US20230080820A1 - Master workstation for robotic surgery, sterile operatory field, surgical robotic system and method - Google Patents
Master workstation for robotic surgery, sterile operatory field, surgical robotic system and method Download PDFInfo
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- US20230080820A1 US20230080820A1 US17/760,396 US202117760396A US2023080820A1 US 20230080820 A1 US20230080820 A1 US 20230080820A1 US 202117760396 A US202117760396 A US 202117760396A US 2023080820 A1 US2023080820 A1 US 2023080820A1
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- holder
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- A—HUMAN NECESSITIES
- 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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- A—HUMAN NECESSITIES
- 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
- A61B34/74—Manipulators with manual electric input means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B46/00—Surgical drapes
- A61B46/10—Surgical drapes specially adapted for instruments, e.g. microscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
- A61B50/10—Furniture specially adapted for surgical or diagnostic appliances or instruments
- A61B50/13—Trolleys, e.g. carts
-
- 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
-
- 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
- A61B90/57—Accessory clamps
-
- 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
- A61B90/60—Supports for surgeons, e.g. chairs or hand supports
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
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- A—HUMAN NECESSITIES
- 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
- A61B34/74—Manipulators with manual electric input means
- A61B2034/742—Joysticks
-
- 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
- A61B90/57—Accessory clamps
- A61B2090/571—Accessory clamps for clamping a support arm to a bed or other supports
Definitions
- the master workstation according to the present invention is particularly suitable for being located within a sterile operatory field.
- the present invention also relates to a operatory field and to a surgical robotic system comprising at least said master workstation.
- the present invention also relates to method for performing surgery.
- sterile holsters have been provided for dropping medical suction tubes, as shown for example in document US-2005-0194507, as well as organizers have been provided for expendable supplies for medical patients as shown in document US-2009-0301927.
- Robotic surgery apparatuses are used in robotic-aided surgery and generally comprise a surgeon master console for receiving a manual command from the surgeon, a robotic slave central tower (or robotic cart) and a plurality of robotic slave arms carrying one or more surgical instruments (end-effectors) extending from the slave central tower and controlled by means of said surgeon master console. Said one or more slave surgical instruments are distally attached to the robotic slave arms, in order to perform surgical procedures to a patient who lies within a sterile operatory field. Surgical drape draping non-disposable parts of the robotic apparatus is typically provided to avoid contamination of the sterile operatory filed that may be caused by the robotic surgery apparatus. Straps and strings may be provided on the outer surface of the surgical drape for the purpose of tying the drape around the robot reducing the volume of the drape so that it results substantially tight fit.
- Microsurgery procedures are carried out in several phases of the reconstruction of biological tissues, such as for example in the execution of blood vessel anastomosis, comprising small diameter vessels and nerves, as well as in the reconstruction of anatomic parts after the occurrence of traumatic lesions, in re-vascularization of tissues, reattachment of limbs, in transplantation and replantation procedures.
- robotic apparatuses allow a high degree of miniaturization of the surgical instrument when compared to traditional microsurgery and allows at the same time to reduce the transmission of tremor to the slave surgical instrument of the robotic surgery system.
- Robotic surgery apparatuses are also suitable for robot-aided laparoscopic surgery, where the surgical instruments and at least one camera are individually inserted inside the patient's body by means of a set of percutaneous trocars, and wherein a visualization screen visualizes the laparoscopic images of the inner patient's body acquired from the camera.
- the robotic aid it is reduced the fulcrum effect during surgery due to the lever arm formed across the length of each percutaneous rigid trocar during manipulation of traditional (non-robotic) laparoscopic surgical instruments.
- the laparoscopic surgeon is provided with an improved comfort during surgery due to the ergonomic features of the surgeon master console.
- Remote surgeon master consoles have been provided for, as shown for example in documents US-2014-0018960 and EP-2845556.
- such remote surgeon master consoles comprise a visualization device, a surgeon seat and/or a surgeon forearm resting elements, and master input appendices hinged to the body of the master console to receive a manual command from the surgeon for controlling the slave surgical instrument.
- the comfort of the laparoscopic surgeon is even enhanced in that he/she is not required to even attend the sterile field of the operatory room and can perform surgery from a non-sterile remote location.
- Wearable and mechanically ungrounded master controllers are also known for example from documents WO-2019-099854 and EP-2467082, and typically comprise a pair of rings to fit the surgeon fingers integrally associated to a grip command interface of the ungrounded master controller.
- a master workstation for a surgical robotic system comprises a ungrounded master input handle, suitable for being hand held by a surgeon during surgery for controlling a slave robotic assembly of said surgical robotic system; and a console comprising at least one positioning body; and a sterile drape draping at least a portion of said console; and at least one sterile holder.
- said at least one sterile holder delimits at least one cavity and comprises: at least one resting element within said cavity suitable for the master input handle to rest thereon when said master input handle is not hand held; and at least one positioning element engaged with said at least one positioning body of the console.
- Said positioning element may comprise a positioning clip and said positioning body may comprise a convex body, so that the positioning clip elastically engages the convex body through and preferably also across the sterile drape, while preserving the sterility of the operatory field.
- a console such as a surgical chair, when draped by a sterile barrier assembly exposes a cavity for the purpose of providing a resting element for a master input handle to rest thereon, for example during hand surgery.
- the proposed solutions are particularly suitable for, although not exclusively limited to, robotic-aided microsurgery. Furthermore, the proposed solutions are particularly suitable for, although not exclusively limited to, microsurgical procedures that contemplates the alternation of hand microsurgery and robot-aided microsurgery.
- FIG. 1 is an axonometric view that diagrammatically shows a surgical robotic system located within a sterile operatory field and having a master workstation, according to an embodiment
- FIG. 2 is an axonometric view that diagrammatically shows a surgical robotic system located within a sterile operatory field near an operatory bed, according to an embodiment
- FIG. 3 shows diagrammatically in axonometric view a master workstation comprising a console, a sterile holder and a draped master input handle, according to an embodiment
- FIG. 4 is an axonometric view that shows a portion of a console covered by a surgical drape and a sterile holder, according to an embodiment
- FIG. 5 is an axonometric view that shows a sterile holder, according to an embodiment
- FIG. 6 -A is an elevation side view diagrammatically showing a sterile holder and a sterile drape, according to an embodiment
- FIG. 6 -B is an axonometric view showing the sterile holder integral with the sterile drape, according to an embodiment, from the inner side of the sterile drape;
- FIG. 7 in an axonometric view showing a sterile holder, according to an embodiment
- FIG. 8 in an axonometric view showing a sterile holder, according to an embodiment
- FIG. 9 shows a possible mode of operation of a method according to an embodiment
- FIG. 10 shows diagrammatically a master workstation comprising a draped console, a pair of sterile holders and a draped master input handle, according to an embodiment.
- a master workstation 301 for a surgical robotic system 300 is provided.
- the master workstation 301 is suitable for being located within a sterile operatory field 311 .
- the master workstation 301 comprises a mechanically ungrounded master input handle 310 , suitable for being hand-held by a surgeon during surgery for controlling a slave robotic assembly 330 of said surgical robotic system 300 .
- a “mechanically ungrounded master input handle 310 ” refers to a master controller that is unconstrained with respect to possible position and orientation motion in a large working environment e.g., an operating field or room and is kinematically separated from the ground, e.g., not mechanically supported by a console, supports, or other object attached to the ground.
- a mechanically ungrounded master input handle 310 may be in tethered or untethered connection with one or more associated components such as control processors, data sources, sensors, power supplies, etc.
- the master input handle 310 may be tethered, e.g., connected physically to these components via a cable or wire, or untethered, e.g., not physically connected to such components and in communication with the components via wireless communication signals.
- the master input handle 310 is mechanically unconstrained from said console 302 .
- the term “handle” means an ungrounded master input tool designed to be held in the surgeon's hand when in operative conditions.
- said master input handle 310 may comprise a manipulandum portion suitable for being grasped by a surgeon's hand when in operative conditions.
- said master input handle 310 may comprise a ring or an annular band or a bracelet to be worn by the surgeon's hand or finger or wrist.
- the master workstation 301 further comprises a console 302 and a sterile drape 303 draping or covering at least a portion of said console 302 .
- Said surgical drape 303 preferably has body having an inner surface 304 , or non-sterile surface, and an outer surface 305 , or sterile surface opposite to said inner non-sterile surface 304 .
- the inner surface 304 of the surgical drape 305 is designed to face the console 302 and the outer surface 305 of the surgical drape 303 is designed to face the sterile operatory field 311 .
- said surgical drape 303 forms a drape cavity 322 for enclosing a portion of said console 302 with the purpose of preserve sterility of the sterile operatory field 311 .
