JPWO2019155383A5 - - Google Patents

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JPWO2019155383A5
JPWO2019155383A5 JP2020565030A JP2020565030A JPWO2019155383A5 JP WO2019155383 A5 JPWO2019155383 A5 JP WO2019155383A5 JP 2020565030 A JP2020565030 A JP 2020565030A JP 2020565030 A JP2020565030 A JP 2020565030A JP WO2019155383 A5 JPWO2019155383 A5 JP WO2019155383A5
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master
console
remote manipulator
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JP2021513442A (en
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Priority claimed from PCT/IB2019/050961 external-priority patent/WO2019155383A1/en
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Priority to JP2024028092A priority Critical patent/JP2024079683A/en
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本発明の様々な例示的な実施態様を上で説明したが、本発明から逸脱することなく、様々な変更及び修正を本発明の範囲で行うことができることは当業者には明らかであろう。添付の特許請求の範囲は、本発明の真の範囲内にあるそのようなすべての変更及び修正を含むことを意図している。
本件出願は、以下の態様の発明を提供する。
(態様1)
外科手術を行うための遠隔操作用のシステムであって:
複数のマスターリンクを備えるマスターコンソール;
ハンドルで加えられた動きが該複数のマスターリンクの少なくとも1つを動かすように該マスターコンソールに結合された該ハンドル;
複数のスレーブリンクを備えるスレーブコンソールであって、該マスターコンソールに動作可能に結合され、該ハンドルで加えられる動きに応答して動くように構成されている、該スレーブコンソール;及び
該スレーブコンソールに結合されたエンドエフェクタであって、該ハンドルでの作動に応答して動き、かつ該スレーブコンソールでの動きに応答して動いて該外科手術を行うように構成されている、該エンドエフェクタを含み;
該スレーブコンソールが、該エンドエフェクタに動作可能に結合された複数のアクチュエータを備え、該アクチュエータが、該ハンドルでの作動に応答して作動されると、マクロ同期状態中には該複数のスレーブリンクの少なくとも1つにマクロな並進運動を加えるが、マクロ非同期状態では該並進運動を加えず、ミクロ同期状態中には該エンドエフェクタにミクロな動きを加えるが、ミクロ非同期状態では該ミクロな動きを加えない、前記システム。
(態様2)
前記マスターコンソールが、前記外科手術中に無菌を維持するように構成されている、態様1記載のシステム。
(態様3)
前記ハンドルが、前記外科手術中に無菌であり、かつ追加の外科手術のために取り外されている間も滅菌可能であるように、前記マスターコンソールに取り外し可能に結合されている、態様2記載のシステム。
(態様4)
前記ハンドルが、クリップアタッチメントを介して前記マスターコンソールに取り外し可能に結合されている、態様1~3のいずれか一項記載のシステム。
(態様5)
前記ハンドルが、ねじアタッチメントを介して前記マスターコンソールに取り外し可能に結合されている、態様1、2、又は3記載のシステム。
(態様6)
前記ハンドルが、該ハンドルの作動に応答して動く格納式ピストンを備え、前記マスターコンソールの少なくとも1つのセンサが、該格納式ピストンの動きを検知して、前記複数のアクチュエータに前記エンドエフェクタで対応するミクロな動きをさせるように構成されている、態様1~5のいずれか一項記載のシステム。
(態様7)
前記スレーブコンソールが、前記少なくとも1つのセンサが少なくとも所定程度の前記格納式ピストンを検知しない限り、前記マスターコンソールでの動きに応答しない、態様6記載のシステム。
(態様8)
前記マスターコンソールが、前記複数のマスターリンクの少なくとも1つのマスターリンクの動きを制限するように構成された機械的制限部を備える、態様1~7のいずれか一項記載のシステム。
(態様9)
前記マスターコンソールに結合されたディスプレイをさらに含み、該ディスプレイが、前記システムの操作中に使用者が前記エンドエフェクタを視覚化できるように構成されている、態様1~8のいずれか一項記載のシステム。
(態様10)
