WO2023148381A1 - Manipulateur pour chirurgie robotisée et unité stérile - Google Patents
Manipulateur pour chirurgie robotisée et unité stérile Download PDFInfo
- Publication number
- WO2023148381A1 WO2023148381A1 PCT/EP2023/052862 EP2023052862W WO2023148381A1 WO 2023148381 A1 WO2023148381 A1 WO 2023148381A1 EP 2023052862 W EP2023052862 W EP 2023052862W WO 2023148381 A1 WO2023148381 A1 WO 2023148381A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- coupling structure
- wedge
- instrument
- unit
- sterile
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
Definitions
- the invention relates to a manipulator for robotic surgery, which comprises an instrument drive unit and a sterile unit for coupling a surgical instrument, the sterile unit having a base with at least one transmission body, which is mounted such that it can rotate about an axis of rotation, with a first coupling structure and a first fastening mechanism which the sterile unit is connected to the instrument drive unit.
- the instrument drive unit has at least one drive with a drive body which is associated with the at least one transmission body and has a second coupling structure complementary to the first coupling structure.
- the first and the second coupling structure together form an alignment mechanism, so that the at least one transmission body is aligned in accordance with the second coupling structure assigned to it, while the sterile unit is connected to the instrument drive unit.
- the alignment which is caused by the first and second coupling structures meeting when the sterile unit is connected to the instrument drive unit, causes the coupling structures to be oriented to one another and brought into contact in such a way that they allow a torque generated by the drive to be transmitted to the associated transmission body.
- the sterile unit thus allows the torque to be transmitted through a sterile barrier to an instrument coupled to the sterile unit.
- the first and the second coupling structure are designed in such a way that they absorb a force acting parallel to the axis of rotation on the sterile unit and/or the instrument drive unit and convert it into an alignment movement of the transmission body and/or the drive body through their shape.
- the invention also relates to a sterile unit for the sterile connection of an instrument drive unit, which comprises at least one drive, the at least one drive having a drive body with a first coupling structure, with a surgical instrument comprising at least one output, wherein the at least one output is associated with the at least one drive and the at least one output has an output body with a fourth coupling structure.
- the sterile unit comprises a base with at least one transfer body mounted rotatably about an axis of rotation, a first fastening mechanism with which the sterile unit is connected to the instrument drive unit, and a second fastening mechanism with which the instrument is connected to the sterile unit.
- the at least one transmission body has a second coupling structure that is complementary to the first coupling structure and a third coupling structure that is complementary to the fourth coupling structure.
- the at least one transmission body is in a coupled state of the sterile unit between the at least one drive and the at least one output.
- Telemanipulators have been used successfully for many decades in a wide variety of environments that a human cannot easily reach. This applies to space applications, underwater applications, nuclear reactors and, above all, surgical applications.
- instruments In manual laparoscopic surgery, instruments are used which have a long shaft, at the distal end of which there is an end effector, eg gripper or scissors, and at the proximal end of which there is a handle.
- the latter has a lever, knob or similar mechanism that can be used to move the end effector.
- the handling of such instruments is difficult, since they are guided through a small incision in the patient and their freedom of movement is severely restricted. It is also difficult for the doctor to orientate himself, since a generally deviating viewing angle of the endoscope has to be compensated for.
- This difficulty can be solved by a telemanipulator.
- Such a robot consists of several robotic arms, the manipulators, and usually two input devices, one for each hand.
- One of the manipulators holds and controls an endoscope, the others each a surgical instrument.
- a computer connected to the manipulators and input devices can give the surgeon the impression that he is looking at the surgical site from the direction of the endoscope and that the end effectors of the instruments are his hands. This allows him to use his hand-eye coordination and work effectively.
- the manipulators While the input devices of a telemanipulator are usually located away from the patient in the operating room, the manipulators have to get close to the patient. However, this area must be kept sterile in order to prevent contamination of the patient's wounds with germs as far as possible. For this purpose, the manipulators are packaged using sterile foils made of plastic. However, this is not possible for the instruments, so that they are usually sterilized directly. Instruments are used that are sterilized again after use or disposed of after a single use.
