TWI548388B - 骨科手術之手持式機器人以及其控制方法 - Google Patents

骨科手術之手持式機器人以及其控制方法 Download PDF

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TWI548388B
TWI548388B TW102149096A TW102149096A TWI548388B TW I548388 B TWI548388 B TW I548388B TW 102149096 A TW102149096 A TW 102149096A TW 102149096 A TW102149096 A TW 102149096A TW I548388 B TWI548388 B TW I548388B
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tool
force
combination
robot
orientation
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TW201524451A (zh
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顏炳郎
洪碩穗
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國立臺灣大學
佛教慈濟醫療財團法人台北慈濟醫院
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Priority to TW102149096A priority Critical patent/TWI548388B/zh
Priority to CN201410017832.4A priority patent/CN104739487B/zh
Priority to US14/228,726 priority patent/US9561082B2/en
Priority to DE102014005769.0A priority patent/DE102014005769A1/de
Priority to EP14192266.6A priority patent/EP2889015B1/en
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Priority to US15/397,742 priority patent/US11045264B2/en

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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
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613Component parts
    • A61B17/1622Drill handpieces
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1613Component parts
    • A61B17/1626Control means; Display units
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1703Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8875Screwdrivers, spanners or wrenches
    • 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
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • A61B34/75Manipulators having means for prevention or compensation of hand tremors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • A61B34/76Manipulators having means for providing feel, e.g. force or tactile feedback
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B25HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25JMANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
