WO2018177200A1 - Instrument souple pour robot chirurgical, instrument chirurgical et endoscope - Google Patents

Instrument souple pour robot chirurgical, instrument chirurgical et endoscope Download PDF

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Publication number
WO2018177200A1
WO2018177200A1 PCT/CN2018/080147 CN2018080147W WO2018177200A1 WO 2018177200 A1 WO2018177200 A1 WO 2018177200A1 CN 2018080147 W CN2018080147 W CN 2018080147W WO 2018177200 A1 WO2018177200 A1 WO 2018177200A1
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WO
WIPO (PCT)
Prior art keywords
surgical robot
flexible instrument
instrument
flexible
spacer
Prior art date
Application number
PCT/CN2018/080147
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English (en)
Chinese (zh)
Inventor
何超
王常春
何裕源
李涛
袁帅
Original Assignee
微创（上海）医疗机器人有限公司
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Application filed by 微创（上海）医疗机器人有限公司 filed Critical 微创（上海）医疗机器人有限公司
Publication of WO2018177200A1 publication Critical patent/WO2018177200A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0055—Constructional details of insertion parts, e.g. vertebral elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/0051—Flexible endoscopes with controlled bending of insertion part
    • A61B1/0057—Constructional details of force transmission elements, e.g. control wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/008—Articulations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation

Definitions

  • the present invention relates to the field of medical device technology, and in particular to a flexible instrument, a surgical instrument and an endoscope for a surgical robot.
  • a surgical robot is a combination of a set of instruments. It is usually assembled by a surgical instrument such as an endoscopic probe, a knife and scissors, a micro camera and a joystick. The doctor sits in front of the computer screen and carefully observes the lesion in the patient through the display screen and the endoscope.
  • surgical robots can also perform very delicate operations such as organ repair, vascular anastomosis or bone grinding.
  • surgical robots have also been used to perform various important operations including gene transplantation, neurosurgery, and remote surgery, thereby greatly improving the survival rate of critically ill patients.
  • the surgical robot puts high requirements on the surgical instruments that come into contact with the human body, and requires the surgical instruments to have multiple degrees of freedom, sufficient flexibility and control precision, so as to facilitate the matching of the surgical path by bending the surgical instruments in the case of a small surgical opening. Avoid the problem that the patient's postoperative recovery period becomes longer due to the large opening of the operation.
  • WO2003001986A discloses a surgical instrument with multiple degrees of freedom, as shown in Fig. 21, the surgical instrument 70 comprises five joint elements 72-76, wherein the joint element 73 can be swung to the left and right with respect to the joint element 72, the joint element 74 can The joint element 75 is swingable back and forth with respect to the joint element 74 with respect to the joint element 73.
  • the joint element 76 is swingable back and forth with respect to the joint element 74, and a plurality of holes 78 are circumferentially opened on each joint element for controlling the stringing.
  • the bending of the surgical instrument 70 in different directions can be achieved by pulling the control cord.
  • the structure of the surgical instrument 70 is complicated, and only five joint elements shown in Fig.
  • the two joint elements 72, 76 on both sides have a flat first surface and two a second surface connected by a bevel; a joint element 74 located in the middle, both sides of which are connected by two inclined surfaces which are symmetrical in front and rear; the other two joint elements 73, 75 have the most complicated structure and one side surface thereof
  • the two sides are symmetrically connected by two inclined faces, and the other side surface is connected by two oblique faces which are bilaterally symmetrical. Since the joint elements of the surgical instrument 70 adopt different configurations, on the one hand, the manufacturing cost is increased, on the other hand, the assembly difficulty is increased, and when the manufacturing process precision is not high enough, the assembly of the entire surgical instrument may be affected.
  • the support between the two is achieved by the projections 73a at the two bevel joints corresponding to the joints 73 of the joints 72 of the joint elements 72.
  • the movement of the surgical instrument 70 in each swinging direction is achieved by pulling two joint elements, so that the control operation is complicated and a large pulling force needs to be applied.
  • An object of the present invention is to provide a flexible instrument, a surgical instrument, and an endoscope for a surgical robot to further satisfy the surgical use requirements.
  • the present invention provides a flexible instrument for a surgical robot, the flexible instrument for a surgical robot including an initial state and a curved state, the flexible instrument for a surgical robot comprising: a fixed block and a plurality of rotating blocks arranged in sequence, wherein a spacer is disposed between the fixed block and the rotating block adjacent thereto, and between two adjacent rotating blocks; the flexible device for surgical robot further includes at least one elastic structure and At least one guiding structure; the elastic structure is configured to cause the surgical robot to maintain an initial state with a flexible instrument or to restore an initial state from a curved state; the guiding structure for causing the surgical robot to be in a curved state with a flexible instrument.
  • the elastic structure and the guiding structure pass through the rotating block, the spacer is fixed on an adjacent fixing block or a rotating block, or the elastic structure or the guiding structure passes through The rotating block and the spacer; the guiding structure and the distal end of the elastic structure are fixed on the fixing block.