- EP 3 119 328 B1 discloses a sterile adapter which has a plurality of rotatably mounted transfer bodies.
- the transmission bodies In order to come into contact with the drives of the instrument drive unit, the transmission bodies have projections designed to engage in the drives. Furthermore, the transmission bodies each comprise a recess which engages with a locking mechanism which fixes the alignment of the transmission bodies. Coupling the sterile adapter to the instrument drive unit then causes the transfer bodies to be raised so that they either rest against the locking mechanism from below or the locking elements immediately engage in the recesses. In both cases, the drives then rotate, and in the first case the transmission bodies are carried along by friction until they can engage in the locking mechanism and block. The drives rotate until the respective transmission body is aligned with the drive assigned to it, i.e. until the projections and the respective recesses are superimposed, and the respective transmission body engages with the drive assigned to it, so that a torque is transmitted.
- EP 3 099 265 B1 discloses an interface for a surgical system between an instrument drive unit and a surgical instrument.
- transmission structures through which a force for actuating, ie for robot-supported deflection of an end effector of the instrument, is transmitted are designed as inclined surfaces.
- the transmission structures on the instrument side are thereby aligned on the instrument drive unit by sliding the inclined surfaces over one another while the instrument is connected to the instrument drive unit.
- the disadvantage of this interface is that it does not provide a way to introduce a sterile barrier between the instrument and the instrument drive unit. It can also happen that the transmission structures are so superimposed that blocking occurs.
- the object is achieved by a manipulator explained at the outset in that one of the first and second coupling structures is formed by a first wedge-shaped recess and the other of the first and second coupling structures is formed by a first wedge corresponding to the first wedge-shaped recess.
- the alignment of the transfer bodies becomes clear easier because the first wedge is guided along two sides of the coupling structure formed by the first wedge-shaped recess or alternatively because the coupling structure formed by the first wedge-shaped recess slides over the first wedge.
- the forces effecting the alignment act primarily on the edge of the coupling structure to be aligned, so that the application of force is improved and the connection of the sterile unit to the instrument drive unit is generally facilitated.
- the transmission body or the drive body is cylindrical. In this way, a transfer body can be more easily rotated within the base and aligned with the associated drive body.
- a further advantage is that the first wedge no longer has to slide over a surface formed by the first wedge-shaped recess, but over the edges formed by this on the corresponding drive or transmission body. In this way, the first wedge as well as the first wedge-shaped recess can be better aligned with one another.
- the first wedge at a wedge tip on a pin, while a complementary to the pin groove is present on the first wedge-shaped recess.
- the task of the transmission body is to transmit a torque that it absorbs from the drive. This torque acts in the direction perpendicular to the axis of rotation of the transmission body, so that the pin and the associated groove allow improved transmission of the torque.
- the groove does not necessarily have to correspond to the shape of the pin, as long as it completely accommodates the pin and the torque can be passed on in the best possible way.
- the pin is designed as a cuboid which is chamfered or rounded at two remote from the first wedge long edges.
- the chamfered edges facilitate the sliding of the pin over the edges located on the first wedge-shaped recess.
- the sliding over one another of the first wedge and the edges of the wedge-shaped recess can be further advantageously configured in such a way that a plurality of sliding surfaces are formed on the first wedge-shaped recess.
- the sliding surfaces are chamfers that are provided on the edges of the transmission or drive body in the area of the wedge-shaped recess. Ideally, the chamfers extend along the entire wedge-shaped recess.
- the manipulator also includes a surgical instrument which has at least one output drive associated with the at least one transmission body.
- the sterile unit additionally has a second attachment mechanism, with which the instrument is connected to the sterile unit.
- the sterile unit is thus placed between the instrument drive unit and the instrument, and the transmission bodies allow torque to be transmitted from the drives to the associated drives of the instrument.