前記複数のスレーブリンク及び複数のスレーブジョイントが、前記スレーブコンソールのベースが固定されたまま、前記外科手術を行う前に該スレーブコンソールの遠位端部を所望の水平位置に配置するために近位スレーブジョイントを中心に移動可能であるように、該スレーブコンソールのベースが、該複数のスレーブジョイントの該近位スレーブジョイントを介して該複数のスレーブリンクの近位スレーブリンクに結合されている、態様1~9のいずれか一項記載のシステム。
(態様11)
前記スレーブコンソールのベースが、前記複数のスレーブリンクの近位スレーブリンクに結合された調整可能な垂直支柱を備え、該調整可能な垂直支柱が、前記外科手術を行う前に該スレーブコンソールの遠位端部を所望の垂直位置に配置するために該複数のスレーブリンク及び前記複数のスレーブジョイントの高さを調整するように構成されている、態様10記載のシステム。
(態様12)
前記スレーブコンソールの遠位端部と前記外科手術を受けている患者の体内に配置されたトロカールとの整合を可能にするように構成された取り外し可能な切開ポインタをさらに含む、態様1~11のいずれか一項記載のシステム。
(態様13)
制御装置をさらに含み、該制御装置が、前記複数のアクチュエータが該制御装置によって実行される命令に応答して前記スレーブコンソールの前記複数のスレーブリンクに動きを加えるように、該複数のアクチュエータに動作可能に結合されている、態様1~12のいずれか一項記載のシステム。
(態様14)
前記制御装置が、前記複数のアクチュエータに前記スレーブコンソールの前記複数のスレーブリンクをホーム構成に移動させる命令を実行するように構成されており、該ホーム構成では、該複数のスレーブリンクが、前記外科手術を受けている患者に挿入されたトロカール内で前記エンドエフェクタが配置可能であるように後退している、態様13記載のシステム。
(態様15)
前記制御装置が、前記複数のアクチュエータに前記複数のスレーブリンクの角度付けスレーブリンクを、該角度付けスレーブリンク及び該角度付けスレーブリンクの近位側の前記スレーブコンソールのスレーブリンクが前記システムの操作中に固定されたままである角度まで移動させる命令を実行するように構成されている、態様13又は14記載のシステム。
(態様16)
前記角度付けスレーブリンクの角度では、前記スレーブコンソールの遠位端部により、前記エンドエフェクタが、該角度付けスレーブリンクの角度に平行な角度で傾けられた半球形手術作業空間で前記外科手術を行うことが可能である、態様15記載のシステム。
(態様17)
複数のスレーブジョイントのベータジョイントの遠位側の前記複数のスレーブリンクのうちのスレーブリンクが、該ベータジョイントの近位側の該複数のスレーブリンクのうちのスレーブリンク及び前記スレーブコンソールのベースが固定されたまま、該ベータジョイントに対して移動して該スレーブコンソールの遠位端部を前方手術作業空間と反転手術作業空間との間で反転させるように構成されている、態様1~16のいずれか一項記載のシステム。
(態様18)
前記マスターコンソールが、作動されると前記複数のマスターリンクのマクロな並進運動を防止するように構成されたクラッチをさらに備える、態様1~17のいずれか一項記載のシステム。
(態様19)
前記ハンドルに結合された少なくとも1つのセンサが、該ハンドルの作動パターンを検知するように構成され、前記複数のセンサによって検知されたハンドルでの動きが、該少なくとも1つのセンサが該ハンドルの作動パターンを検知しない限り、前記エンドエフェクタによる対応するミクロな動きを引き起こさない、態様1~18のいずれか一項記載のシステム。
(態様20)
近位端部及び遠位端部を有する器具をさらに含み、該近位端部が、前記スレーブコンソールに取り外し可能に結合されるように構成された器具ハブを備え、該遠位端部が前記エンドエフェクタを備える、態様1~19のいずれか一項記載のシステム。
(態様21)
前記スレーブコンソールの遠位端部が、前記複数のスレーブリンクの角度付けスレーブリンクのアルファ軸を中心に回転可能であり、このため、該スレーブコンソールの遠位端部が、使用者が前記マスターコンソールから移動して前記外科手術を受けている患者に腹腔鏡手術を手動で行えるように配置可能である、態様1~20のいずれか一項記載のシステム。
(態様22)
前記マスターコンソールがマスター制御装置を備え、前記スレーブコンソールがスレーブ制御装置を備え、該マスター制御装置が、前記ハンドルで検知された動きに基づいて命令を実行して、該動きに基づいて信号を該スレーブ制御装置に送信するように構成され、該スレーブ制御装置が、該信号を受信し、命令を実行して、該マスター制御装置から送信された信号に基づいて前記複数のスレーブリンク若しくは前記エンドエフェクタの少なくとも1つ、又はその両方を動かすように構成されている、態様1~21のいずれか一項記載のシステム。
(態様23)
前記スレーブコンソールが、右スレーブ遠隔マニピュレータ、右スレーブ制御装置、左スレーブ遠隔マニピュレータ、及び左スレーブ制御装置を備え、
該マスターコンソールが、右マスター遠隔マニピュレータ、左マスター遠隔マニピュレータ、及びマスター制御装置を備え、
前方手術作業空間構成では、該マスター制御装置が該右スレーブ制御装置と通信して、該右マスター遠隔マニピュレータでの動きに応答して該右スレーブ遠隔マニピュレータを動かし、該マスター制御装置が該左スレーブ制御装置と通信して、該左マスター遠隔マニピュレータでの動きに応答して該左スレーブ遠隔マニピュレータを動かし、かつ
