WO2021188017A1

WO2021188017A1 - Assistive surgical complex

Info

Publication number: WO2021188017A1
Application number: PCT/RU2021/050048
Authority: WO
Inventors: Дмитрий Юрьевич ПУШКАРЬ; Рахим Суфьянович НАХУШЕВ
Original assignee: Ассистирующие Хирургические Технологии (Act), Лтд
Priority date: 2020-03-19
Filing date: 2021-02-25
Publication date: 2021-09-23
Also published as: RU2720830C1

Abstract

The invention relates to medical technology. A complex comprises a patient console, an operator console, and a computer numerical control system. The patient console comprises a combined manipulator with a surgical instrument, a camera manipulator with a camera for viewing the surgical site, a system for positioning the manipulators, and means for calculating and evaluating forces acting on the surgical instrument. The operator console comprises an operator controller for controlling the movement of the surgical instrument, and a digital control unit. The means for calculating and evaluating forces comprise strain gauges, a sensor for detecting the strength with which the actuating surfaces of the instrument are gripped, and a surgical instrument torque sensor. The operator controller comprises a delta robot, and a strain gauge platform installed between a movable platform and a fixed support platform of the delta robot. A control handle for monitoring the movement of the operator's hand and the force exerted on the strain gauge platform and for converting same into a digital signal is attached to the movable platform. What is achieved is an increase in control accuracy, a more complete set of robotic surgery functions with controllable rotation of the camera at any permissible rotation angle and simultaneous correction of a coordinate system for the instruments and the controller taking account of said rotation.

Description

ASSISTING SURGICAL COMPLEX

The technical field to which the invention relates

The invention relates to the field of mechanical engineering, namely to mechanisms - mechatronic complexes designed to solve technological problems using tools fixed in manipulators, which are controlled in manual mode using a digital operator controller and / or in automatic mode, when control commands are set by the system numerical control (CNC). The mechatronic complex can be used in the following areas: robotization, teleoperation, minimal invasive surgery, simulators and others. More specifically, the invention may relate to the field of assisted robotic surgical systems for performing minimally invasive surgical procedures and for simulating such surgical procedures in a virtual environment.

Background of the invention

The increasing demands for the quality of surgical treatment require a significant improvement in surgical technologies. Traditional technologies of surgical treatment have largely exhausted the possibility of being improved, and cannot solve the set tasks. This is primarily due to the physiological capabilities of the person / surgeon, limited accuracy of hand movement, hand tremor, limited visual acuity, significant hand size, limited hand speed and other factors. A fundamentally new surgical technology capable of overcoming the listed limitations and disadvantages is required, opening up new frontiers of significant improvement in surgery. The most important parameter in the development of surgery is the indicator of the accuracy of manipulating the surgical instrument. Traditionally, when the instrument is held by the surgeon, this value is limited to 0.1 mm. And this is with the best surgeons. However, the limit / milestone of the development of surgery for this parameter is in the range of 0.01 mm, which corresponds to the size of a large cell. The closer to this border the surgical technology approaches, the greater the advantage it will have, namely, it will allow minimizing the surgical field, thereby minimizing tissue trauma during the operation, preserving nerve endings, suturing small vessels, completely removing small ones, up to size cells, neoplasms and more.

The most actively developing alternative to traditional surgery today is robo-surgery. Robo surgery is an innovative, previously inaccessible surgical technology, largely made possible by the development of mechatronics and information technologies, which has proven its worth in clinics around the world and provides new, high-quality medicine.

The use of a robot in surgery, or, more correctly, of an assisting mechatronics complex, makes it possible to obtain functional capabilities and quality that were previously unavailable to a doctor: the possibility penetrate and operate in hard-to-reach areas; higher accuracy and preset speed of movement of miniature tools; lack of tremor; rigidity and more. Robot-assisted surgeries have many advantages over traditional surgeries: for example, they can significantly reduce the volume of intraoperative blood loss and reduce the frequency of blood transfusions. Procedures of this kind are less traumatic, and therefore, in the rehabilitation period, the pain syndrome in patients is not as pronounced as with the traditional approach.

A traditional robotic surgical complex implements a surgical technology in which a mini-instrument controlled by a manipulator acts on the operating field, being delivered to it through small punctures in the patient's body. The ability to see the operating field is provided by a camera that transmits the signal to a 3D monitor. The camera, like the instrument, is inserted through the puncture and controlled by a separate manipulator. Actions / commands to the instruments and the camera through the manipulators are set by the operator's controller, controlled by the surgeon's hands. The surgeon's workplace, consisting of two controllers and a 3D monitor, is located at a considerable distance from the surgical table. This creates a difference and significant advantages over traditional laparoscopic surgery. The surgeon operates in a sitting position, in a comfortable posture, he is less tired and does not lose concentration. Also, in contrast to laparoscopy, the movement of the surgeon's control movements can be multiplied when transmitted to the manipulator and the instrument with a coefficient greater and less than 1.

Robotic surgery is being actively implemented in clinics around the world, primarily thanks to the DA VINCI robot from Intuitive Surgical Inc. Many companies are trying to compete with him and also enter the market.

For example, a surgical robot developed by the Spanish company Tecnalia and the University of Malaga is disclosed in WO2017220822 A1. The goal of the project is to provide hospitals with affordable robotic surgery that offers high precision in the performance of operations within the range of laparoscopy requirements. The robot consists of three six-axis (six-degree) manipulator arms that can function together or separately, according to the requirements of the operation. Robotic arms were chosen for this project because of their simple programming system that allows engineers to tailor their software to the specific needs of surgical procedures. Each arm weighs no more than 18 kilograms, which makes it easy to mount them on a vertical support that has been adapted to avoid the need for long cables and thus allow free and unimpeded movement of healthcare workers throughout the operating room. The robot also includes a 3D Vision screen, which allows the surgeon to expand his field of view for better control of a pair of joysticks that mimic laparoscopic instruments.

When comparing already completed developments and patented technical solutions, it is important to determine from what point of view, and by what parameters to make such a comparison. Regardless of the type or type of technical implementation, robotic surgical technologies have their own basic, their forming features and predominant parameters / signs. These are: tremor relief, instrument movement accuracy, which is superior to traditional laparoscopy, and functionality / features. It is from the standpoint of comparing these parameters that it is advisable to analyze patents of robotic surgical systems.

In early September 2019, Medtronic introduced the Hugo robotic surgical platform, which has been in development for many years. The company promises that the new robotic surgeon with a modular kitting system will reduce the cost of many operations and expand the scope of surgical robotics. The module platform consists of an open surgeon's console, an imaging system, and robotic manipulators with surgical instruments. At the same time, the imaging system and many instruments, such as surgical staplers, can be used in both robotic and laparoscopic procedures, and various components can be updated according to the financial capabilities of the hospital.

In mid-November 2019, a robotic surgeon from Corindus, which Siemens had bought a few weeks earlier, performed the first neurovascular surgery. The treatments were performed over 5G wireless, dedicated fiber optic connections, and commercial public networks by a physician 3,000 miles from the patients. The networks provided low latency connectivity and successful remote procedures. The CorPath GRX system allowed the physician to monitor the robot's actions in real time from a remote location. The findings will enable interventional cardiologists to use robotic technology to safely and effectively perform remote coronary procedures anywhere in the country. This approach will shorten the waiting time for surgery and expand access to highly qualified medical care. This technology is disclosed in international application WO2019222641 A1.

The analysis of already created, created or just patented robotic surgical systems allows us to note both their innovative differences and to draw attention to significant shortcomings and remarks. The solutions known from the prior art do not allow solving the following set of problems in one design of a robotic surgical complex:

1. To realize one of the most important advantages of robotic surgery - to create conditions that allow the surgical instrument during the operation to move / position relative to the tissues of the operating field in the range of accuracy that exceeds the accuracy of the surgeon's hand, especially with automatic, without compensating doctor's commands, control.

2. To realize another major advantage of robotic surgery - to create new, previously non-existent surgical and technological methods, thereby significantly enriching and expanding the functional arsenal of the surgeon.

3. Provide conditions for automated and automated performance of robotic surgery. 4. Provide ease of movement of the controller to control the surgical robot over the entire range of the surgeon's arms.

5. Ensure the transformation of commands from the movement of hands into scaled movements of the surgical instrument, while: the scale is not limited and depends only on the tasks for the operation; scaling can occur both upward and downward.

6. To reduce, in comparison with traditional robotic surgery, the preparatory and final time of the operation.

The listed problems reduce the efficiency of the robotic surgical complex and do not make it possible to fully realize the advantages of robotic surgical technologies.

This application is dedicated to the solution of the listed problems.

The essence of the invention

The technical problem and the achieved technical result of the present invention are to create an assisting surgical complex that surpasses prototypes and analogues in terms of key requirements of robotic surgery based on a new architecture, made possible by new properties of key blocks and a new structure of their interaction, which provides:

- the ability to achieve accuracy values that exceed the capabilities of the surgeon's hands, without compensating doctor's commands during control;

- a more complete set of robotic-surgical functions implemented by the complex, including functions performed automatically;

- the ability to receive on the hand holding the operator's controller, tactile sensations from the patient's tissues when the instrument comes into contact with them during the operation;

- Convenience and ease of the surgeon's work when controlling the operator's controller at the full amplitude of hand movements to form commands, scaled (proportionally increased or decreased in magnitude) tool movements, while the scale has no restrictions;

- automated and automatic movement of the tool and other elements of the complex at a given command from the numerical control system (CNC);

- the possibility of controlled rotation of the camera during the operation to any permissible angle of rotation with simultaneous correction taking into account this rotation of the coordinate system of the instruments and the controller;

- a significant reduction in the preparatory and final time of the operation.

At the same time, the developed assisting surgical complex should also be universal and adapt / localize to various types of surgical intervention. In order to solve the set tasks, an assisting surgical complex was developed, which is described in detail below.