- the sterile unit is itself part of a sterile barrier that shields the area on the manipulator side from the operating area in a sterile manner. The number of drives, transmission bodies and outputs can be adjusted depending on the application.
- the number of drives will match the number of transmission bodies for the purpose of interchangeability, but adjustments are also possible if an instrument has a number of degrees of freedom of an end effector that differs from the number of drives or transmission bodies.
- the number of degrees of freedom depends on the mobility and the functions of the end effector located on the instrument: an endoscope, for example, can have a single degree of freedom, while a stapling instrument can be movable in five degrees of freedom.
- the at least one transmission body also advantageously comprises a third coupling structure and the at least one driven body comprises a fourth coupling structure which is complementary to the third coupling structure.
- the third coupling structure and the fourth coupling structure together form a second alignment mechanism so that the at least one driven body is aligned according to the third coupling structure corresponding to it when the instrument is attached to the sterile unit while the sterile unit is already connected to the instrument drive unit.
- Each output can move the end effector located on the instrument in one degree of freedom.
- one of the third or fourth coupling structures by a second wedge-shaped recess present on the transmission body or on the driven body and the other of the third or fourth coupling structures is formed by a second wedge corresponding to the second wedge-shaped recess, since the alignment of the driven bodies is made possible by improved transmission of the torque analogous to the embodiment described above.
- first and the third coupling structure are formed as first and second wedge-shaped recesses and are offset from one another by 90° on the transmission body.
- This version is particularly compact. It is also particularly advantageous here if the first and the second wedge each have a recess in the middle. This makes it possible to arrange the first and the second wedge-shaped recess on the transmission body in such a way that they overlap. An opening created in this way must then be filled with material in order to maintain the sterile separation. The cutouts on the first and second wedges make it possible to make the transmission bodies more compact.
- the object is also achieved in a sterile unit as described above in that the second coupling structure is formed by a first wedge-shaped recess or by a first wedge. Alignment of the transfer body is thus significantly simplified compared to the known prior art.
- the third coupling structure is advantageous here to design the third coupling structure as a second alignment structure, which aligns the at least one transfer body relative to the fourth coupling structure when the sterile unit is connected to the instrument, and particularly advantageously the third coupling structure by a second wedge-shaped recess or is formed by a second wedge.
- This makes it possible to also align the at least one transmission body with the associated output body or, if the transmission body is blocked, for example by contact with the associated drive, to align the corresponding output body of the outputs of the instrument on the transmission body as described above.
- FIG. 2 shows a drive unit, a sterile unit and a surgical instrument in an exploded view
- FIG. 3A shows the sterile unit from FIG. 2 in a first view
- FIG. 3B shows the sterile unit from FIG. 2 in a second view
- FIG. 4 shows the surgical instrument from FIG. 2,
- manipulators 50 include a variety of joints that allow free positioning of the instrument 30 in space. They can be used independently as an aid for the surgeon, e.g. as endoscope holders, or as part of a surgical telemanipulator. Since the area around a patient to be operated on must always be sterile in order to avoid infections, parts of the system that are difficult to sterilize, ie the manipulator 50 and the instrument drive unit 20, are separated from the sterile area by a sterile barrier 60. In order to still be able to actuate the instrument 30, which is designed here as an endoscope, the sterile unit 10 is designed as an adapter, as described above.
- Fig. 2 shows how the instrument 30, a sterile unit 10 and the instrument drive unit 20 are arranged in relation to one another.
- the sterile unit 10 has a base 11 and a plurality of transmission bodies 12 which are mounted so as to be rotatable about an axis of rotation.
- the sterile unit 10 is arranged between the instrument 30 and the instrument drive unit 20 .
- the surgical instrument 30 is also composed of an instrument housing 31 and an instrument shaft 32 .
- An end effector 35 in the form of a gripper is arranged here at a distal end of the instrument shaft 32 .
- all types of end effectors 35 can be used, such as scissors, stapling instruments or dissectors.
- an endoscope can also be used.