反転手術作業空間構成では、該マスター制御装置が該左スレーブ制御装置と通信して、該右マスター遠隔マニピュレータでの動きに応答して該左スレーブ遠隔マニピュレータを動かし、該マスター制御装置が該右スレーブ制御装置と通信して、該左マスター遠隔マニピュレータでの動きに応答して該右スレーブ遠隔マニピュレータを動かす、態様1~22のいずれか一項記載のシステム。
(態様24)
外科手術を行うための遠隔操作用のシステムであって:
マスター制御装置、複数の右マスターリンクを有する右マスター遠隔マニピュレータ、及び複数の左マスターリンクを有する左マスター遠隔マニピュレータを備えるマスターコンソール;
該右マスター遠隔マニピュレータを操作するために該右マスター遠隔マニピュレータに結合された右ハンドル;
該左マスター遠隔マニピュレータを操作するために該左マスター遠隔マニピュレータに結合された左ハンドル;
右スレーブ制御装置、複数の右スレーブリンクを有する右スレーブ遠隔マニピュレータ、左スレーブ制御装置、及び複数の左スレーブリンクを有する左スレーブ遠隔マニピュレータを備えるスレーブコンソール;
該右スレーブ遠隔マニピュレータに結合された右エンドエフェクタであって、該右又は左ハンドルでの作動に応答して動いて該外科手術を行うように構成されている、該右エンドエフェクタ;並びに
該左スレーブ遠隔マニピュレータに結合された左エンドエフェクタであって、該左又は右ハンドルでの作動に応答して動いて該外科手術を行うように構成されている、該左エンドエフェクタを含み;
前方手術作業空間構成では、該マスター制御装置が該右スレーブ制御装置と通信して、該右マスター遠隔マニピュレータでの動きに応答して該右スレーブ遠隔マニピュレータを動かし、該マスター制御装置が該左スレーブ制御装置と通信して、該左マスター遠隔マニピュレータでの動きに応答して該左スレーブ遠隔マニピュレータを動かし、かつ反転手術作業空間構成では、該マスター制御装置が該左スレーブ制御装置と通信して、該右マスター遠隔マニピュレータでの動きに応答して該左スレーブ遠隔マニピュレータを動かし、該マスター制御装置が該右スレーブ制御装置と通信して、該左マスター遠隔マニピュレータでの動きに応答して該右スレーブ遠隔マニピュレータを動かす、前記システム。
(態様25)
前記右スレーブ遠隔マニピュレータの遠位端部が、前記複数の右スレーブリンクの右角度付けスレーブリンクのアルファ軸を中心に回転可能であり、前記左スレーブ遠隔マニピュレータの遠位端部が、前記複数の左スレーブリンクの左角度付けスレーブリンクのアルファ軸を中心に回転可能であり、このため、該右及び左スレーブ遠隔マニピュレータの遠位端部が、使用者が前記マスターコンソールから移動して前記外科手術を受けている患者に腹腔鏡手術を手動で行うことができるように配置可能である、態様1~24のいずれか一項記載のシステム。
(態様26)
前記右ハンドルが、前記右マスター遠隔マニピュレータに取り外し可能に結合され、前記左ハンドルが、前記左マスター遠隔マニピュレータに取り外し可能に結合されている、態様1~25のいずれか一項記載のシステム。
(態様27)
外科手術を行うための遠隔操作用のシステムであって:
該外科手術中に無菌を維持するように構成された、複数のマスターリンクを備えるマスターコンソール;
ハンドルで加えられた動きが複数のマスターリンクの少なくとも1つを動かすように、該マスターコンソールに取り外し可能に結合された該ハンドルであって、該外科手術中は無菌であり、かつ追加の外科手術のために取り外されている間も滅菌可能である、該ハンドル;
複数のスレーブリンクを備えるスレーブコンソールであって、前記マスターコンソールに動作可能に結合され、かつ該ハンドルで加えられる動きに応答して動くように構成されている、該スレーブコンソール;及び
該スレーブコンソールに結合されたエンドエフェクタであって、該ハンドルでの作動に応答して動き、かつ該スレーブコンソールでの動きに応答して動いて該外科手術を行うように構成されている、該エンドエフェクタを含む、前記システム。
(態様28)
前記ハンドルが、前記マスターコンソールから取り外されている間の外科手術間の滅菌を容易にするために、電子機器を備えずに純粋に機械的である、態様1~27のいずれか一項記載のシステム。
(態様29)
前記ハンドルが、クリップアタッチメントを介して前記マスターコンソールに取り外し可能に結合されている、態様1~28のいずれか一項記載のシステム。
(態様30)
前記ハンドルが、ねじアタッチメントを介して前記マスターコンソールに取り外し可能に結合されている、態様1~29のいずれか一項記載のシステム。

Although various exemplary embodiments of the invention have been described above, it will be apparent to those skilled in the art that various modifications and modifications can be made within the scope of the invention without departing from the invention. The appended claims are intended to include all such modifications and amendments within the true scope of the invention.
