌外科手術機材を装着する工程と、
上記マニピュレータアームを用いて、患者のターゲット部位に上記外科手術機材を導入する工程とを含む、方法。
上記カニューレアダプタにカニューレを装着する工程と、
患者の人体腔に上記カニューレを介して外科手術機器を導入する工程とを更に含む、項目24に記載の方法。
上記マニピュレータアームに相対して上記外科手術機材を軸方向に移動させるように、上記キャリッジを軸方向に移動させる工程とを更に含む、項目24に記載の方法。
マニピュレータアームに上記外科手術機器アッセンブリのうちの1つの上記リストユニットシャフトの上記近位端を接続する工程と、
上記マニピュレータアームを用いて、患者の治療部位に上記外科手術機器アッセンブリのうちの上記1つの機器を導入する工程とを含む、方法。
上記無菌ドレープを通して、上記マニピュレータアームに無菌アダプタを装着する工程と、
上記無菌アダプタに上記外科手術機器アッセンブリのうちの上記1つの上記リストユニットシャフトの上記近位端を装着する工程とを更に含む、項目39に記載の方法。
本発明は、特に、開放性外科手術処置手順(open surgical procedures)、定位脳手術のような神経外科手術処置手順、および、腹腔鏡検査、関節鏡検査、胸腔検査などのような内視鏡処置手順を含め、患者にロボット支援式外科手術処置手順を実施する複数構成要素システムおよびその方法を提供する。本発明のシステムおよび方法は、患者から遠隔にある位置からサーボ機構を介して外科手術機器を外科医が操作することを可能にする遠隔ロボット外科手術システムの一部として、特に有用である。そのため、本発明のマニピュレータ装置すなわちスレーブは、力反射を備えた遠隔検知システムを形成するように、運動学的に同等なマスターにより駆動されるのが普通である。好適なスレーブ/マスターシステムは、1995年8月21日に出願された、同時係属特許出願番号第08/517,053号(弁護士事件記録第287−004810)中に見られるが、この完全な開示内容は、本明細書中に参考として援用される。
置および配向で固定され得るように、制動器(図示せず)を含む。ジョイント30は、ジョイント30を手術台Oに搭載するための、かつ各マニピュレータアッセンブリ4をサーボ機構16に接続するための受容体32に搭載される。これに加えて、受容体32はジョイント30をRF電源、吸引潅注システムなどのような他のシステムに接続し得る。受容体32は、手術台Oの外側レール36に沿ってスライド自在に配置される搭載アーム34を含む。もちろん、マニピュレータアッセンブリ4は他の機構と共に、手術台O上に位置決めされればよい。例えば、同システムは、患者の上で1つ以上のマニピュレータアッセンブリ4を移動させかつ保持する、支持システム(手術室の天井または壁に連結される)を組み入れ得る。
。
リストユニット22に運動を伝達する。回転シャフト124は、リストユニット22のリスト60を中心とした外科手術機材62のヨーおよびピッチ運動、Z軸を中心としたリストユニット22の回転、および機材62の作動を含め、リストユニット22の少なくとも4自由度を供与するのが好ましい。勿論、同システムは、望まれれば、これより多くのまたはこれより少ない自由度を提供するように構成され得る。機材62の作動は、顎ハサミ、把持器または鋏、付与クリップまたはステープラーなどの開閉運動のような、多様な運動を含み得る。リストユニット22および機材62のZ方向への運動は、前方アームハウジング120の両端の各回転可能プーリ128および129の間で延びる、1対のキャリッジケーブルドライブ126により提供される。ケーブルドライブ126は、前方アームハウジング120に相対してZ方向にキャリッジ122およびリストユニット22を移動させるように機能する。
70まで逆に延びる。ケーブル172はモータ駆動プーリ174でピンと張られ、そこで連結駆動プーリ182とで固定されるのが好ましい。図8に示されるように、連結駆動プーリ182は、連結アッセンブリ130の内部で複数のケーブル186を介して複数のより小型のプーリ184に接続され、モータ170からの運動をリストユニットアダプタ52に伝達する。
本発明は、患者にロボット補助外科手術手順を実施するシステムと方法を提供する。特に、非滅菌駆動および制御構成(40)、滅菌端部作動体もしくは手術機材(20)、および手術機材(20)および駆動と制御構成要素(40)を結合する機械要素を含む中間コネクタ構成要素(24)を含み、それらの間で運動と電気信号が伝達される、3構成要素(2)が提供される。駆動および制御構成要素(40)は、滅菌した手術部位から遮断され、手術機材(20)は滅菌され使い捨て可能で中間コネクタ(24)は滅菌され再使用可能である。このようにして、ロボットシステムの駆動および制御構成要素(40)内部のモータ(170)または電気的接続を損傷することなく、外科手術後に中間端子コネクタ(24)を滅菌し得る。