- the number of degrees of freedom depends on the type of instrument 30, which includes not only the movement of end effector joints but also a mechanical triggering of additional functions, such as opening and closing jaw parts of a gripper or activating a blade, as individual degrees of freedom.
- the number of degrees of freedom is between one for an endoscope, for example, or five for a stapling instrument, but in principle it is arbitrary and can be adapted to the specific application.
- the instrument drive unit 20 includes a drive housing 22 in which five drives 21 are housed, each having a drive body with a have a second coupling structure and a motor, not visible here, which are generally electric motors that generate torque.
- the second coupling structure is arranged outside of the drive housing 22, with its structure being described in more detail below.
- the torque generated by the motor is transmitted by the respective drive bodies, each with the second coupling structure, to the transmission bodies 12 and passed on by them to the output drives of the instrument 30 , which are covered here, in order to move the end effector 35 .
- the instrument drive unit 20 includes one or more first fastening elements 23 which fasten the sterile unit 10 to the instrument drive unit 20 .
- the sterile unit 10 again has a complementary first fastening mechanism that is covered in this figure.
- a second attachment mechanism 14 On the side of the sterile unit 10 facing the instrument 30 there is a second attachment mechanism 14 which in turn makes it possible to attach the surgical instrument 30 to the sterile unit 10 .
- This connection can be released by means of a release mechanism 33.
- the sterile unit 10 is shown in more detail in FIGS. 3A and 3B.
- a first attachment mechanism 13 and a second attachment mechanism 14 are attached to the sterile unit 10 in addition to the transfer bodies 12 and the base 11 .
- Both fastening mechanisms 13, 14 are part of a snap connection, but in general the first and the second fastening mechanism 13, 14 can be designed as desired by a specialist, provided that the sterile unit 10 can be detachably or non-detachably connected to the instrument 30 and the instrument drive unit 20 by means of a positive or non-positive connection .
- the transfer bodies 12 are each introduced into a through-opening in the base 11, and there are various options for the specific design.
- the base 11 can be designed in two parts, so that the transmission bodies 12 are accommodated between the two parts of the base 11 become.
- the transfer bodies 12 themselves are provided with a means of attachment. They can themselves be composed of two bodies which clamp the base 11 between them, or they can be equipped with fastening means which hold them rotatably mounted on the base 11 about an axis of rotation. Snap hooks, ball joint connections or similar are suitable for this.
- transmission bodies 12 or an electrical contact for conducting current signals through the sterile unit 10.
- a sterile film is attached here by means of gluing or welding, which together with the sterile unit 10 forms a sterile barrier 60 .
- Another possibility, customary in the art, for inserting the sterile foil is to design the base 11 in two parts, so that the sterile foil is clamped between the two parts.
- Each output 34 comprises an output body with a fourth coupling structure, which is at least partially visible from the outside, and a transmission mechanism located in the instrument housing 31, which is firmly connected to the output body and transmits a torque acting on the output body to the end effector 35.
- one or more second fastening elements 36 are present which engage in the second fastening mechanism 14 so that the instrument 30 is held on the sterile unit 10.
- the second fastening elements 36 can be moved by means of the release mechanism 33 and the connection between the instrument 30 and the sterile unit 10 can thus be released.
- the design of the second fastening elements 36 and the second fastening mechanism 14 is generally freely selectable.
- 5A and 5B show the example of the drive body 25 and the transmission body 12, how the coupling structures are formed and how they work. The principle can easily be transferred to the coupling structures between the transmission body 12 and the driven body of the instrument 30 , even if the description below is based on the coupling structures of the transmission body 12 and the drive body 25 .
- the transmission body 12 has a wedge 43 as the first coupling structure, at the tip of which a pin 44 is located.
- the pin 44 is designed as a cuboid whose edges facing the drive 21 are rounded.
- On the side facing the instrument 30, an open structure is shown here, which can engage in the driven body and transmit a torque.
- the associated drive body 25 comprises a second coupling structure, which has a wedge-shaped recess 42 complementary to the wedge 43 and a groove 45 complementary to the pin 44 .
