JP7233841B2 - ロボット外科手術システムのロボットナビゲーション - Google Patents
ロボット外科手術システムのロボットナビゲーション Download PDFInfo
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- JP7233841B2 JP7233841B2 JP2018005533A JP2018005533A JP7233841B2 JP 7233841 B2 JP7233841 B2 JP 7233841B2 JP 2018005533 A JP2018005533 A JP 2018005533A JP 2018005533 A JP2018005533 A JP 2018005533A JP 7233841 B2 JP7233841 B2 JP 7233841B2
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Description
内で多くの空間を占める。例えば、手術室空間内の貴重な不動産が、追跡カメラを有するスタンドアロンナビゲーションステーション/コンソール、視覚的なフィードバックのために使用されるスクリーン、さらなる混乱物を作り出すコードならびにプラグ、電力システム、コントローラ、などによって占められ得る。また現行の光学ナビゲーションシステムは、全ての追跡された器具が、追跡されるためにカメラに可視の状態のままとならなければならない、見通し線条件を有する。十分な基準(例えば、範囲、LED)がない場合、可視マーカー位置は、判定され得ない。さらなるリスクが、基準位置が、難読化(例えば、一滴の血液または透明なドレープ)のためにナビゲーションシステムによって誤読され得ることである。電磁ナビゲーションシステムは、磁場に影響を及ぼし、そのためマーカー位置測定にエラーを与え得る、磁場内に設置された金属及び強磁性材料による問題を有する。さらに、ナビゲーションシステムは、およそ200,000ドル以上のコストがかかり、高価である。測定の精度は、例えば、位置測定のための0.3mmRMSエラーのレベルにおいて、商業用ステーションでは比較的低い。加えて、測定は、うるさい音がでる。測定の周波数は、低い(すなわち、およそ20Hzである)。
定義
本開示をより容易に理解されるように、本明細書において使用されたある特定の用語が、以下に定義される。以下の用語及びその他の用語のための付加的な定義は、明細書を通して説明され得る。
抑えるためにより堅固となり得る。図6において示される例示的な構成において、力センサ604は、ドリルビット602の軸に統合される。いくつかの実装において、力センサ604は、図6において示されるように、ドリルの本体610の外部でドリルビット602上に位置付けられる。他の実装において、力センサ604は、ドリルの本体610の内部に位置付けられ、それにより外部の影響から力センサ604をよりよく保護する。力センサは、例えば、1~3力及び/または1~3トルクの多自由度及び量を有することができる。力は、コネクタ606を通り回転軸から送信される。コネクタは、いくつかの実装において、力センサ604に電気接続を提供する1つ以上のブラシである。力センサが光学センサの場合、コネクタは光送信機(例えば、LED)及び/または光受信機(例えば、光ダイオード)となり得る。この実施例において、ブラシは、ドリルビットに接触し、それによって力センサ604と電気接続を形成する。いくつかの実装において、ブラシは、電気接続を形成するためにドリルビット上の1つ以上の接点に触れる。電気または空気圧モータ608は、ドリルビット602軸を回転させる。いくつかの実装において、センサ612(例えば、エンコーダ)は、軸の位置を測定する。センサ612は、力センサによって測定された力を軸の相対位置に相互に関係させるために、軸の位置を測定する。例えば、力センサがドリル内に位置付けられる場合、力の方向の測定値は、ドリルビットが回転すると変化するであろう。特に、力センサは、力及び力の方向を周期的に(例えば、ミリ秒毎、マイクロ秒毎、またはそれらの間のどこか)測定する。ドリルビットは、外科医がそれを骨の中で押すと回転する。ドリルが骨に接触するとき、力センサは、方向(D1)でいくつかの力(F1)を示すであろう。1つの期間後(例えば、1ミリ秒)、ドリルビットはわずかに回転し、そのため力センサが異なる方向(D2)において同じ値(F1)を示すであろう(定力が適用されると仮定する)。力の方向は、たとえ外科医が骨に定力で押す場合でも、ドリルビットが回転すると単一の視点に対して変更し続けるであろう。絶えず変更している力方向は、受け入れられない。方向(例えば、D1、D2)を(外科医、ロボットシステムなどによって見られる)骨からの力の全体的な方向(D)と相互に関連させるために、全体的なスペース内のドリルの位置は、ドリルビットが回転すると計算されなくてはならない。センサ612は、シャフトの位置を測定し、力(D)の全体的な方向を判定するために使用される。センサ612は、図6において示されるようにモータ608の背後に位置付けられ得る。センサ612は、同様にモータ608に対する他の配置で位置付けられ得る。力センサ604は、図7A~Dにおいて示されるように様々な構成で提供され得る。各構成において、目標は、ツール(例えば、ドリルビット超音波ビットなど)の先端上の力を測定することである。図7Aにおいて示される実施例において、力センサ604は、図6に関して記載されるようにドリルビット602の軸内に統合される。力センサ604は、センサケーブル702を介して(図6において示される)コネクタ606と通信し得る。センサケーブル702は、いくつかの実装において、ドリルビット602内部に送られる。いくつかの実装において、コネクタ606(図6において示される)は、1つ以上の接続パッドを介してセンサケーブル702に電気的に接続される。本実施例の力センサ604は、例えば、変換器を使用して力及びトルクの全て6つの構成部品を測定する小型工業用センサ(例えば、Apex,N.C.のATI Industrial Automation,Inc.製の多軸力/トルクセンサ)となり得る。代替的に、力センサ604は、光学センサとなり得る。代替的に、力センサ604は、図7Bにおいて示されるように、ドリルビット602の軸内に直接統合された歪みゲージ706を備え得る。
