WO2023221075A1 - 一种手术设备、手术方法及手术装置 - Google Patents

一种手术设备、手术方法及手术装置 Download PDF

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Publication number
WO2023221075A1
WO2023221075A1 PCT/CN2022/094031 CN2022094031W WO2023221075A1 WO 2023221075 A1 WO2023221075 A1 WO 2023221075A1 CN 2022094031 W CN2022094031 W CN 2022094031W WO 2023221075 A1 WO2023221075 A1 WO 2023221075A1
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WIPO (PCT)
Prior art keywords
surgical
auxiliary
robot arm
puncture
surgical instrument
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PCT/CN2022/094031
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English (en)
French (fr)
Inventor
潘文荣
Original Assignee
北京歌锐科技有限公司
苏州歌锐医疗科技有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Application filed by 北京歌锐科技有限公司, 苏州歌锐医疗科技有限公司 filed Critical 北京歌锐科技有限公司
Priority to CN202280001686.9A priority Critical patent/CN117440785A/zh
Priority to PCT/CN2022/094031 priority patent/WO2023221075A1/zh
Publication of WO2023221075A1 publication Critical patent/WO2023221075A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/37—Master-slave robots

Definitions

  • This description relates to the field of major surgery, and in particular to a surgical equipment, surgical method and surgical device.
  • surgical equipment can be used to assist operators in performing operations, thereby reducing the uncertainty of manual operations during the operation, improving the safety of the operation, and easing the pain during the operation. Operator burden.
  • This specification provides a surgical equipment, a surgical method and a surgical device to partially solve the above-mentioned problems existing in the prior art.
  • This specification provides a surgical equipment, which includes a first auxiliary robotic arm 1, an operating robotic arm 2, and a control device 3;
  • the control device 3 is used to obtain the positions of the first auxiliary manipulator 1 and the operating manipulator 2, and control the position of the first auxiliary manipulator 1 and the manipulator 2 according to the positions of the first auxiliary manipulator 1 and the manipulator 2 and the operation of the operator. Action to send control instructions to the first auxiliary robot arm 1 and the operating robot arm 2;
  • the first auxiliary manipulator 1 includes a fixing device 11 and a rotating device 12; the rotating device 12 is configured on the fixing device 11; the fixing device 11 is used to place the working cannula 13 inserted into the patient's body; response Based on the control instructions sent by the control device 3, the working cannula 13 placed on the fixing device 11 is controlled to rotate, so that the working cannula 13 pushes away the surrounding area 7 located in the pre-planned designated area in the wound. dangerous parts;
  • a surgical instrument assembly 21 is disposed on the operating robot arm 2; in response to a control instruction sent by the control device 3, the surgical instrument 211 contained in the surgical instrument assembly 21 is controlled to perform a surgical operation on the designated area 7.
  • the surgical equipment further includes a second auxiliary robotic arm 4; the second auxiliary robotic arm 4 includes a fixation needle 41;
  • control device 3 determines that the patient is located at the designated position, controls the second auxiliary robotic arm 4 to press the patient;
  • the second auxiliary robotic arm 4 controls the fixed needle 41 disposed at the end of the second auxiliary robotic arm 4 to puncture the patient's body, so as to perform puncture on the patient's body.
  • the affected part of the patient was fixed.
  • the surgical equipment further includes a second auxiliary robotic arm 4; the second auxiliary robotic arm 4 includes a fixation needle 41;
  • the operator manually controls the second auxiliary robotic arm 4 to press the patient;
  • the operator manually controls the fixation needle 41 disposed at the end of the second auxiliary robotic arm 4 to puncture the patient in order to fix the patient's diseased part.
  • the surgical equipment further includes a scanning device 5; the scanning device 5 is used to scan the patient and obtain scanning results of the diseased parts of the patient's body;
  • the scan result of the diseased part is sent to the control device 3, so that the control device 3 receives and displays the scan result of the diseased part.
  • the surgical equipment further includes a positioning device 6;
  • the operating robot arm 2 is configured with a first positioning light source mark 22;
  • the first auxiliary robot arm 1 is configured with a second positioning light source mark 17;
  • the arm 4 is configured with a third positioning light source mark 42;
  • the positioning device 6 determines the operating robot arm 2 and the first positioning light source mark 22 according to the light emitted or reflected by the collected first positioning light source mark 22, the second positioning light source mark 17 and the third positioning light source mark 42.
  • the position of the auxiliary manipulator 1 relative to the patient is sent to the control device 3 so that the control device 3 can adjust the position of the operating manipulator 2 and the first auxiliary manipulator 1 as well as the position of the operator.
  • the operation action is to send control instructions to the first auxiliary robot arm 1 and to the operation robot arm 2 .
  • the control device 3 includes a planning module 31; the planning module 31 is configured to determine based on the positions of the operating robotic arm 2 and the first auxiliary robotic arm 1 and the scan results of the diseased part.
  • a designated area 7 that allows the surgical instrument 211 disposed at the end of the operating robot arm 2 to perform safe surgical operations on the diseased site, and enables the working cannula 13 and the surgical instrument 211 to reach the designated area 7 puncture position and puncture direction 8, so that the control device 3 controls the first auxiliary robot arm 1 and the operating robot arm 2 according to the designated area 7, the puncture position and the puncture direction 8. Perform surgical operations on the designated area.
  • the first auxiliary robot arm 1 includes a first slide rail 15 and a clamping device 14; the first slide rail 15 is fixed on the first auxiliary robot arm 1; the clamping device 14 A first slider 141 is configured, and the first slider 141 slides on the first slide rail 15 to drive the clamping device 14 on the first auxiliary robot arm 1 along the first slide rail 15 to slide in the extension direction of the first slide rail 15 to drive the tool held by the clamping device 14 to slide along the extension direction of the first slide rail 15 .
  • the clamping device 14 is used to clamp the puncture tool 16; the clamping device 14 controls the first slider 141 in response to the second puncture instruction sent by the control device 3.
  • the first slide rail 15 slides along the puncture direction 8 to drive the puncture tool 16 to puncture along the puncture direction 8 at the puncture position, so that the head end of the puncture tool 16 reaches the designated area 7 to form a puncture wound.
  • the working cannula 13 is inserted into the puncture wound along the puncture direction 8 and fixed on the fixing device 11 so that the head end of the working cannula 13 is located in the designated area 7 ;
  • the rotating device 12 When it is detected that the head end of the working casing 13 is located in the designated area 7, the rotating device 12 responds to the rotation instruction sent by the control device 3, controls the rotating device 12 to rotate, and drives the rotating device 12 placed in the designated area 7.
  • the working cannula 13 on the fixing device 11 rotates so that the head end of the working cannula 13 pushes away the dangerous parts around the designated area 7 in the puncture wound.
  • the rotation instruction carries a designated rotation direction and a designated rotation angle of the working cannula 13; the designated rotation direction and the designated rotation are determined by the control device 3 according to the designated area 7 and the patient. The scan results of the diseased area are confirmed.
  • the clamping device 14 is used to clamp the endoscope 9; the clamping device 14 controls the first slider 141 to move along the endoscope 9 in response to the endoscope control instruction sent by the control device 3.
  • the first slide rail 15 slides to drive the endoscope 9 held by the clamping device 14 to be inserted into the working casing 13 to collect and send real-time images of the designated area 7 .
  • the operating robot arm 2 includes a second slide rail 23 and a surgical instrument assembly 21; the second slide rail 23 is fixed on the operating robot arm 2; and a second slide rail is configured on the surgical instrument assembly 21.
  • Block 24, the second slide block 24 slides on the second slide rail 23, driving the surgical instrument assembly 21 to slide on the operating robot arm 2 along the extension direction of the second slide rail 23, so that The surgical instrument 211 is inserted into the working cannula 13 or the working channel of the endoscope 9 to perform surgical operation on the designated area 7 .
  • the surgical instrument assembly 21 includes a plurality of surgical instruments 211; the installation forms of the plurality of surgical instruments 211 in the surgical instrument assembly 21 include parallel installation, offset installation, inclined surface installation, and vertical installation. at least one of;
  • the surgical instrument assembly 21 controls each surgical instrument 211 included in the surgical instrument assembly 21 to switch between each other.
  • control device 3 includes a display 32, an auxiliary control lever 33 and an operation control lever 34;
  • the display 32 is used to display the real-time image of the designated area 7 and the scan results of the diseased part;
  • the auxiliary control lever 33 is used to send a rotation instruction to the rotating device 12 in response to the operator's first operating action, so that the rotating device 12 rotates and drives the working casing placed on the fixing device 11 13 rotates so that the working cannula 13 pushes away the dangerous parts around the designated area 7 in the puncture wound;
  • the operation control lever 34 is used to send an instrument movement instruction to the operation robot arm 2 in response to the operator's second operation action, and control the second slider 24 disposed on the surgical instrument assembly 21 to move along the first
  • the two slide rails 23 slide to drive the surgical instrument 211 contained in the surgical instrument assembly 21 to be inserted into the working cannula 13 along the puncture direction 8; when it is detected that the surgical instrument 211 reaches the designated area 7,
  • a surgical operation instruction is sent to the surgical instrument 211 so as to control the surgical instrument 211 to perform a surgical operation on the designated area 7 .
  • This specification provides a surgical method, which method is applied to a control device, and the method includes:
  • a rotation instruction is sent to the first auxiliary device configured on any of the above surgical equipments.
  • Robotic arm so that the rotation device configured on the first auxiliary robot arm controls the rotation of the working cannula fixed on the fixing device, so that the working cannula pushes away the dangers located around the pre-planned designated area in the puncture wound.
  • a surgical operation instruction is sent to the operating robot arm configured on any of the above-mentioned surgical equipment. , so that the surgical instrument assembly configured on the operating robot arm controls the surgical instruments included in the surgical instrument assembly to perform surgical operations on the pre-planned designated area.
  • This specification provides a surgical device, which is used in a control device, and the device includes:
  • a position acquisition module used to acquire the positions of the first auxiliary manipulator and the operating manipulator
  • a rotation instruction sending module configured to send a rotation instruction to any one of the above operations in response to the operator's operation action when it is determined that the working cannula configured on the first auxiliary robotic arm is inserted into the pre-planned designated area.
  • the first auxiliary robot arm is configured on the equipment so that the rotation device configured on the first auxiliary robot arm controls the rotation of the working cannula fixed on the fixing device, so that the working cannula is pushed open in the puncture wound and is positioned in advance.
  • a surgical operation instruction sending module configured to send a surgical operation instruction to any one of the above in response to the operator's operation action when it is determined that the surgical instrument installed on the operating robot arm is inserted into the puncture wound on the patient's body.
  • An operating robot arm is configured on the surgical equipment, so that the surgical instrument assembly configured on the operating robot arm controls the surgical instrument included in the surgical instrument assembly to perform a surgical operation on the pre-planned designated area.
  • This specification provides a computer-readable storage medium.
  • the storage medium stores a computer program.
  • the computer program is executed by a processor, the above surgical method is implemented.
  • the surgical equipment includes a first auxiliary robotic arm, an operating robotic arm, and a control device.
  • the control device sends a signal to the first auxiliary robotic arm according to the positions of the first auxiliary robotic arm and the operating robotic arm and the operating actions of the operator.
  • the robotic arm and the operating robotic arm send control instructions to rotate the working casing placed on the fixing device disposed at the end of the first auxiliary robotic arm, so that the working casing can push away the dangerous parts located around the pre-planned designated area in the wound, Further, in response to the control instruction sent by the control device, the operating robot arm controls the surgical instrument included in the surgical instrument assembly to perform a surgical operation on the designated area. It can be seen that the automatic rotation of the working cannula by the surgical equipment can protect human tissues in the dangerous area, thereby reducing the risk of intraoperative infection and postoperative complications, and eliminating the need for operators to perform manual rotation during the operation.
  • Figure 1 is a schematic diagram of the surgical equipment in this manual
  • Figure 2 is a schematic diagram of a surgical device in this manual
  • Figure 3 is a schematic diagram of a surgical device in this manual
  • Figure 4A is a schematic diagram of the operation mode of the surgical equipment in this manual
  • Figure 4B is a schematic diagram of the operation mode of the surgical equipment in this manual
  • Figure 4C is a schematic diagram of the operation mode of the surgical equipment in this manual.
  • Figure 5A is a schematic diagram of the operation mode of the surgical equipment in this manual
  • Figure 5B is a schematic diagram of the layout of surgical instruments in this specification.
  • Figure 5C is a schematic diagram of the layout of surgical instruments in this specification.
  • Figure 6A is a schematic diagram of a surgical device in this specification.
  • Figure 6B is a schematic diagram of a surgical device in this specification.
  • Figure 7 is a schematic diagram of a surgical device in this manual
  • Figure 8 is a schematic flow chart of a surgical method in this manual
  • Figure 9 is a schematic diagram of a surgical device provided in this specification.
  • minimally invasive surgical equipment to assist operators (such as doctors) in performing surgical operations has been widely used in the field of spinal endoscopic minimally invasive surgery.
  • spinal endoscopic minimally invasive surgery transforaminal endoscopic surgery ( Both Percutaneous Endoscopic Lumbar Discectomy (PELD) and Unilateral Biportal Endoscopy (UBE) can be assisted by minimally invasive surgical equipment.
  • PELD Percutaneous Endoscopic Lumbar Discectomy
  • UBE Unilateral Biportal Endoscopy
  • spinal endoscopic minimally invasive surgery since it is possible to touch human tissues in dangerous areas such as the spinal cord and nerve roots when treating protruding disc tissue in the diseased area, in addition to conventional endoscopic insertion In addition to the operation of surgical instruments, it is also necessary to protect human tissues in the dangerous area during the operation.
  • the current common practice is to manually rotate the working cannula during the operation so that the opening slope of the working cannula points to the cranial, dorsal, caudal, and ventral sides in order, and place the nerve root and dura mater on the dorsal side of the working channel.
  • Protective shielding to prevent damage to human tissues (such as nerve roots) in the dangerous area when the minimally invasive surgical equipment assists the operator in performing surgical operations on the diseased area, thereby causing complications.