    • B25J1/00Manipulators positioned in space by hand
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B25HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25JMANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
    • B25J15/00Gripping heads and other end effectors
    • B25J15/0019End effectors other than grippers
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B25HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25JMANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
    • B25J17/00Joints
    • B25J17/02Wrist joints
    • B25J17/0208Compliance devices
    • B25J17/0216Compliance devices comprising a stewart mechanism
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B25HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25JMANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
    • B25J9/00Programme-controlled manipulators
    • B25J9/10Programme-controlled manipulators characterised by positioning means for manipulator elements
    • B25J9/1005Programme-controlled manipulators characterised by positioning means for manipulator elements comprising adjusting means
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B25HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25JMANIPULATORS; CHAMBERS PROVIDED WITH MANIPULATION DEVICES
    • B25J9/00Programme-controlled manipulators
    • B25J9/16Programme controls
    • B25J9/1615Programme controls characterised by special kind of manipulator, e.g. planar, scara, gantry, cantilever, space, closed chain, passive/active joints and tendon driven manipulators
    • B25J9/1623Parallel manipulator, Stewart platform, links are attached to a common base and to a common platform, plate which is moved parallel to the base
    • GPHYSICS
    • G05CONTROLLING; REGULATING
    • G05BCONTROL OR REGULATING SYSTEMS IN GENERAL; FUNCTIONAL ELEMENTS OF SUCH SYSTEMS; MONITORING OR TESTING ARRANGEMENTS FOR SUCH SYSTEMS OR ELEMENTS
    • G05B15/00Systems controlled by a computer
    • G05B15/02Systems controlled by a computer electric