An assisting surgical complex for performing high-precision minimally invasive surgical operations contains an executive console for a patient, which includes at least one combined manipulator with a surgical instrument installed on it for performing a surgical operation, at least one manipulator of a camera with a camera attached to it for viewing the operating field, providing its movement along three translational degrees of freedom; a positioning system for at least one manipulator, fixed on at least one longitudinal side of the surgical table and configured to store at least one manipulator under the surgical table in a non-working position and automatically independently extend and move each of the manipulators in a predetermined area of the operating area in a working position , means for calculating and evaluating the forces acting on the distal end of the surgical instrument and the forces acting on other working parts of the surgical instrument, an operator input console, which includes: at least one operator controller for controlling the movement of the surgical instrument mounted on the specified combined manipulator configured to provide independent seven degrees of freedom when appropriate control forces and / or movements from the operator's hand occur to rotate and / or move the controller by the operator's hand, while counter the operator's oller is configured to switch to the camera control mode using the control pedal; and a digital control unit for the operator's controller, which for each degree of the operator's controller's mobility generates a signal of the operator's hand movement and converts it into a control signal for subsequent control of the combined manipulator and / or the surgical instrument and / or the camera manipulator, the numerical program control system of the assisting surgical complex, connected with at least one combined manipulator, camera manipulator, with means for calculating and evaluating forces, with a positioning system for manipulators, with a digital controller control unit, made with the possibility of simultaneous and independent control of all elements of the complex as a whole, to generate control signals characterizing the force effect for each degree of mobility of the surgical instrument and / or the impact calculated on the basis of a given model, and transmission of these signals to the digital control unit of the operator's controller for converting them into mechanical movements of the elements of the operator's controller, and the combined manipulator includes a mechanism equipped with drive elements and made in the form of a fixed support platform and a movable platform connected to each other by means of three rods, the movable platform of the mechanism is made with the possibility of placing a surgical instrument on it, and a portal a mechanism made in the form of a transverse movement module and a longitudinal movement module, each of which is equipped with a drive unit, while the drive elements and drive units are configured to transmit and / or receive data from the numerical control system of the assisting surgical complex, while the mechanism is installed on the transverse movement module with the ability to move along it in the transverse direction, and the transverse movement module is installed on the longitudinal movement module with the ability to move along it in the longitudinal direction; moreover, all elements of the positioning system are equipped with servo drives and controllers capable of receiving and transmitting control commands from the numerical control system of the assisting surgical complex to perform the elements of the system of coordinated movements, and the means for calculating and evaluating forces include a three-axis lower strain gauge located on the manipulator support in the place of fixation of the trocar and in direct contact with it, to measure the forces applied to the instrument and directed along the xn y axes; a three-axis upper strain gauge sensor located on the manipulator support under the drive of the surgical instrument to measure the force applied to the instrument and directed along the z axis, the sensor of the gripping force of the actuating surfaces of the tool, made in the form of a current sensor for the electric motor of the drive of the tool, which provides compression of the actuating surfaces of the tool, the torque sensor vr a surgical instrument, made in the form of a current sensor for the electric motor of the instrument drive, which ensures the rotation of the surgical instrument around its longitudinal axis, and the strain gauges are connected to the corresponding digital data processing modules, and the gripping force sensor and the torque sensor are connected to the corresponding motor control systems, digital processing modules and electric motor control systems are connected to a processing module, which is programmed to perform calculations by means of group processing and synchronization of signals from strain gauges, a torque sensor and a gripping force sensor: forces directed along linear axes, tool torques along the x and y axes relative to the point of insertion of the trocar into the patient's body, the torque of the instrument along the z-axis relative to the point of insertion of the trocar into the patient's body, the compressive force of the executive surfaces of the instrument, the modulus of work is designed to transmit data to the numerical control system of the assisting surgical complex, and the operator controller includes a delta robot driven by a drive mechanism, each link of which is made in the form of a crank-connecting rod a mechanism driven by a ball screw servo drive; strain gauge platform installed between the movable platform and the fixed support platform of the delta robot, and strain gauges coupled to each ball screw are located on the strain gauge; at the same time, a control handle is attached to the movable platform with the possibility of covering it by the operator's hand and configured to control and convert into a digital signal of the operator's hand movement along at least three rotational degrees of freedom and force action on the strain-gauge platform along three linear degrees of freedom, while forming on strain gauges, the signal is transmitted to the digital control unit of the controller, which calculates and transmits to the servo drive of the corresponding link of the drive mechanism commands to compensate for the weight and / or movement along the planned trajectory calculated on the basis of the data obtained, and the numerical control system of the assisting surgical complex is made with the possibility of compensating for movement when camera movement control.

In some embodiments, the operator controller control handle includes a wrist controller providing two rotational degrees of freedom in orthogonal planes and a hand controller providing two other rotational degrees of freedom.

In some embodiments, the hand controller is equipped with a grip and finger grips.

In some embodiments of the invention, at least one actuator and a rotation sensor are mounted within the handle of the hand controller.

In some embodiments, the wrist controller is equipped with at least one actuator and a rotation sensor.

In some embodiments of the invention, at least one manipulator in an inoperative position is located under the surgical table in the leg position.

Theoretical substantiation confirming the achievement of the set technical task and technical result when using an assisting surgical complex.

One of the main and undoubtedly demanded advantages of robotic surgery is the significant, inaccessible with the previous techniques of performing operations (open or laparoscopic), technological capabilities of the instrument for performing the operation. The most significant technological capabilities essential for robotic surgery are: movements along seven (three rotations, three linear movements and one opening of the branches) and more axes of the executive surfaces of the surgical instrument during the operation; moving the surgical instrument, if necessary, during the operation with an accuracy exceeding the maximum permissible accuracy of the surgeon's hand. The last indicator includes both the accuracy of the movement of the surgeon's hand holding the instrument and the indirect effect on this indicator due to the presence of hand tremor.

Modern robotic surgery has two distinct directions of development:

According to the robotic-surgical type of movement of the surgical instrument, there are seven axes of movement of the executive surfaces of the instrument. According to the laparoscopic type of movement of the surgical instrument, there are four (three linear movements and one opening of the jaws) axes of movement of the executive surfaces of the instrument.

For surgical robots that have entered or are entering the market, the declared (passport) accuracy of the instrument movement is inferior to the accuracy of the movement of the surgeon's hand. This fact significantly reduces the functionality of such robots and does not allow the full potential of robotic surgery to be revealed.

This situation has a general tendency for all robots being developed as a functional competitor to the Da Vinci robot. The main reason for this situation is associated with the complexity of the design of robotic surgical systems, which have a significant number of links / elements that affect the accuracy. To overcome this barrier is possible only by fundamentally changing the architecture of the surgical robot. The new architecture should contain both a new structure (architecture) and the composition of mechatronic blocks and elements and mechanical connections between them, as well as a new, completely digital architecture for controlling the robotic surgical complex.

This application aims to propose a new architecture of the assisting complex, potentially capable, if necessary by the surgeon, to overcome the accuracy barrier and remove the limitations of the development of robotic surgery.

The task and the technical result are achieved due to the fact that the complex uses as modular elements new, developed for the tasks of robotic surgery, blocks that make up the assisting surgical complex, as well as more advanced architectures of their mechanical and information connections, while the information interaction of all elements of the complex is completely digital, in a single digital environment.

1. Achievement of accuracy values that exceed the capabilities of the surgeon's hands is ensured as a result of a combination of properties and features of the blocks of the surgical complex interacting during operation. In this case, the individual blocks, the properties and features of which create conditions for solving the problem, are:

A. Combined manipulator of the assisting surgical complex, influencing the achievement of the task by increased structural rigidity and dynamic accuracy due to the design of the manipulator in the form of a two-component spatial mechanism, which is an improved tripod in combination with portal mechanism of its linear movements over the working area. Such a kinematic scheme allows to ensure sufficient mobility of the surgical instrument and the angle of rotation of the surgical instrument.

B. Controller of the operator of the assisting surgical complex, influencing the achievement of the task and the set technical result with an increased accuracy of determining the position of the operator's / surgeon's hands in the entire possible range of their movement due to the use of a delta-robot mechanism in the operator's controller design, a strain-gauge platform located between a movable and a stationary platforms of the delta-robot mechanism and the digital control unit of the controller.

C. The positioning system of the manipulator of the assisting surgical complex, influencing the achievement of the task and the set technical result due to the rigidity of the structure and the possibility of attaching the manipulator directly to the operating table to the standard attachment points of additional equipment, which provides a minimum number of links / elements, the error of which affects the accuracy of movement tool.

D. The numerical control system (CNC) of the assisting surgical complex, influencing the achievement of the set task and the set technical result due to the control, correction and compensation of the position of the instrument during its movement and deviation from the desired position set by the surgeon. The CNC system provides the transformation of the coordinates of each element of the operator's controller when it is controlled by the surgeon into the coordinates of the executive device, which is a manipulator with a surgical instrument attached to it and / or the surgical instrument itself. Also, the CNC system generates drive control signals for each degree of mobility of the actuator in such a way that its movement corresponds to the direction in which the operator-surgeon acted on the mechanism of the control controller, and it was intuitive for him.

E. The system for assessing the efforts on the robotic surgical instrument of the assisting surgical complex, which affects the achievement of the set task and the set technical result due to the identification of the nature, direction and magnitude of the forces acting on the surgical instrument during operation (during the surgical operation) based on the measurement of the amount of movement of the instrument in the area of the used multi-axis strain gauge sensors, one of which is located on the manipulator support under the drive of the surgical instrument, and the other is located at the place where the trocar is attached, and each of which is connected to the digital processing module of the incoming data.

2. Achievement of a more complete set of robotic surgical functions implemented by the proposed surgical complex, including functions performed automatically, is ensured as a result of a combination of properties and features of the blocks of the complex interacting in working hours. At the same time, the properties and features of individual blocks that create conditions for solving the task and the technical result are:

A. The combined manipulator of the assisting surgical complex, influencing the achievement of the set task and the set technical result by the fact that its design is designed for the most complete implementation of robotic surgical technologies, while the unit is completely mechatronic and digital and has both direct and feedback circuits.

B. The controller of the operator of the assisting surgical complex, influencing the achievement of the task and the set technical result by the fact that its design is designed for the most complete implementation of robotic surgical technologies, while the unit is completely mechatronic and digital and has both direct and feedback circuits.

C. The positioning system of the manipulator of the assisting surgical complex, influencing the achievement of the task and the set technical result in that it has the properties to position the manipulators in various positions necessary for performing robotic operations, while being completely mechatronic and digital and has a contour of both straight and feedback.

D. The numerical control system (CNC) of the assisting surgical complex, influencing the achievement of the set task and the set technical result by ensuring fully digital control of both individual blocks and units, and the complex as a whole.