  • Figure 1 is a schematic diagram of surgical equipment provided in this manual.
  • This specification provides a surgical device that can assist an operator in performing a surgical operation.
  • the specific technical solution will be described by taking spinal endoscopic surgery as an example.
  • the surgical equipment at least includes a first auxiliary robotic arm 1 , an operating robotic arm 2 , and a control device 3 .
  • equipment A and equipment B are located on both sides of the operating table respectively, and the first auxiliary robot arm 1 and the operating robot arm 2 are fixed on equipment A and equipment B respectively.
  • the patient is placed in a prone position on a designated position on the operating table so that the operator and surgical equipment can perform surgical operations on the patient's diseased parts.
  • the first auxiliary robot arm 1 at least includes a fixing device 11 and a rotating device 12 configured on the fixing device 11 , wherein the fixing device 11 is used to place (clamp) the working sleeve 13 , and the rotating device 12 is used to rotate in response to the rotation instruction.
  • Working casing13 In order to ensure the flexibility of the first auxiliary robot arm 1 , the first auxiliary robot arm 1 may use a robot arm with five or more movable joints.
  • the operating robot arm 2 at least includes a surgical instrument assembly 21 and a second slide rail 23.
  • the surgical instrument assembly 21 may include one or more surgical instruments 211 used for minimally invasive spinal surgery, such as nucleus pulposus forceps, electrode electrocoagulation, microscopy, etc. Scalpel, micro forceps, microwave ablation needle, etc.
  • the surgical instrument assembly 21 is equipped with a second slider 24. In response to the instrument movement instruction sent by the control device 3, the second slider 24 slides on the second slide rail 23 to drive the surgical instrument assembly 21.
  • the designated area 7 refers to a safe surgical area within the patient's diseased area where surgical operations can be performed.
  • a robotic arm with six or more movable joints may be used. It should be noted that, before performing a surgical operation on the designated area 7 of the patient, the control device 3 can be based on the positions of the first auxiliary robot arm 1 and the operating robot arm 2, and the relative positions of the first auxiliary robot arm 1 and the operating robot arm 2.
  • the surgical position is suitable for putting the endoscope 9 into the working cannula 13 along the puncture direction.
  • the surgical instrument 211 is suitable for being put into the working cannula 13 along the puncture direction 8 or inserted into the endoscope 9. Arrive at the surgical position in designated area 7 through the working channel.
  • the control device 3 can be a computer host equipped with designated software (such as three-dimensional software, planning software, etc.), and is connected to the first auxiliary robot arm 1, the operating robot arm 2 and other devices through wired or wireless means.
  • the control device 3 may be configured inside device A or device B, or may be configured in device C that is independent of device A and device B. The embodiments of this specification are not limited to this.
  • the first auxiliary robotic arm 1 and the operating robotic arm 2 can also be installed on the same equipment on the side of the hospital bed.
  • the equipment can be temporarily fixed on the ground, or the equipment can be equipped with pulleys that can be moved according to actual needs. move as shown in Figure 2.
  • the surgical equipment also includes a positioning device 6.
  • the positioning device 6 can be suspended alone directly above the patient (above the operating table), or can be installed on equipment A or equipment B where the robotic arm is located, or can be Set up a device C that is independent of device A or device B and is specifically used to install the positioning device 6, and is placed above the patient to facilitate acquisition of the first positioning light source mark 22, the second positioning light source mark 17 or the third positioning light source mark 42 Emitted or reflected light.
  • the positioning light source mark can be an infrared light emitting device, a light emitting diode (LED), or a passive reflective sphere.
  • the positioning device 6 generates emitted or reflected light by receiving the positioning light source mark, thereby capturing the first auxiliary robotic arm 1 and the position where the robotic arm 2 is operated.
  • the control device 3 simulates the endoscope 9 and the surgical instruments 211 installed on the operating robot arm 2.
  • the second positioning light source mark 17 can be installed on the first auxiliary robot arm 1
  • the first positioning light source mark 22 can be installed on the operating robot arm 2
  • the second positioning light source mark 22 can be installed on the second auxiliary robot arm 1.
  • a third positioning light source mark 42 is disposed on the robotic arm 4 or at a target position within a preset range of the patient's diseased part to ensure that the accurate coordinates of the endoscope 9 and surgical instruments 211 in the three-dimensional image of the diseased part can be simulated. location and shape.
  • the specific position of the first positioning light source mark 22 on the operating robot arm 2 the specific position of the second positioning light source mark 17 on the first auxiliary robot arm 1 and the third positioning light source mark 42 on the second auxiliary robot arm 4
  • the specific position or the target position of the third positioning light source mark 42 within the preset range of the patient's diseased part can be set according to the specific surgical scene, and this specification does not limit this.
  • the operator can perform scanning through the scanning device 5 provided in the surgical environment (such as intraoperative computed tomography (Computed Tomography), CT), three-dimensional (3-dimensional, 3D) C-arm X-ray machine, etc.) to scan the patient's diseased parts, as shown in Figure 3.
  • the scanning device 5 sends the scanning results to the control device 3, and then uses the three-dimensional software in the control device 3 to simulate a three-dimensional image of the endoscope 9, the surgical instrument 211 and the patient's diseased part, and uploads the three-dimensional image to the control device 3
  • the display 32 on the device provides a reference for the operator's surgical operation.
  • the control device 3 can use the built-in planning module 31 (not shown in the figure) to plan according to the positions of the first auxiliary robot arm 1 and the operating robot arm 2 determined by the positioning device 6 and the scan results of the diseased parts. Find the appropriate puncture location and puncture direction8 to ensure safety while minimizing trauma to the patient's body.
  • the control device 3 can plan a safe surgical area that allows the surgical instrument 211 to perform surgical operations on the diseased part as the designated area 7 based on the positions of the first auxiliary robot arm 1 and the operating robot arm 2 determined by the positioning device 6.
  • the surgical operation is performed in the designated area 7 to perform surgery on the diseased parts of the patient's body. Because the surgical instrument 211 is installed on the operating robot arm 2, the operating robot arm 2 can only move within a specified range and angle. It is ensured that the surgical instruments 211 on the operating robot arm 2 cannot leave the designated area 7, thereby further ensuring the safety of the operation.
  • a dangerous area can be planned based on the positions of the first auxiliary robot arm 1 and the operating robot arm 2 determined by the positioning device 6.
  • the dangerous area is where the surgical instrument 211 is not allowed to operate.
  • the surgical operation area since the operating robot arm 2 can only move within a specified range and angle, it can be ensured that the surgical instrument 211 only performs surgical operations within the specified area 7 and will not enter the dangerous area.
  • the second auxiliary robotic arm 4 can be installed not only on device A, but also on device B or the operating bed, or even on a separate device.
  • the rotation or tilt of the working cannula 13 placed on the first auxiliary robotic arm 1 can be used. Push away the human tissue in the dangerous area around the diseased part, expand the operating range of the surgical instrument 211, and avoid damage to the human tissue in the dangerous area caused by the intraoperative surgical instrument 211 performing surgical operations on the diseased part. Intraoperative infection and postoperative complications.
  • the preoperative operation steps of the control device 3 on the patient's diseased area specifically include the following three steps:
  • Step 1 The control device 3 can receive the positions of the first auxiliary robot arm 1 and the operating robot arm 2 relative to the patient, which are acquired and sent by the positioning device 6 .
  • Step 2 The planning module 31 in the control device 3 can determine whether it is allowed to operate the robotic arm 2 based on the positions of the first auxiliary robotic arm 1 and the operating robotic arm 2 relative to the patient and the scan results of the patient's diseased parts.
  • the surgical instrument 211 disposed at the end is a designated area 7 for safe surgical operation on the diseased site, as well as a puncture position and puncture direction 8 that enable the working cannula 13 and the surgical instrument 211 to reach the designated area 7 .
  • the puncture position and puncture direction 8 that enable the surgical instrument 211 to reach the designated area 7 can be used as the surgical path planned by the control device 3 for the diseased part of the patient.
  • Step 3 The control device 3 can send control instructions to the first auxiliary robotic arm 1 and the operating robotic arm 2 according to the determined surgical path planned for the diseased part and the operating actions of the operator, so that all The first auxiliary robot arm 1 and the operation robot arm 2 take actions such as rotation and surgical operation in response to the control instructions sent by the control device 3 .
  • the first auxiliary robotic arm 1 can respond to the control instructions sent by the control device 3 to provide preoperative and intraoperative assistance to the process of operating the robotic arm 2 to perform surgical operations on the patient's diseased parts.
  • Preoperative assistance may include puncture, installation of the working cannula 13 , and rotating or tilting the working cannula 13 ; intraoperative assistance may include rotating or tilting the working cannula 13 .
  • the first auxiliary robot arm 1 may include a first slide rail 15 and a clamping device 14 .
  • the first slide rail 15 is fixed on the first auxiliary robot arm 1
  • the first slide block 141 is disposed on the clamping device 14.
  • the first slide block 141 slides on the first slide rail 15, driving the The clamping device 14 slides on the first auxiliary robot arm to drive tools clamped on the clamping device 14, such as puncture tools 16, endoscopes 9, etc.
  • the process of holding the puncture tool 16 and the endoscope 9 by the holding device 14 will be described in detail below:
  • the clamping device 14 when the patient is at a designated position and the first auxiliary robotic arm 1 swings above the patient, the clamping device 14 clamps the puncture tool 16 , the clamping device 14 can respond to the second puncture instruction sent by the control device 3 to perform puncture at the puncture position pre-planned by the control device 3 and along the puncture direction 8 pre-planned by the control device 3, so that The head end of the puncture tool 16 reaches the designated area 7 and forms a puncture wound.
  • the puncture wound can be obtained by puncturing the designated area 7 with the puncture tool 16 and expanding the hole.
  • the puncture tool 16 used has the ability to puncture and expand the hole.
  • the puncture tool 16 used in the embodiment of this specification can be any existing puncture tool 16 with the function of puncture and hole expansion. This specification does not limit the specific material and hole expansion method of the puncture tool 16.
  • the operator can manually place the working cannula 13, as shown in Figure 4B, insert the working cannula 13 into the puncture wound along the puncture direction 8, and fix it on the fixing device 11, so that the head end of the working casing 13 is located in the designated area 7.
  • the fixing device 11 also includes a rotating device 12, the rotating device 12 can respond to the rotation instruction sent by the control device 3 and control the rotating device 12 to move itself to drive the working casing 13 placed on the fixing device 11. Rotate so that the head end of the working cannula 13 pushes away the dangerous parts around the designated area 7 in the wound.
  • the rotation instruction carries a designated rotation direction and a designated rotation angle of the working cannula 13, and the designated rotation direction and designated rotation are determined by the control device 3 based on the scan results of the designated area 7 and the diseased part.
  • the timing when the rotation device 12 responds to the rotation instruction sent by the control device 3 may be when the control device 3 detects that the head end of the working cannula 13 is located in the designated area 7 before surgery, or during surgery.
  • the control device 3 detects that the surgical instrument 211 may operate on the dangerous part, this specification does not limit this.
  • the first auxiliary manipulator 1 can also control its own tilt in response to the tilt instruction sent by the control device 3 to drive the working casing placed on the fixation device 11 at the end of the first auxiliary manipulator 1 to tilt to achieve push.
  • the tilt instruction carries the tilt direction and tilt angle of the first auxiliary robot arm 1 .
  • the tilt direction and tilt angle of the first auxiliary robot arm 1 can be controlled by the control device 3 according to the relative positions of the first auxiliary robot arm 1 and the second auxiliary robot arm 1 .
  • the location of the specified location where the patient is located, and the scan results of the diseased area are determined.
  • the clamping device 14 can also control the endoscope 9 to rotate in response to the endoscope rotation instruction sent by the control device 3 so as to collect real-time images of the designated area 7 at different angles.
  • the clamping device can also respond to other instructions for the endoscope sent by the control device 3 according to the specific application scenario and the operator's operation actions, such as forward, backward, etc.
  • the operating robot arm 2 can respond to the control instructions sent by the control device 3 to perform surgical operations on the patient's diseased parts, as shown in Figure 5A, which specifically includes the following steps:
  • the operating robot arm 2 includes a second slide rail 23 and a surgical instrument assembly 21 , where the second slide rail 23 is fixed on the operating robot arm 2 .
  • the surgical instrument assembly 21 is provided with a second slider 24.
  • the second slider 24 can slide on the second slide rail 23, and at the same time, drive the surgical instrument assembly 21 on the operating robot arm 2 along the extension direction of the second slide rail 23. Slide to insert the surgical instrument 211 into the working cannula 13 or the working channel of the endoscope 9 to perform surgical operation on the designated area 7 .
  • the operating robot arm 2 when the operating robot arm 2 receives a surgical operation instruction sent by the control device 3 , it controls the surgical instrument 211 included in the surgical instrument assembly 21 to perform a surgical operation on the designated area 7 .
  • the surgical instrument assembly 21 includes a plurality of surgical instruments 211 . This is because in the face of different disease conditions (such as nucleus pulposus herniation, spinal stenosis, nerve root compression, dural sac and bone tissue hyperplasia, etc.), the surgical instruments used are different, and a surgery for the patient The process may need to deal with different disease conditions. Manual replacement of a single surgical instrument 211 configured on the operating robot arm multiple times during the operation not only increases the operation time, but also increases the difficulty of the operation for the operator. Therefore, the operator can configure multiple surgical instruments 211 in the surgical instrument assembly 21 according to the actual condition of the patient's diseased part to meet the requirements of using different surgical instruments to perform different surgical operations (such as removing protrusions) during one operation. tissue, bone removal, radiofrequency electrode repair of damaged annulus fibrosus, etc.).
  • the surgical instrument assembly 21 when the surgical instrument assembly 21 includes two surgical instruments 211A and 211B, it can be shown in FIG. 5B .
  • the arrangement of the plurality of surgical instruments 211 included in the surgical instrument assembly 21 can be as shown in FIG. 5C .
  • the arrangement of the plurality of surgical instruments 211 can be one of parallel, misaligned, inclined, vertically mounted, etc. or similar forms.