- the inner surface 304 faces the cavity 322 , and the drape cavity 322 may be tight sealed or open forming an opening 331 to access the cavity 322 that leads to said outer surface 305 of the surgical drape 303 .
- the margin of said opening 331 or other parts of the drape 303 may fit the body of the console 302 by cooperating with adhesive strips, elastic strips, magnetic attraction or any suitable means.
- the body of the surgical drape 303 is made of flexible sheet, such as polyethylene, and/or polyurethane, and/or polyester and/or any suitable drape material, such as paper, and/or woven fabric, and/or non-woven fabric, and/or any combination of the above.
- the console 302 comprises at least one positioning body 309 , for example a convex body 309 , and the sterile drape 303 drapes or covers at least a portion of said convex body 309 of the console 302 .
- the term “convex body” does not necessarily exclude that the convex body 309 may present a concave surface, but it has to comprise also a convex portion or convex surface.
- the term “convex body” also encompasses an upright of the console 302 having a substantially cylindrical outer surface, which is a convex body, comprising localized concave surfaces or portion or longitudinal grooves that defines a recess that in turn define a concave surface.
- Said master workstation 301 comprises a sterile holder 306 comprising at least one cavity 345 .
- the sterile holder 306 acts a sterile basket.
- the holder 306 is made of plastic, preferably hard plastic material, and the cavity is for example molded or thermoformed.
- the holder 306 is made of sterilizable metallic material.
- the holder 306 is disposable.
- the sterile holder 306 comprises at least one resting element 307 within said cavity 345 .
- said at least one resting element 307 for example at least one resting surface 307 , within said cavity 345 of the sterile holder 306 allows the master input handle 310 to rest thereon when said master input handle 310 is not hand-held, for example when is temporary not hand-held by a surgeon during surgery. Thereby, the at least one resting element 307 supports the master input handle 310 at least partially within the cavity 345 of said sterile holder 306 .
- the sterile holder 306 comprises at least one positioning element 308 (or positioning clip 308 or clip 308 ) engaged with said at least one positioning body 309 (or convex body 309 ) through said sterile drape 303 , while preserving the integrity of the sterile barrier formed at least partially by the sterile drape 303 .
- the sterile barrier is formed by the sterile drape 303 and by a portion of the outer wall 332 of the holder 306 .
- the sterile drape 303 may be attached to the holder 306 and may comprise a through passage 348 for allowing the connector 308 to pass there through.
- the boundary 350 of the through passage 348 may be glued or welded or otherwise secured to the outer wall 332 of the sterile holder 306 , as shown for example in FIG. 6 B .
- a portion of the outer wall 332 of the holder 306 acts as sterile barrier together with the sterile drape 303 .
- the sterile holder 306 comprises at least one positioning clip 308 engaged with said at least one convex body 309 through said sterile drape 303 , while preserving the integrity of the sterile barrier, which is formed at least partially by the sterile drape 303 .
- said positioning clip 308 covers a portion of the outer surface 305 of the sterile drape 303 , which thereby results put in between the positioning clip 309 of the sterile holder 306 and the convex body 309 of the console 302 , locally preserving the sterile operatory field 311 near the clip 308 .
- the positioning clip 308 engages with said convex body 309 of the console 302 firmly to position the holder 306 in a desired location near to where the surgeon stands or seats during surgery.
- the positioning body 309 may also be concave, or may comprise a slot, or may have a positioning surface suitably treated or machined in order to engage with the positioning element.
- the positioning element 308 may have any shape and feature to engage with said positioning surface.
- the positioning element 308 may comprise a snap-fit device, or may comprise attachment means for engaging with said positioning body.
- the positioning clip 308 mechanically and detachably engages the convex body 309 .
- the clip 308 snap fits to the convex body 309 .
- Said positioning clip 308 is suitable for position the cavity 345 of the sterile holder 306 at a desired location near the console 302 and within the sterile operatory field 311 .
- said cavity 345 of said sterile holder 306 allows the surgeon to drop the mechanically ungrounded master input handle 310 within the cavity 345 and to make it rest on said at least one resting element 307 . Thanks to said cavity 345 of the sterile holder 306 , the mechanically ungrounded master input handle 310 results boxed in the sterile holder 306 within the sterile operatory field 311 when is not hand held by the surgeon. Moreover,
- said sterile holder 306 has a box-like body provided with an opening 333 to access the cavity 345 , preferably facing the surgeon and/or facing upwards when in operative conditions.
- the positioning clip 308 may be located on the outer surface 332 of the sterile holder 306 , and its particular location may be chosen with the purpose to position the sterile holder 306 for receiving the mechanically ungrounded master input handle 310 in a desired location within the sterile operatory field 311 .
- the sterile holder 306 is integral with the sterile drape 303 , as shown for example in FIG. 6 B .
- the sterile holder 306 is welded or glued to the outer surface of the sterile drape.
- the positioning element 308 may be integral with the sterile drape and at the same time detachably engaged with the positioning body 309 .
- the sterile drape 303 may be attached to the holder 306 , and preferably to the outer surface 332 thereof, and may comprise a through passage 348 for allowing the connector 308 to pass there through, while preserving the integrity of the sterile barrier.
- the positioning clip 308 is integral with the outer surface 332 of the sterile holder 306 , although they may be made in separate pieces, so that to rigidly determines the position and spatial orientation of the resting element 307 , for example a resting surface 307 , relative to the convex body 309 of the console 302 where the clip 308 is engaged.
- said positioning clip 308 acts as constraining element for locally constraining the surgical drape 303 against said convex body 309 of the master sterile console 302 , in order to locally reduce the volumetric encumber of the surgical drape 303 .
- the surgical drape 303 may have a loose body that drapes air other than the console 302 , therefore thanks to the provision of said at least one clip 308 is allowed to constrain a portion of the drape to a portion of the console 302 , preferably at or near the at least one convex body 309 .
- the at least one clip 308 at the same time locally close-fits the body of the sterile drape 303 against the convex body 309 of the master sterile console 302 and holds the sterile holder 306 in place within the sterile operatory field 311 .
- said at least one clip 308 comprises at least one cable guide 314 for guiding a cabled connection 315 for example of the console 302 .
- the at least one clip 308 has the further advantage of guiding the cabled connection 315 , for example a power supply and/or a data cable of said master console 302 .
- said cable guide 314 comprise a groove for receiving an elongated body dig in a wall of the clip 308 facing the outer surface 305 of the body of the surgical drape 303 .
- said at least one clip 308 has an arched concave surface 321 facing said outer surface 305 of the surgical drape 303 so to be suitable for fitting said convex body 309 of the console 302 .
- the arched concave surface 321 of said at least one clip 308 describes substantially the profile of a “C”.
- said at least one resting element 307 comprises a resting surface 307 , for example said resting surface 307 is a surface of a bottom wall 347 of said sterile holder 306 facing the cavity 345 .
- said resting surface for supporting at least a portion of a master input handle 310 to rest thereon is a bottom surface of a basket, i.e. a substantially cup-shaped container, and said basket corresponds to the sterile holder 306 .
- said holder 306 is designed for temporary supporting a master input tool 310 when not hand-held by a surgeon within the sterile operatory field 311 , and the at least one resting surface 307 comprises a bottom surface of the holder 306 .
- said sterile holder 306 comprises an opening 333 for the access to said cavity 345 .
- said opening 333 is opposite to said resting surface 307 in respect of said cavity 345 .
- the holder 306 also comprises side surfaces 332 delimiting the opening 333 and the cavity 345 .
- a surgeon may alternate hand microsurgery and robotic-aided microsurgery during a single intervention, without for this reason compromise the sterility of the sterile operatory field 311 . Thereby, it is avoided the need of sterilize the master input tool 310 each time the surgeon switches from hand microsurgery to robotic-aided microsurgery and vice-versa during a single surgical intervention.
- Said side surfaces 332 ′ face towards the cavity 345 and said outer surfaces 332 face opposite, and preferably said positioning clip 308 is integrally connected to at least one of said outer surfaces 332 .
- said outer surface 332 is substantially flat to favor the attachment of the clip 308 .
- the orientation of the clip 308 i.e. the direction of longitudinal extension of the “C” shaped seat 346 defined by said arched surface 321 of said clip 308 of the holder 306 , may be substantially aligned with the direction of development of the cavity 345 of the sterile holder 306 .
- the cavity 345 may be delimited by said resting surface 307 , said bottom wall 347 , said side surfaces 332 ′.