The present application provides the invention of the following aspects.
(Aspect 1)
A remote-controlled system for performing surgery:
Master console with multiple master links;
The handle coupled to the master console so that the movement applied by the handle moves at least one of the plurality of master links;
A slave console with multiple slave links that is operably coupled to the master console and configured to move in response to movements applied by the handles; and
An end effector coupled to the slave console that is configured to move in response to movement at the handle and to perform the surgery in response to movement at the slave console. Includes end effectors;
The slave console comprises a plurality of actuators operably coupled to the end effector, and when the actuator is actuated in response to an actuation at the handle, the plurality of slave links during a macrosynchronous state. A macro translational motion is applied to at least one of the above, but the translational motion is not applied in the macro asynchronous state, and a micro motion is applied to the end effector during the micro synchronous state, but the micro motion is applied in the micro asynchronous state. Not added, said system.
(Aspect 2)
The system according to aspect 1, wherein the master console is configured to remain sterile during the surgery.
(Aspect 3)
23. Aspect 2 of Embodiment 2, wherein the handle is detachably coupled to the master console so that it is sterile during the surgery and also sterile while being removed for additional surgery. system.
(Aspect 4)
The system according to any one of aspects 1 to 3, wherein the handle is detachably coupled to the master console via a clip attachment.
(Aspect 5)
The system according to aspect 1, 2, or 3, wherein the handle is detachably coupled to the master console via a screw attachment.
(Aspect 6)
The handle comprises a retractable piston that moves in response to the actuation of the handle, and at least one sensor of the master console detects the movement of the retractable piston and responds to the plurality of actuators with the end effector. The system according to any one of aspects 1 to 5, which is configured to make a microscopic movement.