  • the installation sequence and specific positions of the surgical instruments 221A, 221B and 221C in the Z-shaped installation are not limited in the embodiment of this specification.
  • the operator can arrange multiple surgical instruments 211 included in the surgical instrument assembly 21 according to specific surgical needs.
  • the embodiment of this specification does not limit the specific arrangement of the surgical instruments 211 .
  • the surgical instrument assembly 21 can respond to the instrument switching instructions sent by the control device 3,
  • the surgical instruments 211 included in the surgical instrument assembly 21 are controlled to switch between each other.
  • the instrument switching instruction sent by the control device 3 may be sent by the operator through the operation control lever 34 or the operation foot brake 36 configured on the control device 3, or may be based on a pre-planned operation of the surgical instrument 211 on the robotic arm 2.
  • the planned surgical action for the diseased part can also be sent through the instrument switching option configured in the control device 3, which is not limited in this manual.
  • control device 3 includes a display 32, an auxiliary control lever 33 and an operation control lever 34.
  • the display 32 can display images used to assist the operator in controlling the first auxiliary robotic arm 1 and operating the robotic arm 2. , the operator can control the movement of the first auxiliary robotic arm 1 and the operating robotic arm 2 by manually operating the control rod 34 to implement puncture, placement and rotation of the working cannula 13 and surgical operations.
  • Figure 6A is a schematic diagram of a control device provided in this specification.
  • the display 32 installed on the control device 3 is used to display the scan results (CT image or X-ray image) of the patient's diseased part, the three-dimensional image generated by the control device 3 and the internal wound on the patient's body collected by the endoscope 9 Real-time images of the diseased part, thereby providing a reference for the operator to perform surgery.
  • the scanning results of the patient's diseased parts can be displayed in the display area 321
  • the three-dimensional image generated by the control device 3 can be displayed in the display area 322
  • the scan results of the diseased parts in the wound on the patient's body collected by the endoscope 9 Live images may be displayed in display area 323.
  • the three-dimensional image generated by the control device 3 shown in the display area 322 may be a three-dimensional image in which the control device 3 simulates the endoscope 9, the surgical instrument 211 and the diseased part of the patient through the built-in designated three-dimensional software.
  • the operator can manually control the auxiliary control lever 33 to control the movement of the first auxiliary robotic arm 1 by referring to the image on the display 32 to implement puncture, placement and rotation of the working cannula 13, surgical operations, etc., and manually control the operation control lever 34 to control
  • the operating robot arm 2 moves in different directions and controls the opening and closing of the tips of the surgical instruments 211 to implement surgical operations.
  • the operable directions of the auxiliary control lever 33 may be forward and backward, left and right, and rotation, and the operable directions of the operation control lever 34 may be forward and backward, left and right, and rotation.
  • the optional operating control lever 34 can be set as a control lever that moves gears in the four directions of front, rear, left, and right. At this time, the operator can control the operating control lever 34 with the current position of the operating control lever 34 as the starting point.
  • the operation control lever 34 can also be controlled to swing forward, backward, left and right with the operation control lever 34 as the axis.
  • the auxiliary control lever can also be split into three auxiliary control levers according to different control functions and respectively configured in the control device 3.
  • the control device 3 is configured with a first auxiliary control lever 33A, The second auxiliary control lever 33B and the third auxiliary control lever 33C.
  • the first auxiliary control lever 33A can be used to issue a rotation command to the rotation device 12 of the first auxiliary robotic arm 1 so that the rotation device 12 drives the working sleeve 13 to rotate.
  • the second auxiliary control lever 33B can be used to send a tilt instruction to the first auxiliary robot arm 1 so that the first auxiliary robot arm 1 drives the working casing 13 to tilt.
  • the third auxiliary control lever 33C can be used to issue control instructions such as forward, backward, rotation, etc. to the clamping device 14 configured on the first auxiliary robot arm 1, so that the tools (such as puncture tools 16 and endoscopes) clamped by the clamping device 14 9) Perform forward, backward, and rotation.
  • control instructions such as forward, backward, rotation, etc.
  • an auxiliary foot brake 35 may also be provided to cooperate with the operation of the auxiliary control lever 33 and the operation control lever 34 .
  • the operator can control the auxiliary control lever 33 to operate the first auxiliary robotic arm 1, adjust the position of the first auxiliary robotic arm 1, and then control the light source and camera at the end of the endoscope 9 Fine adjustment of the angle and position, and if the operator does not step on the auxiliary foot brake 35, even if the operator operates the auxiliary control lever 33, the first auxiliary robot arm 1 cannot be operated.
  • the operator can control the operating control lever 34 to operate the operating robotic arm 2, adjust the position of the operating robotic arm 2 on the patient's body, and achieve fine adjustment of the angle and position of the surgical instrument 211. , and control the surgical instrument 211 to complete the corresponding surgical operation. If the operator does not step on the operating foot brake 36, even if the operator controls the operating control lever 34, the operating robot arm 2 cannot be operated to ensure safety.
  • control device 3 is also equipped with an emergency stop foot brake 37.
  • an emergency stop foot brake 37 Once the operator finds that the first auxiliary robot arm 1 and/or the operating robot arm 2 has an abnormal operation during the execution of puncture instructions, rotation instructions, and surgical operation instructions, and When the first auxiliary robot arm 1 and/or the operating robot arm 2 encounter abnormal operation conditions when the operator performs manual operations through the control device 3, the operator can step on the emergency stop foot brake 37 to stop the first auxiliary robot arm 1 and Operate the movement of robot arm 2.
  • the operator can also manually and slightly adjust the angle and position of the endoscope 9 and the arm of the surgical instrument 211 in the wound according to the specific surgical conditions, and manually operate the surgical instrument 211 to perform surgical treatment on the diseased part.
  • an intraoperative CT or C-type X-ray arm scan can be performed on the patient during the operation to obtain an intraoperative X-ray image of the designated area 7 within the patient's diseased part.
  • a protective device can be placed around the control device 3.
  • the patient needs to be anesthetized before minimally invasive surgery is performed on the patient.
  • the minimally invasive spine endoscopic surgery in the embodiments of this specification uses local anesthesia to ensure that the patient is awake during the surgery. This is because minimally invasive spinal endoscopic surgery targets the protruding intervertebral disc tissue, nucleus pulposus and other human tissues in the intervertebral foramen. During the operation, the nerve roots may be touched.
  • the advantage of local anesthesia is that if the surgical operation pulls the nerve root or there is radiofrequency cauterization in the middle, which affects the nerve root, the patient can immediately report it, so that the operator will stop the operation that may cause damage to the nerve, ensuring the safety of the operation.
  • the operator can communicate with the patient at any time during the operation and allow the patient to do activities such as lower limbs to coordinate with the operation, so as to ensure the patient's safety during the operation at all times.
  • a second auxiliary robotic arm 4 can be added to fix the patient and prevent the patient's body from shifting.
  • the surgical equipment shown in Figure 1 can also include a second auxiliary robotic arm 4.
  • the second auxiliary robotic arm 4 can be installed on the equipment A where the first auxiliary robotic arm 1 is located, or can be installed on one side of the operating bed. B or on a separate device.
  • the second auxiliary robotic arm 4 can press the patient to fix the patient's diseased part to prevent damage to the patient due to the displacement of the patient's diseased part during the operation.
  • the second auxiliary robot arm 4 can be a robot arm with three or more movable joints.
  • the second auxiliary robotic arm 4 can respond to the first puncture instruction sent by the control device 3 and control the position at the end of the second auxiliary robotic arm 4
  • the fixation needle 41 punctures the patient's body to further fix the patient's diseased part.
  • the second auxiliary robotic arm 4 can be manually controlled by the operator to move and use the end of the second auxiliary robotic arm 4 to press the patient to fix the patient.
  • the operator can manually puncture the patient to implant the fixation pin 41 .
  • the end of the second auxiliary manipulator 4 can also be equipped with a third positioning light source mark 42.
  • the third positioning light source mark 42 is used to indicate the position of the patient's diseased part.
  • the third positioning light source mark 42 is in contact with the first positioning light source.
  • the combination of the mark 22 and the second positioning light source mark 17 jointly determines the position of the first auxiliary robot arm 1 and the operation robot arm 2 relative to the patient, which can improve the accuracy of positioning the first auxiliary robot arm 1 and the operation robot arm 2 .
  • the third positioning light source mark 42 is also used to indicate the movement of the patient's body.
  • the second auxiliary robotic arm 4 and the fixation device located at the end of the second auxiliary robotic arm 4 have been used to fix the diseased part of the patient, Considering the uncertainty of the patient's diseased part displacement during the operation, the positioning device 6 can track the micro-movements of the patient's body through the light source emitted or reflected by the third positioning light source mark 42, so that when the patient's body is displaced, the positioning device 6 can adjust the position of the patient's body in real time when the patient's body is displaced.
  • the placement position of the second auxiliary robot arm 4 where the third positioning light source mark 42 is located on the patient's body needs to be located at the patient's diseased part. at a position within the preset range of the site. For example, when performing minimally invasive spine surgery, in order to prevent the second auxiliary robotic arm 4 from affecting the surgical operation of the diseased site, the operator places the second auxiliary robotic arm 4 on the patient's affected area.
  • the fixation needle 41 disposed at the end of the second auxiliary robotic arm 4 Position within the preset range of the diseased site, and enable the fixation needle 41 disposed at the end of the second auxiliary robotic arm 4 to be inserted into other bone tissue (vertebral body or pedicle) within the preset range near the patient's diseased spine superior.
  • the second auxiliary manipulator 4 can be prevented from affecting the puncture operation of the patient's body by the puncture tool 16 configured on the first auxiliary manipulator 1, as well as the operation of the manipulator 2 on the patient's diseased parts, and the patient can also be immobilized. Function of the body that indicates the location of the diseased part to the patient.
  • the preset range can be set according to actual conditions, and this application does not limit this.
  • this specification also provides a surgical device for performing UBE surgery by installing surgical instruments or endoscopes on the first auxiliary robotic arm and the operating robotic arm respectively, as shown in FIG. 7 .
  • the working cannula 13 is fixed on the fixing device 11 at the end of the first auxiliary robotic arm 1 .
  • the endoscope 9 enters the working cannula 13 to collect real-time images of the patient's designated area and send them to the control device 3 .
  • the end of the operating robot arm 2 is equipped with a surgical instrument assembly 21, which enters the patient's body from another puncture wound different from the puncture wound where the working cannula 13 is located and reaches a designated area.
  • the operating actions performed on the device perform surgical operations on designated areas.
  • this manual also provides a schematic flow chart of a surgical method to illustrate the control method of the above-mentioned surgical equipment during the actual operation, as shown in Figure 8.
  • Figure 8 is a schematic flow chart of a minimally invasive surgical equipment operation method provided in this manual, including the following steps:
  • control device can be a computer host equipped with designated software (such as three-dimensional software, planning software, etc.), and is connected to the first auxiliary robot arm, the operating robot arm and other devices through wired or wireless means. Therefore, the surgical method provided in the embodiments of this specification can have a control device to execute the execution process of the surgical method.
  • designated software such as three-dimensional software, planning software, etc.
  • the positioning device has a first positioning light source mark 22 installed on the first auxiliary mechanical arm, a second positioning light source mark 17 installed on the end of the operating robot arm, and a third positioning light source mark installed on the end of the second auxiliary machine.
  • the positioning device sends the acquired positions of the first auxiliary manipulator and the operating manipulator to the control device, and the control device receives and displays the positions of the first auxiliary manipulator and the operating manipulator.
  • the diseased part is scanned through a CT or C-type relative positions between parts.
  • S102 Based on the positions of the first auxiliary robotic arm and the operating robotic arm, determine a designated area that allows the surgical instrument disposed at the end of the operating robotic arm to perform safe surgical operations on the diseased site, and that enables the work to be performed The cannula and surgical instrument reach the puncture location and puncture direction of the designated area.
  • the planning module in the control device can determine, based on the positions of the first auxiliary manipulator 1 and the operating manipulator relative to the patient and the scan results of the patient's diseased parts, that the surgical instruments allowed to be configured at the end section of the operating manipulator are used in the patient.
  • the puncture position and puncture direction that enable the surgical instrument to reach the designated area can be used as the surgical path planned by the control device for the diseased part of the patient.
  • the control device sends a second puncture instruction.
  • the puncture tool configured on the first auxiliary robot arm responds to the second puncture instruction and performs puncture according to the puncture position and the puncture direction, so that the endoscope can collect the diseased information.
  • the real-time image of the puncture wound of the site is taken, and a working cannula is placed in the puncture wound.
  • the clamping device clamps the puncture tool.
  • the clamping device can respond to the second puncture instruction sent by the control device, and perform the operation as planned in advance by the control device.
  • puncture is performed along the puncture direction pre-planned by the control device, so that the head end of the puncture tool reaches the designated area and forms a puncture wound.
  • the operator can manually place the working cannula, insert the working cannula into the puncture wound along the puncture direction, and fix it on the fixing device, so that the working cannula The head end is located in the designated area.
  • the fixing device also includes a rotating device
  • the rotating device can respond to the rotation instruction sent by the control device and control the rotating device itself to move to drive the working casing placed on the fixing device to rotate, so that the working sleeve can be rotated.
  • the head end of the cannula pushes away the dangerous part around the designated area within the wound.
  • the rotation instruction carries the designated rotation direction and the designated rotation angle of the working cannula; the designated rotation direction and the designated rotation are determined by the control device according to the scanning results of the designated area and the diseased part.
  • S108 The operator puts the endoscope into the working casing, and sends an instrument movement instruction through the control device, so that the surgical instruments assembled on the operating robot arm enter the working casing.
  • the tool held by the clamping device can be changed from a puncture tool to an endoscope.
  • the clamping device responds to the endoscope control instruction sent by the control device, controls the first slider to slide along the first slide rail, and drives the endoscope held by the clamping device to be inserted into the working casing.
  • the endoscope can collect the real-time image of the designated area, and send the real-time image of the designated area to the control device, so that the control device performs a surgical operation on the designated area based on the real-time image of the designated area.