- groove 45 and the peg 44 need not be positively engaged. Rather, it is sufficient for torque transmission if there are surfaces on the groove 45 and pin 44 that are parallel to the axis of rotation 48 of the transmission body 12 .
- the rounded edges of the pin 44 allow better sliding over the edges of the drive body 25 on the wedge-shaped recess 42.
- the arched shape of the wedge-shaped recess 42 causes the transmission body 12 to start rotating until the first and the second coupling structure, ie here the wedge 43 and the wedge-shaped recess 42, are in positive contact with one another. Now a generated by the drive 21 Torque can be transmitted to the transmission body 12. Since the torque acts perpendicularly to the axis of rotation 48, the transmission is improved by the groove 45 and pin 44 as described above.
- 5B shows the inverse case, where the second coupling structure of the drive body 25 is formed as a wedge 43 and the first coupling structure of the transmission body 12 is formed by the wedge-shaped recess 42.
- the procedure for aligning the transmission body 12 on the drive body 25 is basically identical, but the transmission body 12 with the wedge-shaped recess 42 adapts to the wedge 43 .
- additional sliding surfaces 46 are present on the transmission body 12 in the area of the edges of the wedge-shaped recess 42, which further improve the alignment by guiding the wedge 43 better. Furthermore, abrasion is reduced by the sliding surfaces 46 since the wedge 43 comes into contact with a surface and not with a sharp edge.
- the transmission body 12 has a first wedge-shaped recess 42a as the first coupling structure and a second wedge-shaped recess 42b as the third coupling structure, the wedge-shaped recesses 42a, 42b being offset from one another by 90° in a plane perpendicular to the axis of rotation 48. Both grooves 45a, 45b and sliding surfaces 46 are present.
- the second coupling structure of the drive body 25 and the fourth coupling structure of the driven body 37 are each designed as a first and second wedge 43a, 43b, each with a pin 44a, 44b. In this exemplary embodiment, the edges of each pin 44a, 44b facing the transmission body 12 are chamfered.
- a motor 24 which is connected to the drive body 25 and transmits a torque to it.
- the grooves 45a, 45b of the first and the third coupling structure lie in one plane, so that there is an overlap in the middle of the transmission body 12. This overlap is filled with material so that the sterile barrier 60 does not break through here, which would make the entire system unsuitable for use in surgery. This results in an increase within both grooves 45a, 45b. In order to take this increase into account, there are corresponding recesses 47a, 47b on both pins 44a, 44b. This allows him Transmission body 12 and thus the entire sterile unit 10 are made particularly compact.
- connection of the transmission body 12 to the drive body 25 is analogous to that already described with reference to FIGS. 5A and 5B.
- the system consisting of the drive body 25 and the transmission body 12 is generally fixed in a position which corresponds to the zero position of the instrument 30, in which the end effector 35 is not deflected.
- the fourth coupling structure of the driven body 37 can be aligned with the third coupling structure of the transfer body 12 when the instrument 30 is connected to the sterile unit 10 .
- the torque acting on the driven body 37 is transmitted directly to the end effector 35 of the instrument 30, which is brought to its zero position in this way if the position of the end effector 35 deviates from this position.