3. Achievement of the ability to receive on the hand of the surgeon holding the controller, tactile sensations from the patient's tissues when the instrument comes into contact with them during the operation, is ensured as a result of a combination of properties and features of the blocks of the complex interacting during operation. At the same time, the properties and features of individual blocks, which create conditions for solving the task at hand, are:

A. Combined manipulator of the assisting surgical complex, which influences the achievement of the set task and the set technical result in that it is completely mechatronic and digital and has both direct and feedback circuits.

B. The controller of the operator of the assisting surgical complex, which affects the achievement of the bed task and the set technical result by being completely mechatronic and digital, and has both a direct and a feedback loop.

C. The system of numerical software control system (CNC) of the assisting surgical complex, which affects the achievement of the set task and the set technical result by providing fully digital control of the operator's controller, manipulator and the system for assessing the force on the instrument, separately for each unit and during their interaction ...

D. The system for evaluating the effort on a robotic surgical instrument, which affects the achievement of the set task and the set technical result due to the evaluation of efforts on a tool and increasing the reliability of identifying their sources, as well as due to the presence of the following properties in the structure: the ability to assess the forces acting on a surgical instrument of a robotic surgical system applied to any part of its structure; the ability to unambiguously determine the direction and numerical value attached to the surgical instrument

5 strength; the possibility of uninterrupted operation of the force assessment system in the conditions of using electrocoagulation with a surgical instrument; the ability to measure the gripping force that occurs when the jaws of a surgical instrument are closed; ensuring the possibility of transmitting data on measured forces to external control systems of the robotic-surgical complex; resistance to electromagnetic interference from a household network; the possibility of using measuring sensors

10 different types and operating principles for different degrees of freedom.

4. Achieving the convenience and ease of the surgeon's work when controlling the controller at the full amplitude of hand movements to generate commands for scaled (proportionally increased or decreased in magnitude) tool movements at a scale that does not have

15 restrictions are provided as a result of a combination of properties and features of the blocks of the complex interacting during operation. At the same time, the properties and features of individual blocks, which create conditions for solving the task at hand, are:

A. Combined manipulator of the assisting surgical complex, which affects the achievement of the task by increased characteristics of the rigidity of the structure and its

20 dynamic precision.

B. Controller of the operator of the assisting surgical complex, which affects the achievement of the set task by a fully digital mechatronic implemented design that allows the operator / surgeon to interact with the hand, in any range of their movement, with the surgical complex and directly with the component

25 complex manipulator, both giving him a command and receiving feedback in response.

C. Numerical control system (CNC) of the assisting surgical complex, which affects the achievement of the task due to a completely digital control system and an algorithm for calculating the movement of the manipulator, converting it into commands for the manipulator.

IN

5. Achieving a significant reduction in the preparatory and final operation time is ensured as a result of a combination of properties and features of the complex blocks interacting during operation. At the same time, the properties and features of individual blocks, which create conditions for solving the task at hand, are:

35 A. The combined manipulator of the assisting surgical complex, which influences the achievement of the assigned task by being compact, lightweight, fully mechatronic and digital. B. Positioning system of manipulators of the assisting surgical complex, which affects the achievement of the task due to the rigidity of attachment of the manipulators while simultaneously increasing the possible positions of the manipulators relative to the patient and increasing the speed and reducing the time for moving the manipulators to the working position (working area) and back to the storage area located under leg part of the tabletop of the operating table in such a way as to preserve the traditional functionality of the table, which allows you to quickly interrupt the robotic surgery and continue it in the abdominal operation mode.

C. Numerical control system (CNC) of the assisting surgical complex, which affects the achievement of the task by providing fully digital control of the positioning system of the manipulator and the combined manipulator, both as separate units and their joint work.

6. Achievement of automated and automatic movement of the tool and other elements of the complex at a given command from the numerical control system (CNC) is ensured as a result of a combination of properties and features of the blocks of the complex interacting during operation. At the same time, the properties and features of individual blocks, which create conditions for solving the task at hand, are:

A. Combined manipulator of the assisting surgical complex, which affects the achievement of the task by being fully mechatronic and digital

B. The controller of the operator of the assisting surgical complex, which influences the achievement of the assigned task by a fully digital mechatronic implemented design.

C. The positioning system of the manipulator of the assisting surgical complex, which affects the achievement of the task by being completely mechatronic and digital.

D. Numerical control system (CNC) of the assisting surgical complex, which affects the achievement of the task due to a fully digital control system for the manipulator, operator controller and positioning system of the complex.

7. Achievement of the possibility of controlled rotation of the camera during the operation at any permissible angle of rotation with simultaneous correction taking into account this rotation of the coordinate system of the instruments and the controller is provided as a result of a combination of properties and features of the blocks of the complex interacting during operation. At the same time, the properties and features of individual blocks, which create conditions for solving the task at hand, are: A. Combined manipulator of the assisting surgical complex, which affects the achievement of the task by being fully mechatronic and digital

B. The controller of the operator of the assisting surgical complex, which affects the achievement of the task by being a fully digital mechatronic implemented design.

C. The system of compensation by the camera of the assisting surgical complex, which influences the achievement of the set task in that it is completely mechatronic and digital and has a special unit for setting and controlling.

The objects and advantages of the present invention will become more apparent to those skilled in the art upon consideration of the following detailed description and drawings.

Brief Description of Drawings

The accompanying drawings, which are incorporated and form part of the present specification, illustrate embodiments of the invention, and together with the foregoing general description of the invention and the following detailed description of embodiments thereof, serve to explain the principles of the present invention.

FIG. 1 depicts a structural model of a robotic surgical system that is used for the present invention.

FIG. 2 illustrates a schematic diagram of a specific embodiment of an assisting surgical unit.

FIG. 3 illustrates a perspective view of a controller for controlling the mechatronic devices of an assisting surgical unit by an operator.

FIG. 4 illustrates the developed model of an operator controller with a positioning unit made in the form of a delta robot.

FIG. 5 illustrates an operator controller positioning unit.

FIG. 6 illustrates a general view of the structure of a manipulator.

FIG. 7 shows a general view of a model of a tripod with a surgical instrument installed on its movable platform.

FIG. 8 illustrates a general view of the structure of the manipulator with a surgical instrument installed on its movable platform.

FIG. 9 illustrates a schematic representation of a surgical instrument located on a support attached to a manipulator.

FIG. 10 depicts the architecture of a force rating system.

FIG. 11 illustrates the mechanism of the manipulator positioning system and its attachment to the operating surgical table. FIG. 12 illustrates a general view of the assembly of the manipulator positioning system in the working position.

FIG. 13 depicts a block diagram of the operation of the automatic control system of the camera manipulator.

FIG. 14 illustrates the interaction of the surgeon's hands with the controller for nephrectomy.

FIG. 15 illustrates the most common position of the surgeon's hands during the operation.

Terms and Definitions

For a better understanding of the present invention, below are some of the terms used in the present description of the invention. Unless otherwise specified, technical and scientific terms in this application have the standard meanings generally accepted in the scientific and technical literature.

In the present description and in the claims, the terms “includes”, “including” and “includes”, “having”, “equipped”, “containing” and their other grammatical forms are not intended to be construed in an exclusive sense, but, on the contrary, are used in a non-exclusive sense (ie, in the sense of "including"). Only expressions of the type “consisting of” should be considered as an exhaustive list.

In these application materials, the terms “robotic technological complex”, “robotic system”, “robotic complex”, “robotic surgical complex”, “robotic surgical system”, “assisting surgical complex” mean complex systems or complexes in surgery using a robotic assistant during operation time. "Robot assistive systems" or "robotic assisted surgical systems" are robotic systems designed to perform medical operations. These are not autonomous, automatic devices, robotic-assisting systems during the operation are controlled by surgeons.

In these application materials, the term "mechatronic complex" or "mechatronic system" means a complex or system with computer control of motion, which is based on knowledge in the field of mechanics, electronics and microprocessor technology, computer science and computer control of the movement of machines and assemblies.

In this application, the term "operator" refers to the performing the operation of the surgeon. The terms "operator" and "surgeon" in the present description of the invention are synonymous.

In these application materials, the term "manipulator" means a mechatronic mechanism designed to secure and move (change the position) of a surgical instrument during a surgical operation in accordance with given commands from the control system of the robotic surgical complex.

In these application materials, the term "portal mechanism" is understood as a mechanism of a robotic system, consisting of two support (portal) frames, which are able, upon command from the control system of the robotic surgical complex, to move relative to one another along axes located at an angle of 90 ° relative to each other.

In the present application materials, the terms "longitudinal displacement module" and "lateral displacement module" are understood as mechanisms that ensure the mutually perpendicular movement of one or another element relative to each other.

In this application, the term "surgical instrument", "instrument" means a special instrument of small size, which is fixed in a surgical robot for performing operations. During surgery, instruments can move, rotate, and rotate over a much wider range and much more accurate than the human hand. Depending on the type of operation, the appropriate tool is used that allows it to be carried out most efficiently. A miniature robotic surgical instrument performs tissue dissection, tissue movement, clamping, suturing, etc., which allows you to work with hard-to-reach parts of organs without the risk of damaging healthy tissues.

In the present application, under the sign "tool execution surfaces", "tool execution part" means the tool surfaces or part of the tool with which the tool performs its service purpose. Typically, the actuation surfaces, such as jaws, are located at the end of the instrument inserted into the patient's body and perform complex movements initiated and controlled by the surgeon.

Under the term “universal” in terms of its use with respect to the controller, in this document, the controller is raised, which “digitizes” - translates the position of the operator's hand into numerical values / coordinates and allows integrating a new tool into the complex and controlling it, without further changes in the controller design. Having mastered the controller once, the operator uses it for a long period of his practice, thanks to the controller's property to integrate ("represent" the surgeon's hand) in various, including remote mechatronic devices.

Sweat by the term "absolute position" in this document means a coordinate defined relative to a fixed structural member.

The term "rotation sensor" in this document refers to a device designed to convert the angle of rotation of a rotating object into electrical or analog signals, allowing you to determine the angle of rotation. In principle, all types of angle encoders are suitable for determining the value of the angle of rotation of an element. However, most of the sensors used require, first of all, permanent registration and storage of the current data on the rotation of the element. Rotary sensors can be used on based on incremental and absolute encoders. The sensors have digital output signals Linedriver (TTL, RS422), Push-Pull (HTL), SSI, CAN, Profibus, Profmet and others. Sensors based on analog steering angle sensors and / or magnetic steering angle sensors can also be used.

The term "connected" means functionally connected, and any number or combination of intermediate elements between the connected components (including the absence of intermediate elements) can be used.