  • the automatic rotation of the working cannula by the first auxiliary robotic arm can protect human tissues in the dangerous area, thereby reducing the risk of intraoperative infection and postoperative complications, and eliminating the need for operators to perform manual rotation during the operation.
  • Figure 9 is a schematic diagram of a surgical device provided in this manual, which specifically includes:
  • the position acquisition module 200 is used to acquire the positions of the first auxiliary manipulator and the operating manipulator;
  • the rotation instruction sending module 202 is configured to send a rotation instruction to any one of the above in response to the operator's operation action when it is determined that the working casing configured on the first auxiliary manipulator is inserted into the pre-planned designated area.
  • the first auxiliary robotic arm is configured on the surgical equipment, so that the rotation device configured on the first auxiliary robotic arm controls the rotation of the working cannula fixed on the fixing device, so that the working cannula is pushed away from the position in the puncture wound. Pre-planned hazardous locations around designated areas;
  • the surgical operation instruction sending module 204 is configured to send a surgical operation instruction to any of the above institutions in response to the operator's operation action when it is determined that the surgical instrument installed on the operating robot arm is inserted into the puncture wound on the patient's body.
  • the operating robot arm configured on the surgical equipment allows the surgical instrument assembly configured on the operating robot arm to control the surgical instruments included in the surgical instrument assembly to perform surgical operations on the pre-planned designated area.
  • This specification also provides a computer-readable storage medium that stores a computer program.
  • the computer program can be used to perform the surgical method provided in Figure 8 above.
  • PLD Programmable Logic Device
  • FPGA Field Programmable Gate Array
  • HDL Hardware Description Language
  • the controller may be implemented in any suitable manner, for example, the controller may take the form of, for example, a microprocessor or processor and a computer readable medium storing computer readable program code (eg, software or firmware) executable by the (micro)processor. , logic gates, switches, Application Specific Integrated Circuit (ASIC), programmable logic controllers and embedded microcontrollers.
  • controllers include but are not limited to the following microcontrollers: ARC 625D, Atmel AT91SAM, For Microchip PIC18F26K20 and Silicone Labs C8051F320, the memory controller can also be implemented as part of the memory's control logic.
  • the controller in addition to implementing the controller in the form of pure computer-readable program code, the controller can be completely programmed with logic gates, switches, application-specific integrated circuits, programmable logic controllers and embedded logic by logically programming the method steps. Microcontroller, etc. to achieve the same function. Therefore, this controller can be considered as a hardware component, and the devices included therein for implementing various functions can also be considered as structures within the hardware component. Or even, the means for implementing various functions can be considered as structures within hardware components as well as software modules implementing the methods.
  • a typical implementation device is a computer.
  • the computer may be, for example, a personal computer, a laptop computer, a cellular phone, a camera phone, a smartphone, a personal digital assistant, a media player, a navigation device, an email device, a game controller, a tablet computer, a wearable device, or A combination of any of these devices.
  • embodiments of the present invention may be provided as methods, systems, or computer program products.
  • the invention may take the form of an entirely hardware embodiment, an entirely software embodiment, or an embodiment combining software and hardware aspects.
  • the invention may take the form of a computer program product embodied on one or more computer-usable storage media (including, but not limited to, disk storage, CD-ROM, optical storage, etc.) having computer-usable program code embodied therein.
  • These computer program instructions may also be stored in a computer-readable memory that causes a computer or other programmable data processing apparatus to operate in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including the instruction means, the instructions
  • the device implements the functions specified in a process or processes of the flowchart and/or a block or blocks of the block diagram.
  • These computer program instructions may also be loaded onto a computer or other programmable data processing device, causing a series of operating steps to be performed on the computer or other programmable device to produce computer-implemented processing, thereby executing on the computer or other programmable device.
  • Instructions provide steps for implementing the functions specified in a process or processes of a flowchart diagram and/or a block or blocks of a block diagram.
  • a computing device includes one or more processors (CPUs), input/output interfaces, network interfaces, and memory.
  • processors CPUs
  • input/output interfaces network interfaces
  • memory volatile and non-volatile memory
  • Memory may include non-permanent storage in computer-readable media, random access memory (RAM) and/or non-volatile memory in the form of read-only memory (ROM) or flash memory (flash RAM). Memory is an example of computer-readable media.
  • RAM random access memory
  • ROM read-only memory
  • flash RAM flash random access memory
  • Computer-readable media includes both persistent and non-volatile, removable and non-removable media that can be implemented by any method or technology for storage of information.
  • Information may be computer-readable instructions, data structures, modules of programs, or other data.
  • Examples of computer storage media include, but are not limited to, phase change memory (PRAM), static random access memory (SRAM), dynamic random access memory (DRAM), other types of random access memory (RAM), and read-only memory.
  • PRAM phase change memory
  • SRAM static random access memory
  • DRAM dynamic random access memory
  • RAM random access memory
  • read-only memory read-only memory
  • ROM read-only memory
  • EEPROM electrically erasable programmable read-only memory
  • flash memory or other memory technology
  • compact disc read-only memory CD-ROM