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/14Surgical saws ; Accessories therefor
    • A61B17/15Guides therefor
    • A61B17/154Guides therefor for preparing bone for knee prosthesis
    • A61B17/155Cutting femur
    • 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
    • A61B2034/2055Optical tracking systems
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    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B34/30Surgical robots
    • A61B2034/304Surgical robots including a freely orientable platform, e.g. so called 'Stewart platforms'
    • 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
    • A61B2090/061Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • 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
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/064Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/066Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring torque
    • 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
    • A61B2090/0801Prevention of accidental cutting or pricking
    • A61B2090/08021Prevention of accidental cutting or pricking of the patient or his organs

Description

骨科手術之手持式機器人以及其控制方法
本發明係關於一種手術用之機器人,特別係關於一種用於骨科手術中,並且可以結合骨頭所回饋的力/力矩以及定位單元所提供之位置與方位資訊自動進行動作補償的手持式機器人以及其控制方法。
在常見的骨科手術,如利用骨板、骨釘等工具或者是以切骨的方式進行之手術中,一般是透過手術製具、電腦輔助導航軟體或者影像導引機械臂等方式來進行輔助,以達到在手術中定位之目的。
在使用專用手術製具進行量測與切骨定位時,醫師在手術中必須頻繁地更換定位製具,容易造成定位上的誤差。此外,在手術中亦需仰賴醫師對於器械之熟稔度、操作技巧及臨床經驗,對於需要長時間進行手術的醫師而言,不論是在精神或是體力方面皆為一大考驗。在以電腦輔助導航軟體進行定位的骨科手術中,是透過導航軟體的導引來協助在骨頭上固定導塊的位置與方位;然而,在實際實施時,為了使導塊符合導航軟體所顯示的位置與方位,醫師需要不斷地以手動的方式調整導塊,使得定位的過程較為繁複。近年來,業界中有針對此問題提出以調整螺絲來對導塊的位置與方位進行微調的解決方案,其雖然可以解決導塊定位的部分問題,然而,在使用調整螺絲固定導塊的過程中,仍有可能因為在固定螺絲的過程中產生之偏差,導致定位精度的降低。
使用影像導引機械臂定位的方法,是結合醫學影像與機器人來進行骨科手術中的定位。手術前,醫師會先透過電腦 斷層攝影(Computer Tomography,CT)影像進行手術路徑的術前規劃,並且在手術中將骨頭固定不動,同時利用定位系統偵測骨頭是否有移動。若骨頭有移動時,即重新進行座標系擬合程序,以確保手術的精度與安全性;或者,也可以使用定位系統量測機器手臂與骨頭的相對位置與方位,並且透過動態追蹤補償控制來進行精密定位與切骨。其中,光學定位系統為目前業界中經常使用的定位方式之一。光學定位系統係利用一光學追蹤器追蹤設置於骨頭與機器手臂上的反光球,藉此判斷病患與機械手臂之間的相對位置、方位以及速度等資訊。影像導引機械臂便利用該些資訊配合一控制方法判斷病患與器械間之參數是否合乎手術程序,進而補償刀具與病患之間的位置與方位。然而,由於光學定位系統有反應頻寬的限制,導致機械手臂補償移動的反應不夠快速,進而影響手術的精度。此外,更嚴重的是,光學定位系統常會發生遮掩的問題。當反光球被遮掩而無法被正確判讀時,光學定位系統即無法即時提供骨頭與機械手臂相對的位置與方位,因此,在單純以光學定位系統作為動態追蹤補償的情形下,將無法及時修正機械手臂的動作,導致手術有安全性的顧慮。再者,影像導引機器手臂與傳統的手持手術器械相比,其體積過於龐大,在使用上有許多的不便與限制。