In addition, the terms "first", "second", "third", etc. are used simply as conditional markers, without imposing any numerical or other restrictions on the enumerated objects.

Detailed description of the invention

The description of exemplary embodiments of the present invention below is provided by way of example only and is intended for illustrative purposes and is not intended to limit the scope of the disclosed invention.

The present solution relates generally to an assisting surgical system, the general structure of which is shown in FIG. 1. The robotic surgical complex includes three main units. The first node is the controllers, which serve as a master device and with which the surgeon interacts directly. The second executive unit is manipulators on which medical instruments are installed. Depending on the procedure performed, it is possible to change the medical instrument to a more suitable one. The third node of the robotic-surgical complex is the computing unit, with the help of which all interactions of the system are carried out. The robotic surgical complex can be used for various surgical procedures, including urology, gynecology, abdominal, neuro- and cardiac surgery.

In more detail, the robotic surgical complex 1000 consists of three interconnected main units: the patient carriage (actuator) 1300, the automatic control system 1200 and the control console (master device) 1100, which receives commands from the surgeon 1130 to further transform them into movement of surgical instruments or to ensure the generation of control commands from the surgeon for other units of the robotic surgical complex.

Also, one of the nodes in the robotic surgical complex is a stereo imaging system (imaging system), which includes a camera 1400 for obtaining an image of the operating field 1330 and a monitor of the imaging system 1140 for displaying a three-dimensional image of the operating field obtained from the camera. The efficiency of the operation depends on the quality of the image obtained by the surgeon. The modern development of mechatronic systems and the constant improvement of robotic surgery present new requirements for the developed devices of the visualization system.

The control console 1100 is located outside the sterile zone of the surgical unit and is made with the ability to control: manipulators 1310, 1311, 1312 with surgical instruments attached to them; a manipulator 1320 with a camera 1400 attached to it; directly by the surgical instruments themselves. The control involves the controller 1110, controlled by the hands of the surgeon, and the pedals 1120, controlled by the feet of the surgeon.

Typically, manipulators with surgical instruments and a camera are mounted on a patient trolley, which is designed to support and position them relative to the patient. It should be understood that the robotic surgical system can have any number of manipulators, such as one or more manipulators. FIG. 1 shows three manipulators 1310, 1320, 1330, made with the possibility of movement in three planes and rotation in three planes, as well as a manipulator 1320 of the camera 1400. All manipulators indicated in the structural diagram and being part of the patient cart have common mechanical characteristics and design features ... Each manipulator has a casing and a manipulator connection unit, to which a surgical instrument or camera can be detachably attached, the movement and position of which the surgeon can change by manipulating / controlling using a control controller that digitizes the movement of the surgeon's hands.

The surgeon control controller 1110 (operator controller) allows you to control the surgical instruments and the camera located inside the patient during surgery. The operator controller 1110 converts the mechanical movements of the surgeon's hand over the entire natural range of motion in six degrees of freedom to generate control commands for the robotic surgical complex.

The surgeon's control controller (operator controller) 1110 generates a command to move the surgical instrument. Additionally, the controller controls the turning and opening-closing of the jaw on the surgical instrument. The surgeon 1130 has the ability to generate at least three translational and three rotational degrees of freedom and additionally at least one degree of freedom when opening / closing jaws, which is sufficient to control a surgical instrument performing a surgical operation.

Pedal 1120 in this application is understood as a contact switching device (mechanical or electronic) capable of turning on / off the passage of current in a circuit. A pedal, button, switch, switch and the like can act as such an apparatus. Hereinafter, within the scope of this present application, the pedal 1120 is a footswitch that closes an electrical circuit when the surgeon depressing the pedal with his foot. There can be several pedals in the control console. The pedals are designed to change the operating modes of the control controller, or to switch an additional functional, such as coagulation, laser and the like. Footswitches allow the surgeon to control the camera, instruments, electrosurgical instruments.

The automatic control system 1200, based on the data received from the controllers 1110 and the signal from the pedals 1120, generates control commands that can be directed both to the manipulators 1310, 1311, 1312 with surgical instruments, and to the manipulator 1320, in which the camera is fixed. Pressing and holding the footswitch 1120 disables controllers 1110 from operating surgical instruments (from operating manipulators 1310, 1311, 1312 with surgical instruments) and enables and allows movement of manipulator 1320 with camera 1400. In this mode, both controllers 1110, right and left work at the same time. When the pedal 1120 is released, the controllers 1110 will again operate the surgical instruments. In this case, the automatic control system 1200 receives data on three translational and three rotational degrees of freedom from the control controller 1110 and generates on their basis three translational and three rotational movements of the manipulator with a surgical instrument.

Since the surgeon can control the movement and orientation of the surgical instruments without actually holding the surgical instruments directly in his hands, he (the surgeon) can operate the complex both in a sitting and standing position. As an adaptation for a seated position, the complex can be provided with a chair.

A preferred embodiment of an assisting surgical unit 2000 according to the present invention is depicted in FIG. 2. The complex consists of the following main components:

2110 - The surgeon's control controller (operator's controller) used in the complex according to the present invention, which receives commands from the surgeon, converts them into the movement of the surgical instrument inside the patient's body during the surgical operation and / or provides all control commands from the surgeon with the components of the robotic surgical complex.

2150 - Digital operator controller control unit.

2200 - An automatic control system made in the form of a numerical programmed control (CNC) system of an assisting surgical complex, and providing numerical control of the entire complex and individual units, such as a monitoring system for the operating field, surgical instruments, auxiliary technological equipment, an operating table, and equipment.

2310 — A surgical instrument manipulator used in the assembly of the present invention.

2340 - Positioning system of the manipulator relative to the operated one.

2320 - Camera manipulator, which allows you to obtain an image of the operating field during a surgical operation. In this case, the control controller (operator controller) 2110 interacts with the mechanical manipulator 2320, which is part of the robotic surgical complex, with a camera attached to it, in such a way as to reduce or completely eliminate the number of compensatory movements performed by the surgeon when controlling the camera, thereby ensuring a reduction in the duration of the operation , reducing the risk of surgeon errors, as well as reducing surgeon fatigue based on the most intuitive way to control the camera.

Also, in the force feedback loop of the present robotic surgical complex, a system for evaluating the forces of action on the patient's tissues and organs with a tool in the process of a robotic surgical operation is integrated. The use of such a system allows the surgeon to realize tactile sensations from the contact of the instrument surfaces with the patient's tissues, without creating sensations from the contact of the instrument with the trocar, which are forced to arise in the form of friction and various lateral forces when the instrument moves in the trocar during operation.

Below is a detailed description of the design of the improved blocks, which are the constituent elements of the assisting surgical complex, as well as their informational links with each other.

The operator controller 3000 (Fig. 3) belongs to the class of mechanisms that ensure the conversion into an electronic digital signal of commands that a person sets with a movement of the hand. A general view of the operator's controller is shown in Fig. 3. The operator controller 3000 generally consists of a control handle 3100, a positioning platform unit 3200, and a digital control unit (not shown in the drawing).

The specified controller 3000 has a feed-forward loop for giving commands from the operator (surgeon) through the movement of his hand to the mechatronic device, and a feedback loop for transmitting in reverse order to the operator's hand the response commands-responses from the mechatronic device. The controller 3000's feedback loop is designed to transmit tactile sensations to the hand.

The hand contact of the controller 3000 is realized at the control handle 3100. The control handle 3100 generally consists of a hand controller 3110 and a wrist controller 3120, each of which provides two rotational degrees of freedom for the controller 3000.

The 3200 controller positioning platform block is a hand controller that provides three translational degrees of freedom of the controller 3000 by reciprocating the movement of the controller 3000 mechanism along three mutually orthogonal axes. At the same time, a wrist controller 3120 is attached to the hand controller 3200, which is part of the control handle of the controller 3100. Thus, the operator controller 3000 monitors and converts into a digital signal the movement of the hand in six degrees of freedom. FIG. 4 depicts a perspective view of a mechatronic device controller with six degrees of freedom and consisting of a hand controller, a wrist controller, and a hand controller.

The hand controller (or block-positioning platform) 3200 consists of at least two platforms - fixed support and movable - and a positioning unit. A movable platform is attached to the fixed support platform by means of a weight compensation mechanism including a positioning unit made on the principles of a parallel structure, preferably based on a delta type mechanism (delta robot or deltapod), and a drive mechanism that drives the delta robot while ensuring minimal backlash.

Anyone can use the parallel structure mechanism. In a preferred embodiment of the controller, the positioning unit is a closed kinematic chain consisting of rods of constant length arranged in pairs in parallel and connected at one end to the corresponding actuators fixed on a fixed support platform, and at the other ends to a movable platform. Delta mechanisms have increased maneuverability and an extended border of the working area.

Moreover, the controller based on the parallel structure mechanism, in comparison with the sequential structure controllers and other controllers, has a significantly lower weight and size, while at the same time greater accuracy, rigidity and power.

The delta robot (FIG. 5) is a view of a parallel robot that consists of three arms 410 located at an angle of 120 ° relative to each other and attached to a support platform 420. An advantage of the delta robot design is the use of parallelograms 440 containing constant-length rods arranged in pairs in parallel and connected to each other using cardan joints 450. The parallelograms 440 are connected at one end by the corresponding levers 410, and at the other end are connected to the movable platform 430. This design allows you to maintain the spatial orientation of the robot mechanisms. In this case, the movable platform 430 is always parallel to the supporting platform 420.

The connection of the arms 410 to the support platform 420 is made through the upper bearing assemblies 460 to provide the necessary angles for the initial state of the delta robot. The upper bearing assemblies 460 are fixed on a support platform 420. Mounted on the upper bearing assemblies 460, the levers 410 form an equilateral triangle at the connection centers, the angles of which affect the size of the useful working area of the delta robot. Levers 410 are responsible for the movement along the Z axis. By increasing the length of the lever 410, the stroke along the Z axis increases. The dimensions when moving along the X and Y axes are set by parallelograms 440.