- said positioning clip 308 and the side surface 332 ′ of the sterile holder 306 defining said cavity 345 may have a relative degree of freedom for adjusting the position of the cavity 345 upon engagement of the clip 308 with the convex body 309 , for example a hinge or a rotative joint such as a universal joint, may be provided articulating the clip 308 and the side surface 332 ′ of the sterile holder 306 for rotating the holder 306 when the clip 308 is engaged with said convex body 309 of the console 302 and/or a slider connects the clip 308 and the outer surface 332 of said holder 306 .
- said convex body 309 faces towards the inner surface 304 of the surgical drape 303 . Thereby, it is avoided the need of sterilizing the convex body 308 of the master sterile console 302 .
- said at least one convex body 309 comprises at least one convex surface 313 , so that said clip 308 engages said convex surface 313 .
- the sterile drape 303 is interposed between the convex body 309 and the holder 306 .
- the body of the sterile drape 303 is interposed between, preferably in contact with both, the clip 308 and the convex body 309 .
- the body of the sterile drape 303 is interposed between, preferably in contact with both, said arched surface 314 of the clip 308 of the accessory 306 and said convex surface 313 of the convex body 308 .
- said console 302 comprises a chair 320 .
- the word “chair” used herein is intended to also encompass a “saddle stool”.
- said at least one convex body 309 is a an upright 319 of a surgical chair 320 of a master sterile console 302 .
- said at least one convex body 309 is an upright 319 of a surgical chair 320 supporting a armrest 340 , preferably of rounded shape so that the surgeon can rest the elbow thereon.
- said chair 320 comprises at least one armrest 340 having said convex body 309 , for example a connecting element connecting the armrest to a seating surface 318 of said chair 320 , and said positioning clip 308 of the sterile holder 306 engages said convex body 309 of the armrest 340 .
- said console 302 for example said chair 320 , is provided with said tracking field generator 339 designed to track the position and orientation of the at least one mechanically ungrounded master input handle 310 .
- the tracking field generator 339 may be an optical tracking field generator such as at least one camera of a stereoscopic camera set.
- said at least one sterile holder 306 is associated to the outer surface 305 of the surgical drape 303 .
- said opening 333 of the at least one sterile holder 306 opens on the outer surface 305 of the surgical drape 303 .
- said at least one positioning element 308 of the at least one sterile holder 306 is engaged with at least one positioning body 309 of the console 302 through said sterile drape 303 while preserving the integrity of the sterile barrier.
- said positioning element 308 rigidly determines the relative position and spatial orientation of said resting surface 307 within said cavity 345 and said convex body 309 of the console 302 .
- said positioning element 308 is detachably engaged with said positioning body 309 of the console 302 .
- said positioning element 308 comprises a positioning clip elastically engaging a positioning body 309 of the console 302 .
- the clip is preferably elastically loaded.
- said positioning element 308 comprises at least one flap 312 to detach the positioning element 308 from the positioning body 309 of the console 302 .
- the flap 312 may be elastically loaded and cooperating with the clip of the positioning element 308 .
- Said positioning element 308 may comprise a pair of flaps 312 .
- the flap 312 may act as a handle for releasing the clip of the positioning element 308 .
- the clip may be formed by two pieces elastically connected, and the at least one flap 312 is attached to one of said two pieces of the clip.
- Two flaps 312 may be provided, each flap 312 being attached to one of said two pieces of the clip.
- the provision of said at least one flap 312 may determine to open the clip of the positioning element thereby avoiding scratching the surgical drape 303 during detachment of the clip. Thereby the clip may have a stronger elastic clamping force without compromising the integrity of the sterile drape 303 .
- the master workstation 301 comprises a further sterile holder 306 so that to comprise at least two sterile holders 306 , and a further ungrounded master input handle 310 , so as to comprise two master input handles 310 , wherein preferably each sterile holder 306 is for individually housing one master input handle 310 .
- said two sterile holders 306 are spaced apart on the same outer surface 305 of the same surgical drape 303 .
- said console 302 comprises a chair 320 and wherein said surgical drape 303 covers said chair 320 .
- said two sterile holders 306 are attached to different positioning bodies 309 of the console 302 .
- said different positioning bodies 309 of the console 302 are spaced apart.
- said two sterile holders 306 are attached to a same positioning body 309 of the console 302 .
- said console 302 comprises a tower 315 and wherein said surgical drape 303 covers said tower 315 , as diagrammatically shown for example in FIG. 10 .
- the tower may comprise a screen 316 .
- the screen 316 may display a portion of the sterile operatory field 311 such as a portion of the slave workspace where the at least one surgical instrument 337 operates.
- the tower 315 may comprise ground contact units, such as a plurality of wheels.
- An optical and/or magnetic tracking field generator 339 may be provided integral with said tower 315 to track position and orientation of the at least one ungrounded master input handle 310 .
- the tower 315 of the console 302 may be equipped by said positioning body 309 , for example a convex body.
- a sterile operatory field 311 comprising at least one master workstation 301 according to any one of the embodiments above.
- the sterile operatory field 311 comprises at least one operatory bed 341 providing a support for a patient's anatomy to be treated.
- the sterile operatory field 311 is delimited by a sterile barrier formed by at least one sterile drape 303 .
- the sterile barrier is formed by at least one sterile drape 303 and by at least a portion of the holder 306 , and preferably by at least a portion of the outer wall 332 of the holder 306 .
- the connector 308 of the holder 306 may be located within the sterile operatory field 311 or may be located out of the sterile operatory field 311 .
- said sterile operatory field 311 further comprises a slave robotic assembly 330 controlled by said master workstation 310 .
- a surgical robotic system 300 comprising at least one master workstation 301 according to any one of the embodiments above.
- said system 300 further comprises a slave robot assembly 330 comprising at least one surgical arm 334 suitable for manipulating at least one surgical instrument 337 , and preferably said at least one surgical arm comprises at least one motorized manipulator 335 controlled by said master workstation 301 manipulating said at least one surgical instrument 337 .
- said slave robot assembly 330 comprises at least one surgical arm 334 manipulating said surgical instrument 337 .
- said salve robot assembly 330 comprises at least one micromanipulator 335 manipulating said surgical instrument 304 .
- said at least one micromanipulator 335 is directly connected in series to said surgical arm 334 forming a kinematic chain with said surgical arm 334 and manipulates said surgical instrument 337 .
- at least two micromanipulators 335 are directly connected in series to said surgical arm 334 forming an at least two-branched kinematic chain with said surgical arm 334 .
- said slave robot assembly 330 comprises at least one robotic cart 336 and said at least one arm 334 extends from the robotic cart 336 .
- said system 300 comprises a control unit, suitable for receiving at least a position and orientation associated to said mechanically ungrounded master input handle 310 and suitable for transmitting a command signal to the slave robot assembly 330 in order to actuate said surgical instrument 337 .
- said control unit is suitable for receiving a first command signal containing information about said manual command and to transmit a second command signal containing information about said manual command to the slave robot assembly 330 in order to actuate said surgical instrument 337 .
- said robotic microsurgery system 300 and preferably said draped console 302 of said robotic microsurgery system 300 , further comprises at least one tracking system comprising a field generator 339 , suitable to detect within a predefined tracking volume position and orientation of said master input tool 310 ,
- said magnetic field generator 339 is located integral with the seating surface 318 of the chair 320 of the console 302 .
- At least one slave drape 338 may be provided to drape at least a portion of the robotic slave assembly 330 .
- said robotic microsurgery system 300 further comprises at least one surgical microscope 342 .
- a microscope drape 343 may be provided for draping at least a portion of the microscope 342 .
- said sterile operatory field 311 comprises said robotic surgery system 300 .
- said sterile operatory field 311 further comprises at least a portion of at least one robotic slave manipulator 330 according to any one of the embodiments described above. Thereby, said sterile operatory field 311 further comprises at least a portion of at least one robotic surgery system 300 according to any one of the embodiments described above.
- a holder 306 it is provided a solution able to drape master console 302 preserving sterility and at the same time making the master input handle 310 easier to manipulate within a sterile operatory field 311 , even when the surgeon switches to hand microsurgery, enabling the surgeon to switch back to the robot-aided microsurgery as desired while allowing the surgeon to drop or grasp the mechanically ungrounded master input handle 310 with minimum efforts, as the cavity 345 of the holder 306 is located in a desired location near within the sterile operatory field 311 .
- the cavity 345 of the sterile holder 306 has a depth that is shallower than the length of the master input handle 310 so that a portion of the master input handle 310 pop out of the opening 333 , making simpler for the surgeon to grasp the mechanically ungrounded master input handle 310 from the resting element 307 within the cavity 345 of the sterile holder 306 .
- a method for performing surgery, and preferably robotic-aided surgery comprises the following steps.
- the method comprises the step of providing a master workstation 301 within a sterile operatory field 311 , wherein preferably the master workstation 301 comprises at least one mechanically ungrounded master input handle 310 suitable for being held in hand of the surgeon to control a slave robotic assembly comprising at least a surgical instrument 337 .