另一方面,目前結合醫學影像與定位資訊進行機器手臂動作補償的控制方法中,當機械手臂前端的磨削頭超出所術前規劃的預設區域時,大都是將驅動前端磨削頭的馬達即時停止以防止手術器械切削到規劃區域外的血管、神經或軟組織。此種控制方法由於無法協助使用者將前端的磨削頭維持在設定的區域內,手術器械的移動完全需要依賴使用者的技巧,使得整個手術過程相當耗費使用者的精力。
基於上述理由,本發明之一主要目的在於提供一種骨科手術之手持機器人,其係利用定位單元所量測之器械與骨頭 之間的相對位置與方位資訊,結合力量感測器所量測之骨頭反饋於刀具的力量/力矩資訊,快速且即時的進行刀具的自動動作補償,使得刀具能夠維持在預先規劃的手術範圍內,藉此減少手術時的誤差,並且提昇手術精度。
本發明之另一目的在於,利用特殊設計的刀具來進一步偵測骨頭相對於刀具之間的偏移力,藉此提升刀具動作補償的靈敏度,避免刀具自規劃的手術路線上偏移。
為達成前述之目的,本發明提供一種骨科手術之手持式機器人。所述手持式機器人包括:一主體、一握把、一移動機構、一工具端接器、一刀具、一力量感測器、以及一定位單元。所述主體具有一內空間,而握把係連接於主體的一側。所述移動機構係設置於主體之內空間中,並且具有六個移動自由度。移動機構包括一固定板、一可動板以及複數組致動單元,其中,該等致動單元係固定於固定板上,並且透過複數個連桿與可動板連接。所述工具端接器係設置於可動板上,而刀具則連接於工具端接器。刀具具有一有刃段以及一無刃段,其中,刀具之有刃段具有一第一直徑,無刃段具有一第二直徑,且第一直徑係小於第二直徑。所述力量感測器係設置於工具端接器與可動板之間。定位單元是設置於該可動板上,用以定位刀具之位置與方位。根據本發明之手持式機器人,係藉由力量感測器量測切削物語刀具之間平行於刀具軸向方向的力量;此外,藉由力量感測器配合刀具之有刃段與無刃段之間的一直徑差,並且藉由力量感測器量測切削物與刀具之間正交於刀具軸向方向的力量與力矩,進一步求得刀具與切削物之間的偏移力與力矩。其中,手持式機器人係結合定位單元取得之刀具位置與方位資訊以及力量感測器所量測之力量資訊,調整刀具之位置與方位,使得刀具得以維持在預先規劃的手術範圍或路徑中。
根據本發明的一實施例,所述移動機構進一步包括一馬達固定板,且該等致動單元之每一者係包括:一馬達、一聯軸器、一導螺桿以及一滑桿。所述馬達係設置於馬達固定板上, 而聯軸器則設置於馬達與馬達固定板之間。所述導螺桿係連接於馬達。滑桿係透過一滑塊嚙合於導螺桿,且滑桿的一端係透過一接頭與連桿連接。其中,當馬達驅動導螺桿旋轉時,導螺桿係透過滑塊帶動滑桿在直線方向上移動。
根據本發明的一實施例,所述定位單元為複數個反光球,其係配合一光學定位系統定位刀具之位置與方位。此外,亦可使用電磁定位系統,或者使用慣性量測單元等定位系統作為定位單元。
根據本發明的一實施例,工具端接器包括一主軸馬達,用以驅動刀具旋轉。
根據本發明的一實施例,握把與主體之間亦可選擇進一步設置有一個力量感測器,用以量測使用者操作手持式機器人時之施力。
另外,本發明提供一種可以應用於上述骨科手術之手持式機器人之控制方法。所述控制方法包括以下步驟:規劃一手術路徑;透過一定位單元取得手持式機器人前端一刀具之位置與方位資訊,並且根據位置與方位資訊調整該刀具之位置與方位,使該刀具維持在預先規劃之該手術路徑中;以及透過一力量感測器量測刀具與一切削物之間的力量/力矩,並且根據所量測之力量/力矩調整該刀具之位置與方位,使該刀具維持在預先規劃之該手術路徑中。
其中,透過力量感測器量測之力量/力矩包括刀具與切削物之間的一偏移力。此外,所述控制方法進一步包括將定位單元取得之位置與方位資訊以及力量感測器所量測之力量/力矩資訊進行資料融合,並根據融合後之資料調整刀具之位置與方位,使刀具維持在預先規劃之該手術路徑中。
100‧‧‧手持式機器人
1‧‧‧主體
10‧‧‧內空間
2‧‧‧握把
21‧‧‧按鈕
3‧‧‧移動機構
31‧‧‧固定板
32‧‧‧可動板
33‧‧‧致動單元
331‧‧‧馬達
332‧‧‧聯軸器
333‧‧‧導螺桿
334‧‧‧滑桿
3341‧‧‧滑塊
34‧‧‧連桿
35‧‧‧馬達固定板
36‧‧‧接頭
37‧‧‧接頭
4‧‧‧工具端接器
41‧‧‧主軸馬達
5‧‧‧刀具
51‧‧‧有刃段
52‧‧‧無刃段
55‧‧‧骨釘
5a‧‧‧銑刀刀具
5b‧‧‧鑽頭刀具
6‧‧‧力量感測器
7‧‧‧定位單元
71‧‧‧光學定位系統
9‧‧‧導塊
91‧‧‧固定孔
d’‧‧‧直徑差