  • the elastic structure is one or two, and/or the guiding structure is one or more.
  • the number of the rotating blocks is 4-14.
  • the distance between two adjacent rotating blocks is 0.5 mm to 3 mm, and/or the spacing between the fixed block and the adjacent rotating block. It is 0.5mm to 3mm.
  • the rotating block has one or more first circumferential holes arranged circumferentially.
  • each of the guiding structures passes through one of the first circumferential holes of the rotating block.
  • the elastic structure when the elastic structure is one, one elastic structure passes through one of the first circumferential holes of the rotating block; when the elastic structure In two cases, two of the elastic structures respectively pass through two adjacent first circumferential holes of the rotating block.
  • the spacer is disposed separately from the rotating block, and the spacer is located radially inside the first circumferential hole.
  • the fixing block has a circumferentially disposed second circumferential hole to fix the elastic structure and/or the guiding structure, at least one of the second A circumferential hole corresponds to the first circumferential hole.
  • the rotating block has a first central hole, and the first central hole is located at a center of the rotating block.
  • the elastic structure passes through the first central hole of the rotating block, and the distal end of the elastic structure is fixedly connected with the fixed block.
  • the fixing block has a second central hole at a center of the fixed block, and the second central hole corresponds to the first central hole.
  • the outer shape of the spacer is cylindrical, conical, truncated, wedge-shaped or tubular, and the maximum diameter of the spacer is 1 mm to 8 mm.
  • the spacer is provided with a third central hole at a center of the spacer.
  • the pad has a wedge shape, and the pad includes opposite first and second faces, and the first face is opposite to the second face Adjacent to the fixing block, the first surface includes a first inclined surface and a second inclined surface connected to the first inclined surface, and the intersection line formed by the first inclined surface and the second inclined surface is in the middle of the rotating block The axes intersect, the second face is a flat surface; the spacer is fixedly coupled to the rotating block on a side of the second face.
  • the spacer has one or more third circumferential holes arranged circumferentially.
  • the third circumferential hole when the third circumferential hole is plural, two of the third circumferential holes are located at the first inclined surface and the second inclined surface The intersection line, and the intersection line is located on a plane defined by the axes of the two third circumferential holes.
  • a first angle formed between the first inclined surface and the second surface is greater than 0° and less than or equal to 80°
  • the second inclined surface is The second angle formed between the second faces is greater than 0° and less than or equal to 80°.
  • the first angle is equal to the second angle.
  • the rotating blocks are divided into a plurality of groups, each group comprising at least two of the rotating blocks and a pad fixedly connected thereto, and all the blocks in each group are
  • the angle of the intersection line is 0°
  • the angle of the intersection line of the adjacent two groups of blocks is greater than or equal to 0° and less than or equal to 90°.
  • the present invention also provides a surgical instrument comprising an instrument tip, a flexible instrument, a tubular, a flexible member, and a controller as described above, wherein the instrument tip, the flexible instrument, the tubular, and The controller is sequentially connected, the flexible member is connected to the controller at one end, and the other end is connected to the end of the instrument through the tubular body, and the proximal end of the guiding structure in the flexible device is connected to the controller.
  • the controller controls movement of the end of the instrument by the flexible member, and the flexible instrument is controlled to swing by the guiding structure.
  • the invention also provides an endoscope comprising an imaging system, a flexible instrument, a tubular as described above, and a controller; wherein the imaging system, the flexible instrument, the tubular, and the The controller is sequentially connected; the proximal end of the guiding structure in the flexible instrument is connected to the controller; the controller controls the flexible instrument to swing by the guiding structure, thereby adjusting the position of the distal end of the imaging system posture.
  • the flexible instrument for surgical robot of the present invention provides a spacer between adjacent rotating blocks, that is, a method in which the rotating block and the spacer are arranged at intervals, which brings advantages of simple control and precision.
  • High, flexible instruments have a small radius of rotation and a correspondingly small working space.
  • the flexible device for the surgical robot is restored to the initial state by the elastic structure, and the guiding structure makes the flexible instrument for the surgical robot in a curved state, thereby forming a multi-degree of freedom flexibility.
  • the device thereby increasing the flexibility of use, can further meet the surgical use requirements.
  • the flexible instrument for the surgical robot is included, thereby enabling the end of the instrument or the imaging system to reach a desired position and posture.
  • FIG. 1 is a schematic structural view of a flexible instrument for a surgical robot according to a first embodiment of the present invention
  • FIG. 2 is a schematic structural view of another flexible instrument for a surgical robot according to Embodiment 1 of the present invention.
  • FIG. 3 is a schematic structural view of a fixing block according to Embodiment 1 of the present invention.
  • FIG. 4 is a schematic structural view of a rotating block according to Embodiment 1 of the present invention.
  • FIG. 5 is a schematic structural view of a flexible instrument for a surgical robot according to a second embodiment of the present invention.
  • FIG. 6 is a schematic structural view of another flexible instrument for a surgical robot according to a second embodiment of the present invention.