- the master workstation 310 , the sterile operatory field 311 and the slave robotic assembly 330 may be any as described in any of the embodiments above
- the clip 308 mechanically engages the convex body 309 .
- the method comprises the step of draping a console 302 of the master workstation 301 , preferably by means of a surgical drape 303 .
- the method comprises the step of clipping a sterile holder 306 to a convex body 309 of the console 302 so that a holder cavity 345 is within the sterile operatory field 311 .
- the method comprises the step of associating at least one sterile holder 306 to the outer surface 305 of the surgical drape 303 . That may open at least one opening 333 for accessing a cavity 345 on the outer surface 305 of the surgical drape 303 .
- the method comprises the step of associating at least one sterile holder 306 to the outer surface 305 of the surgical drape 303 in a detachable manner.
- the method comprises the step of detaching the at least one sterile holder 306 from the outer surface 305 of the surgical drape 303 .
- the method comprises the step of associating at least one sterile holder 306 to the outer surface 305 of the surgical drape 303 in a detachable manner by means of mechanically engaging said positioning element 308 , for example said clip, of at least one sterile holder 306 with a positioning body 309 of the console 302 , the positioning body 309 being preferably a convex body.
- This step may comprise acting on said at least one flap 312 of the at least one sterile holder 306 . Acting on said at least one flap 312 may determine the positioning element 308 , such as said clip, to open.
- the method comprises the step of detaching at least one sterile holder 306 from the outer surface 305 of the surgical drape 303 by means of mechanically disengaging said positioning element 308 , for example said clip, from said at positioning body 309 of the console 302 , the positioning body 309 being preferably a convex body.
- the method comprises the step of defining a desired location within the sterile operatory field 311 with the aim of positioning the sterile holder 306 there.
- the method comprises the step of holding in hand the mechanically ungrounded master input handle 310 , with the purpose of controlling said surgical instrument 337 of the slave robotic assembly 330 .
- the method comprises the further step of dropping or resting a master input handle 310 within said cavity 345 so that the master input handle 310 rests on a resting element 307 within the cavity 345 .
- the method comprises the further step of lifting or grasping the master input handle 310 from the sterile holder 306 , and preferably from the resting element 307 within the cavity 345 of the sterile holder 306 placed in a desired location within the sterile operatory field 311 , thereby holding again in hand the master input handle 302 .
- the method is carried out by a master workstation 310 and/or a sterile operatory field 311 and/or a surgical robotic system 300 according to any of the embodiments described above.
- the surgeon is able to easily drop the ungrounded master controller within the cavity of the sterile holder at any time during surgery;
- the volumetric encumber of the sterile drape covering the console may be reduced
- the holder may acts as a sterile holster within the sterile operatory field for receiving the master input tool when is not hand-held, for example during alternation of hand surgery and robotic microsurgery;
- the sterile drape may be held in place by a sterile holder having a positioning clip.
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Abstract
A master workstation for a surgical robotic system suitable for being located within a sterile operatory field includes an ungrounded master input handle, suitable for being hand held by a surgeon during surgery for controlling a slave robotic assembly of the surgical robotic system; a console including at least one convex body; a sterile drape draping at least a portion of the console; at least one sterile holder having at least one cavity; at least one resting element within the cavity suitable for the master input handle to rest thereon; and at least one positioning clip engaged with the at least one convex body of the console across and through the sterile drape while preserving the integrity of the sterile drape. The positioning clip is suitable for positioning the cavity of the sterile holder at a desired location near the console and within the sterile operatory field.
Description
- It is an object of the present invention a master workstation for robotic surgery.
- The master workstation according to the present invention is particularly suitable for being located within a sterile operatory field.
- The present invention also relates to a operatory field and to a surgical robotic system comprising at least said master workstation.
- Moreover, the present invention also relates to method for performing surgery.
- Broadly in the medical field, sterile holsters have been provided for dropping medical suction tubes, as shown for example in document US-2005-0194507, as well as organizers have been provided for expendable supplies for medical patients as shown in document US-2009-0301927.
- Robotic surgery apparatuses are used in robotic-aided surgery and generally comprise a surgeon master console for receiving a manual command from the surgeon, a robotic slave central tower (or robotic cart) and a plurality of robotic slave arms carrying one or more surgical instruments (end-effectors) extending from the slave central tower and controlled by means of said surgeon master console. Said one or more slave surgical instruments are distally attached to the robotic slave arms, in order to perform surgical procedures to a patient who lies within a sterile operatory field. Surgical drape draping non-disposable parts of the robotic apparatus is typically provided to avoid contamination of the sterile operatory filed that may be caused by the robotic surgery apparatus. Straps and strings may be provided on the outer surface of the surgical drape for the purpose of tying the drape around the robot reducing the volume of the drape so that it results substantially tight fit.
- For example, documents WO-2017-064301 and WO-2018-189729 in the name of the same Applicant disclose solutions of robotic surgery system, suitable for miniaturize the surgical instrument resulting suitable, inter alia, for robot-aided microsurgery. Traditional (non-robotic) microsurgery requires the surgeon to operate together with an operating microscope, typically an optical microscope, able to magnify the surgery field and therefore robotic surgery apparatuses for microsurgery are suitably equipped with an operating microscope.
- Microsurgery procedures are carried out in several phases of the reconstruction of biological tissues, such as for example in the execution of blood vessel anastomosis, comprising small diameter vessels and nerves, as well as in the reconstruction of anatomic parts after the occurrence of traumatic lesions, in re-vascularization of tissues, reattachment of limbs, in transplantation and replantation procedures. In the field of microsurgery, robotic apparatuses allow a high degree of miniaturization of the surgical instrument when compared to traditional microsurgery and allows at the same time to reduce the transmission of tremor to the slave surgical instrument of the robotic surgery system.
- Robotic surgery apparatuses are also suitable for robot-aided laparoscopic surgery, where the surgical instruments and at least one camera are individually inserted inside the patient's body by means of a set of percutaneous trocars, and wherein a visualization screen visualizes the laparoscopic images of the inner patient's body acquired from the camera. Thanks to the robotic aid, it is reduced the fulcrum effect during surgery due to the lever arm formed across the length of each percutaneous rigid trocar during manipulation of traditional (non-robotic) laparoscopic surgical instruments. Moreover, thanks to the robotic aid, the laparoscopic surgeon is provided with an improved comfort during surgery due to the ergonomic features of the surgeon master console.
- Remote surgeon master consoles have been provided for, as shown for example in documents US-2014-0018960 and EP-2845556. Generally, such remote surgeon master consoles comprise a visualization device, a surgeon seat and/or a surgeon forearm resting elements, and master input appendices hinged to the body of the master console to receive a manual command from the surgeon for controlling the slave surgical instrument. Thereby, the comfort of the laparoscopic surgeon is even enhanced in that he/she is not required to even attend the sterile field of the operatory room and can perform surgery from a non-sterile remote location.
- However, to have a large physical distance between the team in the sterile operatory field and the surgeon handling the master input appendices at the remote master console may create communication problems during surgery among the team and in particular with the surgeon.
- It is therefore felt the need for the surgeon to attend the sterile operatory filed, even in presence of a robotic surgery system.
- Moreover, in some applications of the robotic-aided microsurgery it is desirable the presence of the surgeon within the sterile operatory field during the robotic-aided surgery. Thereby, during a single intervention, the microsurgeon can switch from robotic-aided microsurgery to traditional (non-robotic) microsurgery grabbing in hand traditional microsurgery tools, such as tweezers, and/or back to the surgeon master console. Document WO-2014-151621 discloses a system for alternating hand surgery and robotic surgery using a mechanically ungrounded master controller that is designed for being hand held by the surgeon.
- Wearable and mechanically ungrounded master controllers are also known for example from documents WO-2019-099854 and EP-2467082, and typically comprise a pair of rings to fit the surgeon fingers integrally associated to a grip command interface of the ungrounded master controller.
- Document WO-2019-220409 of the same Applicant discloses a sterile console for robotic surgery comprising a surgical chair comprising a pair of cups attached to the chair armrests for dropping the ungrounded master input tool.
- Therefore, it is felt the need of a solution that allow the surgeon to effectively alternate robot-aided surgery and traditional hand surgery.
- At the same time, it is felt the need to simplify the switching from robot-aided surgery to traditional surgery in a single intervention, and vice-versa.
- It is a scope of the present invention to overcome the drawbacks mentioned with reference to the known art.
- These and other scopes are achieved by a master workstation according to claim 1.
- Some preferred embodiments are the subject of dependent claims.