第一圖為顯示根據本發明較佳實施例之一手持式機器人 之一立體圖;第二圖為顯示根據本發明較佳實施例之手持式機器人之一側視圖;第三圖為顯示根據本發明較佳實施例之手持式機器人之一立體分解圖;第四A圖以及第四B圖分別為顯示根據本創作較佳實施例之刀具之一局部放大圖;第五圖為顯示根據本發明較佳實施例之手持式機器人於手術時使用之系統配置的一立體示意圖;第六圖為顯示使用本發明之手持式機器人於股骨骨板手術中鑽孔時,產生偏移情形的示意圖;第七圖為顯示使用本發明之手持式機器人於股骨骨板手術中鑽孔時,產生偏角情形的示意圖;第八圖為顯示使用本發明之手持式機器人於脛骨骨內釘手術中鑽孔時,產生偏移情形的示意圖;第九圖為顯示使用本發明之手持式機器人於脛骨骨內釘手術中鑽孔時,產生偏角情形的示意圖;第十圖所顯示的為利用定位單元取得之位置與方位資訊調整刀具之位置與方位之控制方法;第十一圖為顯示根據本發明的手持式機器人在鑽孔或鎖骨釘時,利用力量感測器量測之力量/力矩資訊調整刀具位置與方位的控制方法;第十二圖為顯示使用本發明之手持式機器人切除骨頭時的示意圖; 第十三圖為顯示使用本發明之手持式機器人切除骨頭時,產生偏移情形的示意圖;第十四圖為顯示使用本發明之手持式機器人切除骨頭時,產生偏角情形的示意圖;第十五圖為顯示根據本發明的手持式機器人在切除骨頭時,利用力量感測器量測之力量/力矩資訊調整刀具位置與方位的控制方法;第十六圖為使用本發明之手持式機器人鎖固切除導塊時的示意圖;第十七圖為顯示根據本發明的手持式機器人在鎖固導塊時,利用力量感測器量測之力量/力矩資訊調整刀具位置與方位的控制方法。
以下配合圖式及元件符號對本發明的實施方式做更詳細的說明,俾使熟習該項技藝者在研讀本說明書後能據以實施。
第一圖為顯示根據本發明之一骨科手術之手持式機器人100之一立體圖。如第一圖所示,根據本發明較佳實施例之手持式機器人100包括:一主體1、一握把2、一移動機構3、一工具端接器4、一刀具5、一力量感測器6、以及一定位單元7。
第二圖為顯示根據本發明較佳實施例之手持式機器人100之一側視圖,而第三圖為顯示根據本發明較佳實施例之手持式機器人100之一立體分解圖。如第一圖~第三圖所示,所述主體1具有一內空間10,而握把2係連接於主體1的一側,以供操作者握持。握把2上設置有一按鈕21,可以供操作者操控手持式機器人100之開關。所述移動機構3具有六個移動自由度,其係設置於主體1之內空間10中。移動機構3主要包括一固定板31、 一可動板32以及複數組致動單元33,其中,該等致動單元33係固定於固定板31上,並且透過複數個連桿34與可動板32連接。移動機構3的詳細構造與作動方法會在下文中進行更詳細的說明。
在本發明的較佳實施例中,移動機構3係採用了一具有六個移動自由度的並聯式機構。由於並聯式機構之結構穩定,具高剛性、無累積誤差及較小運動慣性與工作空間等特點,故而適合應用於需高精度、工作空間精簡之手術器械。
如第二圖以及第三圖所示,根據本發明較佳實施例之移動機構3進一步包括一馬達固定板35,其係固定於所述固定板31上,且兩者之間具有一距離。每一個致動單元33係包括:一馬達331、一聯軸器332、一導螺桿333以及一滑桿334。所述馬達331係設置於馬達固定板35上,而聯軸器332則設置於馬達331與馬達固定板35之間。所述導螺桿333係穿過馬達固定板35以及聯軸器332連接於馬達331。滑桿334係透過一滑塊3341嚙合於導螺桿333,且滑桿334的一端係透過一具有兩個自由度的接頭36與連桿34連接。連桿34的另一端則是透過一具有三個自由度的接頭37連接於可動板32。當馬達331驅動導螺桿333旋轉時,導螺桿333會透過滑塊3341帶動滑桿334在直線方向上移動,進而帶動連桿34作動。在本發明的較佳實施例中,移動機構3一共設置有六組致動單元33。透過上述的配置,當致動單元33帶動連桿34作動時,連帶使得可動板32於空間中移動或旋轉至不同位置/方位,藉此將刀具5移動到所需的位置/方位。
如第二圖以及第三圖所示,所述工具端接器4係設置於可動板32上,而刀具5則連接於工具端接器4。在本發明的手持式機器人100中,刀具5可以依手術目的的不同而更換為適合的刀具。舉例來說,當需要切骨時,可以將刀具切換為電動銑刀;當需要旋轉骨釘時,可以將刀具更換為電動起子;而在需要鑽穿骨頭的手術中,則可以將刀具更換為電動鑽頭。工具端接器4包括一主軸馬達41,用以驅動刀具5轉動。力量感測器6係設置於工具端接器4與可動板32之間,用以量測進行手術動作時,骨 頭回饋於手術工具端的力/力矩。
在此,值得一提的是,為了提升力量感測器6偵測力量的靈敏度,根據本發明較佳實施例的刀具5係經過特殊的設計。第四A圖為顯示根據本發明較佳實施例之一銑刀刀具5a前端之局部放大圖,而第四B圖為顯示根據本發明較佳實施例之一鑽頭刀具5b前端之局部放大圖。如第四A圖以及第四B圖所示,銑刀刀具5a與鑽頭刀具5b皆具有一有刃段51以及一無刃段52,其中,刀具之有刃段51具有一第一直徑,無刃段52具有一第二直徑,且第一直徑係小於第二直徑,有刃段51與無刃段52之間具有一直徑差d’。