  • DVD digital versatile disc
  • Magnetic tape cassettes tape magnetic disk storage or other magnetic storage devices or any other non-transmission medium can be used to store information that can be accessed by a computing device.
  • computer-readable media does not include transitory media, such as modulated data signals and carrier waves.
  • embodiments of the present specification may be provided as methods, systems, or computer program products.
  • the present description may take the form of an entirely hardware embodiment, an entirely software embodiment, or an embodiment that combines software and hardware aspects.
  • the present description may take the form of a computer program product embodied on one or more computer-usable storage media (including, but not limited to, disk memory, CD-ROM, optical storage, etc.) having computer-usable program code embodied therein.
  • program modules include routines, programs, objects, components, data structures, etc. that perform specific tasks or implement specific abstract data types.
  • the present description may also be practiced in distributed computing environments where tasks are performed by remote processing devices connected through communications networks.
  • program modules may be located in both local and remote computer storage media including storage devices.

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Abstract

一种手术设备、手术方法及手术装置，手术设备包括第一辅助机械臂（1）、操作机械臂（2）以及控制装置（3），控制装置（3）通过根据第一辅助机械臂（1）以及操作机械臂（2）的位置以及操作人员的操作动作，向第一辅助机械臂（1）以及操作机械臂（2）发送控制指令，以使第一辅助机械臂（1）末端配置的固定装置（11）上放置的工作套管（13）旋转，以便工作套管（13）推开位于预先规划的指定区域（7）周围的危险部位，操作机械臂（2）响应于控制装置（3）发送的控制指令，控制手术器械组件（21）中包含的手术器械（211）对指定区域（7）进行手术操作。可见，控制第一辅助机械臂（1）自动旋转工作套管（13），可以保护危险区域内的人体组织，进而降低术中感染以及术后并发症的风险，免除操作人员在术中进行的人工旋转的操作。

Description

一种手术设备、手术方法及手术装置 技术领域
本说明书涉及大外科手术领域，尤其涉及一种手术设备、手术方法及手术装置。
背景技术
随着微创手术技术的发展，对于微创和精准的手术操作要求越来越高。其中，脊椎内镜微创手术作为一项开展较早的微创技术，已经在临床上广泛应用。与传统开放手术相比，脊椎内镜微创手术具有创伤小、出血少、恢复快、疗效确切等优点。
现有技术中，为了降低操作人员人工进行手术的难度，可以使用手术设备辅助操作人员进行手术操作，进而降低手术过程中的人工操作的不确定性，在提高手术安全性的同时，缓解手术中操作人员的负担。
然而，目前的手术设备仍然更倾向于关注手术器械抵达患病部位的精准性，对患病部位周围的其他部位的保护操作仍然需要通过操作人员手动进行，这就导致发生术中意外损伤、感染以及术后并发症的问题依然存在，而且实际发生机率较高。
发明内容
本说明书提供一种手术设备、手术方法及手术装置，以部分的解决现有技术存在的上述问题。
本说明书采用下述技术方案：
本说明书提供一种手术设备，所述手术设备包括第一辅助机械臂1，操作机械臂2，控制装置3；
所述控制装置3用于获取所述第一辅助机械臂1与所述操作机械臂2的位 置，并根据所述第一辅助机械臂1与所述操作机械臂2的位置以及操作人员的操作动作，向所述第一辅助机械臂1以及所述操作机械臂2发送控制指令；
所述第一辅助机械臂1包括固定装置11和旋转装置12；所述旋转装置12配置在所述固定装置11上；所述固定装置11用于放置插入到患者体内的工作套管13；响应于由所述控制装置3发送的控制指令，控制放置在所述固定装置11上的工作套管13旋转，以使所述工作套管13在创口内推开位于预先规划的指定区域7周围的危险部位；
所述操作机械臂2上配置手术器械组件21；响应于由所述控制装置3发送的控制指令，控制所述手术器械组件21中包含的手术器械211对所述指定区域7进行手术操作。
可选地，所述手术设备还包括第二辅助机械臂4；所述第二辅助机械臂4包括固定针41；
当所述控制装置3确定所述患者位于指定位置时，控制所述第二辅助机械臂4按压所述患者；
所述第二辅助机械臂4响应于由所述控制装置3发送的第一穿刺指令，控制配置在所述第二辅助机械臂4末端的固定针41对所述患者身体进行穿刺，以便对所述患者的患病部位进行固定。
可选地，所述手术设备还包括第二辅助机械臂4；所述第二辅助机械臂4包括固定针41；
当所述患者位于指定位置时，由所述操作人员手动控制所述第二辅助机械臂4按压所述患者；
由所述操作人员手动控制配置在所述第二辅助机械臂4末端的固定针41对所述患者进行穿刺，以便对所述患者的患病部位进行固定。
可选地，所述手术设备还包括扫描装置5；所述扫描装置5用于对所述患者进行扫描并得到患者身体内患病部位的扫描结果；
将所述患病部位的扫描结果发送给控制装置3，以使所述控制装置3接收 并显示所述患病部位的扫描结果。
可选地，所述手术设备还包括定位装置6；所述操作机械臂2配置第一定位光源标记22；所述第一辅助机械臂1配置第二定位光源标记17；所述第二辅助机械臂4配置第三定位光源标记42；
所述定位装置6根据采集到的第一定位光源标记22、第二定位光源标记17以及所述第三定位光源标记42所发射或反射的光线，确定所述操作机械臂2和所述第一辅助机械臂1相对于所述患者的位置，并发送给所述控制装置3，以使所述控制装置3根据所述操作机械臂2以及所述第一辅助机械臂1的位置以及操作人员的操作动作，向所述第一辅助机械臂1以及向所述操作机械臂2发送控制指令。
可选地，所述控制装置3包括规划模块31；所述规划模块31用于根据所述操作机械臂2以及所述第一辅助机械臂1的位置、所述患病部位的扫描结果，确定允许所述操作机械臂2末端配置的手术器械211在所述患病部位上进行安全手术操作的指定区域7、以及能够使所述工作套管13和所述手术器械211达到所述指定区域7的穿刺位置以及穿刺方向8，以使所述控制装置3根据所述指定区域7、所述穿刺位置以及所述穿刺方向8，控制所述第一辅助机械臂1以及所述操作机械臂2对所述指定区域进行手术操作。
可选地，所述第一辅助机械臂1包括第一滑轨15和夹持装置14；所述第一滑轨15固定在所述第一辅助机械臂1上；所述夹持装置14上配置第一滑块141，所述第一滑块141在所述第一滑轨15上滑动，带动所述夹持装置14在所述第一辅助机械臂1上沿所述第一滑轨15的延伸方向滑动，以便带动所述夹持装置14夹持的工具沿所述第一滑轨15的延伸方向滑动。
可选地，所述夹持装置14用于夹持穿刺工具16；所述夹持装置14响应于由所述控制装置3发送的第二穿刺指令，控制所述第一滑块141在所述第一滑轨15上沿穿刺方向8滑动，以带动所述穿刺工具16在穿刺位置沿穿刺方向8进行穿刺，以使所述穿刺工具16的首端到达所述指定区域7，形成穿刺创口。
可选地，所述工作套管13沿所述穿刺方向8插入所述穿刺创口内，并固定在所述固定装置11上，以使所述工作套管13的首端位于所述指定区域7；
当检测到所述工作套管13的首端位于所述指定区域7时，所述旋转装置12响应于所述控制装置3发送的旋转指令，控制所述旋转装置12旋转，带动放置在所述固定装置11上的工作套管13旋转，以使所述工作套管13的首端在穿刺创口内推开所述指定区域7周围的危险部位。
可选地，所述旋转指令携带所述工作套管13的指定旋转方向以及指定旋转角度；所述指定旋转方向以及所述指定旋转由所述控制装置3根据所述指定区域7以及所述患病部位的扫描结果确定。
可选地，所述夹持装置14用于夹持内镜9；所述夹持装置14响应于由所述控制装置3发送的内镜控制指令，控制所述第一滑块141沿所述第一滑轨15滑动，带动所述夹持装置14夹持的内镜9插入到工作套管13中，以采集并发送指定区域7的实时图像。
可选地，所述操作机械臂2包括第二滑轨23和手术器械组件21；所述第二滑轨23固定在所述操作机械臂2上；所述手术器械组件21上配置第二滑块24，所述第二滑块24在所述第二滑轨23上滑动，带动所述手术器械组件21在所述操作机械臂2上沿所述第二滑轨23的延伸方向滑动，以便将所述手术器械211插入到工作套管13内或内镜9的工作通道中，以对所述指定区域7进行手术操作。
可选地，所述手术器械组件21包括多个手术器械211；所述多个手术器械211在所述手术器械组件21中的安装形式包括平行安装、错位安装、倾斜面安装、品字形安装中的至少一个；
所述手术器械组件21响应于由所述控制装置3发送的器械切换指令，控制所述手术器械组件21包含的各手术器械211之间进行切换。
可选地，所述控制装置3包括显示器32、辅助控制杆33和操作控制杆34；
所述显示器32用于显示所述指定区域7的实时图像，以及所述患病部位 的扫描结果；
所述辅助控制杆33用于响应于操作人员的第一操作动作，向所述旋转装置12发送旋转指令，以使所述旋转装置12旋转，带动放置在所述固定装置11上的工作套管13旋转，以便所述工作套管13在穿刺创口内推开所述指定区域7周围的危险部位；
所述操作控制杆34用于响应于操作人员的第二操作动作，向所述操作机械臂2发送器械移动指令，控制配置在所述手术器械组件21上的第二滑块24沿所述第二滑轨23滑动，带动所述手术器械组件21中包含的手术器械211沿所述穿刺方向8插入所述工作套管13中；当检测到所述手术器械211达到所述指定区域7时，响应于操作人员的第三操作动作，向所述手术器械211发送手术操作指令，以便控制所述手术器械211对所述指定区域7进行手术操作。
本说明书提供了一种手术方法，所述方法应用于控制装置，所述方法包括：
获取第一辅助机械臂与操作机械臂的位置；
当确定所述第一辅助机械臂上配置的工作套管插入到预先规划的指定区域时，响应于操作人员的操作动作，将旋转指令发送给上述任一所述手术设备上配置的第一辅助机械臂，以使所述第一辅助机械臂上配置的旋转装置控制固定在固定装置上的工作套管旋转，以便所述工作套管在穿刺创口内推开位于预先规划的指定区域周围的危险部位；
当确定安装在所述操作机械臂上的手术器械插入到患者身体上穿刺创口内时，响应于操作人员的操作动作，将手术操作指令发送给上述任一所述手术设备上配置的操作机械臂，以使操作机械臂上配置的手术器械组件控制所述手术器械组件中包含的手术器械对所述预先规划的指定区域进行手术操作。
本说明书提供了一种手术装置，所述装置应用于控制装置，所述装置包括：
位置获取模块，用于获取第一辅助机械臂与操作机械臂的位置；
旋转指令发送模块，用于当确定所述第一辅助机械臂上配置的工作套管插入到预先规划的指定区域时，响应于操作人员的操作动作，将旋转指令发送给 上述任一所述手术设备上配置的第一辅助机械臂，以使所述第一辅助机械臂上配置的旋转装置控制固定在固定装置上的工作套管旋转，以便所述工作套管在穿刺创口内推开位于预先规划的指定区域周围的危险部位；
手术操作指令发送模块，用于当确定安装在所述操作机械臂上的手术器械插入到患者身体上穿刺创口内时，响应于操作人员的操作动作，将手术操作指令发送给上述任一所述手术设备上配置的操作机械臂，以使操作机械臂上配置的手术器械组件控制所述手术器械组件中包含的手术器械对所述预先规划的指定区域进行手术操作。
本说明书提供了一种计算机可读存储介质，所述存储介质存储有计算机程序，所述计算机程序被处理器执行时实现上述手术方法。
本说明书采用的上述至少一个技术方案能够达到以下有益效果：
本说明书提供一种手术设备，手术设备包括第一辅助机械臂、操作机械臂以及控制装置，控制装置通过根据第一辅助机械臂以及操作机械臂的位置以及操作人员的操作动作，向第一辅助机械臂以及操作机械臂发送控制指令，以使第一辅助机械臂末端配置的固定装置上放置的工作套管旋转，以便工作套管在创口内推开位于预先规划的指定区域周围的危险部位，进一步地，操作机械臂响应于控制装置发送的控制指令，控制所述手术器械组件中包含的手术器械对所述指定区域进行手术操作。可见，由手术设备自动旋转工作套管，可以保护危险区域内的人体组织，进而降低术中感染以及术后并发症的风险，免除操作人员在术中进行的人工旋转的操作。
附图说明
此处所说明的附图用来提供对本说明书的进一步理解，构成本说明书的一部分，本说明书的示意性实施例及其说明用于解释本说明书，并不构成对本说明书的不当限定。在附图中：
图1为本说明书中一种手术设备示意图；
图2为本说明书中一种手术设备示意图；
图3为本说明书中一种手术设备示意图；
图4A为本说明书中一种手术设备操作方式示意图；
图4B为本说明书中一种手术设备操作方式示意图；
图4C为本说明书中一种手术设备操作方式示意图；
图5A为本说明书中一种手术设备操作方式示意图；
图5B为本说明书中一种手术器械布置示意图；
图5C为本说明书中一种手术器械布置示意图；
图6A为本说明书中一种手术设备示意图；
图6B为本说明书中一种手术设备示意图；
图7为本说明书中一种手术设备示意图；
图8为本说明书中一种手术方法的流程示意图；
图9为本说明书提供的一种手术装置的示意图。
具体实施方式
为使本说明书的目的、技术方案和优点更加清楚，下面将结合本说明书具体实施例及相应的附图对本说明书技术方案进行清楚、完整地描述。显然，所描述的实施例仅是本说明书一部分实施例，而不是全部的实施例。基于本说明书中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本说明书保护的范围。
另外，需要说明的是，本发明中所有获取信号、信息或数据的动作都是在遵照所在地国家相应的数据保护法规政策的前提下，并获得由相应装置所有者给予授权的情况下进行的。
当前无论是骨科，神经和介入等，都需要通过微创手术来进行治疗，对于微创和精准的手术操作要求越来越高，需要能够尽量实现最小创伤，精准抵达患病部位进行有效治疗，而其中，脊椎内镜微创技术作为一项开展较早的微创 技术，对椎旁肌肉损伤较小，且能够最大程度地保留完整的脊柱结构，维持了术后脊柱的稳定，具有创伤小、出血少、恢复快、并发症少、疗效确切等优点。