The controller drive mechanism that drives the controller positioning unit, in particular the levers 410, can be made in the form of any known mechanism, ensuring the reduction of precision losses due to backlash during the operation of the mechanism. In a preferred embodiment of the controller, the drive mechanism can be configured as a crank mechanism. It is driven by a ball screw, which performs rotary movements by a servo drive with an integrated electromagnetic brake and an angle position sensor. Servo drive is an electromechanical device that carries out dynamic movements with constant control of the angle of rotation of the shaft, and also provides the ability to control angular speeds in various actuators. Depending on the value of the control parameter received at the controlled input of the servo drive, as a result of comparing this parameter with the value of the angle position sensor (encoder) or with a mathematical model (the calculation algorithm is sewn into the memory of the frequency converter), the parameters of the electric drive change and some corrective action is taken for the servo motor (or a series of actions), such as shaft rotation, acceleration or deceleration, so that the value from the encoder is as close as possible to the value of the external control parameter. The type of servo used can be anything. In some embodiments of the controller, an integrated servo is used.

In some embodiments of the controller, any known backlash-free gearbox with zero mechanical backlash can be used as a drive mechanism, for example, a backlash-free precision gearbox, preferably wave type, or a planetary gearbox with an angular backlash of less than 6 '.

In a preferred embodiment, the drive mechanism includes a ball screw servo 510 with a crank mechanism. Depending on the pitch of the ball screw and the radius of the crank, the gear ratio of the drive train can be increased or decreased.

On the cylindrical guides 570 between the movable platform 430 and the guide platform (not shown in the drawing), a strain-gauge platform 610 is installed and fixed, which is configured to obtain digital information in three-dimensional space about the applied force, the vector of force application and the acceleration of the force applied to the hand from the forearm and other, higher-located parts of the operator's hand during control of the mechatronic complex. The strain gauge 610 is equipped with strain gauges (strain gauges) 600 to accurately and efficiently determine the applied forces from the operator, which are attached to the strain gauge through bearing assemblies 620. Strain gauges 600 convert the amount of deformation into an electrical signal.

Load cell 600 on one side with its movable end is connected to the support bearing housing 620, and on the other side is connected with the other end to the load platform 610 through the bearing assembly of the load platform 660. Load cells 600 are located on the load cell 610 and are mated to each ball screw, namely shaft ball screw drive, through the support bearing units 620.

When forces arise from the operator's side, the mechanical force applied by the operator and transmitted from the forearm to the operator's hand passes through the movable platform 430 of the hand controller along the rods of parallelograms 440 of equal length, arranged in pairs in parallel and connected by one ends behind the drive crank mechanism. The crank mechanism, in turn, is connected to a ball screw drive. In particular, the arm 410 is connected to the upper bearing assembly 460 and via the connecting rod to the lower bearing assembly. Thus, the rotational movements of the lever 410 are translated into translational movements of the guide platform, on which the lower bearing assemblies and the ball screw nut are installed. The translational movements from the nut are transmitted to the rotational movements of the ball screw shaft, which acts on the support bearing assembly 620. Therefore, through the ball screw, the crank mechanism acts on the support and bearing assembly 620. The load cell 600 mounted on the load cell 610 with its movable end connected to the support bearing housing 620. The load cell 600 converts the amount of deformation into an electrical signal and transmits it through its outputs to a digital controller control unit (not shown in the drawing).

The digital control unit of the controller, in turn, based on the received signal according to a given program, calculates the trajectory of the delta robot along three linear coordinates and, using servo drives, moves the positioning unit to the required position. For example, the digital control unit can be configured to compare the received value of the deformation signal, and therefore the displacement, with a predetermined value that determines the position of the delta robot in equilibrium and supply such a control signal to the servo drive so that the value from the position sensor angles became as close as possible to the value of the external control parameter. Such a mechanism makes it possible to implement a mechanism of controlled counteraction to the natural lowering of the delta-robot under the influence of the gravity of the moving parts of the controller - the “virtual weight” system (SVV). UHV allows you to adjust the weight felt by a person on the control handle of the controller in the range from the actual (100%) to 0% - "zero buoyancy".

The "virtual weight" system multiplies the amount of force applied by the operator's hand to the control handle of the controller, which allows you to individually select and always provide a comfortable and constant force for a person when acting on the controller, regardless of the size and weight of the parts that make up the controller.

The digital control block of the controller is configured and built in such a way that allows you to focus maximum efforts on high-level control algorithms, freeing the user from the need to develop and debug devices and applications for controlling individual servo drives. The digital control unit of the controller has the ability to record all control commands and transfer them to the numerical control system (CNC) of the assisting surgical complex, which can be performed on a computer.

Thus, the configuration of the hand controller makes it possible to move it by the operator's hand along three linear coordinates, without spending significant forces on the operator's hand, compensating for the lack of force by the operation of the actuator motors, controlled by signals from the digital control unit of the controller to obtain the exact coordinates of the hand position from the movement of the forearm and other higher , parts of the hand of the operator-surgeon at least three degrees of freedom, and compensation for the weight of the hand controller in statics or during movement.

The wrist controller 3120 attaches to a movable hand controller platform (FIG. 4). The main purpose of the 3120 wrist controller is to implement contact and interaction with the operator's wrist and provide at least two rotational degrees of freedom, both for realizing the orientation of an element of the mechatronic complex in response to the rotation of the operator's wrist, and for transferring forces to the operator's wrist when simulating one or another steps to train the operator.

The wrist controller 3120 is configured to most accurately determine the angle of rotation of the wrist in two orthogonal directions relative to a given center of rotation (relative to the place of attachment of the wrist controller to the hand controller) over the entire amplitude to obtain digital information about turns in the operator's wrist during control of the mechatronic complex. The design of the wrist controller is limited and specified by the physiological angle of the possible rotation of the wrist in these planes.

The wrist controller 3120 includes at least two blocks: a pivot block and a movable console block, each of which provides two degrees of freedom for the wrist, and at least one wrist controller control block.

The rotation mechanism assembly is attached to the hand controller 3110 so as to be rotatable about the longitudinal axis of the hand controller while providing one degree of freedom for the hand controller. The structure of the movable arm block provides one degree of freedom relative to the swing mechanism block.

The use of at least one angle detection sensor for each rotational degree of freedom allows the absolute position of the tilt angle of the wrist controller to be determined. In some embodiments, in addition to rotation sensors for determining the absolute position of a controller element, these elements may be equipped with tachometers, accelerometers, and force load indicators, each of which may provide electrical signals related to speed. acceleration and force applied to the corresponding element.

For reading data from sensors for determining the angle of rotation and performing a rotation the block of the movable console and / or the block of the rotation mechanism, the hand controller includes the drive elements.

To determine the coordinates of the surgeon's wrist apparatus as part of the operator controller 3000 for controlling the mechatronic complex, the hand controller 3110 is used. The hand controller 3110 is designed for contact and interaction with the surgeon's hand and, most accurately, controls at least one angle of rotation of the hand and movement, relative position of at least two fingers, converting this information into a digital signal.

Additionally, the hand controller 3110 provides a minimum weight load on the operator's hand during control, has and implements a feedback channel from an element of a robotic technological complex or a control system as a whole.

The hand controller 3110 is characterized in that it contains a grip with finger grips. The handle has a body that is gripped and held by the operator during operation. Finger grips are made with the possibility of placing the operator's fingers on them during operation. The hand controller includes sensors for the rotation of the finger grips to determine the absolute position of the finger grips relative to the axis of rotation of the finger grips and a handle rotation sensor to determine the absolute position of the handle relative to its longitudinal axis, drive elements of the handle and finger grips, and a wrist controller control unit.

When forces are exerted by the operator, the 3110 hand controller monitors and digitizes the operator's hand deflection, as well as the position (approach / close / withdrawal) of at least two fingers, together with the operator's hand, wrap around the hand controller handle in the area of the finger grips.

When the handle is turned by the operator's hand, the handle rotation sensor generates a digital signal about the angle of rotation and transmits it to the control unit of the hand controller, which calculates the angle of deflection of the handle relative to its longitudinal axis and transmits this information to the digital control unit of the controller, which is configured to transmit the received signals on the numerical control system (CNC) of the assisting surgical complex, which can be performed on the basis of a computer.

Finger grips work in combination. In one embodiment, one finger grip is integral with the handle body and is stationary relative thereto. The other finger grip is movable and has one turn, rotating around its axis coinciding with the longitudinal axis of the handle. During operation, the finger gripper rotation sensor reads the angle of rotation of the movable finger grip around its axis of rotation and transmits a digital signal to the hand controller control unit, which calculates its position relative to the stationary finger grip and transmits this information to the digital controller, which is configured to transmit the received signals on a numerical software system control (CNC) of the assisting surgical complex, which can be performed on the basis of a computer.

When forces are applied by the operator, the wrist controller monitors and digitizes the deflection of the wrist relative to the anteroposterior axis in the sagittal plane (abduction or adduction of the hand, also sometimes called radial deviation of the hand), as well as the rotation of the wrist around a predetermined center, repeating the rotation of the radius together with a hand around the ulna relative to the longitudinal axis of the operator's hand.

When the movable console unit is deflected by the operator's wrist from the anteroposterior axis lying in the sagittal plane, the rotation sensor of the movable console unit generates a digital signal about the angle of rotation and transmits it to the wrist controller control unit, which calculates the console deflection angle and transmits this information to the digital control unit controller, which is configured to transmit the received signals to the numerical control system (CNC) of the assisting surgical complex, which can be performed on the basis of a computer.

When the rotation mechanism unit is rotated around a predetermined center with the operator's wrist, the rotation sensor of the rotation mechanism unit generates a digital signal about the rotation angle and transmits it to the control unit of the wrist controller, which calculates the angle of deflection of the unit relative to the longitudinal axis of the operator's hand and transmits this information to the digital control unit controller, which is configured to transmit the received signals to the numerical control system (CNC) of the assisting surgical complex, which can be performed on the basis of a computer.

The digital control unit of the controller, on the basis of the received data, plans the trajectory of rotation of the handle and / or finger grips and / or the unit of the swing mechanism and / or the unit of the movable console and using the control signal supplied to the drive element of the handle and / or the drive element of the finger grips and / or the drive element of the pivot mechanism unit and / or the movable console unit, moves the handle and / or finger grips and / or the pivot mechanism unit and / or the movable console unit and the hand itself and / or the operator's wrist to the required position.

Hand controller control units and / or wrist controller control units, strain gauge platform, digital controller control unit can be interfaced with the digital controller control unit via a common data bus. The digital control unit of the controller is configured to record data on received / transmitted commands. The digital control unit of the controller, in turn, through a common data bus is interfaced with the CNC system of the assisting surgical complex.

Thus, the digital control unit of the controller has the ability to repeat / demonstrate the movements of the recorded commands both in free mode and transferring movements to the operator's hand located on the controller handle.

