WO2016142050A1 - Système de robot médical - Google Patents

Système de robot médical Download PDF

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Publication number
WO2016142050A1
WO2016142050A1 PCT/EP2016/000398 EP2016000398W WO2016142050A1 WO 2016142050 A1 WO2016142050 A1 WO 2016142050A1 EP 2016000398 W EP2016000398 W EP 2016000398W WO 2016142050 A1 WO2016142050 A1 WO 2016142050A1
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WO
WIPO (PCT)
Prior art keywords
robot
medical
input device
arrangement
assembly
Prior art date
Application number
PCT/EP2016/000398
Other languages
German (de)
English (en)
Other versions
WO2016142050A8 (fr
Inventor
Sebastian LOHMEIER
Cyrill VON TIESSENHAUSEN
Original Assignee
Kuka Roboter Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Kuka Roboter Gmbh filed Critical Kuka Roboter Gmbh
Publication of WO2016142050A1 publication Critical patent/WO2016142050A1/fr
Publication of WO2016142050A8 publication Critical patent/WO2016142050A8/fr

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Classifications

    • 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
    • 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
    • A61B34/25—User interfaces for surgical systems

Definitions

  • US 2008/0154389 A1 discloses a surgical robot with a mobile base, a multi-jointed robot arm connected to the base, a gripper arm
  • Robot arm guided surgical instrument and a computer known, which may be located in the surgery robot or in or outside an operating room and having an unspecified user input.
  • the object of the present invention is to provide an improved medical robot system.
  • Claim 1 solved.
  • Claim 14 provides a method of configuring a medical robotic system described herein under protection.
  • the subclaims relate to advantageous developments.
  • a medical robot system has a robot arrangement for, in particular alternative or common,
  • Input device arrangement with one or more input devices for, in particular manual, input of control commands for the robot assembly and / or at least one guided by the robot assembly medical device, said input device (s) articulated and / or detachable with the robot assembly, in particular mobile base and / or the robot arm, connectable, in particular connected, is or are, in particular signal technology, in particular electrically, and / or kinematic, in particular magnetic and / or mechanical, in particular positive and / or frictional.
  • An input device connected in an articulated manner to the robot arrangement can advantageously be adjusted in its position and / or orientation relative to the (mobile) robot arrangement and so on different positions of the robot assembly,
  • An input device which can be connected detachably to the robot arrangement, in particular connected can advantageously be provided either with different mobile bases and / or robot arms of the robot arrangement and / or with a robot arrangement external, in particular stationary, base, in particular an examination and / or treatment, in particular operating table or chair , connected and / or optionally replaced by another input device.
  • the same input device can advantageously be arranged or used on or with different bases and / or arms of the robot arrangement and / or at different locations and / or alternatively different input devices can be arranged or used on or with the same elements of the robot arrangement.
  • the robot arrangement has at least one mobile base, in particular at least two mobile bases, to which (or in each case) a robot arm can be mechanically proximally connected, in particular connected, which has several, in particular at least six, in particular at least seven, in particular motor-actuated or actuated, joints, in particular rotary joints, and a distal adapter flange for, in particular mechanical and / or electrical and / or signaling and / or fluidic connection of a medical device.
  • the medical robot system has a medical device arrangement with at least two, in particular alternatively or alternatively, through the
  • the medical device arrangement has at least one mating flange for kinematic, in particular magnetic and / or mechanical, in particular positive and / or frictional, and / or electrical and / or signaling and / or fluidic, in particular hydraulic and / or pneumatic, Connection of a medical device to an adapter flange of a robot arm of the robot assembly.
  • At least one counterflange is in one embodiment firmly connected to a medical device, in particular integrally formed therewith.
  • the medical robotic system includes one or more couplings for releasably attaching a medical device to a distal end of a robotic arm of the robotic assembly, each having the distal adapter flange of the respective robotic arm and the mating flange fixedly attached to the respective medical device ,
  • At least one counter flange is detachable, in particular magnetic, positive and / or frictional, connectable to a medical device, in particular connected.