在採用一般的刀具的情形下,力量感測器6一般僅能量測到骨頭直接反饋於刀具之力量,即,平行於刀具一軸向方向的力量。然而,在刀具的有刃段穿過骨頭後刀具產生偏移或偏角的情況下,一般刀具較難偵測到骨頭施加於刀具上的偏移力,即,骨頭正交於刀具軸向方向的力/力矩。因此,力量感測器也較難偵測到刀具產生之偏移或偏角。透過本發明中特殊設計之刀具5,在刀具5之有刃段51穿過骨頭後刀具5產生偏移或偏角的情形下,骨頭會與有刃段51與無刃段52之間的直徑差d’接觸而產生一偏移力,即,力量感測器6會偵測到與刀具5軸向方向垂直的力量,或者是骨頭與刀具5之間產生之力矩,進而提升力量感測器之偵測靈敏度。
如第二圖以及第三圖所示,定位單元7是設置於該可動板32上,用以定位刀具5之位置與方位。定位單元7可以為一光學定位系統、電磁定位系統或者慣性定位系統等任何習知的定位單元。在本發明的較佳實施例中,定位單元是複數個反光球,其可以搭配一光學定位系統來追蹤刀具5之位置與方位。此外,握把2與主體1之間可以進一步設置有一個力量感測器6,用以量測使用者操作手持式機器人時之施力。
第五圖為顯示根據本發明較佳實施例之手持式機器人100於手術時使用之系統配置的一立體示意圖。如第五圖所示, 本發明的手持式機器人在使用時,是由一操作者握持於手上,依據事前規劃好的手術路徑對一病患的骨頭進行手術。由於手持式機器人100的移動機構3係採用並聯式機構,因此,其體積相對於傳統的機械手臂而言更小,在操作時也更為靈活且方便。在手術中,手持式機器人100係配合一光學定位系統71來追蹤設置於可動板32上的定位單元7,藉此來判斷刀具5與骨頭的相對位置與方位。另外,在刀具5與骨頭接觸後,力量感測器6可以量測刀具5與骨頭之間的力量與力矩,進一步判斷骨頭與刀具之間的相對位置與方位。手持式機器人100係結合定位單元7取得之刀具5位置與方位資訊,以及力量感測器6所量測之力量/力矩資訊,來調整刀具5之位置與方位,使得刀具5得以維持在預先規劃的手術範圍或路徑中。
以下將參照圖示,針對根據本發明之手持式機器人100在各種手術情形中使用的情形進行更詳細的說明。
第六圖與第七圖為顯示本發明之手持式機器人100於股骨骨板手術中使用時的示意圖;第八圖與第九圖為顯示本發明之手持式機器人100於脛骨骨內釘手術中鑽孔時的示意圖。在第六圖~第九圖中,操作者係以本發明之手持式機器人100進行自動鑽孔定位。在第六圖(a)、第七圖(a)、第八圖(a)以及第九圖(a)中,手術工具接觸到病患骨頭之前,主要是以定位單元7所提供之位置與方位資訊進行動作補償。第十圖所顯示的為手術工具在接觸到骨頭之前,利用定位單元7調整刀具5的控制方法。如第十圖所示,手持式機器人100會根據術前規劃之手術路徑,以及根據定位單元7所取得之骨頭與刀具5相對的位置與方位資訊,來計算刀具5的位置與方位。若是刀具5的位置與方位需要調整,則手持式機器人100係透過移動機構3進行刀具5之位置方位的自動微調,使得刀具5能對準預定的位置與方位,達到動態補償的功能。
當刀具5接觸骨頭開始進行鑽孔時,骨頭會相對於刀具5產生作用力。此時,若骨頭移動或者操作者的手移動而導 致刀具5偏離目標的位置與方位,刀具5上的無刃段52將與骨板、骨髓內釘、或骨頭接觸,產生偏移力。如第六圖(b)以及第八圖(b)所示,當刀具5往一方向產生偏移時,或者骨頭往一方向產生偏移時,骨頭與刀具5之間會在一對應方向上出現反作用力,即,與刀具5之軸向方向正交的力。如第七圖(b)以及第九圖(b)所示,當刀具5產生偏角時,骨頭與刀具5之間則會產生一力矩。在上述的情況中,力量感測器6會量測到使刀具產生偏移的力/力矩,並且根據此資訊透過移動機構3調整刀具5之位置與方位,使得刀具5維持在預定的手術路徑上,如第六圖(c)、第七圖(c)、第八圖(c)以及第九圖(c)所示。
第十一圖為顯示根據本發明的手持式機器人100在鑽孔或鑽骨釘時利用力量感測器進行刀具位置與方位補償的控制方法。如第十一圖所示,手持式機器人100是藉由力量感測器6量測刀具5與骨頭之間的力量/力矩,來輔助補償刀具5之位置與方位。藉由計算偏移力/力矩,以調整刀具5之位置與方位的方式將骨頭與刀具軸向方向正交的力/力矩保持在趨近於最小值,可以避免刀具自規劃的手術路徑上產生偏移。而力量感測器6所量測並計算之刀具5鑽孔之作用力/力矩,即,與刀具軸向方向平行的力/力矩,則可做為判斷刀具5鑽過骨頭與否,或是刀具5是否完成骨釘固定的依據。當刀具鑽過骨頭時,手持式機器人即將主軸馬達41停止轉動,避免刀具5傷害到其他組織。
力量感測器6透過上述方式所量測到的力/力矩資訊,可以結合定位單元7所提供之骨頭與工具5之間的相對位置/方位資訊(例如可以使用多取樣率卡曼濾波器進行資料融合),進而使得手持式機器人100可以達到快速與精確地進行動態補償的目的,將刀具5維持在預先規劃的手術路徑內。