(Aspect 7)
13. The system of aspect 6, wherein the slave console does not respond to movement on the master console unless the slave console detects at least a predetermined degree of the retractable piston.
(Aspect 8)
The system according to any one of aspects 1 to 7, wherein the master console comprises a mechanical restriction unit configured to restrict the movement of at least one master link of the plurality of master links.
(Aspect 9)
12. The aspect of any one of embodiments 1-8, further comprising a display coupled to the master console, wherein the display is configured to allow the user to visualize the end effector while operating the system. system.
(Aspect 10)
The plurality of slave links and the plurality of slave joints are proximal to position the distal end of the slave console in the desired horizontal position prior to performing the surgery while the base of the slave console remains fixed. An embodiment in which the base of the slave console is coupled to the proximal slave link of the plurality of slave links via the proximal slave joint of the plurality of slave joints so as to be movable around the slave joint. The system described in any one of 1 to 9.
(Aspect 11)
The base of the slave console comprises an adjustable vertical strut coupled to the proximal slave link of the plurality of slave links, the adjustable vertical strut being distal to the slave console prior to performing the surgery. 10. The system of aspect 10, configured to adjust the height of the plurality of slave links and said plurality of slave joints in order to place the ends in the desired vertical position.
(Aspect 12)
Aspects 1-11, further comprising a removable incision pointer configured to allow alignment of the distal end of the slave console with a trocar placed within the body of the patient undergoing the surgery. The system described in any one of the items.
(Aspect 13)
Further including a control device, the control device operates on the plurality of actuators so that the plurality of actuators make movements on the plurality of slave links of the slave console in response to an instruction executed by the control device. The system according to any one of aspects 1 to 12, which is capable of being coupled.
(Aspect 14)
The control device is configured to execute an instruction to the plurality of actuators to move the plurality of slave links of the slave console to the home configuration, in which the plurality of slave links are the surgical operation. 13. The system of aspect 13, wherein the end effector is retracted so that it can be placed within a trocar inserted into a patient undergoing surgery.
(Aspect 15)
The control device provides the angled slave links of the plurality of slave links to the plurality of actuators, and the angled slave link and the slave link of the slave console on the proximal side of the angled slave link are operating the system. 13. The system according to aspect 13 or 14, configured to perform an instruction to move to an angle that remains fixed to.
(Aspect 16)
At the angled slave link angle, the distal end of the slave console allows the end effector to perform the surgery in a hemispherical surgical workspace tilted at an angle parallel to the angle of the angled slave link. The system according to aspect 15, wherein it is possible.
(Aspect 17)
The slave link of the plurality of slave links on the distal side of the beta joint of the plurality of slave joints is fixed to the slave link of the plurality of slave links on the proximal side of the beta joint and the base of the slave console is fixed. Any of aspects 1-16 configured to move relative to the beta joint and invert the distal end of the slave console between the anterior surgical workspace and the reversal surgical workspace. Or the system described in item 1.
(Aspect 18)
The system according to any one of aspects 1 to 17, further comprising a clutch configured such that the master console is activated to prevent macro-translation of the plurality of master links.
(Aspect 19)
At least one sensor coupled to the handle is configured to detect the operation pattern of the handle, and the movement on the handle detected by the plurality of sensors is such that the at least one sensor has the operation pattern of the handle. The system according to any one of aspects 1 to 18, which does not cause the corresponding microscopic movement by the end effector unless it detects.
(Aspect 20)
It further comprises an instrument with a proximal end and a distal end, the proximal end comprising an instrument hub configured to be detachably coupled to the slave console, the distal end said said. The system according to any one of aspects 1 to 19, comprising an end effector.
(Aspect 21)
The distal end of the slave console is rotatable about the alpha axis of the angled slave links of the plurality of slave links, so that the distal end of the slave console is the user of the master console. The system according to any one of aspects 1 to 20, which can be arranged so as to be able to manually perform laparoscopic surgery on a patient who has moved from and is undergoing the surgery.