  • FIG. 7 is a schematic structural view of another flexible instrument for a surgical robot according to a second embodiment of the present invention.
  • FIG. 8 is a schematic structural view of another flexible instrument for a surgical robot according to a second embodiment of the present invention.
  • FIG. 9 is a schematic structural view of another flexible instrument for a surgical robot according to a second embodiment of the present invention.
  • FIG. 10 is a schematic structural view of a fixing block according to Embodiment 2 of the present invention.
  • Figure 11 is a schematic structural view of a rotating block and a spacer according to a second embodiment of the present invention.
  • FIG. 12 is a schematic structural view of another rotating block and a spacer according to Embodiment 2 of the present invention.
  • FIG. 13 is a schematic structural view of another rotating block and a spacer according to Embodiment 2 of the present invention.
  • FIG. 14 is a schematic view showing the bending of a flexible instrument for a surgical robot according to a second embodiment of the present invention.
  • 15 is a schematic view showing the bending of a flexible instrument for a surgical robot according to a second embodiment of the present invention.
  • 16 is a schematic structural view of a flexible instrument for a surgical robot according to a third embodiment of the present invention.
  • 17 is a schematic structural view of another flexible instrument for a surgical robot according to a third embodiment of the present invention.
  • FIG. 18 is a schematic structural view of another flexible instrument for a surgical robot according to a third embodiment of the present invention.
  • FIG. 19 is a schematic structural view of another flexible instrument for a surgical robot according to a third embodiment of the present invention.
  • FIG. 20 is a schematic structural view of another flexible instrument for a surgical robot according to a third embodiment of the present invention.
  • 21 is a schematic view of a surgical instrument of the prior art.
  • proximal and distal are relative orientations, relative positions, directions of elements or actions relative to each other from the perspective of a physician using the medical device, although “proximal” and “distal” “Not limited, but “proximal” generally refers to the end of the medical device that is near the physician during normal operation, and “distal” generally refers to the end that first enters the patient's body.
  • a flexible instrument for a surgical robot includes an initial state and a curved state, and includes: a fixed block and a plurality of rotating blocks arranged in sequence, wherein between the fixed block and the rotating block, or two adjacent A spacer is disposed between the rotating blocks; the flexible device for a surgical robot further includes an elastic structure and a guiding structure; the elastic structure is configured to restore the initial state of the surgical robot with a flexible device; the guiding structure For making the surgical robot with a flexible instrument in a curved state.
  • the "initial state” is a state in which the surgical robot is placed with a flexible instrument when the structure is not subjected to an external force, and at this time, the elastic structure is not bent.
  • the "bent state” is a state in which the surgical robot uses a flexible instrument when the structure is subjected to an external force, wherein at least one of the rotating blocks is deflected, and at this time, the elastic structure is bent and generated. The surgical robot is restored to the "initial state” stress with a flexible instrument.
  • FIG. 1 is a structural diagram of a flexible instrument for a surgical robot according to a first embodiment of the present invention.
  • the flexible instrument 1 for a surgical robot includes: a fixed block 10 and a plurality of rotating blocks 11 arranged in sequence, wherein between the fixed block 10 and the rotating block 11 or two adjacent A spacer (not shown in FIG. 1) is disposed between the rotating blocks 11, and a distance between the fixed block 10 and the rotating block 11 and two adjacent rotating blocks 11 are held by the spacer the distance between.
  • 11 rotating blocks 11 are schematically shown. In a specific application, the number of the rotating blocks 11 can be adjusted according to the requirements of the flexible instrument for the surgical robot, and the preferred range is 4 to 14.
  • the flexible instrument 1 for a surgical robot further includes an elastic structure 12 and a guiding structure 13 , and the elastic structure 12 and the guiding structure 13 are both fixed to the fixing block 10 after passing through the rotating block 11 .
  • the guiding structure 13 is used to control the swinging direction of the flexible instrument 1 for the surgical robot, and the elastic structure 12 functions as an elastic support.
  • the elasticity When the guiding structure 13 is not subjected to a force, the elasticity The structure 12 maintains the entire surgical robot with the flexible instrument 1 in a flat state, i.e., an initial state.
  • the flexible structure 12 and the guiding structure 13 are both fixed to the fixed block 10 through the rotating block 11 to form a multi-degree-of-freedom flexible device, thereby improving the flexibility of use, thereby enabling further Meet the requirements of surgical use. That is, since the flexible instrument 1 for the surgical robot has a plurality of degrees of freedom and high flexibility, the surgical instrument or the endoscope in which the flexible instrument 1 for the surgical robot is disposed can be bent by the case where the surgical opening is small. Waiting to match the surgical path, thereby avoiding the problem of causing the surgical opening to be too large, and further satisfying the surgical use requirements.
  • FIG. 4 is a schematic structural diagram of a rotating block according to Embodiment 1 of the present invention.
  • the outer shape of the rotating block 11 is cylindrical.
  • the cylindrical structure has a rounded side so as to avoid scratching the human body during use.