第十二~十四圖為顯示使用本發明之手持式機器人切除骨頭時的示意圖。在第十三圖(a)以及第十四圖(a)中,與在鑽孔手術中的情形相同,在刀具5與骨頭接觸前,手持式機器人100係透過定位單元所提供的定位資訊,來進 行刀具5位置與方位的調整;換言之,即是利用第十圖中所示的控制策略來進行手持式機器人的控制。當刀具5接觸骨頭開始進行切削時,骨頭會相對於刀具5產生作用力。此時,若骨頭產生移動或者操作者的手移動而導致工具偏離目標的位置與方位時,刀具5的無刃段52會與骨頭接觸而產生偏移力。如第十三圖(b)所示,當刀具5往一方向產生偏移時,或者骨頭往一方向產生偏移時,骨頭與刀具5之間會在一對應方向上出現反作用力,即,與切除平面法向量平行的力;如第十四圖(b)所示,當刀具5產生偏角時,骨頭與刀具5之間則會產生力矩,更準確而言,兩個與切除平面法向量正交的力矩。力量感測器6在量測到偏移力/力矩後,便會透過移動機構3來調整刀具5之位置與方位,使其保持在預先規劃的手術路徑上,如第十三圖(c)以及第十四圖(c)所示。
第十五圖為顯示根據本發明的手持式機器人100在切除骨頭時利用力量感測器進行刀具位置與方位補償的控制方法。如第十五圖所示,手持式機器人100是藉由力量感測器6量測刀具5與骨頭之間的力量/力矩,來輔助補償刀具5之位置與方位。藉由計算偏移力/力矩,以將與切除平面法向量平行的力以及兩個與此法向量正交的力矩保持在趨近於最小值,可以避免刀具自規劃的手術路徑上產生偏移。此外,力量感測器6所量測並計算之切除力,即,與切除平面平行的力/與切除平面正交的力矩,則可做為判斷刀具5完成切骨與否的依據。當刀具5通過如第十二圖中所標示之虛線而完成切除時,手持式機器人100即將主軸馬達41停止轉動,避免刀具5傷害到其他組織。
同樣地,力量感測器6透過上述方式所量測到的力/力矩資訊,可以結合定位系統7所提供之骨頭與工具5之間的相對位置/方位資訊(例如可以使用多取樣率卡曼濾波器進行資料融合),進而使得手持式機器人100在切除骨頭時可以達到快速與精確地進行動態補償的目的,將刀具5維持在預先規劃的手術路徑內。
第十六圖為使用本發明之手持式機器人鎖固切除導塊9時的示意圖。首先,如第十六圖(a)所示,使用者係先依照影像導引或電腦導航軟體將切除導塊9放置在病患骨頭特定的位置/方位上。在這過程中,若導塊9的位置與方位有些微的誤差,手持式機器人100會依照定位單元7所提供之骨頭與刀具5相對位置/方位的資訊,透過移動機構3進行器械前端的起子與其上的骨釘55之位置/方位的調整,同時導引切除導塊9的固定孔91到導航軟體所規劃的位置/方位,如第十六圖(b)所示。一旦骨釘55進入骨頭內部後,手持式機器人100可以採用兩種方式來進行導塊的固定。第一種固定方式係採用與上述骨頭鑽孔的控制策略,根據力量感測器6所提供的力量/力矩資訊,透過移動機構3調整起子的位置方位,使與起子軸向方向正交的力/力矩趨近於最小值,而與起子軸向方向平行的力/力矩則可做為偵測起子旋緊狀態之用。同時,手持式機器人100係搭配定位單元7所提供的骨頭與工具相對位置/方位的資訊,進行快速與精確的動態補償。當起子如第十六圖(c)所示旋緊時,即將主軸馬達41停止旋轉。在採取第二種策略時,係將手持式機器人轉為手動模式,也就是不再透過移動機構3進行前端起子的位置/方位的微調,由操作者自行進行調整。在此種策略下,由於骨釘已經穿過導塊的導引孔並且將導塊導引至骨頭上的正確位置與方位,因此,接下來的旋轉固定亦可輕易由手動的方式完成。
第十七圖為顯示根據本發明的手持式機器人100在鑽孔時利用力量感測器進行刀具位置與方位補償的控制方法。如第十七圖所示,手持式機器人100是藉由力量感測器6量測刀具5與骨頭之間的力量/力矩,來輔助補償刀具5之位置與方位。藉由計算偏移力/力矩,以調整刀具5之位置與方位的方式將骨頭與起子軸向方向正交的力/力矩保持在趨近於最小值,可以避免刀具5自規劃的手術路徑上產生偏移。而力量感測器6所量測並計算之 刀具5鎖緊力/力矩,即,與起子軸向方向平行的力/力矩,則可做為判斷起子是否完成導塊固定的依據。當完成導塊固定時,手持式機器人100即將主軸馬達41停止轉動,避免刀具5傷害到其他組織。
本發明同時使用了定位單元7所提供之刀具5與病患骨頭之間的空間資訊,搭配刀具端所量測的力量/力矩資訊,進行資訊的融合進行計算,藉此提升刀具動作補償的反應速度。一般而言,光學定位系統的頻寬較慢,因此若單單以光學定位系統的空間資訊作為手術器械前端工具位置與方位補償控制的依據,將會導致工具與病患骨頭追蹤誤差過大。相較之下,力/力矩資訊的回饋反應速度較快,因此,搭配力/力矩資訊進行計算後,可以提升獲得空間資訊的速度。透過此種方式輔助手術器械前端工具位置與方位補償控制時,可以大幅減少工具與病患骨頭追蹤誤差,提升手術精度;同時,可避免單純使用光學定位系統,時常因為標記遭受遮掩而導致標記無法讀取,造成位置與方位補償延遲而有手術安全性的疑慮。