  • the medical robotic system has one or more intermediate flanges for releasably indirectly attaching a medical device to a distal end of a robotic arm of the robotic assembly detachable, in particular magnetic, form with the distal adapter flange and with the medical device - and / or frictionally engaged, connectable, in particular connected or are.
  • an intermediate flange can be sterilized or as a sterile
  • one or more distal adapter flanges and one or more mating flanges form complementary kinematic, in particular mechanical and / or magnetic, and / or electrical and / or signaling and / or fluidic, in particular hydraulic and / or pneumatic, interfaces, so that in one Execution of the same medical device optionally or alternatively on different distal adapter flanges and / or on the same distal
  • Adapter flange alternatively or alternatively different medical devices can be connected or can be.
  • this signal connectable in particular signal-connected.
  • Input device arrangement hardware and / or software technology to be set up, alternatively with different bases and / or robot arms and / or
  • At least two different bases and / or robotic arms and / or medical devices have corresponding signal-technical interfaces and at least one input device has a signal-technical interface complementary thereto.
  • at least two different bases and / or robot arms and / or medical devices have signal-technical interfaces and at least one input device has two signal-technical features that are complementary thereto
  • the input device arrangement in one embodiment, at least two, in particular alternatively, in particular at the same location, with the robot assembly, kinematically, in particular mechanically and / or magnetically, connectable, input devices for inputting control commands for the
  • Robot assembly and / or at least one guided by the robot assembly medical device has couplings for the alternative kinematic connection of various input devices to the robot arrangement, in particular at the same location.
  • modular medical robotic system provided, in which with the same base and / or the same robot arm optionally or alternatively, in particular at the same location and / or by a coupling, various input devices kinematically, in particular magnetically and / or mechanically connected, or may be, and / or in which the same input device optionally or alternatively with different bases and / or robot arms, kinematically, in particular
  • Adapter flanges can be tethered to be or be robotically guided, and / or in which with the same medical device or
  • various input devices can be signal-connected or to be able to control this, and / or in which the same input device or alternatively
  • it may be signal connected to various medical devices to control this.
  • a medical device is in an embodiment for intra- or extracorporeal mechanical, hydraulic, pneumatic and / or electromagnetic
  • a patient or provided has in one embodiment a, in particular minimally invasive, surgical, imaging, fluid and / or gas-to-and / or -abmixden and / or electrical and / or magnetic end effector, in particular a pair of pliers, clamp , a scalpel, an ultrasound or endoscope head, a cannula or electrode or the like.
  • a medical device has one or more kinematic passive and / or, in particular motor, hydraulic and / or pneumatic, actuatable, degrees of freedom.
  • the input device assembly includes an articulated arm
  • articulated connection of the same input device or for articulated connection of various input devices with the robot assembly in particular the same or different bases and / or robot arms on.
  • an articulated arm has one or more hinges and / or one or more thrust joints.
  • advantageously different poses of the articulated arm and thus different positions and / or orientations of the input device can be represented.
  • Articulated arm fixable in particular frictionally and / or positively, in particular by Rest.
  • a pose of the articulated arm and thus a position and / or orientation of the input device can be fixed.
  • one or more, in particular all, joints of the articulated arm by brakes manually, pneumatically, hydraulically and / or electrically actuated or aktuiert be fixed.
  • one or more, in particular all, joints of the articulated arm are motorized, actuated or actuated.
  • an articulated arm has one or more sensors for detecting a joint position of one or more, in particular all, joints of the
  • the medical robot system has a, in particular manually and / or electrically releasable coupling for, in particular magnetic and / or positive and / or frictional, attachment of the articulated arm to one or, in particular alternatively or alternatively, a plurality of input devices and / or a ,
  • manually and / or electrically releasable coupling for, in particular magnetic and / or positive and / or frictional, attachment of the articulated arm to the robot assembly In this way, advantageously, the input device separated from the articulated arm and replaced by another or optionally attached elsewhere and / or the articulated arm of the robot assembly separated and replaced by another or optionally attached elsewhere.
  • the medical robot system has a