(Aspect 22)
The master console is equipped with a master control device, the slave console is equipped with a slave control device, and the master control device executes an instruction based on the movement detected by the handle and outputs a signal based on the movement. It is configured to transmit to a slave controller, which receives the signal, executes an instruction, and based on the signal transmitted from the master controller, the plurality of slave links or the end effector. The system according to any one of aspects 1 to 21, which is configured to move at least one or both of the above.
(Aspect 23)
The slave console comprises a right slave remote manipulator, a right slave controller, a left slave remote manipulator, and a left slave controller.
The master console comprises a right master remote manipulator, a left master remote manipulator, and a master controller.
In the anterior surgical workspace configuration, the master controller communicates with the right slave controller to move the right slave remote manipulator in response to movement on the right master remote manipulator, and the master controller is the left slave. Communicating with the controller to move the left slave remote manipulator in response to movement in the left master remote manipulator, and
In the reversal surgery workspace configuration, the master controller communicates with the left slave controller to move the left slave remote manipulator in response to movement on the right master remote manipulator, and the master controller is the right slave. The system according to any one of aspects 1 to 22, which communicates with a control device to move the right slave remote manipulator in response to movement in the left master remote manipulator.
(Aspect 24)
A remote-controlled system for performing surgery:
Master console with master controller, right master remote manipulator with multiple right master links, and left master remote manipulator with multiple left master links;
Right handle coupled to the right master remote manipulator to operate the right master remote manipulator;
Left-hand drive coupled to the left master remote manipulator to operate the left master remote manipulator;
A slave console with a right-slave controller, a right-slave remote manipulator with multiple right-slave links, a left-slave controller, and a left-slave remote manipulator with multiple left-slave links;
A right end effector coupled to the right slave remote manipulator, the right end effector configured to move in response to operation with the right or left handle to perform the surgery;
A left end effector coupled to the left slave remote manipulator, comprising the left end effector configured to move in response to operation with the left or right handle to perform the surgery;
In the anterior surgical workspace configuration, the master controller communicates with the right slave controller to move the right slave remote manipulator in response to movement on the right master remote manipulator, and the master controller is the left slave. Communicating with the controller to move the left slave remote manipulator in response to movement in the left master remote manipulator, and in a reversing surgical workspace configuration, the master controller communicates with the left slave controller. The left slave remote manipulator is moved in response to movement in the right master remote manipulator, the master controller communicates with the right slave controller, and the right slave responds to movement in the left master remote manipulator. The system that powers a remote manipulator.
(Aspect 25)
The distal end of the right slave remote manipulator is rotatable about the alpha axis of the right angled slave link of the right slave link, and the distal end of the left slave remote manipulator is the plurality of Left angled left slave link Rotable around the alpha axis of the slave link, so that the distal ends of the right and left slave remote manipulators are moved from the master console by the user to the surgery. The system according to any one of aspects 1 to 24, which can be arranged so that a patient undergoing laparoscopic surgery can be manually performed.
(Aspect 26)
The system according to any one of aspects 1-25, wherein the right-hand drive is detachably coupled to the right master remote manipulator and the left handle is detachably coupled to the left master remote manipulator.
(Aspect 27)
A remote-controlled system for performing surgery:
A master console with multiple master links configured to remain sterile during the surgery;
The handle detachably coupled to the master console such that the movement applied by the handle moves at least one of the plurality of master links, is sterile during the surgery, and additional surgery. The handle, which can be sterilized while being removed for
A slave console with a plurality of slave links, the slave console operably coupled to the master console and configured to move in response to movement applied by the handle; and
An end effector coupled to the slave console that is configured to move in response to movement at the handle and to perform the surgery in response to movement at the slave console. The system comprising an end effector.
(Aspect 28)
13. A section according to any one of aspects 1-27, wherein the handle is purely mechanical without electronic equipment to facilitate sterility during surgery while it is being removed from the master console. system.
(Aspect 29)
The system according to any one of aspects 1-28, wherein the handle is detachably coupled to the master console via a clip attachment.
(Aspect 30)
The system according to any one of aspects 1-29, wherein the handle is detachably coupled to the master console via a screw attachment.

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