記憶された手術可能な体積は、座標マッピングが更新されるとき、または後に更新された座標マッピングを使用するときに更新され得る。座標マッピングは、例えば、患者の解剖学的構造における位置、方向の推移、または変更を反映するために再位置合わせ中に更新される。記憶された手術可能な体積の座標は、新しいロボット座標システムを記憶された手術可能な体積が表されたロボット座標システムにマッピングすることによって、及びそのマッピングを使用する(すなわち、手術可能な体積の各座標を新しい座標システムに変換し、変換された座標を更新された手術可能な体積として記憶する)ことによって、新しいロボット座標システムに変換され得る。
Claims (8)
- 処置中の患者の位置のリアルタイムで動的な再位置合わせのためのロボットベースのナビゲーションシステムであって、
(a)ロボットアームであって、
(i)エンドエフェクタと、
(ii)前記エンドエフェクタの位置を動的に追跡するための位置センサ、および前記エンドエフェクタを操作しているユーザに触覚を届けるための力フィードバックサブシステムとを備え、
前記力フィードバックサブシステムは、後述の(I)~(IV):(I)前記患者の組織に接触し、抗して移動し、貫通し、及び/または中で移動する外科器具によって引き起こされた抵抗力を検出すること、(II)接触された組織の種類を識別すること、(III)操作者によって届けられた力を検出すること、及び(IV)前記操作者によって届けられた前記力と、前記患者の前記組織に対する前記外科器具の移動によってもたらされた前記抵抗力とを識別すること、のうちの1つ以上を実行するための1つ以上のセンサを備える、ロボットアームと、
(b)ディスプレイであって、前記ディスプレイが、使用中に前記ディスプレイを制御するためのタッチセンサを有するディスプレイと、
(c)一組の命令を実行するようにプログラムされた計算デバイスのプロセッサと、を備え、前記一組の命令が、
(i)初期の前記患者の状態の3D表現である3D図式表現及び/または3D触覚表現であって、前記3D図式表現が前記3D触覚表現と同じまたは異なる、前記患者の位置の初期位置合わせにアクセスすることと、
(ii)前記エンドエフェクタの位置を動的に判定し、前記エンドエフェクタによって受容された力及び/または前記エンドエフェクタに届けられる力を動的に判定することと、
(iii)前記エンドエフェクタを動的に追跡するために前記ロボットアームの前記位置センサの位置を動的に判定することと、
(iv)前記位置センサによって判定された前記エンドエフェクタの更新された位置に少なくとも一部基づいて、前記患者の位置を動的に再位置合わせすることと、
(v)前記ディスプレイ上で見るために前記再位置合わせされた患者の位置を図式的にレンダリングすることと、
(vi)前記再位置合わせされた患者の位置に少なくとも一部基づいて、前記力フィードバックサブシステムを介して、前記操作者に届けるための力フィードバックを動的に判定することと、を行うためのものである、システム。 - 患者の解剖学的構造を器具と位置合わせするためのロボット外科手術システムであって、前記器具が、前記ロボット外科手術システムのロボットアームのエンドエフェクタに取り付けられており、前記システムが
エンドエフェクタを備え、そこに器具を取り付けたロボットアームと、
前記ロボットアームに直接または間接的に取り付けられた力センサと、
プロセッサ及び内部に命令を記憶させたメモリと、を備え、前記命令が、前記プロセッサによって実行されたとき前記プロセッサに、
前記エンドエフェクタの移動によって促された、前記力センサからの触覚フィードバックを受信することと、
前記触覚フィードバックが、前記器具の、材料との接触に対応することを判定することと、
一組の空間座標を判定することであって、前記一組の空間座標が、ロボット座標システムを使用して表された、前記器具の前記材料との各接触についての空間座標を含み、各空間座標が、解剖学的構造体積の表面上のポイントに対応する、判定することと、
患者の解剖学的構造の表面に対応する医用画像データ座標システムを使用して表された一組の医用画像データ座標を判定することと、
前記一組の空間座標に対応する前記表面を、前記一組の医用画像データ座標に対応する前記患者の解剖学的構造の表面にマッピングすることと、
前記一組の空間座標に対応する前記表面と、前記一組の医用画像データ座標に対応する前記表面との間の前記マッピングに基づいて、前記ロボット座標システムと前記医用画像データ座標システムとの間の座標マッピングを生成することと、
前記座標マッピングを記憶し、それにより前記患者の解剖学的構造を位置合わせすることと、を行わせる、ロボット外科手術システム。 - 前記命令が、前記プロセッサによって実行されたとき、前記プロセッサに、
ディスプレイ用のレンダリングデータを出力させ、前記レンダリングデータが、部材の位置及び前記座標マッピングに基づく医用画像データの少なくとも一部の表現に対応し、前記部材が、前記エンドエフェクタ、前記器具、及び外科器具からなる群から選択される、請求項2に記載のシステム。 - 前記命令が、前記プロセッサによって実行されたとき、前記プロセッサに、
前記エンドエフェクタの位置の変更に基づいて前記レンダリングデータを修正することによって新しいレンダリングデータを生成することと、
前記新しいレンダリングデータをディスプレイ用に出力することと、を行わせる、請求項3に記載のシステム。 - 基準マーカーが、前記材料を含む、請求項2に記載のシステム。
- 前記ロボットアームが、能動的であり、逆駆動不可能である、請求項2に記載のシステム。
- 前記ロボット外科手術システムが、前記プロセッサを備える、請求項2に記載のシステム。
- 前記命令が、前記プロセッサによって実行されたとき、前記プロセッサに、
患者の解剖学的構造モデルを記憶させ、前記患者の解剖学的構造モデルが、前記ロボット座標システムにおいて表された前記患者の解剖学的構造表面によって画定される、請求項2に記載のシステム。
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