  • the input device arrangement has one or more input devices, which are not kinematically connected to the robot arrangement, for remote control of the robot arrangement and / or at least one medical device guided by the robot arrangement and / or one or more input devices for the, in particular manual, with the robot arrangement, in particular only cable-connected input devices , Input of control commands for the robot assembly and / or at least one guided by the robot assembly medical device.
  • Such an input device has at least one footswitch or pushbutton in one embodiment.
  • the medical robot system includes a device controller
  • the device control is or is signal-connected to the medical device or devices, in particular wired or wireless. Additionally or alternatively, the separate from the robot controller or external device control with the robot controller, in particular wired or wireless,
  • one or more robot arms of the robot assembly with the respective base of the robot assembly are articulated, in particular linearly movable and / or, in particular manually, fixable and / or, in particular motor and / or hydraulic and / or pneumatic, actuatable or aktuiert connected ,
  • the robot arm can advantageously be adapted to different positions of the base and / or different environmental conditions.
  • one or more bases of the robot assembly each have a chassis with one or more wheels.
  • one or more wheels in particular manually and / or actuated retractable.
  • one or more of the bases of the robot assembly each have one, in particular manually and / or, in particular motor and / or hydraulic and / or pneumatic, actuated retractable support. This can Advantageously, a position of the base are determined.
  • One or more, in particular all, wheels of a chassis are passive or driven wheels in one embodiment.
  • the chassis may have one or more drive wheels or with a, in particular motor, drive, coupled wheels.
  • Input device arrangement each one or more, in particular on or
  • multi-axis and / or touch-sensitive, input means for the manual input of control commands in particular one or more uniaxial switches and / or buttons, one or more multi-axis joysticks, one or more, in particular capacitive, touch pads or the like.
  • the medical robotic system has a, in particular one-piece and / or foil-like, sterile sheath for completely or partially enveloping one or more robot arms and / or one or more mobile bases of the robot arrangement and / or one or more, in particular with the arm or the base connected, input devices of the input device arrangement.
  • advantageous mechanical and electrical components of the robot and / or input device arrangement need not be sterilized, which are not regularly sterile in particular due to their mobility.
  • the sterile sheath has at least one, in particular hose-like, bulge for receiving a wrapped robotic arm and / or at least one, in particular tubular, bulge for receiving an enclosed input device and / or an associated articulated arm.
  • two elements which can be kinematically connected to one another in particular connected elements, in particular an input device and a kinematically connectable or connected mobile base, robotic arm or articulated arm, are provided directly or by one or more, in particular rigidly or hingedly interconnected, rigid bodies fastened to each other or fixable, in particular fixed or fixed, and / or are not exclusively by one or more limp Connecting elements, in particular cables, lines or the like connectable or connected.
  • one of a plurality of input devices of the input device arrangement having the same mobile base or the like is optionally selected
  • Input device arrangement optionally with different mobile bases or
  • the robot arrangement has a robot controller for, in particular automatic, controlling the robot arrangement, in particular the robot arm, in particular its drives. This can be arranged in a development, as explained above, in the mobile base.
  • the medical robot system additionally has an external control, in particular not arranged on the mobile base, which in a further development generates externally generated commands for controlling the robot arrangement at the latter
  • Robot controller transmitted and / or from the robot controller
  • Such additional external control may include the above-described external input device, wherein then the externally generated commands based on a, in particular manual, operation of this external input device can come about.
  • manual operation is understood to mean, in particular, an actuation by a body part, in particular by hand and / or foot.
  • the medical robot system in particular the robot arm and / or the medical device connected to it or guided by it, has a force and / or torque sensor system for detecting forces or
  • Torques acting on the system in particular the robot arm and / or the medical device.
  • a haptic and / or, in particular, electrically, actuatable, in particular actuated, input device of the input device arrangement, in particular an input device exercises, in particular