- According to an aspect of the present invention, a master workstation for a surgical robotic system comprises a ungrounded master input handle, suitable for being hand held by a surgeon during surgery for controlling a slave robotic assembly of said surgical robotic system; and a console comprising at least one positioning body; and a sterile drape draping at least a portion of said console; and at least one sterile holder.
- According to an aspect of the present invention, said at least one sterile holder delimits at least one cavity and comprises: at least one resting element within said cavity suitable for the master input handle to rest thereon when said master input handle is not hand held; and at least one positioning element engaged with said at least one positioning body of the console.
- Thereby it is possible to position the cavity of the sterile holder at a desired location near the console and within the sterile operatory field.
- Said positioning element may comprise a positioning clip and said positioning body may comprise a convex body, so that the positioning clip elastically engages the convex body through and preferably also across the sterile drape, while preserving the sterility of the operatory field.
- Thanks to the proposed solutions, a console, such as a surgical chair, when draped by a sterile barrier assembly exposes a cavity for the purpose of providing a resting element for a master input handle to rest thereon, for example during hand surgery.
- The proposed solutions are particularly suitable for, although not exclusively limited to, robotic-aided microsurgery. Furthermore, the proposed solutions are particularly suitable for, although not exclusively limited to, microsurgical procedures that contemplates the alternation of hand microsurgery and robot-aided microsurgery.
- Further features and advantages of the master workstation, of the system, of the sterile operatory field and of the method according to the invention will become apparent from the following description of its preferred examples of embodiment, given by way of indicative and non-limiting example, with reference to the accompanying figures wherein:
-
FIG. 1 is an axonometric view that diagrammatically shows a surgical robotic system located within a sterile operatory field and having a master workstation, according to an embodiment; -
FIG. 2 is an axonometric view that diagrammatically shows a surgical robotic system located within a sterile operatory field near an operatory bed, according to an embodiment; -
FIG. 3 shows diagrammatically in axonometric view a master workstation comprising a console, a sterile holder and a draped master input handle, according to an embodiment; -
FIG. 4 is an axonometric view that shows a portion of a console covered by a surgical drape and a sterile holder, according to an embodiment; -
FIG. 5 is an axonometric view that shows a sterile holder, according to an embodiment; -
FIG. 6 -A is an elevation side view diagrammatically showing a sterile holder and a sterile drape, according to an embodiment; -
FIG. 6 -B is an axonometric view showing the sterile holder integral with the sterile drape, according to an embodiment, from the inner side of the sterile drape; -
FIG. 7 in an axonometric view showing a sterile holder, according to an embodiment; -
FIG. 8 in an axonometric view showing a sterile holder, according to an embodiment; -
FIG. 9 shows a possible mode of operation of a method according to an embodiment; -
FIG. 10 shows diagrammatically a master workstation comprising a draped console, a pair of sterile holders and a draped master input handle, according to an embodiment. - According to a general embodiment, it is provided a
master workstation 301 for a surgicalrobotic system 300. Themaster workstation 301 is suitable for being located within a sterileoperatory field 311. - The
master workstation 301 comprises a mechanically ungroundedmaster input handle 310, suitable for being hand-held by a surgeon during surgery for controlling a slaverobotic assembly 330 of said surgicalrobotic system 300. - As used herein, a “mechanically ungrounded
master input handle 310” refers to a master controller that is unconstrained with respect to possible position and orientation motion in a large working environment e.g., an operating field or room and is kinematically separated from the ground, e.g., not mechanically supported by a console, supports, or other object attached to the ground. In some implementations, a mechanically ungroundedmaster input handle 310 may be in tethered or untethered connection with one or more associated components such as control processors, data sources, sensors, power supplies, etc. For example, themaster input handle 310 may be tethered, e.g., connected physically to these components via a cable or wire, or untethered, e.g., not physically connected to such components and in communication with the components via wireless communication signals. According to an embodiment, themaster input handle 310 is mechanically unconstrained from saidconsole 302. - Moreover, the term “handle” means an ungrounded master input tool designed to be held in the surgeon's hand when in operative conditions. For example, said
master input handle 310 may comprise a manipulandum portion suitable for being grasped by a surgeon's hand when in operative conditions. For example, saidmaster input handle 310 may comprise a ring or an annular band or a bracelet to be worn by the surgeon's hand or finger or wrist. - The
master workstation 301 further comprises aconsole 302 and asterile drape 303 draping or covering at least a portion of saidconsole 302. Saidsurgical drape 303 preferably has body having aninner surface 304, or non-sterile surface, and anouter surface 305, or sterile surface opposite to said innernon-sterile surface 304. Thereby, theinner surface 304 of thesurgical drape 305 is designed to face theconsole 302 and theouter surface 305 of thesurgical drape 303 is designed to face thesterile operatory field 311. According to a preferred embodiment, saidsurgical drape 303 forms adrape cavity 322 for enclosing a portion of saidconsole 302 with the purpose of preserve sterility of thesterile operatory field 311. Thereby, theinner surface 304 faces thecavity 322, and thedrape cavity 322 may be tight sealed or open forming anopening 331 to access thecavity 322 that leads to saidouter surface 305 of thesurgical drape 303. For example, the margin of saidopening 331 or other parts of thedrape 303 may fit the body of theconsole 302 by cooperating with adhesive strips, elastic strips, magnetic attraction or any suitable means. For example, the body of thesurgical drape 303 is made of flexible sheet, such as polyethylene, and/or polyurethane, and/or polyester and/or any suitable drape material, such as paper, and/or woven fabric, and/or non-woven fabric, and/or any combination of the above. - The
console 302 comprises at least onepositioning body 309, for example aconvex body 309, and thesterile drape 303 drapes or covers at least a portion of saidconvex body 309 of theconsole 302. - As used herein, the term “convex body” does not necessarily exclude that the
convex body 309 may present a concave surface, but it has to comprise also a convex portion or convex surface. For example, the term “convex body” also encompasses an upright of theconsole 302 having a substantially cylindrical outer surface, which is a convex body, comprising localized concave surfaces or portion or longitudinal grooves that defines a recess that in turn define a concave surface. - Said
master workstation 301 comprises asterile holder 306 comprising at least onecavity 345. Thereby thesterile holder 306 acts a sterile basket. According to an embodiment, theholder 306 is made of plastic, preferably hard plastic material, and the cavity is for example molded or thermoformed. According to an embodiment, theholder 306 is made of sterilizable metallic material. According to an embodiment, theholder 306 is disposable. - Advantageously, the
sterile holder 306 comprises at least one restingelement 307 within saidcavity 345. - The provision of said at least one resting
element 307, for example at least oneresting surface 307, within saidcavity 345 of thesterile holder 306 allows the master input handle 310 to rest thereon when said master input handle 310 is not hand-held, for example when is temporary not hand-held by a surgeon during surgery. Thereby, the at least one restingelement 307 supports the master input handle 310 at least partially within thecavity 345 of saidsterile holder 306. - According to a preferred embodiment, the
sterile holder 306 comprises at least one positioning element 308 (orpositioning clip 308 or clip 308) engaged with said at least one positioning body 309 (or convex body 309) through saidsterile drape 303, while preserving the integrity of the sterile barrier formed at least partially by thesterile drape 303. - According to an embodiment, the sterile barrier is formed by the
sterile drape 303 and by a portion of theouter wall 332 of theholder 306. Thesterile drape 303 may be attached to theholder 306 and may comprise a throughpassage 348 for allowing theconnector 308 to pass there through. Theboundary 350 of the throughpassage 348 may be glued or welded or otherwise secured to theouter wall 332 of thesterile holder 306, as shown for example inFIG. 6B . Thereby, a portion of theouter wall 332 of theholder 306 acts as sterile barrier together with thesterile drape 303. - According to a preferred embodiment, the