4 マニピュレータアッセンブリ
6 制御アッセンブリ
10 画像スコープアッセンブリ
20 外科手術器具アッセンブリ
22 リストユニット
24 外科手術機材
42 フレーム
46 前方アームアセンブリ
30 搭載ジョイント
52 リストユニットアダプタ
64 カニューレアダプタ
70 無菌ドレープ
120 ハウジング
122 キャリッジ
123 開口部
170 駆動モータ
A 助手
C コンソール
O 手術台
P 患者
S 外科医
Claims (11)
- ロボット駆動構成要素(40)からロボット機材(22)まで運動を伝えるための前方アームアッセンブリ(46)であって、以下:
a)該ロボット駆動構成要素と連結するように適合されたハウジング(120);
b)該ハウジングと連結されるキャリッジ(122)であって、該キャリッジは、該ロボット機材と連結するように適合されている、キャリッジ;
c)該キャリッジと該ロボット機材との間の無菌ドレープ(70)であって、該ドレープは、該キャリッジを該ロボット機材と連結することを可能にする穴を有し、該キャリッジが複数の開口部を有し、該ハウジングが、該ロボット駆動構成要素から該キャリッジの複数の開口部を通って該ロボット機材まで運動を伝えるように構成されている複数の回転可能なシャフト(124)を備える、無菌ドレープ;を備え、
該ロボット機材が、近位端、シャフトおよび遠位端を備え、該ロボット機材の遠位端が端部作動体(140)を備え、該端部作動体が少なくとも2つの自由度で該シャフトに対して移動可能である、前方アームアッセンブリ。 - 前記キャリッジが前記ハウジングと、スライド自在に連結される、請求項1に記載の前方アームアッセンブリ。
- 前記キャリッジが、前記外科手術駆動構成要素に対して移動可能である、請求項1に記載の前方アームアッセンブリ。
- 前記複数の回転可能なシャフトが、前記外科手術機材に少なくとも4つの自由度を提供するように構成されている、請求項1に記載の前方アームアッセンブリ。
- 前記複数の回転可能なシャフトが、前記機材のリストユニットのリストの周りの外科手術機材のヨー運動およびピッチ運動を提供するように構成されている、請求項1に記載の前方アームアッセンブリ。
- 前記機材の作動が、顎部材の開閉、ハサミの開閉、把持器の開閉、クリップの付与、およびステープルの付与からなる群から選択される、請求項5に記載の前方アームアッセンブリ。
- さらに、一体のカニューレ(66)を備える、請求項1に記載の前方アームアッセンブリ。
- 前記一体のカニューレが、該カニューレ内に力検知ベアリングと連結された力検知要素を備える、請求項7に記載の前方アームアッセンブリ。
- 前記力検知要素が、ひずみゲージおよび力検知抵抗器からなる群から選択される部材を備える、請求項8に記載の前方アームアッセンブリ。
- 前記力検知ベアリングが、手術の間に外科手術機材を支持し、そして該機材が回転し、かつ該ベアリングの中央孔を通って軸方向に移動することを可能にするように適合されている、請求項8に記載の前方アームアッセンブリ。
- 前記ハウジングがさらに、2つ以上の回転可能なプーリ間に延びる少なくとも1つのキャリッジケーブルドライブを備え、該少なくとも1つのキャリッジケーブルドライブが、該ハウジングに対してZ軸に沿ってZ方向に前記キャリッジを移動するように構成されている、請求項1に記載の前方アームアッセンブリ。
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Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US3332196P | 1996-12-12 | 1996-12-12 | |
US60/033,321 | 1996-12-12 |
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JP2012027186A Division JP5610547B2 (ja) | 1996-12-12 | 2012-02-10 | 多構成テレプレゼンスシステムおよびその方法 |
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JP52677498A Expired - Lifetime JP4058113B2 (ja) | 1996-12-12 | 1997-12-10 | 多構成テレプレゼンスシステム |
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