  • reaction forces in particular to the input device manually operated user from, which are determined on the basis of the sensors detected forces or torques, in particular these correspond or is
  • soft and / or hardware technology set up, in particular, in order to advantageously provide feedback of the forces detected by the sensor system or
  • Robot bearing having a base and a carrier mounted thereon, pivotable relative to the mobile base between an operating position and a Bergegna.
  • FIG. 1 shows a medical robot system according to an embodiment of the present invention
  • FIG. 3 shows the medical robot system in another configuration in FIG. 2
  • FIG. 4 shows the medical robot system in a further configuration in FIG. 2
  • FIG. 6b shows the medical robot system in a further configuration in FIG. 1.
  • FIG. 1 shows in a side view a patient 1 lying on an examination or operating table 2 and a medical robot system according to an embodiment of the present invention with a robot arrangement comprising a mobile base in the form of a carriage 5 and a multi-articulated robot arm 3, which is connected proximally to the base and has a distal adapter flange 7 to which a medical device 6 guided by the robot assembly is connected.
  • a robot controller 4 for controlling the robot arm is arranged in the mobile base.
  • the medical device 6 can be supplied with energy via the adapter flange 7 and is signal-wise connected to the robot controller 4.
  • Examples of the medical device 6 are endoscopes, ultrasound heads, instruments for open or minimally invasive surgery, puncture needles or biopsy needles.
  • the medical robot system has a counterflange for the mechanical and / or electrical and / or signaling and / or fluidic connection of the medical device 6 to the adapter flange 7.
  • the counterflange is designed as a sterile intermediate flange 6.2, which is detachably connected to the sterile medical device 6 and designed as a preparable component or as a disposable item. In a modification, not shown is the
  • the medical robot system has an input device arrangement.
  • This has an input device 8 for manual input of control commands for the robot arm 3 and guided by this medical device 6, said input device 8 is releasably connected to an articulated arm 9 and connected thereto articulated and with the base 5.
  • Signaling the input device 8 is connected to the robot controller 4, so that an operator can control the movement of the robot arm 3.
  • the input device 8 has one or more single- or multi-axis and / or one or more touch-sensitive input means for the manual input of control commands. Examples of such input means are haptic hand controllers, joysticks, 3-D motion controllers ("space mouse”), capacitive touch pads or switches for triggering special functions and / or preprogrammed
  • the robot arm 3 and / or the medical device 6 has a force and / or torque sensor for detecting forces or
  • a haptic and / or actuated input device in particular a haptic hand controller, can in one embodiment reaction forces
  • the input device arrangement also has further, not shown, input devices for inputting control commands for the robot arm 3 and / or the medical device 6, which, as an alternative to the input device 8, kinematically with the articulated arm 9 and signal technology can be connected to the robot controller, for example, simpler and / or more complex input devices for inputting control commands for other medical devices.
  • input devices for inputting control commands for the robot arm 3 and / or the medical device 6 which, as an alternative to the input device 8, kinematically with the articulated arm 9 and signal technology can be connected to the robot controller, for example, simpler and / or more complex input devices for inputting control commands for other medical devices.
  • an endoscopy and / or biopsy system can be equipped with a simpler and thus more cost-effective input device.
  • the input device arrangement has, in addition to the input device 8, a further input device connected to the robot controller 4 for inputting control commands for the robot arm and / or the medical device 6 in the form of a footswitch 10, for example to switch between different operating modes and / or an action of the medical device 6 trigger.
  • the further input device 10 may have an actuating element of an enabling device, with which an unintentional movement of the robot arm 3 is prevented. An actuation of the input device 8 is therefore converted into a corresponding movement of the robot arm 3 only when the operator simultaneously actuates the enabling device via the further input device 10.
  • the further input device 10 may include an actuator of an emergency stop device, with which the operator can shut down the system, for example in the event of malfunction.
  • the articulated arm 9 for articulated connection of the input device 8 with the mobile base 5 of the robot assembly has two serially arranged joints, in particular at least one rotary joint with at least one rotational degree of freedom and / or a sliding joint with at least one translational degree of freedom.