  • the circumferential direction of the rotating block 11 has a first circumferential hole 11-1 to pass the guiding structure 13, or the elastic structure 12 and the guiding structure 13.
  • the number of the first circumferential holes 11-1 is one or more, preferably 4 to 24, and four of the first circumferential holes 11-1 are schematically shown here.
  • the first circumferential hole 11-1 of the rotating block 11 is evenly distributed in the circumferential direction of the rotating block 11.
  • the number of the first circumferential holes 11-1 on each of the rotating blocks 11 may be equal or not equal.
  • the flexible instrument is required to provide at least one passage for the guide structure 13 to extend through.
  • a rotating block 11 provides a first circumferential hole 11-1 to facilitate the passage of the guiding structure 13 while all the remaining rotating blocks 11 also provide a first circumferential hole 11-1 at a corresponding position. Forming a channel to facilitate the passage of the guiding structure.
  • the resilient structure 12 is also disposed in the first circumferential aperture 11-1, then the flexible instrument is required to provide at least one similar passage. More preferably, the number of the first circumferential holes 11-1 on all of the rotating blocks 11 is equal and the positions correspond.
  • the first circumferential hole 11-1 is mainly used for the guide structure 13 to pass.
  • the number of the guiding structures 13 is at least one (the number of the guiding structures 13 shown in FIG. 1 is four), and each of the guiding structures 13 passes through a first circumferential hole 11 of the rotating block 11. -1.
  • first circumferential hole 11-1 can also be used for the elastic structure 12 to pass. Specifically, when the elastic structure 12 is one, one elastic structure 12 passes through one of the first circumferential holes 11-1 of the rotating block 11; when the elastic structure 12 is two When the two elastic structures 12 pass through the adjacent two first circumferential holes 11-1 of the rotating block 11, respectively.
  • the center of the rotating block 11 has a first central hole 11-2.
  • the first central hole 11-2 is mainly used for the passage of the elastic structure 12.
  • the number of the elastic structures 12 is one, and the elastic structure 12 is fixed to the fixed block 10 after passing through the first central hole 11-2 of the rotating block 11.
  • the elastic structure 12 allows the entire surgical robot with the flexible instrument 1 to remain in a straight state with the distal end of the flexible instrument 1 for the surgical robot without being pulled.
  • the first central aperture 11-2 can also accommodate the remaining components of the surgical robot.
  • the elastic structure 12 may be a solid wire structure, a hollow fiber structure or a spring structure or the like.
  • the outer shape of the fixing block 10 is also cylindrical, and has a through hole design similar to that of the rotating block 11, and preferably the outer diameter of the fixing block 10 is equivalent to the outer diameter of the rotating block 11.
  • FIG. 3 is a schematic structural diagram of a fixed block according to Embodiment 1 of the present invention.
  • the circumferential direction of the fixing block 10 has a second circumferential hole 10-1, and the position of at least one of the second circumferential holes 10-1 and the first circumferential hole 11 of the rotating block Corresponding to the position of -1, the guiding structure 13 is fixed in the second circumferential hole 10-1 through the first circumferential hole 11-1.
  • the number of the second circumferential holes 10-1 and the number of the first circumferential holes 11-1 may or may not be equal.
  • the center of the fixing block 10 has a second center hole 10-2 corresponding to the position of the first center hole 11-2.
  • the elastic structure 12 is fixed in the second center hole 10-2 after passing through the first center hole 11-2.
  • the elastic structure 12 may also be fixed in the second circumferential hole 10-1 through the first circumferential hole 11-1.
  • the elastic structure 12 and the guiding structure 13 in the flexible instrument 1' for the surgical robot are both fixed to the fixed by the first circumferential hole on the rotating block 11.
  • the second circumferential hole in the block 10 is in the hole.
  • the number of the first circumferential hole 11-1 and the second circumferential hole 10-1 is at least 2, and the position of at least 2 of the second circumferential holes 10-1 and the rotating block
  • the first circumference corresponds to the position of the hole 11-1.
  • the number of the elastic structures may also be plural, for example, two.
  • the two elastic structures are respectively fixed in the second circumferential holes on the fixing block 10 through the adjacent two first circumferential holes of the rotating block.
  • the number of the first circumferential hole 11-1 and the second circumferential hole 10-1 is at least three, and the position of at least three of the second circumferential holes 10-1 and the rotating block The first circumference corresponds to the position of the hole 11-1.
  • the spacer may be fixed on the adjacent fixed block 10 or the rotating block 11.
  • the elastic structure 12 or the guiding structure 13 may not pass through the spacer.
  • the spacer is fixed to a position between the opposite first circumferential holes of the rotating block 11, in other words, the spacer is located radially inside the first circumferential hole ( Near the side of the central axis of the rotating block 11).
  • the spacer may not be fixed to the fixed block 10 or the rotating block 11, and at this time, one of the elastic structure 12 or the guiding structure 13 passes through the spacer, that is, in each spacer.