Data transmission means are selected from devices designed to implement the process of communication between various devices via wired and / or wireless communication, in particular, such devices can be: GSM modem, Wi-Fi transceiver, Bluetooth or BLE module, GPRS module, Glonass module, NFS, Ethernet, etc.

The operator controller is used to control a manipulator with surgical instruments or a camera. Therefore, any movement of the hand or wrist or hand of the surgeon leads to movement of manipulators or surgical instruments. Control signals from the digital control unit of the controller go to the CNC system of the assisting surgical complex, to the digital control unit of the manipulator positioning system and directly to the drive elements, the manipulator drive units to set them in motion.

The combined manipulator 4000 (Fig. 6), used in the assisting surgical complex, is a two-component spatial mechanism, or rather an improved tripod design in combination with a portal mechanism of its linear movements over the working area. Such a hybrid kinematic scheme makes it possible to create a manipulator with the necessary mobility and the angle of rotation of the output link, on which the surgical instrument is ultimately installed.

In general, the combined manipulator 4000 includes a 4100 mechanism equipped with drive elements 4200 (tripod or tripod type mechanism) and a portal mechanism for moving the 4100 mechanism along two linear axes, equipped with drive units 4400. In this case, drive units 4200 and drive units 4400 are made with the possibility of transmitting data to the control system of the robotic surgical complex (CNC system of the assisting surgical complex) when moving elements or receiving control signals from the control system of the robotic surgical complex (from the CNC system of the assisting surgical complex) to move the output link of the manipulator to the required position according to the calculated data.

Tripod 4100 consists of two platforms: a fixed support platform (base) 4110 and a movable platform 4120, which are interconnected by three rods 4130 of constant length.

The three rods 4130 are connected at one end through a bearing assembly with corresponding drive elements 4200, and the other ends of the rod 4130 are connected through hinges to the movable platform 4120. The rods 4130 are universal shafts, and the hinges in the preferred embodiment of the invention are cardan joints (Hooke's hinges), which provide two degrees of freedom at the attachment point (two rotational degrees of freedom).

The mechanism 4100 of the "tripod" type is driven by the drive elements 4200. By interconnectedly controlling the three drive elements 4200 according to a certain law, it is possible to move the movable platform 4120 of the manipulator tripod in space (two rotations and one linear movement). The movable platform 4120 of the tripod is its end link, therefore, it is the output link of the tripod.

In some embodiments of the manipulator, the actuator 4200 may be any known mechanism to reduce loss of accuracy due to backlash. For example, any known servo drive can be used as a drive element 4200 in conjunction with a backlash-free gearbox with zero mechanical backlash, for example, a backlash-free precision gearbox, preferably wave-type, or with a planetary gearbox with an angular backlash of less than 6 '.

In a preferred embodiment, the actuator 4200 includes a dynamic and precise synchronous ball screw servo. Depending on the pitch of the ball screw, the gear ratio of the drive element can be increased or decreased.

The design of the portal mechanism provides two additional linear movements for the 4100 tripod in space - longitudinal and transverse. The portal mechanism consists of a transverse movement module, along which tripod 4100 moves in the transverse direction, and a longitudinal movement module, along which a lateral movement module moves in the longitudinal direction. Module structures are located in parallel planes. Each of the modules is made in the form of a rectangular frame.

The drive unit 4400 of the portal mechanism can be made in the form of any known mechanism that provides a reduction in accuracy losses due to backlash during operation.

In a preferred embodiment of the arm, each of the linear axes of the gantry is driven by a precision synchronous servo 4410 in conjunction with a belt drive. The 4410 servo drive is paired with the 4411 precision planetary gearbox. It is required to increase the motor torque and increase the load capacity of the structure. The 4411 gearbox can be any known zero-backlash gearbox. The belt drive is a polyurethane toothed belt paired with 4412 toothed pulleys. These drive belts are not stretched due to the pressed-in cord, and thus are not subject to permanent deformation. The elongation caused by peripheral forces and pretension is extremely small. This solution is suitable for high power transmissions and the required accuracy.

The result is a manipulator as a combination of a kinematic solution in the form of a 4100 tripod mechanism and a portal mechanism of its linear movements. Tripod possesses two rotational and one translational degree of freedom. The translational movement (Z axis) is ensured by the synchronous operation of three servomotors in the same direction. The mechanism of linear movements of the tripod provides an additional two degrees of freedom (along the X, Y axes).

Thus, the developed manipulator allows the most accurate, with the maximum required angles of rotation, with the minimum weight and size of the structure, to ensure the movement of the output link (movable platform of the tripod) around the remote center of movement - point "0".

A surgical instrument 4500 (Fig. 7) is mounted on the output link of the combined manipulator, for example, made in the form of an end effector 4510 with jaws and a drive 4550 to control the end effector of the surgical instrument. The actuator 4550 is mounted on a platform of a surgical instrument (not shown in the drawing), for which a separate actuator 4600 is provided for movement along one linear axis.

Actuator 4600 can be any known mechanism to reduce loss of accuracy due to backlash during operation. In a preferred embodiment of the manipulator, the platform of the surgical instrument, in conjunction with the surgical instrument, is driven by a linearly accurate synchronous servo drive 4610 in conjunction with a belt drive. It provides an additional Z-stroke to the 4500 surgical instrument when movement along this axis, due to the simultaneous operation of the 4210 servo motors of the 4100 tripod, would be insufficient, undesirable or impossible.

To implement the above-described linear movement of the surgical instrument 4500 along the Z axis, the platform 4620 is rigidly connected to the movable platform 4120 of the tripod with a linear guide 4630 installed on it, along which the carriage (not shown in the drawing) with the platform of the surgical instrument fixed to it moves with the help of the servo drive 4610 4500.

Such a kinematic scheme allows the insertion of the instrument into the patient's body at point "0" (the point of entry of the surgical instrument into the patient's body) and, using the developed mathematical apparatus of the control system, ensure the movement of the entire mechanism around this point.

When it becomes necessary to move the manipulator, the surgeon moves the "handle" of the operator's control controller. A digital signal is generated and transmitted to the digital control unit of the controller, and then to the CNC system of the assisting surgical complex. The CNC system transforms the coordinates of all elements of the operator's controller into the coordinates of the executive device (manipulator). It generates drive control signals for each degree of mobility of the actuator in such a way that one or another of its movement corresponds to the direction in which the operator is the surgeon acted on the mechanism of the control controller, and it was intuitive for him. Possible movements of the combined manipulator are shown in Fig. 8.

The drive units (drive elements) of the manipulator and the surgical instrument are connected to the CNC system. They are linked via a common data bus. The CNC system is made with the ability to record data on the received commands. Data transmission media are selected from devices designed to implement the process of communication between various devices via wired and / or wireless communication, in particular, such devices can be: GSM modem, Wi-Fi transceiver, Bluetooth or BLE module, GPRS module, NFS, Ethernet etc.

Force assessment system.

To measure the forces acting on a surgical instrument in the process of carrying out a robotic surgery, and to transmit information containing the measurement results, the complex uses a force assessment system. The system is an integral part of the actuator of the robot-assisted surgical complex and implements the measurement functionality for the implementation of tactile feedback by the complex. The force evaluation system used in the force feedback loop should have the following functions:

• Measurement of data of forces applied to the tool using several multi-axis strain gauges;

• Primary processing of data on applied forces with the provision of conditions for limiting the frequency characteristics of signals in order to reduce measurement noise and suppress the influence of electromagnetic interference;

• Transmission of processed data in real time to a higher-level control system using a wired or wireless communication interface.

FIG. 9 is a schematic illustration of a surgical instrument attachment structure. The mount design is a support configured to position and secure the trocar to it and secure the instrument by securing the instrument drive. For precise positioning of the instrument, a trocar holder is used in the mount design. FIG. 9 numbers indicate the following structural elements: 5100 - three-axis strain gauge (upper strain gauge); 5200 - three-axis strain gauge (bottom strain gauge); 5300 - trocar holder. The designations adopted in FIG. 9: 01 is the point of insertion of the trocar into the patient's body, around which two rotations of the instrument inserted into the trocar are made during the operation (zero point), the point is inside the trocar, A is the position of the end of the surgical instrument that is inserted into the patient's body, B is the position of the opposite the end of the surgical instrument installed in the surgical instrument drive. Angles of orientation (angles of rotation) of the surgical instrument in the horizontal plane and tilt are considered relative to the pivot point (zero point). Zero point 01 is defined as the origin.

The mechanical interaction of the elements of the instrument, the structure of the fastening of the surgical instrument and the elements of the manipulator is realized through two multi-axis strain gauges, one of which is located at one end of the instrument under the instrument drive, and the other at the place where the trocar is fixed. The location of the strain gauges is shown in FIG. 9.

This arrangement of strain gauges has the following advantages:

• Physical distance of the sensitive elements of the sensors from the electrocoagulation interference zone;

• Provides the ability to use various tools without changing their design;

• Allows you to evaluate forces in several degrees of freedom.

As multi-axis strain gauges, bending gauges based on strain gages, capacitive strain gauges or gauges of any other principle of operation can be used, which make it possible to measure the force applied to them.

In a preferred embodiment of the invention, strain gauges with a sensitive element in the form of a strain gauge can be used as strain gauges. Sensors of this type have a high output impedance, and the signal has a low power, which limits its propagation in space.

The design allows you to implement the following features:

• Assess the forces acting on the tool in at least five degrees of freedom using two three-axis strain gauges (three linear degrees of freedom along the X, U, Z axes and rotational moments around the X and Y axes);

• Evaluate the gripping force (compression force), controlling one degree of freedom (the degree of freedom when gripping, compressing the executive surfaces of the surgical instrument);

• Assess the rotational / twisting force acting on the tool (three rotational degrees of freedom around the X, Y, Z axes);

• When evaluating forces, take into account the forces arising at the point of contact of the trocar with the patient's body;

• Ensure sufficient reliability of effort data in the presence of electromagnetic interference from electrocoagulation.

During operation, the executive surfaces located at the end of the instrument inserted into the patient's body (the executive part of the instrument) perform complex movements initiated and controlled by the surgeon. When resistance to the movement of the executive part of the tool occurs or when parts of the tool come into contact with the fabric of the patient, a bending of the sensitive element of the strain gauge along the corresponding axis occurs. Since the instrument, located in the fastening structure of the surgical instrument, contacts the manipulator at two points, one of which is the trocar location zone, and the other is the location of the surgical instrument drive, the effort is measured at both points and further joint processing of these signals.