  • the joints are frictionally lockable with a brake and / or with a brake
  • Locking mechanism in discrete positions form-fitting fixable.
  • the operation of the brake is done manually or automatically, for example, controlled by the user via a switch.
  • the articulated arm 9 optionally has sensors.
  • the operator can align the input device 8 by means of the articulated articulated arm 9 ergonomically in his work environment.
  • the device control of the medical device 6 may be integrated in the robot controller 4. This is advantageous, for example, in medical devices with an actuated end effector in order to ensure simple operability. Some medical devices additionally or alternatively require a separate control device, for example an HF generator of a cautery instrument, a camera controller of an endoscope or the like.
  • the medical robot system optionally and in dashed lines has an external device control 12 for controlling the medical device 6 guided by the robot arrangement, which is controlled by the
  • Robot controller 4 separately and with the medical device 6, in particular wired or wireless, signal-connected.
  • the external device controller 12 may be spaced apart from the robot controller 4 and the mobile base 5, or may be grounded to the mobile base 5 as well.
  • the external device controller 12 may additionally be signal-connected to the robot controller 4.
  • robot controller 4 is arranged to be based on signals of the
  • Input device 8 and / or the further input device 10 and / or stored in the controller 4 pre-programmed program sequences to generate suitable control signals for controlling the medical device 6 and to the external
  • Device controller 12 to transmit.
  • the input device arrangement has an external input device 13 which is kinematically not connected to the robot arrangement
  • the external input device 13 is particularly advantageous in a medical device, for example, for imaging, in particular angiography, computed tomography, sonography, or the like, or for navigation.
  • 13 may also represent an external control, in particular optional, which transmits externally generated commands for controlling the robot arrangement to its robot controller 4 and / or from the robot controller 4 Status information, in particular about an operating state, a pose of
  • Robotic arm or the like receives.
  • an external object such an external
  • Control include the above-described external input device, in which case the externally generated commands based on an operation of this external input device can come about.
  • an external monitor 14 is provided on which endoscopic images and / or images of an external imaging and / or navigation system can be displayed to the operator.
  • the robot controller 4 may be configured to configure and / or
  • the monitor 1 preferably has no direct mechanical or signal-technical connection to the robot arrangement; the representation of configuration and / or status information of the robot system can be effected, in particular indirectly, in particular via the external controller 13.
  • Embodiment via a lifting column 15 and thus linearly movable and fixable with the mobile base 5, which is adjustable in a substantially vertical direction, connected.
  • the adjustment of the lifting column can be done manually or via a
  • the mobile base 5 has one or more supports 16 in order to increase the stability during operation.
  • the supports are adjustable or extendable manually or by a, in particular electrical or hydraulic, drive.
  • the supports 16 can be firmly connected to the mobile base 5 with analogous functionality and their wheels can be retracted.
  • FIG. 2 shows the medical robot system in a top view.
  • the robot system is placed by the medical staff at the table 2 in such a way that the intervention or examination location on the patient 1 with the medical device 6 is achieved while the robot arm 3 is manipulatable at the same time, and the patient 1 continues is sufficiently accessible to an operator 17 and additional medical personnel.
  • the input device 8 is aligned in an ergonomic position for the operator and the joints of the articulated arm 9 are fixed again. If available, other external input devices 10 are arranged on the table 2, that they for the
  • Operator 2 are easily accessible. This makes it possible for the operator to control the medical robotic system directly in the patient's usual working posture, at the same time to guide another optional medical instrument 19 and to keep an eye on the also optional external monitor 14.
  • corresponding features are represented by identical,
  • FIG. 3 shows the medical robot system in another configuration in a representation corresponding to FIG. This configuration differs from the configuration previously described with reference to FIG. 2 only in that the
  • Input device 8 of articulated arm 9 removed by loosening a coupling connecting them and was fixed by means of a corresponding coupling to the table 2.