sterile holder 306 comprises at least onepositioning clip 308 engaged with said at least oneconvex body 309 through saidsterile drape 303, while preserving the integrity of the sterile barrier, which is formed at least partially by thesterile drape 303. Thereby, saidpositioning clip 308 covers a portion of theouter surface 305 of thesterile drape 303, which thereby results put in between thepositioning clip 309 of thesterile holder 306 and theconvex body 309 of theconsole 302, locally preserving thesterile operatory field 311 near theclip 308. At the same time, thepositioning clip 308 engages with saidconvex body 309 of theconsole 302 firmly to position theholder 306 in a desired location near to where the surgeon stands or seats during surgery. - The
positioning body 309 may also be concave, or may comprise a slot, or may have a positioning surface suitably treated or machined in order to engage with the positioning element. Thepositioning element 308 may have any shape and feature to engage with said positioning surface. For example, thepositioning element 308 may comprise a snap-fit device, or may comprise attachment means for engaging with said positioning body. - Preferably, the
positioning clip 308 mechanically and detachably engages theconvex body 309. - According to an embodiment, the
clip 308 snap fits to theconvex body 309. -
Said positioning clip 308 is suitable for position thecavity 345 of thesterile holder 306 at a desired location near theconsole 302 and within thesterile operatory field 311. - The provision of said
cavity 345 of saidsterile holder 306 allows the surgeon to drop the mechanically ungrounded master input handle 310 within thecavity 345 and to make it rest on said at least one restingelement 307. Thanks to saidcavity 345 of thesterile holder 306, the mechanically ungrounded master input handle 310 results boxed in thesterile holder 306 within thesterile operatory field 311 when is not hand held by the surgeon. Moreover, - Preferably said
sterile holder 306 has a box-like body provided with anopening 333 to access thecavity 345, preferably facing the surgeon and/or facing upwards when in operative conditions. - The
positioning clip 308 may be located on theouter surface 332 of thesterile holder 306, and its particular location may be chosen with the purpose to position thesterile holder 306 for receiving the mechanically ungrounded master input handle 310 in a desired location within thesterile operatory field 311. - According to a preferred embodiment, the
sterile holder 306 is integral with thesterile drape 303, as shown for example inFIG. 6B . For example, thesterile holder 306 is welded or glued to the outer surface of the sterile drape. Thepositioning element 308 may be integral with the sterile drape and at the same time detachably engaged with thepositioning body 309. Thesterile drape 303 may be attached to theholder 306, and preferably to theouter surface 332 thereof, and may comprise a throughpassage 348 for allowing theconnector 308 to pass there through, while preserving the integrity of the sterile barrier. - According to an embodiment, the
positioning clip 308 is integral with theouter surface 332 of thesterile holder 306, although they may be made in separate pieces, so that to rigidly determines the position and spatial orientation of the restingelement 307, for example a restingsurface 307, relative to theconvex body 309 of theconsole 302 where theclip 308 is engaged. - According to a preferred embodiment, said
positioning clip 308 acts as constraining element for locally constraining thesurgical drape 303 against saidconvex body 309 of the mastersterile console 302, in order to locally reduce the volumetric encumber of thesurgical drape 303. Thesurgical drape 303 may have a loose body that drapes air other than theconsole 302, therefore thanks to the provision of said at least oneclip 308 is allowed to constrain a portion of the drape to a portion of theconsole 302, preferably at or near the at least oneconvex body 309. - Thereby, the at least one
clip 308 at the same time locally close-fits the body of thesterile drape 303 against theconvex body 309 of the mastersterile console 302 and holds thesterile holder 306 in place within thesterile operatory field 311. - According to an embodiment, said at least one
clip 308 comprises at least onecable guide 314 for guiding a cabledconnection 315 for example of theconsole 302. Thereby, the at least oneclip 308 has the further advantage of guiding the cabledconnection 315, for example a power supply and/or a data cable of saidmaster console 302. For example, saidcable guide 314 comprise a groove for receiving an elongated body dig in a wall of theclip 308 facing theouter surface 305 of the body of thesurgical drape 303. - Preferably, said at least one
clip 308 has an archedconcave surface 321 facing saidouter surface 305 of thesurgical drape 303 so to be suitable for fitting saidconvex body 309 of theconsole 302. For example, the archedconcave surface 321 of said at least oneclip 308 describes substantially the profile of a “C”. - According to a preferred embodiment as shown for example in
FIG. 4 , said at least one restingelement 307 comprises a restingsurface 307, for example said restingsurface 307 is a surface of abottom wall 347 of saidsterile holder 306 facing thecavity 345. - According to an embodiment, said resting surface for supporting at least a portion of a master input handle 310 to rest thereon is a bottom surface of a basket, i.e. a substantially cup-shaped container, and said basket corresponds to the
sterile holder 306. According to a preferred embodiment, saidholder 306 is designed for temporary supporting amaster input tool 310 when not hand-held by a surgeon within thesterile operatory field 311, and the at least oneresting surface 307 comprises a bottom surface of theholder 306. - According to an embodiment, said
sterile holder 306 comprises anopening 333 for the access to saidcavity 345. Preferably, saidopening 333 is opposite to said restingsurface 307 in respect of saidcavity 345. According to an embodiment, theholder 306 also comprises side surfaces 332 delimiting theopening 333 and thecavity 345. Thereby, the surgeon is allowed to drop themaster input tool 310 on asterile resting surface 307 exposed within asterile operatory field 311, during surgery. - Thanks to the provision of such a
surface 307, a surgeon may alternate hand microsurgery and robotic-aided microsurgery during a single intervention, without for this reason compromise the sterility of thesterile operatory field 311. Thereby, it is avoided the need of sterilize themaster input tool 310 each time the surgeon switches from hand microsurgery to robotic-aided microsurgery and vice-versa during a single surgical intervention. - Said side surfaces 332′ face towards the
cavity 345 and saidouter surfaces 332 face opposite, and preferably saidpositioning clip 308 is integrally connected to at least one of saidouter surfaces 332. According to an embodiment, saidouter surface 332 is substantially flat to favor the attachment of theclip 308. The orientation of theclip 308, i.e. the direction of longitudinal extension of the “C” shapedseat 346 defined by saidarched surface 321 of saidclip 308 of theholder 306, may be substantially aligned with the direction of development of thecavity 345 of thesterile holder 306. Thereby, thecavity 345 may be delimited by said restingsurface 307, saidbottom wall 347, said side surfaces 332′. - According to a variation, said
positioning clip 308 and theside surface 332′ of thesterile holder 306 defining saidcavity 345 may have a relative degree of freedom for adjusting the position of thecavity 345 upon engagement of theclip 308 with theconvex body 309, for example a hinge or a rotative joint such as a universal joint, may be provided articulating theclip 308 and theside surface 332′ of thesterile holder 306 for rotating theholder 306 when theclip 308 is engaged with saidconvex body 309 of theconsole 302 and/or a slider connects theclip 308 and theouter surface 332 of saidholder 306. - According to a preferred embodiment, said
convex body 309 faces towards theinner surface 304 of thesurgical drape 303. Thereby, it is avoided the need of sterilizing theconvex body 308 of the mastersterile console 302. - According to an embodiment, said at least one
convex body 309 comprises at least oneconvex surface 313, so that saidclip 308 engages saidconvex surface 313. According to an embodiment, thesterile drape 303 is interposed between theconvex body 309 and theholder 306. According to an embodiment, the body of thesterile drape 303 is interposed between, preferably in contact with both, theclip 308 and theconvex body 309. According to an embodiment, the body of thesterile drape 303 is interposed between, preferably in contact with both, saidarched surface 314 of theclip 308 of theaccessory 306 and saidconvex surface 313 of theconvex body 308. - According to an embodiment as shown for example in
FIG. 3 , saidconsole 302 comprises achair 320. The word “chair” used herein is intended to also encompass a “saddle stool”. - According to a preferred embodiment, said at least one
convex body 309 is a anupright 319 of asurgical chair 320 of a mastersterile console 302. According to a preferred embodiment, said at least oneconvex body 309 is anupright 319 of asurgical chair 320 supporting aarmrest 340, preferably of rounded shape so that the surgeon can rest the elbow thereon. - According to an embodiment, said
chair 320 comprises at least onearmrest 340 having saidconvex body 309, for example a connecting element connecting the armrest to aseating surface 318 of saidchair 320, and saidpositioning clip 308 of thesterile holder 306 engages saidconvex body 309 of thearmrest 340. Preferably, saidconsole 302, for example saidchair 320, is provided with said trackingfield generator 339 designed to track the position and orientation of the at least one mechanically ungroundedmaster input handle 310. Thetracking field generator 339 may be an optical tracking field generator such as at least one camera of a stereoscopic camera set. - According to an embodiment, said at least one