  • One of the elastic structures 12 or one of the guiding structures 13 is passed through.
  • the position of the spacers may also be located between the two first circumferential holes on the rotating block 11, or The spacer is located radially inside the first circumferential hole.
  • the thickness of the spacer depends on the axial distance between the fixed block 10 and the adjacent rotating block 11 and the axial direction between two adjacent rotating blocks 11 distance.
  • the axial distance between the fixed block 10 and the (adjacent) rotating block 11 is 0.5 mm to 3 mm
  • the axial distance between the adjacent two rotating blocks 11 is 0.5 mm to 3 mm. That is, the thickness of the spacer is 0.5 mm to 3 mm.
  • the number of the blocks varies according to the change of the number of the rotating blocks 11.
  • the number of the blocks is the same as the number of the rotating blocks, that is, the fixed blocks 10 and A spacer is disposed between the rotating blocks 11 or between two adjacent rotating blocks 11. In this embodiment, the number of the blocks is 11.
  • the outer shape of the spacer is preferably cylindrical, conical, truncated, wedge-shaped or tubular; the size of the spacer is as small as possible to facilitate the yaw motion of the rotating block 11, for example, the spacer
  • the maximum diameter range is from 1 to 8 mm. If the rotating block 11 is provided with a first central hole 11-2 at a central portion, the spacer may also be provided with a third central hole at a central portion, preferably a third central hole diameter of the spacer and a first central hole The diameter of 11-2 is equivalent.
  • the spacer may have a third circumferential hole arranged circumferentially, the third circumferential hole is at least one, and the position of at least one of the third circumferential hole and the rotating block One week corresponds to the position of the hole 11-1, and the number of the third circumferential holes may be equal to or different from the number of the first circumferential holes 11-1.
  • the spacer includes a first surface and a second surface, the first surface being adjacent to the fixed block 10 with respect to the second surface, that is, the first surface of the spacer abuts the fixed block 10 or is adjacent to the fixed block 10
  • the rotating block 11 on one side, the second side of the spacer abuts or is fixedly connected to the rotating block 11 on the side away from the fixed block 10.
  • the initial state of the flexible instrument 1 for the surgical robot ie, no additional force is applied to the flexible instrument 1 for the surgical robot
  • the The surgical robot swings in different directions with the flexible instrument 1, that is, the relative swing direction between the adjacent two rotating blocks 11 is not limited, and provides sufficient flexibility to meet the requirements of different microtrauma procedures.
  • each of the rotating blocks 11 and each of the blocks in the embodiment has the same configuration, the manufacturing cost and assembly difficulty of the entire flexible device 1 can be effectively reduced.
  • the flexible instrument 1 can be restored from the curved state to the initial state, and when the flexible instrument 1 is controlled to change from one posture to another, the operation difficulty can be reduced, and the operator Only a small force is applied to the guiding structure 13.
  • FIG. 5 is a structural schematic diagram of a flexible instrument for a surgical robot according to a second embodiment of the present invention.
  • the spacer described in the embodiment not only functions to maintain the distance between the rotating blocks, the rotating block and the fixed block, but also limits the rotation block. And the direction of the swing between the rotating block and the fixed block. Further, in the embodiment, the spacer is fixedly formed with the rotating block.
  • the flexible instrument 2 for a surgical robot includes: a fixed block 20 and a plurality of rotating blocks 21 arranged in sequence, wherein between the fixed block 20 and the rotating block 21 or adjacent two rotating blocks 21 Arranged between the spacers, through which the spacers not only serve to maintain the distance between the rotating blocks 21, the rotating block 21 and the fixed block 20, but also limit the rotation blocks 21 and the rotating blocks 21 and fixed The direction of the wobble between blocks 20.
  • 13 rotating blocks 21 are schematically shown. In a specific application, the number of rotating blocks can be adjusted according to the requirements of the flexible instrument for the surgical robot, and the preferred range is 4 to 14.
  • the flexible instrument 2 for a surgical robot further includes an elastic structure 22 and a guiding structure 23, and the elastic structure 22 and the guiding structure 23 are both fixed to the fixing block 20 after passing through the rotating block 21.
  • the elastic structure 22 and the guiding structure 23 are both fixed to the fixing block 20 through the rotating block 21, thereby forming a multi-degree-of-freedom flexible device, thereby improving the flexibility of use.
  • the flexible instrument 2 for the surgical robot has multiple degrees of freedom and high flexibility, in the case where the surgical opening is small, the flexible path 2 for the surgical robot can be bent to match the surgical path, thereby avoiding the operation. The problem of large opening is further satisfied with the requirements for surgical use.
  • the pad has a wedge shape.
  • the spacer includes opposing first and second faces, the first face being closer to the fixed block 20 than the second face.
  • the first face includes a first inclined surface and a second inclined surface connected to the first inclined surface, and an intersection formed by the first inclined surface and the second inclined surface intersects with a central axis of the rotating block 21,
  • the second side is a plane.