  • the input device 8 can be clamped, for example, on a side rail mounted on the table 2 standard rail.
  • the articulated arm 9 is folded away to save space.
  • FIG. 4 shows the medical robot system in a further configuration in a representation corresponding to that in FIGS.
  • the robot assembly comprises two mobile bases 5, 5 'arranged around the table 2 and two multi-jointed robot arms 3, 3' connected thereto, the medical robot system two medical devices 6, 6 'jointly guided by this robot arrangement.
  • the input device 8 was used with the aid of
  • FIG. 5 shows the medical robot system in a further configuration in a representation corresponding to that in FIGS.
  • this configuration also has two mobile bases 5, 5 ', multi-jointed robot arms 3, 3' and two medical devices 6, 6 'guided together by this robot arrangement. Both robot arms 3, 3 'and both medical devices 6, 6' are in this
  • FIG. 5 can be controlled jointly by the same input device 8 and the same external input device 10 by operator 17, which is signal-connected to the robot controls 4, 4 'for this purpose.
  • the assignment of the input device 8 and, if required, one or more functions of the external input device 10 between the robot arm 3 and the robot arm 3 ' is performed by the operator 17, for example by a dedicated switch of the external input device 10.
  • the robot controller 4 is configured to that it processes the control signals generated by input device 8 and external input device 10 according to the assignment set by the operator 17 either directly to the control of the robot arm 3 or to the
  • Robot controller 4 'of the robot arm 3' forwards.
  • FIG. 6b shows the medical robot system in a further configuration in a representation corresponding to FIG.
  • Fig. 6a shows the medical robot system in a further configuration in Fig. 6b corresponding representation.
  • the sterile sheath 18 has a tubular bulge in the region of the robot arm 3, which is designed so that the robot arm 3 can move freely within its working space.
  • the sterile sheath 18 in the region of input device 8 and articulated arm 9 has a second tubular bulge. This allows input device 8 and Articulated arm 9 to be moved by an operator without significant restrictions.
  • the sterile sheath 18 or 18 surrounds the non-sterile adapter flange 7 completely.
  • the intermediate flange 6.2 which is advantageously designed as a separate component, is placed on the adapter flange 7 in the distal direction and fixed mechanically or magnetically.
  • the electrical contacting takes place by Ziflansch workede pins and
  • adapter flange side sockets are joined while piercing the sterile sheath 18 punctually.
  • the intermediate flange 6.2 can also be integrated into the sterile sheath 18 or 18 '.
  • the input device 8 may be designed such that it can be sterilized and thus attached and operated without sterile sheath in the vicinity of the patient 1.
  • the proposed modular medical robotic system may allow a physician in one embodiment to begin an open or conventional laparoscopic procedure. Thereafter, he can decide intraoperatively whether robotic support is required at least in sections.
  • the invention in one embodiment, allows robotic use of a variety of instruments.
  • the various applications extend in particular to the areas of laparoscopic surgery, in particular laparoscopic
  • Instruments such as grippers, cautery, needle holders, spinal surgery, in particular the holding of guide aids for setting pedicle screws, the
  • interventional radiology in particular injectors for local therapy, RF and RF ablators, neurosurgery, in particular the setting of stimulation Electrodes and MKG surgery, especially the placement of cochlear implants.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Robotics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Manipulator (AREA)

Abstract

L'invention concerne un système de robot médical comprenant un ensemble robot qui présente au moins une base mobile (5, 5') et un bras de robot (3, 3') à articulations multiples, qui est relié à la base de manière proximale et comporte une bride formant adaptateur (7) distal(e) pour raccorder un appareil médical (6, 6'), ainsi qu'un ensemble de dispositifs de saisie qui comprend au moins un dispositif de saisie (8, 8') pour entrer, en particulier manuellement, des instructions de commande pour le système de robot et/ou au moins un dispositif médical (6, 6') guidé par l'ensemble robot, ledit dispositif de saisie pouvant être relié à l'ensemble robot de manière articulée et/ou détachable.
PCT/EP2016/000398 2015-03-11 2016-03-07 Système de robot médical WO2016142050A1 (fr)

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Application Number Priority Date Filing Date Title
DE102015003137.6A DE102015003137A1 (de) 2015-03-11 2015-03-11 Medizinrobotersystem
DE102015003137.6 2015-03-11

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WO2016142050A8 WO2016142050A8 (fr) 2016-11-17

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DE102018216692B3 (de) * 2018-09-28 2019-12-12 Kuka Deutschland Gmbh Roboter-Handführgerät

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