sterile holder 306 is associated to theouter surface 305 of thesurgical drape 303. According to an embodiment, saidopening 333 of the at least onesterile holder 306 opens on theouter surface 305 of thesurgical drape 303. - According to an embodiment, said at least one
positioning element 308 of the at least onesterile holder 306 is engaged with at least onepositioning body 309 of theconsole 302 through saidsterile drape 303 while preserving the integrity of the sterile barrier. According to an embodiment, saidpositioning element 308 rigidly determines the relative position and spatial orientation of said restingsurface 307 within saidcavity 345 and saidconvex body 309 of theconsole 302. - According to an embodiment, said
positioning element 308 is detachably engaged with saidpositioning body 309 of theconsole 302. - According to an embodiment, said
positioning element 308 comprises a positioning clip elastically engaging apositioning body 309 of theconsole 302. The clip is preferably elastically loaded. According to an embodiment, saidpositioning element 308 comprises at least oneflap 312 to detach thepositioning element 308 from thepositioning body 309 of theconsole 302. Theflap 312 may be elastically loaded and cooperating with the clip of thepositioning element 308. Saidpositioning element 308 may comprise a pair offlaps 312. Theflap 312 may act as a handle for releasing the clip of thepositioning element 308. The clip may be formed by two pieces elastically connected, and the at least oneflap 312 is attached to one of said two pieces of the clip. Twoflaps 312 may be provided, eachflap 312 being attached to one of said two pieces of the clip. The provision of said at least oneflap 312 may determine to open the clip of the positioning element thereby avoiding scratching thesurgical drape 303 during detachment of the clip. Thereby the clip may have a stronger elastic clamping force without compromising the integrity of thesterile drape 303. - According to an embodiment, the
master workstation 301 comprises a furthersterile holder 306 so that to comprise at least twosterile holders 306, and a further ungroundedmaster input handle 310, so as to comprise two master input handles 310, wherein preferably eachsterile holder 306 is for individually housing onemaster input handle 310. According to an embodiment, said twosterile holders 306 are spaced apart on the sameouter surface 305 of the samesurgical drape 303. - According to an embodiment, said
console 302 comprises achair 320 and wherein saidsurgical drape 303 covers saidchair 320. - According to an embodiment, said two
sterile holders 306 are attached todifferent positioning bodies 309 of theconsole 302. For example, saiddifferent positioning bodies 309 of theconsole 302 are spaced apart. - According to an embodiment, said two
sterile holders 306 are attached to asame positioning body 309 of theconsole 302. - According to an embodiment, said
console 302 comprises atower 315 and wherein saidsurgical drape 303 covers saidtower 315, as diagrammatically shown for example inFIG. 10 . The tower may comprise ascreen 316. Thescreen 316 may display a portion of thesterile operatory field 311 such as a portion of the slave workspace where the at least onesurgical instrument 337 operates. Thetower 315 may comprise ground contact units, such as a plurality of wheels. An optical and/or magnetictracking field generator 339 may be provided integral with saidtower 315 to track position and orientation of the at least one ungroundedmaster input handle 310. Thetower 315 of theconsole 302 may be equipped by saidpositioning body 309, for example a convex body. - According to a general embodiment, it is provided a
sterile operatory field 311 comprising at least onemaster workstation 301 according to any one of the embodiments above. - The
sterile operatory field 311 comprises at least oneoperatory bed 341 providing a support for a patient's anatomy to be treated. - According to an embodiment, the
sterile operatory field 311 is delimited by a sterile barrier formed by at least onesterile drape 303. According to an embodiment, the sterile barrier is formed by at least onesterile drape 303 and by at least a portion of theholder 306, and preferably by at least a portion of theouter wall 332 of theholder 306. Theconnector 308 of theholder 306 may be located within thesterile operatory field 311 or may be located out of thesterile operatory field 311. - Thanks to such a master workstation, the integrity of the
sterile operatory 311 field is preserved, as well as the sterility of theoperatory field 311. - According to an embodiment, said
sterile operatory field 311 further comprises a slaverobotic assembly 330 controlled by saidmaster workstation 310. - According to a general embodiment, it is provided a surgical
robotic system 300 comprising at least onemaster workstation 301 according to any one of the embodiments above. - According to a preferred embodiment, said
system 300 further comprises aslave robot assembly 330 comprising at least onesurgical arm 334 suitable for manipulating at least onesurgical instrument 337, and preferably said at least one surgical arm comprises at least onemotorized manipulator 335 controlled by saidmaster workstation 301 manipulating said at least onesurgical instrument 337. - According to an embodiment, said
slave robot assembly 330 comprises at least onesurgical arm 334 manipulating saidsurgical instrument 337. According to an embodiment, saidsalve robot assembly 330 comprises at least onemicromanipulator 335 manipulating saidsurgical instrument 304. Preferably, said at least onemicromanipulator 335 is directly connected in series to saidsurgical arm 334 forming a kinematic chain with saidsurgical arm 334 and manipulates saidsurgical instrument 337. According to an embodiment, at least twomicromanipulators 335 are directly connected in series to saidsurgical arm 334 forming an at least two-branched kinematic chain with saidsurgical arm 334. According to an embodiment, saidslave robot assembly 330 comprises at least onerobotic cart 336 and said at least onearm 334 extends from therobotic cart 336. - Preferably, said
system 300 comprises a control unit, suitable for receiving at least a position and orientation associated to said mechanically ungrounded master input handle 310 and suitable for transmitting a command signal to theslave robot assembly 330 in order to actuate saidsurgical instrument 337. - .According to a preferred embodiment, said control unit is suitable for receiving a first command signal containing information about said manual command and to transmit a second command signal containing information about said manual command to the
slave robot assembly 330 in order to actuate saidsurgical instrument 337. According to a preferred embodiment, saidrobotic microsurgery system 300, and preferably said drapedconsole 302 of saidrobotic microsurgery system 300, further comprises at least one tracking system comprising afield generator 339, suitable to detect within a predefined tracking volume position and orientation of saidmaster input tool 310, For example, saidmagnetic field generator 339 is located integral with theseating surface 318 of thechair 320 of theconsole 302. At least oneslave drape 338 may be provided to drape at least a portion of therobotic slave assembly 330. - According to a preferred embodiment, said
robotic microsurgery system 300 further comprises at least onesurgical microscope 342. Amicroscope drape 343 may be provided for draping at least a portion of themicroscope 342. - According to an embodiment, said
sterile operatory field 311 comprises saidrobotic surgery system 300. - According to a preferred embodiment, said
sterile operatory field 311 further comprises at least a portion of at least onerobotic slave manipulator 330 according to any one of the embodiments described above. Thereby, saidsterile operatory field 311 further comprises at least a portion of at least onerobotic surgery system 300 according to any one of the embodiments described above. - Thereby, it is allowed the surgeon to alternate hand microsurgery and robotic-aided microsurgery during a single intervention, without for this reason needing to sterilize the master console.
- Thanks to the provision of such a
holder 306, it is provided a solution able to drapemaster console 302 preserving sterility and at the same time making the master input handle 310 easier to manipulate within asterile operatory field 311, even when the surgeon switches to hand microsurgery, enabling the surgeon to switch back to the robot-aided microsurgery as desired while allowing the surgeon to drop or grasp the mechanically ungrounded master input handle 310 with minimum efforts, as thecavity 345 of theholder 306 is located in a desired location near within thesterile operatory field 311. - According to an embodiment, the
cavity 345 of thesterile holder 306 has a depth that is shallower than the length of the master input handle 310 so that a portion of the master input handle 310 pop out of theopening 333, making simpler for the surgeon to grasp the mechanically ungrounded master input handle 310 from the restingelement 307 within thecavity 345 of thesterile holder 306. - In the following a method for performing surgery will be described.
- A method for performing surgery, and preferably robotic-aided surgery, comprises the following steps.