  • the guiding structure is more advantageous for controlling the swing of the rotating block through the first inclined surface and the second inclined surface, respectively.
  • the first face abuts the fixed block 20 or the rotating block 21, and the second face abuts or is fixedly connected to the rotating block 21. In the present embodiment, as shown in FIG.
  • the spacer is fixedly coupled to the rotating block 21 on the side of the second side thereof, preferably integrally formed.
  • each pad is closer to the fixed block than the fixed block to which it is fixedly connected.
  • the first angle between the first slope and the second surface is greater than 0° and less than or equal to 80°
  • the second angle between the second slope and the second surface is More than 0° and less than or equal to 80°.
  • FIG. 11 is a structural schematic diagram of a pad integrally formed with a rotating block according to a second embodiment of the present invention.
  • the lower part of the broken line is a rotating block
  • the upper part of the broken line is a pad.
  • the rotating block 21 and the first central aperture and the first circumferential aperture thereon are no longer labeled in Figure 11, but only the spacer portion.
  • the circumferential direction of the spacer 24 has a third circumferential hole 24-1, and the third circumferential hole 24-1 is also mainly used to make the elastic structure 22, or the guiding.
  • the structure 23 and the elastic structure 22 pass.
  • the third circumferential hole 24-1 corresponds to the first circumferential hole on the rotating block 21 adjacent to the fixed block 20, for example, the number, the size, the position, and the like. That is, the number of the third circumferential holes 24-1 is at least one, and preferably the third circumferential holes 24-1 are evenly distributed in the circumferential direction of the spacer 24. Correspondingly, in the embodiment of the present application, the number of the third circumferential holes 24-1 is also eight.
  • the two third circumferential holes 24-1 are located on the intersection of the first inclined surface and the second inclined surface, and the two third lines on the intersection line
  • the central axis of the circumferential hole 24-1 intersects the intersection (i.e., the intersection is on a plane defined by the axes of the two third circumferential holes 24-1).
  • the rotating block 21 may have more first circumferential holes; correspondingly, the spacer 24 has more third circumferential holes, such as shown in FIG. 24 third circumferential holes 24-1 are shown to further improve the fineness of the deflection direction control of the flexible instrument 2 for the surgical robot.
  • the rotating block 21 may also have fewer first circumferential holes; correspondingly, the spacer 24 has fewer third circumferential holes, such as shown in FIG. Shown, it shows four third circumferential holes 24-1.
  • the center of the spacer 24 has a third center hole 24-2, and the third center hole 24-2 and the first center hole of the fixed connection rotating block 21 correspond.
  • the third central hole 24-2 is also mainly used to pass through the elastic structure 22.
  • the third central hole 24-2 can also accommodate the remaining components of the flexible instrument for the surgical robot.
  • the number of the elastic structures 22 is one, and an elastic structure 22 passes through the first central hole on the rotating block 21 and the third central hole 24-2 on the block 24. It is fixed to the fixed block 20.
  • FIG. 10 is a schematic structural diagram of a fixing block according to Embodiment 2 of the present invention.
  • the outer shape of the fixing block 20 is cylindrical.
  • the outer diameter of the fixed block 20 is equivalent to the rotating block 21.
  • the circumferential direction of the fixing block 20 has a second circumferential hole 20-1, and the position of at least one of the second circumferential holes 20-1 corresponds to the position of the first circumferential hole, the second The number of circumferential holes 20-1 may be equal to or different from the number of the first circumferential holes 21-1.
  • the center of the fixing block 20 has a second center hole 20-2, and the second center hole 20-2 corresponds to the first center hole.
  • the elastic structure 22 is fixed in the second central hole 20-2 through the first central hole
  • the guiding structure 23 is fixed to the first through the first circumferential hole. Two weeks into the hole 20-1.
  • an elastic structure 22 may also be fixed in the second circumferential hole 20-1 through the first circumferential hole and the third circumferential hole.
  • the elastic structure 22 and the guiding structure 23 in the flexible instrument 2a for surgical robot are respectively fixed to the fixed block through the first circumferential hole on the rotating block 21 . 20 on the second circumferential hole.
  • 13 rotating blocks 21 are schematically illustrated, and more or less may be included in a specific application, and the number of the preferred rotating blocks 21 ranges from 4 to ⁇ 14 For example, four rotating blocks 21 are shown in FIGS. 7 and 8.
  • the flexible instruments 2b and 2c for surgical robots each include: a fixed block 20, four rotating blocks 21, an elastic structure 22, and a guiding structure 23.
  • the elastic structure 22 and the guiding structure 23 are both fixed to the fixing block 20 after passing through the rotating block 21 .
  • the difference between Figures 7 and 8 is the position of the resilient structure 22.
  • the rotating block 21 is greater than or equal to n, and the number of the guiding structures 23 is at least n.
  • n is a natural number greater than or equal to 1
  • the rotating block 21 is greater than or equal to n
  • the number of the guiding structures 23 is at least n.