The outputs of the strain gauges are connected directly to the digital processing modules, which amplify the signals and convert them into digital form. The digital processing modules can be located directly next to the strain gauges. The specified location is optional and can be changed if necessary, for example, when using strain gauges with a signal amplification board. However, the location of the digital signal processing module of strain gauges in close proximity to each used strain gauge is preferable, since it provides a high signal-to-noise ratio and resistance to external electromagnetic disturbances.

To measure the gripping / squeezing force on the actuating surfaces of a surgical instrument, such as jaws, current sensors for gripping / squeezing motors can be used. The principle of measuring the compression force is to increase the current consumption of the motors when resistance to the movement of the gripping elements of the tool structure occurs. Compression motors are part of the drive of the surgical instrument.

To measure the torque around the Z axis, an electric motor current sensor can be used, which provides rotation around this axis. The principle of torque measurement is to increase the current consumed by the electric motor when resistance to movement occurs. The motors that rotate around the Z axis are part of the drive for the surgical instrument.

In a preferred embodiment of the invention, electric motors (electric motors) are used as motors. Each of the current sensors of the surgical instrument drive motors can be connected to a motor control system.

The digital processing modules and motor control systems are connected to the processing module via a data bus. The data bus can be RS485, CAN, Bluetooth, or some other wired or wireless data interface. The processing module is designed for group processing and synchronization of signals from strain gauges, torque transducer and gripping force transducer. The use of a separate device as a processing unit is optional. It can be combined with any digital processing module or with a control system. The control system (CNC system of the assisting surgical complex) uses the data received from the processing module to further organize feedback and transmit signals to the surgeon. The architecture of the force assessment system is shown in FIG. ten.

Data from the data processing module goes to the control system of the robotic surgical complex (CNC system of the assisting surgical complex) and is transmitted to the digital control unit of the surgeon's controller.

The surgeon holds the controller in his hands and, moving it, generates a digital signal, with the help of which the instrument is controlled through the control system of the robotic-surgical complex and the manipulator. When the instrument comes into contact with the patient's tissue or trocar, forces are generated that act on the instrument. The force assessment system determines these forces, converts the information into a digital signal, which is transmitted to the surgeon's controller in the reverse order through the control system of the robotic surgical complex. The surgeon's controller is designed in such a way that it receives these signals and converts them into mechanical movements of the controller in the direction opposite to the movements of the surgeon's hand controlling the instrument.

The resulting resistance creates a sensation on the hand as if it were touching tissue. The intuitive movement of the instrument, which coincides with the movements of the hand, as well as the sense of touching the tissue with the instrument, makes the surgeon feel that he is holding the instrument directly in the hand during the operation on the robotic system.

Positioning system by manipulators.

The manipulator positioning system ensures the attachment of manipulators to the operating table and increases the number of possible positions of the manipulator relative to the patient, and, in addition, allows the manipulators to be removed from the operating area in the shortest possible time in an automated or manual mode.

The fastening mechanism (see Fig. 11) of the positioning system of manipulators to the surgical table, in general, consists of two aprons 6007, each of which has the ability to be attached to the side of the surgical table in a removable manner so that on opposite sides of the table there is one apron 6007 (further the description of the system design refers to one of the aprons, while the design of the second apron and its systems is identical).

In general, at least one guitar 6006 can be mounted on one apron 6007, and on it at least one telescopic vertical column 6008, each of which has its own positioning arm (positioning mechanism) with a fixed manipulator (not shown). FIG. 11 shows an example with one column 6008 and correspondingly with one positioning arm. Detailed description of the above items given below.

On the apron 6007, guides 6011 are fixed vertically relative to the table, which serve to bring the manipulators out of the storage area to the working area and along which the horizontal element 6006 moves vertically, which in the following will be referred to as "guitar" 6006 in the materials of the application.

Guitar 6006 is attached on one side to the installation platform, and on the other side is equipped with rails 6012. The installation platform 6022 is connected to the corresponding carriages mounted on the rails 6011 of the apron 6007. The installation platform can be moved along the rails 6011 of the apron 6007 under the influence of any type of actuator (electric, hydraulic, pneumatic, etc.). The drive in FIG. 11 is not shown. Guitar 6006 Guides 6012 are installed along the entire length of 6006.

Guitar 6006 has at least one vertical column 6008 that is horizontally movable along the guitar 6006. The vertical column 6008 is a telescopic two-piece stand. Moreover, the components of the rack are identical and symmetrical. The component facing towards the guitar 6006 is the inside of the vertical column 6008, and the component facing away from the surgical table is the face of the vertical column. Each side is provided with guides extending along the entire length of the vertical column 6008 and ball screw drives 6013 with actuator 6009. On the inner side of the column 6008, some guides are installed, and on the front side of the column 6008, guides 6016 are installed.

The vertical column 6008 is connected to the guitar 6006 as follows. The carriages 6010 are mounted on the guides 6012 of the guitar 6006. The carriages 6010 are equipped with a connecting module 6015, which performs the function of moving the positioning system along the surgical table. The 6015 connection module consists of two parts, which together form a reliable, rigid, quick-release connection. Connecting module 6015 is attached on one side to the carriages 6010, and on the other side of the connecting module 6015, carriages 6014 are attached to it. The carriages 6014 fit into the guides, which in turn are mounted on the inner side of the vertical column 6008. The vertical column 6008 moves horizontally in one whole with the connecting module 6015 along the guides 6012 of the guitar 6006 under the influence of a drive mechanism made in the form of a drive 6009 and a ball screw (ball screw) 6013 located on the guitar.

On the vertical column 6008, a positioning mechanism on a series structure is fixed by means of a connecting element 6004, which consists of two consoles and a turntable 6003 for attaching and positioning a manipulator 6018 (see Fig. 12). Connector 6004 is attached through rails 6016 on the front of the column 6008 in such a way that it forms a kinematic pair with a positioning mechanism on a sequential structure. In this case, the joint of the element 6004 and the console 6002 contains several independent actuators with position sensors, and in the joint of the console 6002 and the console 6005 there are also several independent actuators with position sensors. The listed drives form the drive unit 6017. The joint of the console 6005 and the platform 6003 also contains an independent drive with position sensors. The connecting element 6004, thanks to the carriages, has the ability to make vertical translational movements along the guides 6016 on the front side of the vertical column 6008, and the column 6008 itself has the ability to move vertically along the connecting module 6015 along the guides. The movements can be performed jointly or alternately.

The positioning mechanism of the manipulator carries out movement in the plane of the surgical table, turning relative to the connecting element. Swivel arms 6002 and 6005 are rotatable in a horizontal plane so that the arm 6002, being above the surface of the surgical table in the working position, makes a full 360-degree rotation and has the possibility of limited rotation below the surface of the table when inoperative. On the specified console 6005 there is a mounting and positioning assembly 6003 of the manipulator 6018 with a surgical instrument, made with the possibility of rotation around its axis to bring the manipulator 6018 into the working position (see Fig. 12).

The drive mechanisms can be made in the form of any known mechanism that provides linear movements and reduces the loss of accuracy due to backlash. In a preferred embodiment of the manipulator positioning system, all of the slide movements described above are controlled by ball screws (ball screws) 6013, which drive servomotors 6009, each of which is connected to its own gear.

For the 6017 drive unit, a servo drive is used in conjunction with any known gearboxes with zero mechanical backlash, for example, backlash-free planetary gearboxes. Such drive mechanisms, used on the rotary axes in the structure of the mechanism, ensure high positioning accuracy of the manipulators.

The combination of movements of the entire mechanism provides the necessary movement of the positioning system along the vertical plane of the lateral surface of the surgical table and returns the manipulators to the storage area.

The advantage of this design is to provide linear movements along the lateral surface of the surgical table, to implement the amount of movement required for positioning the manipulator, and to create a rigid frame by the structure to achieve high accuracy. This arrangement of linear movements provides a large coverage of the operating field, while it has a more compact overall size of the entire mechanism positioning.

Camera compensation system.

In one of the manipulators of the assisting surgical complex, a camera is fixed for observing the operating field during the surgical operation. The image of the operated area, broadcast by a stereoscopic camera, is available to the surgeon on the monitor of the imaging system.

A camera is broadly defined in this application as any device structurally configured to generate a stereo image when inserted into a patient's body. An image of the operating field can be obtained optically using fiber optics, objectives and miniaturized imaging systems, for example, using a video endoscope (hereinafter referred to as an endoscope).

The camera is inserted into the body through an opening in the patient's body. The entry point / plane is defined as the "zero point" since all movements of the instrument or camera in the patient's body are provided by two rotational degrees of freedom about this point and one linear degree of freedom. A trocar is located at the “zero point” for additional fixation of instruments and a camera. There is also a "zero point of the camera" in the local coordinate system of the camera, relative to which the position vector of the camera changes its position with the beginning at the "zero point" and with the end coinciding with the actual position of the end of the camera. The camera has a field of view that depends on the characteristics of the camera lens. The camera transmits an image of only that part of the surgical field that fell into the field of view.

The camera's field of view can have an area configured to be visible to the camera at any given time.

As the camera moves, the field of view moves with the camera, allowing you to visually inspect the operating area. The change in the field of view also depends on the peculiarities of camera movement. In this case, the surgeon must be guaranteed unambiguity in understanding the movement of the camera and the associated movement / change of the field of view within the operating field.

The automatic control system (CNC system of the assisting surgical complex) is configured to compensate for camera movement, namely, to implement a method for controlling the movement of a chamber manipulator, which is part of a robotic surgical system to reduce the number of movements of a stereo camera that visualizes the surgical area in the operating field.

The detailed steps of the claimed method are presented below.

The local coordinate system associated with the control controller contains information about the position of the controller in the form of three translational Cartesian coordinates D = \ ° x] \ ^R x]

D _Y and three rotational coordinates R = Ry

W _z \ V ^R z \

From the right controller of the surgeon (operator's controller) vectors R _r , D _r are transmitted to the automatic control system. _{The vectors R L} , D _L are transmitted from the left controller of the surgeon to the automatic control system.

When you press the camera manipulator control pedal, the camera control mode is activated, the signal from the pedal is transmitted not only to the automatic control system, but also to the controllers that block the rotational degrees of freedom, and the R _R and R _L vectors are reset to zero:

R _x = R _Y = R _z = 0, it follows that

Ό

R _r = RL 0 0

To control the camera manipulator, three translational degrees of freedom are sufficient, described by the vector D.