目前利用微创手术设备辅助操作人员(如医生)进行手术操作已经在脊椎内镜微创手术领域内广泛应用，常用的脊椎内镜微创有两种主要的手术方式，椎间孔镜手术(Percutaneous Endoscopic Lumbar Discectomy，PELD)和单侧双通道内镜技术(Unilateral Biportal Endoscopy，UBE)，都已经可以实现由微创手术设备进行辅助操作。在脊椎内镜微创手术中，由于在患病区域内处理突出的间盘组织等时有可能会碰触到脊髓、神经根等危险区域内的人体组织，因此，除了常规的置入内镜以及手术器械的操作之外，还需要在术中对危险区域内的人体组织进行保护。目前常规的做法是在术中人工旋转工作套管，使工作套管的开口斜面依次指向头侧、背侧、尾侧、腹侧，将神经根、硬脊膜置于工作通道的背侧进行保护性遮挡，以免在微创手术设备辅助操作人员针对患病区域进行手术操作时，对危险区域内的人体组织(如神经根)造成伤害，进而引起并发症。
然而，利用微创手术台辅助操作人员进行手术操作的根本目的在于减轻操作人员在术中操作的负担，而目前在术中旋转工作套管的操作依然是由操作人员人工操作。因此，本说明书提供了一种具备旋转工作套管功能的手术设备，以便在术中由手术设备自动旋转工作套管，达到保护危险区域内的人体组织的目的，进而降低术中感染以及术后并发症的风险。
以下结合附图，详细说明本说明书各实施例提供的技术方案。
图1为本说明书提供的一种手术设备示意图。
本说明书提供了一种手术设备，所述手术设备可以辅助操作人员进行外科手术操作。本说明书实施例中，为了便于理解，以脊椎内镜手术为例，对具体技术方案进行说明。
如图1所示，手术设备至少包括第一辅助机械臂1，操作机械臂2，控制装置3。其中，设备A与设备B分别位于手术台的两侧，第一辅助机械臂1与 操作机械臂2分别固定在设备A与设备B上。通常情况下，患者以俯卧位姿势位于手术台的指定位置上，以便操作人员以及手术设备针对患者的患病部位进行手术操作。
第一辅助机械臂1至少包括固定装置11以及配置在固定装置11上的旋转装置12，其中，固定装置11用于放置(夹持)工作套管13，旋转装置12用于响应于旋转指令旋转工作套管13。为了保证第一辅助机械臂1的灵活性，第一辅助机械臂1可以采用五个或五个以上活动关节的机械臂。
操作机械臂2至少包括手术器械组件21以及第二滑轨23，手术器械组件21可以包括一个或多个用于脊椎微创手术操作的手术器械211，如髓核钳、电极电凝，显微手术刀、显微镊、微波消融针等。手术器械组件21上配置有第二滑块24，响应于由控制装置3发送的器械移动指令，所述第二滑块24在所述第二滑轨23上滑动，带动所述手术器械组件21在所述操作机械臂2上沿所述第二滑轨23的延伸方向(穿刺方向8)滑动，将所述手术器械211插入到工作套管13内或插入到内镜9的工作通道中，以便手术器械211对预先规划的指定区域7进行手术操作。其中所述指定区域7指的是患者患病部位内可进行手术操作的安全手术区域。为了保证操作机械臂2的灵活性，操作机械臂2可以采用六个或六个以上活动关节的机械臂。需要说明的是，在对患者的指定区域7进行手术操作之前，控制装置3可根据第一辅助机械臂1以及操作机械臂2的位置，以及第一辅助机械臂1以及操作机械臂2相对于患者的位置，将第一辅助机械臂1以及操作机械臂2摆动至适宜为患者进行手术操作的手术位置，其中，适宜为患者进行手术操作的手术位置可以指的是：适宜将穿刺工具16在穿刺位置沿穿刺方向8穿刺的手术位置、适宜将内镜9沿穿刺方向放入工作套管13的手术位置、适宜将手术器械211沿穿刺方向8放入工作套管13或插入到内镜9的工作通道中到达指定区域7的手术位置。
控制装置3可以为装有指定软件(如三维软件，规划软件等)的电脑主机，通过有线或者无线的方式，分别与第一辅助机械臂1、操作机械臂2等装置相 连接。控制装置3可以配置在设备A内部或者设备B内部，也可以配置在独立于设备A和设备B的设备C中，本说明书实施例对此不做限定。
可选地，第一辅助机械臂1与操作机械臂2也可以是安装在病床一侧的同一设备上，该设备可以临时固定在地面，或者设备上装有可以进行移动的滑轮，根据实际需求进行移动，如图2所示。
在本说明实施例中，手术设备还包括定位装置6，定位装置6可以单独悬吊于患者的正上方(手术台上方)，也可以安装在机械臂所在的设备A或设备B上，还可以设置独立于设备A或设备B的专门用于安装定位装置6的设备C，并放置于患者的上方，以便于获取第一定位光源标记22、第二定位光源标记17或第三定位光源标记42发射或反射的光线。
定位光源标记可以为红外光发射装置、发光二极管(Light Emitting Diode，LED)或者被动反射球体等，定位装置6通过接收定位光源标记产生所发射或反射的光线，进而捕捉到第一辅助机械臂1以及操作机械臂2的位置。
具体的，为了获取到第一辅助机械臂1、操作机械臂2以及患者的患病部位之间的相对位置，进而由控制装置3模拟出内镜9以及操作机械臂2上安装的手术器械211与患者患病部位在三维图像中的坐标位置和形状，可以在第一辅助机械臂1上安装第二定位光源标记17，操作机械臂2上安装第一定位光源标记22，以及在第二辅助机械臂4上或者患者的患病部位的预设范围内的目标位置上配置第三定位光源标记42，以保证可以模拟出准确的内镜9与手术器械211在患病部位三维图像中的坐标位置和形状。其中，第一定位光源标记22在操作机械臂2上的具体位置，第二定位光源标记17在第一辅助机械臂1上的具体位置以及第三定位光源标记42在第二辅助机械臂4上的具体位置或第三定位光源标记42在患者的患病部位的预设范围内的目标位置可以根据具体的手术场景设置，本说明书对此不做限制。
在第一定位光源标记22、第二定位光源标记17以及第三定位光源标记42部署完成后，操作人员可以通过手术环境中提供的扫描装置5(如：术中电子 计算机断层扫描(Computed Tomography，CT)、三维(3-dimensional，3D)C型臂X光机等)对患者的患病部位进行扫描，如图3所示。扫描装置5将扫描结果发送给控制装置3，进而通过控制装置3中的三维软件，模拟出内镜9、手术器械211与患者患病部位的三维图像，并将该三维图像上传到控制装置3上的显示器32中，为操作人员的手术操作提供参照。
控制装置3可以通过内置的规划模块31(图中未示出)，根据定位装置6确定出的第一辅助机械臂1以及所述操作机械臂2的位置，和患病部位的扫描结果，规划出合适的穿刺位置和穿刺方向8，在保证安全的同时尽量减少对患者身体造成的创伤。
此外，由于在对患者进行手术时，患者的患病部位附近区域(如神经根、脊髓等)往往是十分危险的，一旦操作失误及有可能引发患者出现其他并发症甚至威胁患者的生命安全，因此，控制装置3可以根据定位装置6确定出的第一辅助机械臂1以及操作机械臂2的位置，规划出允许手术器械211在患病部位上进行手术操作的安全手术区域作为指定区域7，在指定区域7内进行手术操作，以对患者身体上的患病部位实施手术，因为手术器械211安装在操作机械臂2上，所以操作机械臂2只能在规定的范围和角度内移动，以保证操作机械臂2上的手术器械211无法离开指定区域7，从而进一步保证手术的安全。
可选地，还可以在规划指定区域7的基础上，根据定位装置6确定出的第一辅助机械臂1以及操作机械臂2的位置规划出危险区域，危险区域为手术器械211不被允许进行手术操作的区域，由于操作机械臂2只能在规定的范围和角度内移动，可以保证手术器械211仅在指定区域7内进行手术操作，不会进入到危险区域。
可选地，第二辅助机械臂4不但可以安装在设备A上，也可以安装在设备B上或手术床上，甚至是单独的设备上。
另外，为了在利用手术设备辅助操作人员(如医生)进行微创手术时，避开患病部位周围的危险区域，可以利用第一辅助机械臂1上放置的工作套管13 的旋转或倾斜，将患病部位周围的危险区域的人体组织推开，扩大手术器械211的操作范围，避免因术中手术器械211针对患病部位执行手术操作时，对危险区域内的人体组织的伤害，造成的术中感染以及术后并发症。
在本说明书实施例中，控制装置3术前针对患者的患病部位的操作步骤具体包括以下三步：
第一步：控制装置3可接收由定位装置6获取并发送的第一辅助机械臂1与所述操作机械臂2相对于患者的位置。
第二步：控制装置3中的规划模块31可以根据所述第一辅助机械臂1与所述操作机械臂2相对于患者的位置以及患者的患病部位的扫描结果，确定允许操作机械臂2末端配置的手术器械211在患病部位上进行安全手术操作的指定区域7、以及能够使工作套管13和手术器械211达到所述指定区域7的穿刺位置以及穿刺方向8。其中，能够使手术器械211达到所述指定区域7的穿刺位置以及穿刺方向8可以作为控制装置3针对患者的患病部位规划的手术路径。
第三步：控制装置3可根据确定出来的针对患病部位规划的手术路径，以及操作人员的操作动作，向所述第一辅助机械臂1以及所述操作机械臂2发送控制指令，以便所述第一辅助机械臂1以及所述操作机械臂2响应于由控制装置3发送的控制指令采取旋转、手术操作等动作。
在本说明书实施例中，第一辅助机械臂1可响应于控制装置3发送的控制指令，对操作机械臂2针对患者的患病部位进行手术操作的过程进行术前辅助以及术中辅助。其中，术前辅助可包括穿刺、安装工作套管13、以及旋转或倾斜工作套管13；术中辅助可包括旋转或倾斜工作套管13。
具体的，第一辅助机械臂1可包括第一滑轨15和夹持装置14。其中，第一滑轨15固定在所述第一辅助机械臂1上，夹持装置14上配置第一滑块141，所述第一滑块141在所述第一滑轨15上滑动，带动所述夹持装置14在所述第一辅助机械臂上滑动，以便带动所述夹持装置14上夹持的工具，如穿刺工具16、内镜9等。以下分别对夹持装置14夹持穿刺工具16和夹持内镜9的过程 进行详细阐述：
对于夹持装置14夹持穿刺工具16对患者进行穿刺的过程：如图4A所示，在患者位于指定位置且第一辅助机械臂1摆动至患者上方时，夹持装置14夹持穿刺工具16，夹持装置14可以响应于由所述控制装置3发送的第二穿刺指令，在由控制装置3预先规划好的穿刺位置，沿由控制装置3预先规划好的穿刺方向8进行穿刺，以使穿刺工具16的首端到达所述指定区域7，并形成穿刺创口。其中，由于手术后续操作需要通过穿刺创口插入工作套管13等器械，因此穿刺创口可以是有穿刺工具16穿刺后到达指定区域7并扩孔得到，显然，采用的穿刺工具16具备穿刺扩孔的功能，本说明书实施例中所采用的穿刺工具16可以是目前现有的任意具备穿刺扩孔功能的穿刺工具16，本说明书对穿刺工具16的具体材质已经扩孔方式不做限定。
针对穿刺扩孔形成的穿刺创口，操作人员可以手动放置工作套管13，如图4B所示，将所述工作套管13沿所述穿刺方向8插入穿刺创口内，并固定在所述固定装置11上，以使所述工作套管13的首端位于所述指定区域7。
进一步的，由于固定装置11上还包括旋转装置12，旋转装置12可响应于控制装置3发送的旋转指令，控制旋转装置12自身移动，以带动放置在所述固定装置11上的工作套管13旋转，以使所述工作套管13的首端在创口内推开所述指定区域7周围的危险部位。其中，所述旋转指令携带所述工作套管13的指定旋转方向以及指定旋转角度，而指定旋转方向以及指定旋转由控制装置3根据所述指定区域7以及所述患病部位的扫描结果确定。
所述旋转装置12响应于所述控制装置3发送的旋转指令的时机可以是控制装置3在术前检测到所述工作套管13的首端位于所述指定区域7时，也可以是在术中操作人员观察到和/或控制装置3检测到手术器械211可能对危险部位采取操作时，本说明书对此不做限定。
可选地，第一辅助机械臂1还可以响应于控制装置3发送的倾斜指令，控制自身倾斜，以带动放置在第一辅助机械臂1末端的固定装置11上的工作套 管倾斜，达到推开指定区域7周围危险部位的目的。其中，倾斜指令携带第一辅助机械臂1的倾斜方向和倾斜角度，第一辅助机械臂1的倾斜方向和倾斜角度可以由控制装置3根据第一辅助机械臂1以及第二辅助机械臂相对于患者所处的指定位置的位置，以及患病部位的扫描结果确定。
对于夹持装置14夹持内镜9并将内镜置入穿刺创口的过程：如图4C所示，在放置并旋转工作套管13后，可以将夹持装置14夹持的工具由穿刺工具16更换为内镜9。夹持装置14响应于由所述控制装置3发送的内镜控制指令，控制所述第一滑块141沿所述第一滑轨15滑动，带动所述夹持装置14夹持的内镜9插入到工作套管13中，内镜9可以采集所述指定区域7的实时图像，并将指定区域7的实时图像发送给控制装置3，以使控制装置3根据指定区域7的实时图像对指定区域7进行手术操作。
夹持装置14还可以响应于由所述控制装置3发送的内镜旋转指令，控制内镜9进行旋转，以便采集到不同角度的指定区域7的实时图像。当然，夹持装置在夹持内镜9时还可以根据具体的应用场景以及操作人员的操作动作响应于由所述控制装置3发送的其他针对内镜的指令，如前进、后退等。
在本说明书实施例中，操作机械臂2可响应于控制装置3发送的控制指令，针对患者的患病部位进行手术操作，如图5A所示，具体包括以下几个步骤：
首先，操作机械臂2包括第二滑轨23和手术器械组件21，其中，第二滑轨23固定在操作机械臂2上。手术器械组件21上配置有第二滑块24，第二滑块24可以在第二滑轨23上滑动，同时，带动手术器械组件21在操作机械臂2上沿第二滑轨23的延伸方向滑动，以便将手术器械211插入到工作套管13内或内镜9的工作通道内，对指定区域7进行手术操作。
进一步的，当所述操作机械臂2接收到由所述控制装置3发送的手术操作指令时，控制所述手术器械组件21中包含的手术器械211对指定区域7进行手术操作。
其中，手术器械组件21包括多个手术器械211。这是由于面对不同的患病 情况(如髓核突出、椎管狭窄，神经根压迫、硬膜囊和骨组织增生等)，所采用的手术器械有所不同，而针对患者的一场手术过程可能需要处理不同的患病情况，在术中人工针对操作机械臂上配置的单个手术器械211进行多次人工更换不仅增加了手术时间，也增加了操作人员操作难度。因此，操作人员可以根据患者患病部位的实际病情，通过在手术器械组件21中配置多个手术器械211的方式，以满足在一场手术过程中使用不同手术器械进行不同手术操作(如摘除突出组织、去除骨质、射频电极修复破损纤维环等)的需求。
具体的，当手术器械组件21中包含两个手术器械211A以及211B时可如图5B所示。手术器械组件21中包含的多个手术器械211的布置方式可以如图5C所示，多个手术器械211的布置方式可以是平行，错位，倾斜面，品字形安装等或类似的形式中的一种，其中，品字形安装中的手术器械221A、221B以及221C的安装顺序以及具体位置本说明书实施例不做限定。操作人员可以根据具体的手术需要，对手术器械组件21中包含的多个手术器械211进行布置，本说明书实施例对具体的手术器械211布置方式不做限定。
另外，由于在手术过程中，需要针对患者患病部位的不同病情，更换手术器械211对患者的指定区域7进行手术操作，因此手术器械组件21可以响应于由控制装置3发送的器械切换指令，控制手术器械组件21包含的各手术器械211之间进行切换。其中，控制装置3发送的器械切换指令可以是由操作人员通过操作控制装置3上配置的操作控制杆34或者操作脚闸36发送，也可以是根据预先规划的操作机械臂2上的手术器械211对患病部位的手术规划动作发送，还可以通过控制装置3中配置的器械切换选项发送，本说明书对此不做限定。
在本说明书另一个实施例中，控制装置3包括显示器32、辅助控制杆33和操作控制杆34，显示器32可显示用于辅助操作人员控制第一辅助机械臂1以及操作机械臂2所用的图像，操作人员可以通过手动操作控制杆34的方式，控制第一辅助机械臂1以及操作机械臂2的移动，实现穿刺、放置并旋转工作 套管13以及手术操作等。如图6A为本说明书提供的一种控制装置的示意图。