  • the surgical robot can increase the number of the guiding structures 23 by using a flexible instrument (for example, the rotating blocks 21 in the same swinging direction are respectively controlled by the two guiding structures 23) to realize the operation of the surgical robot.
  • Flexible instrument swings for more precise control.
  • the fixed position of the guiding structure 23 for controlling the direction in which the rotating block is swung may be on the rotating block or on the rotating block at the distal end of the rotating block (if any) or on the fixed block. Therefore, the distal end of at least one of the guiding structures is fixed to the fixed block. More preferably, the distal end of the guiding structure is fixed to the fixing block.
  • the angle (circumferential relative deflection angle) between the intersection lines of the spacers fixed on the adjacent two rotating blocks 21 is greater than or equal to 0° and less than or equal to 90°.
  • the angle of intersection of the spacers fixed on the adjacent two rotating blocks 21 is 90°.
  • the flexible instrument 2, 2a, 2b, 2c for the surgical robot can be preferably controlled to swing in two mutually perpendicular directions, for example, as shown in FIGS. 14 and 15, the swing can be performed in the front-rear direction, or Swing in the left and right direction.
  • the angle of intersection of the pads fixed on the adjacent two rotating blocks 21 may also be 45°. As shown in FIG.
  • the flexible instrument 2d for a surgical robot includes: a fixed block 20, 12 rotating blocks 21, an elastic structure 22, and a guiding structure 23, which are fixed in two rotating blocks 21
  • the angle of intersection of the spacers is 45°, which is arranged in a spiral, whereby the swinging direction of the flexible instrument 2d for the surgical robot can be controlled with good precision.
  • the flexible instrument for the surgical robot in the embodiment adopts a manner in which the spacer and the rotating block are arranged at intervals, and the phase is realized by the relative swing between the wedge-shaped surface of the spacer and the planar surface of the opposite rotating block. Control of the relative position between adjacent rotating blocks.
  • the spacer and the rotating block are arranged at intervals, and the phase is realized by the relative swing between the wedge-shaped surface of the spacer and the planar surface of the opposite rotating block.
  • Control of the relative position between adjacent rotating blocks When controlling the swing angle between two adjacent rotating blocks, it is only necessary to control one of the rotating blocks and the blocks thereof, thereby reducing the control difficulty.
  • the way of engaging the wedge surface and the plane also makes the swing angle between the adjacent two rotating blocks small, the control is simple and the precision is high, so that the working space of the flexible device is small, and the requirements for microtrauma surgery in the human body are more satisfied. .
  • the difference between the third embodiment and the second embodiment is that the plurality of rotating blocks are divided into a plurality of groups, each group including at least two (multiple) rotating blocks, and the blocks fixed on all (a plurality of) rotating blocks in each group
  • the angle of intersection is 0°
  • the angle of intersection of the blocks fixed on the adjacent two sets of rotating blocks is greater than or equal to 0° and less than or equal to 90°.
  • the flexible instrument for surgical robot includes 12 rotating blocks 31, and 12 rotating blocks 31 are divided into 6 groups, each group including 2 rotating blocks 31, two of each group.
  • the angle of intersection of the spacers fixed on the rotating block 31 is 0°, that is, the intersection of the fixed blocks on the two rotating blocks 31 in each group is parallel. Further, the angle of intersection of the pads fixed on the adjacent two sets of rotating blocks is 90°, thereby increasing the maximum swing angle of the flexible instrument for swinging in the direction of the surgical robot. 16 differs from FIG. 17 in the position of the resilient structure 32.
  • the flexible instrument for a surgical robot includes four rotating blocks 31, and the four rotating blocks 31 are divided into two groups, each group including two rotating blocks 31, two of each group.
  • the intersection angle of the spacers fixed on the rotating blocks 31 is 0°, that is, the intersection lines of the fixed blocks on the two rotating blocks 31 in each group are parallel. Further, the angle of intersection of the blocks fixed on the adjacent two sets of rotating blocks is 90°. Thereby, the maximum swing angle of the flexible instrument for the surgical robot to swing in each direction can be increased. 18 differs from FIG. 19 in the position of the resilient structure 32.
  • the rotating blocks in each group may also include more.
  • the flexible instrument for surgical robot includes 12 rotating blocks 31, and 12 rotating blocks 31 are divided into four groups, each group including three rotating blocks 31, and three rotating blocks in each group.
  • the angle of intersection of the fixed blocks on 31 is 0°, that is, the intersection of the fixed blocks on the three rotating blocks 31 in each group is parallel.
  • the angle of intersection of the pads fixed on the adjacent two sets of rotating blocks is 90°, thereby increasing the maximum swing angle of the flexible instrument for swinging in the direction of the surgical robot.
  • the elastic structure and the guiding structure are both fixed to the fixed block through the rotating block, thereby forming a multi-degree-of-freedom flexible device, thereby improving the use. Flexibility to further meet surgical requirements.