- The method comprises the step of providing a
master workstation 301 within asterile operatory field 311, wherein preferably themaster workstation 301 comprises at least one mechanically ungrounded master input handle 310 suitable for being held in hand of the surgeon to control a slave robotic assembly comprising at least asurgical instrument 337. Themaster workstation 310, thesterile operatory field 311 and the slaverobotic assembly 330 may be any as described in any of the embodiments above Preferably, theclip 308 mechanically engages theconvex body 309. - The method comprises the step of draping a
console 302 of themaster workstation 301, preferably by means of asurgical drape 303. - The method comprises the step of clipping a
sterile holder 306 to aconvex body 309 of theconsole 302 so that aholder cavity 345 is within thesterile operatory field 311. - According to a mode of operation, the method comprises the step of associating at least one
sterile holder 306 to theouter surface 305 of thesurgical drape 303. That may open at least oneopening 333 for accessing acavity 345 on theouter surface 305 of thesurgical drape 303. - According to a mode of operation, the method comprises the step of associating at least one
sterile holder 306 to theouter surface 305 of thesurgical drape 303 in a detachable manner. According to a mode of operation, the method comprises the step of detaching the at least onesterile holder 306 from theouter surface 305 of thesurgical drape 303. - According to a mode of operation, the method comprises the step of associating at least one
sterile holder 306 to theouter surface 305 of thesurgical drape 303 in a detachable manner by means of mechanically engaging saidpositioning element 308, for example said clip, of at least onesterile holder 306 with apositioning body 309 of theconsole 302, thepositioning body 309 being preferably a convex body. This step may comprise acting on said at least oneflap 312 of the at least onesterile holder 306. Acting on said at least oneflap 312 may determine thepositioning element 308, such as said clip, to open. According to a mode of operation, the method comprises the step of detaching at least onesterile holder 306 from theouter surface 305 of thesurgical drape 303 by means of mechanically disengaging saidpositioning element 308, for example said clip, from said atpositioning body 309 of theconsole 302, thepositioning body 309 being preferably a convex body. - According to a mode of operation, the method comprises the step of defining a desired location within the
sterile operatory field 311 with the aim of positioning thesterile holder 306 there. - According to a mode of operation, the method comprises the step of holding in hand the mechanically ungrounded
master input handle 310, with the purpose of controlling saidsurgical instrument 337 of the slaverobotic assembly 330. - The method comprises the further step of dropping or resting a master input handle 310 within said
cavity 345 so that the master input handle 310 rests on aresting element 307 within thecavity 345. - According to a mode of operation, the method comprises the further step of lifting or grasping the master input handle 310 from the
sterile holder 306, and preferably from the restingelement 307 within thecavity 345 of thesterile holder 306 placed in a desired location within thesterile operatory field 311, thereby holding again in hand themaster input handle 302. - Preferably the method is carried out by a
master workstation 310 and/or asterile operatory field 311 and/or a surgicalrobotic system 300 according to any of the embodiments described above. - Thanks to the features described above, provided either disjointly or together in particular embodiments, it is possible to respond to the above mentioned needs providing the above cited advantages, and in particular:
- the surgeon is able to easily drop the ungrounded master controller within the cavity of the sterile holder at any time during surgery;
- the sterility of the operatory field is maintained;
- the volumetric encumber of the sterile drape covering the console may be reduced;
- it is reduced the risk of braking the sterile drape;
- it is maintained the integrity of the sterile barrier that surrounds the sterile operatory field;
- the holder may acts as a sterile holster within the sterile operatory field for receiving the master input tool when is not hand-held, for example during alternation of hand surgery and robotic microsurgery;
- the sterile drape may be held in place by a sterile holder having a positioning clip.
- To the embodiments described above, one skilled in the art may, to satisfy contingent and specific needs, make numerous modifications, adaptations and replacements of elements with others that are functionally equivalent, without however departing from the scope of the appended claims.
-
- 300 Surgical robotic system
- 301 Master workstation
- 302 Console
- 303 Surgical drape or sterile drape
- 304 Inner non-sterile surface of the drape
- 305 Outer sterile surface of the drape
- 306 Sterile holder, or holder
- 307 Resting element, or resting surface
- 308 Positioning element, for example a clip, or positioning clip
- 309 Positioning body of the console, for example a convex body of the console
- 310 Master input handle or master input tool
- 311 Sterile operatory field
- 312 Flap of the positioning element
- 313 Convex surface of the convex body
- 314 Cable guide
- 315 Tower of the console
- 316 Screen
- 318 Seating surface, or saddle seating surface
- 319 Connecting element of the armrest
- 320 Surgical chair, or saddle stool
- 321 Arched clip surface
- 322 Drape cavity
- 325 Cabled connection
- 330 Slave robotic assembly
- 331 Opening of the drape
- 332 Outer surface of the holder
- 332′ Side surface of the holder
- 333 Opening of the holder
- 334 Robotic arm
- 335 Motorized manipulators
- 336 Robotic cart
- 337 Surgical instrument
- 338 Slave drape
- 339 Tracking field generator
- 340 Armrest
- 341 Operatory bed
- 342 Surgical microscope
- 343 Microscope drape
- 344 Master drape
- 345 Cavity of the holder
- 346 Seat of the clip
- 347 Bottom wall of the holder
- 348 Through passage or through hole of the drape
- 350 Boundary of the though passage
Claims (21)
1. A master workstation for a surgical robotic system suitable for being located within a sterile operatory field, the master workstation comprising:
a ungrounded master input handle suitable for being hand held by a surgeon during surgery for controlling a slave robotic assembly of said surgical robotic system;
a console comprising at least one positioning body;
a sterile drape draping at least a portion of said console and forming at least partially a sterile barrier; and
at least one sterile holder, wherein said at least one sterile holder comprises:
at least one cavity; and
at least one resting element within said cavity and suitable for the master input handle to rest thereon when said master input handle is not hand held;
wherein said at least one sterile holder comprises at least one positioning element, and
wherein said at least one positioning element is engaged with said at least one positioning body of the console through said sterile drape while preserving the integrity of the sterile barrier.
2. The master workstation of claim 1 , wherein said positioning element is suitable for positioning the cavity of the sterile holder at a desired location near the console and within the sterile operatory field.
3. The master workstation of claim 1 , wherein said positioning element comprises a positioning clip elastically engaging said positioning body of the console.
4. The master workstation of claim 1 , wherein said positioning body of the console comprises a convex body.
5. The master workstation of claim 1 , wherein said sterile holder is integral with the sterile drape.
6. The master workstation of claim 1 , wherein said positioning element acts as constraining element for locally constraining the surgical drape against said positioning body of the master sterile console.
7. The master workstation of claim 1 , wherein said console comprises a chair.
8. The master workstation of claim 1 , wherein said console comprises a tower and wherein said surgical drape covers said tower.
9. The master workstation of claim 1 , wherein said at least one resting element comprises a resting surface, including a bottom surface of said sterile holder delimiting the cavity; and/or
wherein said sterile holder comprises an opening for the access to said cavity.
10. The master workstation of claim 1 , wherein said positioning element is detachably engaged with said positioning body.
11. The master workstation of claim 1 , wherein said positioning element rigidly determines the relative position and spatial orientation of said resting surface within said cavity and said convex body of the console.
12. The master workstation of claim 1 , wherein said ungrounded master input handle includes a cabled connection and the positioning element acts as a constraining element for locally constraining said cabled connection against said positioning body of the master sterile console.
13. The master workstation of claim 1 , wherein said positioning element is detachably engaged with said positioning body of the console.
14. The master workstation of claim 1 , wherein said positioning element comprises at least one flap to detach the positioning element from the positioning body of the console.
15. The master workstation of claim 1 , comprising a further sterile holder so as to comprise at least two sterile holders, and a further ungrounded master input handle, so as to comprise two master input handles, wherein each sterile holder is for individually housing one master input handle.
16. The master workstation claim 15 , wherein said two sterile holders are spaced apart on the same outer surface of the same surgical drape.
17. Robotic surgery system comprising at least one master workstation according to claim 1 and a slave robotic assembly controlled by said master workstation.
18. Sterile operatory field comprising:
at least one master workstation according to claim 1 , and
at least one operatory bed providing a support for a patient's anatomy to be treated.
19. (canceled)
20. The master workstation of claim 1 , wherein an outer surface of the sterile holder forms together with the sterile barrier formed by the sterile drape.
21. The master workstation of claim 8 , wherein said chair comprises at least one armrest having said positioning body, for example a connecting element connecting the armrest to a seating surface of said chair, and said positioning element of the sterile holder engages said positioning body of the armrest.
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IT102020000002554 | 2020-02-10 | ||
IT102020000002554A IT202000002554A1 (en) | 2020-02-10 | 2020-02-10 | CONTROL STATION FOR ROBOTIC SURGERY, STERILE OPERATIVE FIELD, ROBOTIC SURGERY SYSTEM AND METHOD |
PCT/IB2021/051061 WO2021161177A1 (en) | 2020-02-10 | 2021-02-10 | Master workstation for robotic surgery, sterile operatory field, surgical robotic system and method |
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US7967137B2 (en) * | 2008-06-09 | 2011-06-28 | Fulbrook Jason D | Organizer of expendable supplies for medical patients (OESMP) |
US8521331B2 (en) | 2009-11-13 | 2013-08-27 | Intuitive Surgical Operations, Inc. | Patient-side surgeon interface for a minimally invasive, teleoperated surgical instrument |
US10383699B2 (en) | 2013-03-15 | 2019-08-20 | Sri International | Hyperdexterous surgical system |
KR102306959B1 (en) | 2013-09-04 | 2021-10-01 | 삼성전자주식회사 | Surgical robot and control method thereof |
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IT201700042116A1 (en) | 2017-04-14 | 2018-10-14 | Medical Microinstruments Spa | ROBOTIC ASSEMBLY FOR SURGERY |
US20190156394A1 (en) | 2017-11-18 | 2019-05-23 | Walmart Apollo, Llc | Distributed Sensor Systems and Methods for Inventory Control |
IT201800005471A1 (en) * | 2018-05-17 | 2019-11-17 | Robotic system for surgery, particularly microsurgery |
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AU2021219105A1 (en) | 2022-09-08 |
BR112022015767A2 (en) | 2022-10-11 |
KR20220139966A (en) | 2022-10-17 |
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