具体的，控制装置3上安装的显示器32用来显示对患者患病部位的扫描结果(CT图像或X光图像)、控制装置3生成的三维图像和内镜9采集到的患者身体上创口内的患病部位的实时图像，从而为操作人员进行手术提供参照。如图6A所示，患者患病部位的扫描结果可以显示在显示区域321，控制装置3生成的三维图像可以显示在显示区域322，内镜9采集到的患者身体上创口内的患病部位的实时图像可以显示在显示区域323。其中，显示区域322所示控制装置3生成的三维图像可以是控制装置3通过内置的指定三维软件，模拟出内镜9、手术器械211与患者患病部位的三维图像。操作人员可以通过参照显示器32上的图像，手动控制辅助控制杆33控制第一辅助机械臂1移动，实现穿刺、放置并旋转工作套管13以及手术操作等，以及手动控制操作控制杆34，控制操作机械臂2向不同方向移动、控制手术器械211的尖端张合实现手术操作。其中，辅助控制杆33的可操作方向可以是前后、左右以及旋转，操作控制杆34的可操作方向可以是前后、左右、旋转。可选的操作控制杆34可以设置为沿前、后、左、右四个方向的档位动作的控制杆，此时操作人员可以控制操作控制杆34以操作控制杆34当前所在位置为起点向前、后、左、右四个方向的档位运动，也可以以操作控制杆34为轴，控制操作控制杆34向前、后、左、右四个方向摆动。
可选地，还可以将辅助控制杆根据控制功能的不同拆分为三个辅助控制杆分别配置在控制装置3中，如图6B所示，控制装置3中配置了第一辅助控制杆33A、第二辅助控制杆33B以及第三辅助控制杆33C。其中，第一辅助控制杆33A可用于针对第一辅助机械臂1的旋转装置12发出旋转指令，以使旋转装置12带动工作套管13转动。第二辅助控制杆33B可用于针对第一辅助机械臂1发送倾斜指令，以使第一辅助机械臂1带动工作套管13倾斜。第三辅助控制杆33C可用于针对第一辅助机械臂1上配置的夹持装置14发出前进、后退、旋转等控制指令，以使夹持装置14夹持的工具(如穿刺工具16以及内镜 9)执行前进、后退、旋转。
另外，还可以设置辅助脚闸35、操作脚闸36以及紧急停止脚闸37，配合辅助控制杆33以及操作控制杆34的操作。
当操作人员踩下辅助脚闸35时，操作人员可以控制辅助控制杆33对第一辅助机械臂1进行操作，调整第一辅助机械臂1的位置，进而对内镜9末端的光源和摄像机进行角度和位置的微调，而若操作人员没有踩下辅助脚闸35，则即使操作人员操作辅助控制杆33，也无法对第一辅助机械臂1进行操作。
当操作人员踩下操作脚闸36时，操作人员可以控制操作控制杆34对操作机械臂2进行操作，调整操作机械臂2在患者身体上的位置，实现对手术器械211进行角度和位置的微调，以及控制手术器械211完成相应的手术操作，而若操作人员没有踩下操作脚闸36，则即使操作人员控制操作控制杆34，也无法对操作机械臂2进行操作，以保证安全。
此外，控制装置3还配置有紧急停止脚闸37，一旦操作人员发现第一辅助机械臂1和/或操作机械臂2在执行穿刺指令、旋转指令、手术操作指令的过程中出现操作异常，以及第一辅助机械臂1和/或操作机械臂2在操作人员通过控制装置3进行人为操作时出现操作异常的情况，操作人员可以踩下紧急停止脚闸37，以停止第一辅助机械臂1和操作机械臂2的移动。
当然，操作人员也可以根据具体的手术情况，手动微小调整内镜9与手术器械211臂在创口内的角度和位置，并手动操作手术器械211对患病部位进行手术处理。
在本说明书一个可选的实施例中，可以在手术过程中对患者进行术中CT或C型X光臂的扫描，以获得患者的患病部位内指定区域7的术中X光图像。由于术中CT或C型X光臂的扫描会使手术环境中存在一定的辐射，因此，为了保护操作人员的身体安全，可以在控制装置3外围放置防护装置，例如，该防护装置可以是>＝0.5mmPb当量的射线防护板或铅玻璃装置，从而防止操作人员受到手术环境中的辐射。
可选地，在对患者进行微创手术之前，需要对患者进行麻醉。本说明书实施例中的脊椎内镜微创手术采用的是局麻的方式，保证手术过程中病人是清醒的。这是由于，脊椎内镜微创手术是针对椎间孔内突出的间盘组织、髓核等人体组织进行处理，在手术的过程中，有可能会碰触到神经根。局麻的好处在于如果手术操作拉扯到了神经根或者是中间有射频烧灼，影响到了神经根，患者能够立刻反映，这样操作人员会停止有可能对神经造成伤害的操作，保证了手术的安全性。而且手术中操作人员随时可以跟患者进行交流，并让患者做下肢这样一些配合手术操作的活动，以便时刻确认手术过程中患者的安全。
虽然局麻可以保证患者的安全，但是由于手术局麻时，患者是始终清醒的，患者的身体可能会出现位移，导致手术位置的偏移，这在利用手术设备辅助手术操作的过程中时十分危险的状况，为了保证患者在术中不会发生偏移，可以增加第二辅助机械臂4对患者进行固定，防止患者身体的位移。
如图1所示的手术设备还可以包括第二辅助机械臂4，第二辅助机械臂4可以安装在第一辅助机械臂1所在的设备A上，也可以安装在手术床的一侧，设备B上或者单独的设备上。当确定所述患者位于病床上的指定位置时，所述第二辅助机械臂4可以按压患者，用于固定患者的患病部位，以防术中由于患者的患病部位的位移对患者造成伤害。另外，由于第二辅助机械臂4的灵活性要求不高，第二辅助机械臂4可以采用三个或三个以上活动关节的机械臂。
进一步的，为了防止患者的患病部位在术中发生位移，第二辅助机械臂4可以响应于由所述控制装置3发送的第一穿刺指令，控制配置在所述第二辅助机械臂4末端的固定针41对所述患者身体进行穿刺，以便对患者的患病部位进行进一步地固定。
可选地，第二辅助机械臂4可以由操作人员手动控制移动并利用第二辅助机械臂4的末端对患者进行按压，以便对患者进行固定。
可选地，操作人员可以手动对患者进行穿刺以植入固定针41。
可选地，第二辅助机械臂4的末端还可以配置第三定位光源标记42，第三 定位光源标记42用于指示患者的患病部位的位置，第三定位光源标记42与第一定位光源标记22以及第二定位光源标记17结合，共同确定第一辅助机械臂1以及操作机械臂2相对于患者的位置，能够提高定位第一辅助机械臂1以及操作机械臂2的位置的精确度。
此外，第三定位光源标记42还用于指示患者身体的移动，尽管已经采用了第二辅助机械臂4以及位于第二辅助机械臂4末端配置的固定针对患者的患病部位进行了固定，但考虑到术中患者的患病部位位移的不确定性，定位装置6可以通过第三定位光源标记42发射或反射的光源跟踪患者身体的微动，便于在患者身体发生位移时，实时调整针对第一辅助机械臂1以及操作机械臂2的控制。
基于此，为了使第三定位光源标记42具备指示患者的患病部位的位置的功能，第三定位光源标记42所在的第二辅助机械臂4在患者身体上的放置位置需要位于患者的患病部位预设范围内的位置上，例如，在进行脊椎微创手术时，为了避免第二辅助机械臂4影响对患病部位的手术操作，操作人员将第二辅助机械臂4放置于患者的患病部位预设范围内的位置上，并使配置在第二辅助机械臂4末端的固定针41能够插入患者的患病脊椎附近预设范围内的其他骨组织(脊椎椎体或椎弓根)上。这样既可以避免第二辅助机械臂4影响第一辅助机械臂1上配置的穿刺工具16对患者身体进行的穿刺操作，以及操作机械臂2针对患者患病部位的手术操作，也可以达到固定患者身体，指示患者的患病部位的位置的功能。其中，所述预设范围可以根据实际情况进行设定，本申请对此不做限定。
可选地，本说明书中还提供一种通过第一辅助机械臂以及操作机械臂分别安装手术器械或内镜来进行UBE手术的手术设备，如图7所示。第一辅助机械臂1末端的固定装置11上固定着工作套管13，内镜9从工作套管13内进入，以采集患者的指定区域的实时图像并发送给控制装置3。操作机械臂2的末端配置手术器械组件21，从不同于工作套管13所处的穿刺创口的另一个穿刺创 口内进入患者体内并达到指定区域，响应于预先规划的手术动作或者操作人员在控制装置上执行的操作动作针对指定区域进行手术操作。
为了便于对上述手术设备的理解，本说明书还提供了一种手术方法的流程示意图，以说明上述手术设备在实际手术过程中的操控方法，如图8所示。
图8为本说明书中提供的一种微创手术设备操作方法的流程示意图，包括以下步骤：
S100：获取第一辅助机械臂与操作机械臂的位置。
一般的，控制装置可以为装有指定软件(如三维软件，规划软件等)的电脑主机，通过有线或者无线的方式，分别与第一辅助机械臂、操作机械臂等装置相连接。因此本说明书实施例中提供的一种手术方法，可有控制装置执行该手术方法的执行过程。
定位装置通过安装在第一辅助机械臂的第一定位光源标记22、安装在操作机械臂的末端的第二定位光源标记17，以及安装在第二辅助机械末端的第三定位光源标记，定位装置通过接收辅定位光源标记以及辅助定位光源标记发射或反射的光线，来获取第一辅助机械臂、操作机械臂的位置。
定位装置将获取到的第一辅助机械臂、操作机械臂的位置发送给控制装置，控制装置接收并显示第一辅助机械臂、操作机械臂的位置。
可选地，通过CT或C型X光臂对患病部位进行扫描，控制装置结合扫描结果，第一辅助机械臂、操作机械臂的位置，确定第一辅助机械臂、操作机械臂以及患病部位之间的相对位置。
S102：根据所述第一辅助机械臂与所述操作机械臂的位置，确定允许所述操作机械臂末端配置的手术器械在所述患病部位上进行安全手术操作的指定区域、以及能够使工作套管和手术器械达到所述指定区域的穿刺位置以及穿刺方向。
控制装置中的规划模块可以根据所述第一辅助机械臂1与所述操作机械臂相对于患者的位置以及患者的患病部位的扫描结果，确定允许操作机械臂末端 段配置的手术器械在患病部位上进行安全手术操作的指定区域、以及能够使工作套管和手术器械达到所述指定区域的穿刺位置以及穿刺方向。其中，能够使手术器械达到所述指定区域的穿刺位置以及穿刺方向可以作为控制装置针对患者的患病部位规划的手术路径。
S104：控制装置发送第二穿刺指令，第一辅助机械臂上配置的穿刺工具响应于所述第二穿刺指令，根据所述穿刺位置和所述穿刺方向进行穿刺，得到使内镜采集到患病部位的实时图像的穿刺创口，并在穿刺创口中放入工作套管。
在患者位于指定位置且第一辅助机械臂摆动至患者上方时，夹持装置夹持穿刺工具，夹持装置可以响应于由所述控制装置发送的第二穿刺指令，在由控制装置预先规划好的穿刺位置，沿由控制装置预先规划好的穿刺方向进行穿刺，以使穿刺工具的首端到达所述指定区域，并形成穿刺创口。
针对穿刺扩孔形成的穿刺创口，操作人员可以手动放置工作套管，将所述工作套管沿所述穿刺方向插入穿刺创口内，并固定在所述固定装置上，以使所述工作套管的首端位于所述指定区域。
S106：当确定所述第一辅助机械臂上配置的工作套管插入到预先规划的指定区域时，响应于操作人员的操作动作，将旋转指令发送给手术设备上配置的第一辅助机械臂，以使所述第一辅助机械臂上配置的旋转装置控制固定在固定装置上的工作套管旋转，以便所述工作套管在穿刺创口内推开位于预先规划的指定区域周围的危险部位。
进一步的，由于固定装置上还包括旋转装置，旋转装置可响应于控制装发送的旋转指令，控制旋转装置自身移动，以带动放置在所述固定装置上的工作套管旋转，以使所述工作套管的首端在创口内推开所述指定区域周围的危险部位。其中，所述旋转指令携带所述工作套管的指定旋转方向以及指定旋转角度；所述指定旋转方向以及所述指定旋转由所述控制装置根据所述指定区域以及所述患病部位的扫描结果确定。
S108：操作人员将内镜放入工作套管中，并通过控制装置发送器械移动指 令，使操作机械臂上装配的手术器械进入工作套管中。
在放置并旋转工作套管后，可以将夹持装置夹持的工具由穿刺工具更换为内镜。夹持装置响应于由所述控制装置发送的内镜控制指令，控制所述第一滑块沿所述第一滑轨滑动，带动所述夹持装置夹持的内镜插入到工作套管中，内镜可以采集所述指定区域的实时图像，并将指定区域的实时图像发送给控制装置，以使控制装置根据指定区域的实时图像对指定区域进行手术操作。
S110：当确定安装在所述操作机械臂上的手术器械插入到患者身体上穿刺创口内时，响应于操作人员的操作动作，将手术操作指令发送给所述手术设备上配置的操作机械臂，以使操作机械臂上配置的手术器械组件控制所述手术器械组件中包含的手术器械对所述预先规划的指定区域进行手术操作。
可见，由第一辅助机械臂自动旋转工作套管，可以保护危险区域内的人体组织，进而降低术中感染以及术后并发症的风险，免除操作人员在术中进行的人工旋转的操作。
以上为本说明书的一个或多个实施例提供的手术方法，基于同样的思路，本说明书还提供了相应的手术装置，如图9所示。
图9为本说明书提供的一种手术装置示意图，具体包括：
位置获取模块200，用于获取第一辅助机械臂与操作机械臂的位置；
旋转指令发送模块202，用于当确定所述第一辅助机械臂上配置的工作套管插入到预先规划的指定区域时，响应于操作人员的操作动作，将旋转指令发送给上述任一所述手术设备上配置的第一辅助机械臂，以使所述第一辅助机械臂上配置的旋转装置控制固定在固定装置上的工作套管旋转，以便所述工作套管在穿刺创口内推开位于预先规划的指定区域周围的危险部位；
手术操作指令发送模块204，用于当确定安装在所述操作机械臂上的手术器械插入到患者身体上穿刺创口内时，响应于操作人员的操作动作，将手术操作指令发送给上述任一所述手术设备上配置的操作机械臂，以使操作机械臂上配置的手术器械组件控制所述手术器械组件中包含的手术器械对所述预先规 划的指定区域进行手术操作。
本说明书还提供了一种计算机可读存储介质，该存储介质存储有计算机程序，计算机程序可用于执行上述图8提供的手术方法。
当然，除了软件实现方式之外，本说明书并不排除其他实现方式，比如逻辑器件抑或软硬件结合的方式等等，也就是说以下处理流程的执行主体并不限定于各个逻辑单元，也可以是硬件或逻辑器件。
在20世纪90年代，对于一个技术的改进可以很明显地区分是硬件上的改进(例如，对二极管、晶体管、开关等电路结构的改进)还是软件上的改进(对于方法流程的改进)。然而，随着技术的发展，当今的很多方法流程的改进已经可以视为硬件电路结构的直接改进。设计人员几乎都通过将改进的方法流程编程到硬件电路中来得到相应的硬件电路结构。因此，不能说一个方法流程的改进就不能用硬件实体模块来实现。例如，可编程逻辑器件(Programmable Logic Device,PLD)(例如现场可编程门阵列(Field Programmable Gate Array，FPGA))就是这样一种集成电路，其逻辑功能由用户对器件编程来确定。由设计人员自行编程来把一个数字系统“集成”在一片PLD上，而不需要请芯片制造厂商来设计和制作专用的集成电路芯片。而且，如今，取代手工地制作集成电路芯片，这种编程也多半改用“逻辑编译器(logic compiler)”软件来实现，它与程序开发撰写时所用的软件编译器相类似，而要编译之前的原始代码也得用特定的编程语言来撰写，此称之为硬件描述语言(Hardware Description Language，HDL)，而HDL也并非仅有一种，而是有许多种，如ABEL(Advanced Boolean Expression Language)、AHDL(Altera Hardware Description Language)、Confluence、CUPL(Cornell University Programming Language)、HDCal、JHDL(Java Hardware Description Language)、Lava、Lola、MyHDL、PALASM、RHDL(Ruby Hardware Description Language)等，目前最普遍使用的是VHDL(Very-High-Speed Integrated Circuit Hardware Description Language)与Verilog。本领域技术人员也应该清楚，只需要将方法流程用上述几种硬件描述语言稍作 逻辑编程并编程到集成电路中，就可以很容易得到实现该逻辑方法流程的硬件电路。
控制器可以按任何适当的方式实现，例如，控制器可以采取例如微处理器或处理器以及存储可由该(微)处理器执行的计算机可读程序代码(例如软件或固件)的计算机可读介质、逻辑门、开关、专用集成电路(Application Specific Integrated Circuit，ASIC)、可编程逻辑控制器和嵌入微控制器的形式，控制器的例子包括但不限于以下微控制器：ARC 625D、Atmel AT91SAM、Microchip PIC18F26K20以及Silicone Labs C8051F320，存储器控制器还可以被实现为存储器的控制逻辑的一部分。本领域技术人员也知道，除了以纯计算机可读程序代码方式实现控制器以外，完全可以通过将方法步骤进行逻辑编程来使得控制器以逻辑门、开关、专用集成电路、可编程逻辑控制器和嵌入微控制器等的形式来实现相同功能。因此这种控制器可以被认为是一种硬件部件，而对其内包括的用于实现各种功能的装置也可以视为硬件部件内的结构。或者甚至，可以将用于实现各种功能的装置视为既可以是实现方法的软件模块又可以是硬件部件内的结构。