  • the present invention also provides a surgical instrument including a distal end of a device, a flexible instrument for a surgical robot, a tubular member, a flexible member, and a controller, wherein the end of the instrument, the flexible instrument for the surgical robot, the The tube and the controller are sequentially connected, the flexible member is connected to the controller at one end, and the other end is connected to the end of the instrument after passing through the tubular body, and the proximal end of the guiding structure of the flexible robot with the surgical robot The controller is connected, the controller controls the movement of the end of the instrument through the flexible member, and controls the swing of the flexible instrument for the surgical robot through the guiding structure.
  • the end of the instrument mainly includes a surgical tool such as a scissors, a pliers, an electric hook, etc., which is directly operated in a human body; the fixing block of the flexible instrument is connected with the end of the instrument, and the rotating block of the proximal end is connected with the tubular object.
  • a surgical tool such as a scissors, a pliers, an electric hook, etc.
  • the tubular body is a hollow thin-walled tube for supporting the instrument so that the end of the instrument can extend into the human body while the front end of the surgical instrument is placed outside the body;
  • the controller is used for controlling the end movement of the instrument and the swing of the flexible instrument;
  • the proximal end of the flexible member is coupled to the controller, the distal end being coupled to the end of the instrument via a tubular member;
  • the surgical robot is coupled to the controller by a proximal end of the guiding structure of the flexible instrument.
  • the surgical instrument controls the posture of the flexible instrument to bring the end of the instrument to a desired position and posture, and controls the end of the instrument to perform clamping, cutting, and the like at the end of the instrument.
  • the present invention also provides an endoscope including an imaging system, a flexible instrument for a surgical robot, a tubular, and a controller; wherein the imaging system, the flexible instrument for the surgical robot, the tubular And the controller is connected in sequence; the surgical robot uses a proximal end of the guiding structure of the flexible instrument to connect the controller; the controller controls the surgical robot to swing with the flexible instrument through the guiding structure, thereby adjusting the endoscope The pose of the far end.
  • the imaging system is mainly an objective lens group including an endoscope for realizing acquisition of a picture in an endoscope field of view;
  • the flexible instrument is used for connecting an imaging system and a tubular object, and adjusting an attitude of the imaging system;
  • a hollow thin-walled tube for supporting the end and the leading end of the endoscope such that the end of the endoscope can be inserted into the human body while the proximal end of the endoscope is placed outside the body;
  • the controller is used to control flexibility
  • the surgical robot is connected to the controller with a proximal end of the guiding structure of the flexible instrument.
  • the endoscope implements control of the pose of the flexible instrument by the controller such that the endoscopic imaging system can reach a desired pose.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Rehabilitation Therapy (AREA)
  • Manipulator (AREA)

Abstract

La présente invention concerne un instrument souple (1) pour robot chirurgical. L'instrument souple (1) pour robot chirurgical revient à un état initial à l'aide d'une structure élastique (12, 22), une structure guide (13, 23) permet à l'instrument souple (1) destiné au robot chirurgical de se trouver dans un état de flexion, et par conséquent un instrument souple présentant de multiples degrés de liberté est formé, la souplesse d'utilisation est améliorée, afin de satisfaire davantage aux exigences d'utilisation de la chirurgie. L'invention concerne également un instrument chirurgical et un endoscope, équipés de l'instrument souple (1) pour le robot chirurgical. Par conséquent, les extrémités de queue de l'instrument ou d'un système d'imagerie peuvent atteindre une position et une posture souhaitées.
PCT/CN2018/080147 2017-03-30 2018-03-23 Instrument souple pour robot chirurgical, instrument chirurgical et endoscope WO2018177200A1 (fr)

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CN201710202661.6 2017-03-30
CN201710202661.6A CN106880405B (zh) 2017-03-30 2017-03-30 手术机器人用柔性器械、手术器械及内窥镜

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CN106880405B (zh) * 2017-03-30 2019-11-22 微创（上海）医疗机器人有限公司 手术机器人用柔性器械、手术器械及内窥镜
CN107320193B (zh) * 2017-07-31 2023-06-30 成都博恩思医学机器人有限公司 连接组件、手术机器人的手术器械及手术机器人
CN107928790B (zh) * 2017-12-01 2020-05-05 微创（上海）医疗机器人有限公司 蛇形手术器械
CN109866213A (zh) * 2017-12-01 2019-06-11 深圳光启合众科技有限公司 柔性弯曲结构及具有其的机器人
CN112998862B (zh) * 2018-01-10 2023-03-10 北京术锐技术有限公司 柔性手术工具和柔性手术工具系统
CN108309207B (zh) * 2018-03-12 2020-07-17 湖南瀚德微创医疗科技有限公司 一种双向调弯的内窥镜
CN110338741B (zh) * 2019-05-30 2020-09-22 中国科学院沈阳自动化研究所 一种可视柔性手术臂
CN114305684B (zh) * 2021-12-06 2024-04-12 南京航空航天大学 一种自主多自由度扫描型内窥镜微创手术导航装置及其系统
CN113876285B (zh) * 2021-12-08 2022-03-18 德宝恒生科技服务有限公司 一种内窥镜

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