以上所述僅係本發明的實施例及其應用範例,當不可用以限定本發明可實施的範圍,而任何熟知此技藝一般技術者根據本文內容所能完成的各種改良及變化,均應視為不脫離本發明實質內容而涵蓋於下文所申請專利範圍內者。凡是利用本文內容及所附圖式而達成的等效結構,不論是直接或間接應用於此技藝或其他相關技術領域,均應視為屬於本發明的申請專利範圍內。
100‧‧‧手持式機器人
1‧‧‧主體
2‧‧‧握把
21‧‧‧按鈕
3‧‧‧移動機構
31‧‧‧固定板
32‧‧‧可動板
4‧‧‧工具端接器
5‧‧‧刀具
6‧‧‧力量感測器
7‧‧‧定位單元

Claims (15)

  1. 一種骨科手術之手持式機器人,包括:一主體;一握把,連接該主體;一移動機構,連接該主體;一工具端接器,連接該移動機構;一刀具,連接該工具端接器;以及一力量感測器,用以量測可使該刀具偏離預先規劃之一手術路徑的一偏移力、一偏移力矩或其組合,其中該移動機構能夠根據所量測的該偏移力、該偏移力矩或其組合,調整該刀具的至少一位置與方位。
  2. 根據申請專利範圍第1項之骨科手術之手持式機器人,其中,該刀具具有一有刃段以及一無刃段。
  3. 根據申請專利範圍第2項之骨科手術之手持式機器人,其中,該有刃段具有一第一直徑,該無刃段具有一第二直徑,且該第一直徑係小於該第二直徑。
  4. 根據申請專利範圍第1項之手持式機器人,更包含:一定位單元,用以取得該刀具之一位置資訊、一方位資訊或其組合,其中該移動機構能夠根據所取得之該刀具之該位置資訊、該方位資訊或其組合,調整該刀具的該位置與方位。
  5. 根據申請專利範圍第4項之手持式機器人,其中,該定位單元為複數個反光球,其係配合一光學定位系統定位該刀具之該位置與方位。
  6. 根據申請專利範圍第4項之手持式機器人,其中,該定位單元為電磁定位系統、慣性定位系統或其組合。
  7. 根據申請專利範圍第1項之手持式機器人,其中,該工具端接器包括一主軸馬達,用以驅動該刀具旋轉。
  8. 根據申請專利範圍第1項之手持式機器人,其中,該握把與該主體之間進一步設置有一個該力量感測器。
  9. 一種用以控制一機器人之方法,包括:接收具有預先規劃之一手術範圍、預先規劃之一手術路徑或其組合之一手術計劃;量測可使一刀具偏離所接收之該手術計劃的預先規劃之該手術範圍、預先規劃之該手術路徑或其組合的一偏移力、一偏移力矩或其組合;以及根據所量測的該偏移力、該偏移力矩或其組合,調整該刀具的至少一位置與方位,使該刀具維持在所接收之該手術計劃的預先規劃之該手術範圍、預先規劃之該手術路徑或其組合內。
  10. 根據申請專利範圍第9項之控制方法,更包含:取得該刀具之一位置資訊、一方位資訊或其組合;以及根據所取得之該刀具之該位置資訊、該方位資訊或其組合,調整該刀具的該位置與方位,使該刀具維持在該手術計劃的預先規劃之該手術範圍、預先規劃之該手術路徑或其組合內。
  11. 根據申請專利範圍第10項之控制方法,更包含: 把所量測的該偏移力、該偏移力矩或其組合,結合至所取得之該位置資訊、該方位資訊或其組合,其中調整該刀具的步驟係根據所結合的一結果資訊。
  12. 根據申請專利範圍第9項之控制方法,其中,當該機械人被用作鑽孔時,該偏移力、該偏移力矩或其組合包含與該刀具之一軸向方向正交之一力量、一力矩或其組合。
  13. 根據申請專利範圍第9項之控制方法,其中,當該機械人被用作鑽孔時,該控制方法更包含:計算與該刀具之一軸向方向平行之一鑽孔力、一鑽孔力矩或其組合,以判斷鑽孔是否完成。
  14. 根據申請專利範圍第9項之控制方法,其中,當該機械人被用作切除時,該偏移力、該偏移力矩或其組合包含與一切除平面之一法向量平行的一力量,也包含與該切除平面之該法向量正交的兩力矩。
  15. 根據申請專利範圍第9項之控制方法,其中,當該機械人被用作切除時,該控制方法更包含:計算一切除力以及一切除力矩之一組合,其包含與一切除平面平行之一力量以及與該切除平面正交之一力矩,以判斷切除是否完成。
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US14/228,726 US9561082B2 (en) 2013-12-30 2014-03-28 Handheld robot for orthopedic surgery and control method thereof
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CN104739487B (zh) 2017-07-14
US20150182285A1 (en) 2015-07-02
US9561082B2 (en) 2017-02-07
US20170112579A1 (en) 2017-04-27
TW201524451A (zh) 2015-07-01
EP2889015A1 (en) 2015-07-01

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