The vectors obtained by the automatic control system are processed using the algorithm for differentiating and combining motion. Control is carried out using the relative movement of the controller from the moment the camera starts control, initialized by pressing the pedal. Thus, the flexibility of the control system is increased.

The camera is controlled by both controllers at the same time. Thus, the following summarizes the relative movement of each of the controllers:

The resulting AD vector can be scaled, inverted, rotated around orthogonal axes, and composited with turns. Any of the listed mathematical operations can be performed using a cross product.

Further scaling is carried out. Scaling is a cross product of AD and the line S = [5 ^, S _Y , S] containing the scaling factors for each coordinate.

The scaling operation takes place in the scaling and integration unit. The scaled increment of signals from the surgeon's controllers obtained at the previous stage is added to the current position of the camera manipulator in its local Cartesian coordinate system.

Thus, the in-plane motion compensation unit receives the calculated position of the camera manipulator in the local Cartesian coordinate system.

To control the manipulator, it is necessary to convert the calculated Cartesian coordinates into spherical ones. In this regard, the operations of transferring vectors from one coordinate system to another are important. Conversion from Cartesian to spherical coordinate system is carried out by the following algebraic transformations:

In addition to the algorithm for compensating for the manipulator's movement in the plane, it is also necessary to implement an algorithm for comparing the horizon line with the middle line of the frame, which consists in calculating the angle of divergence between the horizon line and the midline of the frame, depending on the tilt angles f and Q. The divergence of the center line of the frame with the horizon line is calculated in the horizon compensation block according to the formula:

At the final stage of the method, the obtained data is simultaneously transmitted to the manipulator movement control unit with a camera attached to it, for its movement inside the patient in order to display the operating field. In this case, the manipulator with the camera carries out both translational movements to compensate for the movement of the camera and controllers, and rotation around its longitudinal axis to level the horizon line and the center line of the frame of the image obtained from the camera. The above stages of the proposed method, carried out using an automatic control system chamber manipulator are described according to the block diagram shown in FIG. 13.

First, data is obtained on the movement of the right and left controllers of the surgeon. In the next step, it is determined whether the signal came from the pedal. In the event that a signal is sent to the automatic control system from the pedal that switches the controllers to the camera control mode, a signal is initiated to start the operation of the automatic control system of the camera manipulator.

At the next stage, the actual data received from the controller are sequentially sent to the computing unit of derivatives for the right and left controllers, the increment of which is the total displacement.

At the next stage, this movement must be scaled taking into account the distance of the endoscope from the zero point.

Next, the resulting increment is integrated with the position of the manipulator in its Cartesian coordinate system. This compensated plane of motion is converted into the spherical coordinates of the manipulator f, q, R, on the basis of which, at the next stage, the compensation value of the horizon line R _z ^{comp is} calculated. The resulting data set (f, q, R, R _z ° ^mp ) is transferred to the camera manipulator. Then the steps are repeated.

The proposed method for controlling the camera movement adds an intuitive interaction with the robotic surgical complex and increases the efficiency of the robotic surgical operation.

An example of the implementation of an assisting surgical complex.

An experimental robotic surgery was performed on an animal - nephrectomy. A video recording of the operator's workplace was carried out to track the position of the hands at various stages of the operation for subsequent analysis of the convenience of control and interaction. Optimal seating of the operator-surgeon at the control console was carried out in such a way that the possibility of placing the hands in anatomically unnatural positions that lead to increased fatigue was excluded.

The design of the control controller allows movement and rotation along specified axes, while providing the maximum range of motion in the surgeon's working area. The working area does not constrain the movements of the surgeon, the design features allow, if necessary, to use all the space limited in width by the span of the arms, in depth - by the length of the arms, in height - by the distance to the knees.

Ergonomically beneficial solutions such as maximum use of the space above the surgeon's knee and the absence of protruding structural elements to prevent possible collisions ensure comfortable handling, which is an important factor in long-term operations.

The implemented six degrees of freedom of the controller allow you to fully to realize the minimum necessary for carrying out a robotic surgery surgical actions - tissue capture, resection, suture. The interaction of the surgeon with the controller during pig nephrectomy is shown in FIG. 14.

After the surgical intervention, it was found that: · the surgeon did not have to make additional efforts to perform surgical interventions;

• the surgeon's working field was not limited by the controller's design - all the necessary movements and rotations were carried out with the maximum amplitude;

• ergonomic design made it possible to reduce fatigue and fatigue in comparison with analogues during long-term operations;

• the proposed design of the controller has increased the ease of control of the robotic surgical complex in comparison with analogues;

• more than 50% of the time the surgeon's wrists are in the position shown in FIG. 15.

While this patent application relates to what is defined in the claims appended below, it is important to note that this patent application contains a basis for the formulation of other inventions, which may, for example, be claimed as the subject of the refined claims of the present application or as the subject of the claims in the allocated and / or a continuing application. Such an object can be characterized by any feature or combination of features described herein.

Claims

CLAIM

1. Assistant surgical complex for performing high-precision minimally invasive surgical operations, containing an executive console for the patient, which includes

5 at least one combined manipulator with a surgical instrument installed on it for performing a surgical operation, at least one camera manipulator with a camera attached to it for viewing the operating field, ensuring its movement in three translational degrees

10 freedom; a positioning system for at least one manipulator attached to at least one longitudinal side of the surgical table and configured to store at least one manipulator under the surgical table when not in use

15 position and automatic independent extension and movement of each of the manipulators in a predetermined area of the operating zone in the working position, means for calculating and evaluating the forces acting on the distal end of the surgical instrument and the forces acting on other working parts of the surgical instrument,

20 an operator input console, which includes at least one operator controller for controlling the movement of a surgical instrument mounted on the specified combined manipulator, configured to provide independent seven degrees of freedom when appropriate control forces and / or movements from the hand occur

25 operator to rotate and / or move the controller by the operator's hand, wherein the operator controller is configured to switch to the camera control mode using the control pedal; a digital control unit for the operator's controller, which generates a signal for the movement of the operator's hand for each degree of mobility of the operator's controller and

VO converts it into a control signal for subsequent control of a combined manipulator and / or a surgical instrument and / or a camera manipulator, a numerical program control system of an assisting surgical complex associated with at least one combined manipulator, a camera manipulator, with means for calculating and evaluating forces, with positioning system with manipulators, with

35 digital control unit of the controller, made with the possibility of simultaneous and independent control of all elements of the complex as a whole, and to generate control signals characterizing the force effect for each degree of mobility of the surgical instrument and / or the effect calculated on the basis of a given model, and transmitting these signals to the digital control unit of the operator's controller for converting them into mechanical movements of the elements of the operator's controller, and the combined manipulator includes a mechanism equipped with drive elements and made in the form of a fixed support platform and a movable platform connected to each other by means of three rods, the movable platform of the mechanism is made with the possibility of placing a surgical instrument on it, and a portal mechanism made in the form of a transverse movement module and a longitudinal movement module, each of which it is equipped with a drive unit, while the drive elements and drive units are made with the possibility of transmitting and / or receiving data from the numerical control system of the assisting surgical complex, with this the ohm mechanism is installed on the transverse movement module with the ability to move along it in the transverse direction, and the transverse movement module is installed on the longitudinal movement module with the ability to move along it in the longitudinal direction; moreover, all elements of the positioning system are equipped with servo drives and controllers capable of receiving and transmitting control commands from the numerical control system of the assisting surgical complex to perform the elements of the system of coordinated movements, and the means for calculating and evaluating forces include

- a three-axis lower strain gauge transducer, located on the manipulator support at the trocar attachment point and in direct contact with it, to measure the forces applied to the instrument and directed along the x and y axes,

- a three-axis upper strain gauge sensor, located on the manipulator support under the drive of the surgical instrument, to measure the force applied to the instrument and directed along the z-axis,

- a sensor of the gripping force of the actuating surfaces of the tool, made in the form of a current sensor for the electric motor of the drive of the tool, which provides compression of the actuating surfaces of the tool,

- a torque sensor of a surgical instrument, made in the form of a current sensor for the electric motor of the instrument drive, which ensures the rotation of the surgical instrument around its longitudinal axis, moreover, strain gauges are connected to the corresponding digital data processing modules, and the gripping force sensor and the torque sensor are connected to the corresponding motor control systems, digital processing modules and motor control systems are connected to

5 by the processing module, which is programmed to perform calculations by means of group processing and synchronization of signals from strain gauges, a torque sensor and a gripping force sensor:

- forces directed along linear axes,

- tool torques along the x and y axes relative to the trocar insertion point

10 into the patient's body,

- tool torque along the z-axis relative to the trocar insertion point into the patient's body,

- the compressive forces of the executive surfaces of the tool, the processing module is configured to transmit data to the numerical system

15 programmed control of the assisting surgical complex, and the operator's controller includes a delta robot driven by a drive mechanism, each link of which is made in the form of a crank mechanism driven by a ball screw servo drive;

20 strain gauge platform installed between the movable platform and the fixed support platform of the delta robot, and strain gauges coupled to each ball screw are located on the strain gauge; at the same time, a control handle is attached to the movable platform with the possibility of covering it by the operator's hand and configured for control and conversion into a digital signal

25 movements of the operator's hand along at least three rotational degrees of freedom and force action on the strain gauge platform along three linear degrees of freedom, while the signal formed on the strain gauges is transmitted to the digital control unit of the controller, which calculates and transmits the weight compensation commands to the servo drive of the corresponding link of the drive mechanism and / or moving along the planned trajectory,

VO calculated on the basis of the obtained data, and the numerical control system of the assisting surgical complex is designed to compensate for movement when controlling the movement of the camera.

2. The complex according to claim 1, characterized in that the control handle of the operator controller includes a wrist controller that provides two rotational degrees of freedom in

35 orthogonal planes, and a brush controller providing two other rotational degrees of freedom.

3. The complex according to claim 2, characterized by the fact that the hand controller is equipped with a handle and finger grips.

4. The complex according to claim 3, characterized in that at least one drive element and a rotation sensor are installed inside the handle of the hand controller.

5. The complex of claim. 2, characterized in that the wrist controller is equipped with at least one drive element and a rotation sensor.

6. The complex according to claim. 1 characterized in that at least one manipulator in the inoperative position is located under the surgical table in the part for the location of the legs.