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Robotics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Manipulator (AREA)
Abstract
L'invention concerne un manipulateur pour chirurgie robotisée, comprenant une unité d'entraînement d'instrument (20) et une unité stérile (10) pour accoupler un instrument chirurgical (30), l'unité stérile (10) ayant une base (11) avec au moins un corps de transfert (12) monté rotatif autour d'un axe de rotation et ayant une première structure d'accouplement et un premier mécanisme de fixation pour relier l'unité stérile (10) à l'unité d'entraînement d'instrument (20). L'unité d'entraînement d'instrument (20) comporte au moins un entraînement (21) qui est associé audit au moins un corps de transfert (12) et comprend un corps d'entraînement qui présente une deuxième structure d'accouplement complémentaire de la première structure d'accouplement. La première et la seconde structure d'accouplement forment ensemble un mécanisme d'alignement de telle sorte que ledit au moins un corps de transfert (12) est aligné conformément à la seconde structure d'accouplement associée à celle-ci tandis que l'unité stérile (10) est reliée à l'unité d'entraînement d'instrument (20). Afin de faciliter l'alignement, l'une des première et seconde structures de couplage est formée par un premier évidement en forme de coin et l'autre des première et seconde structures de couplage est formée par un premier coin correspondant au premier évidement en forme de coin.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102022102805.4A DE102022102805A1 (de) | 2022-02-07 | 2022-02-07 | Manipulator für die robotische Chirurgie und Sterileinheit |
DE102022102805.4 | 2022-02-07 |
Publications (1)
Publication Number | Publication Date |
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WO2023148381A1 true WO2023148381A1 (fr) | 2023-08-10 |
Family
ID=85199376
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/EP2023/052862 WO2023148381A1 (fr) | 2022-02-07 | 2023-02-06 | Manipulateur pour chirurgie robotisée et unité stérile |
Country Status (2)
Country | Link |
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DE (1) | DE102022102805A1 (fr) |
WO (1) | WO2023148381A1 (fr) |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20120289973A1 (en) * | 2008-09-30 | 2012-11-15 | Intuitive Surgical Operations, Inc. | Instrument interface |
EP3119328B1 (fr) | 2014-03-17 | 2020-01-15 | Intuitive Surgical Operations, Inc. | Coupleur pour transférer le mouvement à un instrument chirurgical d'un servo-actionneur |
WO2021037170A1 (fr) * | 2019-08-30 | 2021-03-04 | 上海微创医疗机器人(集团)股份有限公司 | Ensembles de transmission, d'entraînement et stérile, instrument chirurgical et système, et robot chirurgical |
CN113367798A (zh) * | 2021-07-14 | 2021-09-10 | 深圳康诺思腾科技有限公司 | 无菌适配器与手术器械的传动连接结构及手术机器人的器械驱动传动机构 |
EP3099265B1 (fr) | 2014-01-31 | 2021-09-15 | Covidien LP | Interfaces pour systèmes chirurgicaux |
CN113520606A (zh) * | 2021-08-11 | 2021-10-22 | 上海微创医疗机器人(集团)股份有限公司 | 无菌板组件、手术机器人及手术机器人系统 |
Family Cites Families (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
AU2016321332B2 (en) | 2015-09-09 | 2020-10-08 | Auris Health, Inc. | Instrument device manipulator for a surgical robotics system |
-
2022
- 2022-02-07 DE DE102022102805.4A patent/DE102022102805A1/de active Pending
-
2023
- 2023-02-06 WO PCT/EP2023/052862 patent/WO2023148381A1/fr unknown
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20120289973A1 (en) * | 2008-09-30 | 2012-11-15 | Intuitive Surgical Operations, Inc. | Instrument interface |
EP3099265B1 (fr) | 2014-01-31 | 2021-09-15 | Covidien LP | Interfaces pour systèmes chirurgicaux |
EP3119328B1 (fr) | 2014-03-17 | 2020-01-15 | Intuitive Surgical Operations, Inc. | Coupleur pour transférer le mouvement à un instrument chirurgical d'un servo-actionneur |
WO2021037170A1 (fr) * | 2019-08-30 | 2021-03-04 | 上海微创医疗机器人(集团)股份有限公司 | Ensembles de transmission, d'entraînement et stérile, instrument chirurgical et système, et robot chirurgical |
CN113367798A (zh) * | 2021-07-14 | 2021-09-10 | 深圳康诺思腾科技有限公司 | 无菌适配器与手术器械的传动连接结构及手术机器人的器械驱动传动机构 |
CN113520606A (zh) * | 2021-08-11 | 2021-10-22 | 上海微创医疗机器人(集团)股份有限公司 | 无菌板组件、手术机器人及手术机器人系统 |
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DE102022102805A1 (de) | 2023-08-10 |
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