上述实施例阐明的系统、装置、模块或单元，具体可以由计算机芯片或实体实现，或者由具有某种功能的产品来实现。一种典型的实现设备为计算机。具体的，计算机例如可以为个人计算机、膝上型计算机、蜂窝电话、相机电话、智能电话、个人数字助理、媒体播放器、导航设备、电子邮件设备、游戏控制装置、平板计算机、可穿戴设备或者这些设备中的任何设备的组合。
为了描述的方便，描述以上装置时以功能分为各种单元分别描述。当然，在实施本说明书时可以把各单元的功能在同一个或多个软件和/或硬件中实现。
本领域内的技术人员应明白，本发明的实施例可提供为方法、系统、或计算机程序产品。因此，本发明可采用完全硬件实施例、完全软件实施例、或结合软件和硬件方面的实施例的形式。而且，本发明可采用在一个或多个其中包含有计算机可用程序代码的计算机可用存储介质(包括但不限于磁盘存储器、 CD-ROM、光学存储器等)上实施的计算机程序产品的形式。
本发明是参照根据本发明实施例的方法、设备(系统)、和计算机程序产品的流程图和/或方框图来描述的。应理解可由计算机程序指令实现流程图和/或方框图中的每一流程和/或方框、以及流程图和/或方框图中的流程和/或方框的结合。可提供这些计算机程序指令到通用计算机、专用计算机、嵌入式处理机或其他可编程数据处理设备的处理器以产生一个机器，使得通过计算机或其他可编程数据处理设备的处理器执行的指令产生用于实现在流程图一个流程或多个流程和/或方框图一个方框或多个方框中指定的功能的装置。
这些计算机程序指令也可存储在能引导计算机或其他可编程数据处理设备以特定方式工作的计算机可读存储器中，使得存储在该计算机可读存储器中的指令产生包括指令装置的制造品，该指令装置实现在流程图一个流程或多个流程和/或方框图一个方框或多个方框中指定的功能。
这些计算机程序指令也可装载到计算机或其他可编程数据处理设备上，使得在计算机或其他可编程设备上执行一系列操作步骤以产生计算机实现的处理，从而在计算机或其他可编程设备上执行的指令提供用于实现在流程图一个流程或多个流程和/或方框图一个方框或多个方框中指定的功能的步骤。
在一个典型的配置中，计算设备包括一个或多个处理器(CPU)、输入/输出接口、网络接口和内存。
内存可能包括计算机可读介质中的非永久性存储器，随机存取存储器(RAM)和/或非易失性内存等形式，如只读存储器(ROM)或闪存(flash RAM)。内存是计算机可读介质的示例。
计算机可读介质包括永久性和非永久性、可移动和非可移动媒体可以由任何方法或技术来实现信息存储。信息可以是计算机可读指令、数据结构、程序的模块或其他数据。计算机的存储介质的例子包括，但不限于相变内存(PRAM)、静态随机存取存储器(SRAM)、动态随机存取存储器(DRAM)、其他类型的随机存取存储器(RAM)、只读存储器(ROM)、电可擦除可编程只读存储器(EEPROM)、 快闪记忆体或其他内存技术、只读光盘只读存储器(CD-ROM)、数字多功能光盘(DVD)或其他光学存储、磁盒式磁带，磁带磁磁盘存储或其他磁性存储设备或任何其他非传输介质，可用于存储可以被计算设备访问的信息。按照本文中的界定，计算机可读介质不包括暂存电脑可读媒体(transitory media)，如调制的数据信号和载波。
还需要说明的是，术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含，从而使得包括一系列要素的过程、方法、商品或者设备不仅包括那些要素，而且还包括没有明确列出的其他要素，或者是还包括为这种过程、方法、商品或者设备所固有的要素。在没有更多限制的情况下，由语句“包括一个……”限定的要素，并不排除在包括所述要素的过程、方法、商品或者设备中还存在另外的相同要素。
本领域技术人员应明白，本说明书的实施例可提供为方法、系统或计算机程序产品。因此，本说明书可采用完全硬件实施例、完全软件实施例或结合软件和硬件方面的实施例的形式。而且，本说明书可采用在一个或多个其中包含有计算机可用程序代码的计算机可用存储介质(包括但不限于磁盘存储器、CD-ROM、光学存储器等)上实施的计算机程序产品的形式。
本说明书可以在由计算机执行的计算机可执行指令的一般上下文中描述，例如程序模块。一般地，程序模块包括执行特定任务或实现特定抽象数据类型的例程、程序、对象、组件、数据结构等等。也可以在分布式计算环境中实践本说明书，在这些分布式计算环境中，由通过通信网络而被连接的远程处理设备来执行任务。在分布式计算环境中，程序模块可以位于包括存储设备在内的本地和远程计算机存储介质中。
本说明书中的各个实施例均采用递进的方式描述，各个实施例之间相同相似的部分互相参见即可，每个实施例重点说明的都是与其他实施例的不同之处。尤其，对于系统实施例而言，由于其基本相似于方法实施例，所以描述的比较简单，相关之处参见方法实施例的部分说明即可。
以上所述仅为本说明书的实施例而已，并不用于限制本说明书。对于本领域技术人员来说，本说明书可以有各种更改和变化。凡在本说明书的精神和原理之内所作的任何修改、等同替换、改进等，均应包含在本说明书的权利要求范围之内。

Claims (17)

  1. 一种手术设备，其特征在于，所述手术设备包括第一辅助机械臂(1)，操作机械臂(2)，控制装置(3)；
    所述控制装置(3)用于获取所述第一辅助机械臂(1)与所述操作机械臂(2)的位置，并根据所述第一辅助机械臂(1)与所述操作机械臂(2)的位置以及操作人员的操作动作，向所述第一辅助机械臂(1)以及所述操作机械臂(2)发送控制指令；
    所述第一辅助机械臂(1)包括固定装置(11)和旋转装置(12)；所述旋转装置(12)配置在所述固定装置(11)上；所述固定装置(11)用于放置插入到患者体内的工作套管(13)；响应于由所述控制装置(3)发送的控制指令，控制放置在所述固定装置(11)上的工作套管(13)旋转，以使所述工作套管(13)在创口内推开位于预先规划的指定区域(7)周围的危险部位；
    所述操作机械臂(2)上配置手术器械组件(21)；响应于由所述控制装置(3)发送的控制指令，控制所述手术器械组件(21)中包含的手术器械(211)对所述指定区域(7)进行手术操作。
  2. 如权利要求1所述的手术设备，其特征在于，所述手术设备还包括第二辅助机械臂(4)；所述第二辅助机械臂(4)包括固定针(41)；
    当所述控制装置(3)确定所述患者位于指定位置时，控制所述第二辅助机械臂(4)按压所述患者；
    所述第二辅助机械臂(4)响应于由所述控制装置(3)发送的第一穿刺指令，控制配置在所述第二辅助机械臂(4)末端的固定针(41)对所述患者身体进行穿刺，以便对所述患者的患病部位进行固定。
  3. 如权利要求1所述的手术设备，其特征在于，所述手术设备还包括第二辅助机械臂(4)；所述第二辅助机械臂(4)包括固定针(41)；
    当所述患者位于所述指定位置时，由所述操作人员手动控制所述第二辅助机械臂(4)按压所述患者；
    由所述操作人员手动控制配置在所述第二辅助机械臂(4)末端的固定针(41)对所述患者进行穿刺，以便对所述患者的患病部位进行固定。
  4. 如权利要求1所述的手术设备，其特征在于，所述手术设备还包括扫描装置(5)；所述扫描装置(5)用于对所述患者进行扫描并得到患者患病部位的扫描结果；
    将所述患病部位的扫描结果发送给控制装置(3)，以使所述控制装置(3)接收并显示所述患病部位的扫描结果。
  5. 如权利要求1所述的手术设备，其特征在于，所述手术设备还包括定位装置(6)；所述操作机械臂(2)配置第一定位光源标记(22)；所述第一辅助机械臂(1)配置第二定位光源标记(17)；第二辅助机械臂(4)配置第三定位光源标记(42)；
    所述定位装置(6)根据采集到的所述第一定位光源标记(22)、所述第二定位光源标记(17)以及所述第三定位光源标记(42)所发射或反射的光线，确定所述操作机械臂(2)和所述第一辅助机械臂(1)相对于所述患者的位置，并发送给所述控制装置(3)，以使所述控制装置(3)根据所述操作机械臂(2)以及所述第一辅助机械臂(1)的位置以及操作人员的操作动作，向所述第一辅助机械臂(1)以及向所述操作机械臂(2)发送控制指令。
  6. 如权利要求1所述的手术设备，其特征在于，所述控制装置(3)包括规划模块(31)；所述规划模块(31)用于根据所述操作机械臂(2)以及所述第一辅助机械臂(1)的位置、患病部位的扫描结果，确定允许所述操作机械臂(2)末端配置的手术器械(211)在所述患病部位上进行安全手术操作的指定区域(7)、以及能够使所述工作套管(13)和所述手术器械(211)到达所述指定区域(7)的穿刺位置以及穿刺方向(8)，以使所述控制装置(3)根据所述指定区域(7)、所述穿刺位置以及所述穿刺方向(8)，控制所述第一辅助机械臂(1)以及所述操作机械臂(2)对所述指定区域进行手术操作。
  7. 如权利要求1所述的手术设备，其特征在于，所述第一辅助机械臂(1) 包括第一滑轨(15)和夹持装置(14)；所述第一滑轨(15)固定在所述第一辅助机械臂(1)上；所述夹持装置(14)上配置第一滑块(141)，所述第一滑块(141)在所述第一滑轨(15)上滑动，带动所述夹持装置(14)在所述第一辅助机械臂(1)上沿所述第一滑轨(15)的延伸方向滑动，以便带动所述夹持装置(14)夹持的工具沿所述第一滑轨(15)的延伸方向滑动。
  8. 如权利要求7所述的手术设备，其特征在于，所述夹持装置(14)用于夹持穿刺工具(16)；所述夹持装置(14)响应于由所述控制装置(3)发送的第二穿刺指令，控制所述第一滑块(141)在所述第一滑轨(15)上沿穿刺方向(8)滑动，以带动所述穿刺工具(16)在穿刺位置沿穿刺方向(8)进行穿刺，以使所述穿刺工具(16)的首端到达所述指定区域(7)，形成穿刺创口。
  9. 如权利要求8所述的手术设备，其特征在于，所述工作套管(13)沿所述穿刺方向(8)插入所述穿刺创口内，并固定在所述固定装置(11)上，以使所述工作套管(13)的首端位于所述指定区域(7)；
    当检测到所述工作套管(13)的首端位于所述指定区域(7)时，所述旋转装置(12)响应于所述控制装置(3)发送的旋转指令，控制所述旋转装置(12)旋转，带动放置在所述固定装置(11)上的工作套管(13)旋转，以使所述工作套管(13)的首端在穿刺创口内推开所述指定区域(7)周围的危险部位。
  10. 如权利要求9所述的手术设备，其特征在于，所述旋转指令携带所述工作套管(13)的指定旋转方向以及指定旋转角度；所述指定旋转方向以及所述指定旋转由所述控制装置(3)根据所述指定区域(7)以及患病部位的扫描结果确定。
  11. 如权利要求7所述的手术设备，其特征在于，所述夹持装置(14)用于夹持内镜(9)；所述夹持装置(14)响应于由所述控制装置(3)发送的内镜控制指令，控制所述第一滑块(141)沿所述第一滑轨(15)滑动，带动所 述夹持装置(14)夹持的内镜(9)插入到工作套管(13)中，以采集并发送指定区域(7)的实时图像。
  12. 如权利要求1所述的手术设备，其特征在于，所述操作机械臂(2)包括第二滑轨(23)和手术器械组件(21)；所述第二滑轨(23)固定在所述操作机械臂(2)上；所述手术器械组件(21)上配置第二滑块(24)，所述第二滑块(24)在所述第二滑轨(23)上滑动，带动所述手术器械组件(21)在所述操作机械臂(2)上沿所述第二滑轨(23)的延伸方向滑动，以便将所述手术器械(211)插入到工作套管(13)内或内镜(9)的工作通道中，以对所述指定区域(7)进行手术操作。
  13. 如权利要求1或12任一所述的手术设备，其特征在于，所述手术器械组件(21)包括多个手术器械(211)；所述多个手术器械(211)在所述手术器械组件(21)中的安装形式包括平行安装、错位安装、倾斜面安装、品字形安装中的至少一个；
    所述手术器械组件(21)响应于由所述控制装置(3)发送的器械切换指令，控制所述手术器械组件(21)包含的各手术器械(211)之间进行切换。
  14. 如权利要求1所述的手术设备，其特征在于，所述控制装置(3)还包括显示器(32)、辅助控制杆(33)和操作控制杆(34)；
    所述显示器(32)用于显示所述指定区域(7)的实时图像，以及患病部位的扫描结果；
    所述辅助控制杆(33)用于响应于操作人员的第一操作动作，向所述旋转装置(12)发送旋转指令，以使所述旋转装置(12)旋转，带动放置在所述固定装置(11)上的工作套管(13)旋转，以便所述工作套管(13)在穿刺创口内推开所述指定区域(7)周围的危险部位；
    所述操作控制杆(34)用于响应于操作人员的第二操作动作，向所述操作机械臂(2)发送器械移动指令，控制配置在所述手术器械组件(21)上的第二滑块(24)沿第二滑轨(23)滑动，带动所述手术器械组件(21)中包含的 手术器械(211)沿穿刺方向(8)插入所述工作套管(13)中；当检测到所述手术器械(211)达到所述指定区域(7)时，响应于操作人员的第三操作动作，向所述手术器械(211)发送手术操作指令，以便控制所述手术器械(211)对所述指定区域(7)进行手术操作。
  15. 一种手术方法，其特征在于，所述方法应用于控制装置，所述方法包括：
    获取第一辅助机械臂与操作机械臂的位置；
    当确定第一辅助机械臂上配置的工作套管插入到预先规划的指定区域时，响应于操作人员的操作动作，将旋转指令发送给如权利要求1～14任一所述手术设备上配置的第一辅助机械臂，以使所述第一辅助机械臂上配置的旋转装置控制固定在固定装置上的工作套管旋转，以便所述工作套管在穿刺创口内推开位于预先规划的指定区域周围的危险部位；
    当确定安装在所述操作机械臂上的手术器械插入到患者身体上穿刺创口内时，响应于操作人员的，将手术操作指令发送给如权利要求1～14任一所述手术设备上配置的操作机械臂，以使操作机械臂上配置的手术器械组件控制所述手术器械组件中包含的手术器械对所述预先规划的指定区域进行手术操作。
  16. 一种手术装置，其特征在于，所述手术装置应用于控制装置，所述手术装置包括：
    位置获取模块，用于获取第一辅助机械臂与操作机械臂的位置；
    旋转指令发送模块，用于当确定所述第一辅助机械臂上配置的工作套管插入到预先规划的指定区域时，响应于操作人员的操作动作，将旋转指令发送给如权利要求1～14任一所述手术设备上配置的第一辅助机械臂，以使所述第一辅助机械臂上配置的旋转装置控制固定在固定装置上的工作套管旋转，以便所述工作套管在穿刺创口内推开位于预先规划的指定区域周围的危险部位；
    手术操作指令发送模块，用于当确定安装在所述操作机械臂上的手术器械插入到患者身体上穿刺创口内时，响应于操作人员的操作动作，将手术操作指 令发送给如权利要求1～14任一所述手术设备上配置的操作机械臂，以使操作机械臂上配置的手术器械组件控制所述手术器械组件中包含的手术器械对所述预先规划的指定区域进行手术操作。
  17. 一种计算机可读存储介质，其特征在于，所述存储介质存储有计算机程序，所述计算机程序被处理器执行时实现上述权利要求15所述的方法。
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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20160361128A1 (en) * 2015-06-12 2016-12-15 avateramedical GmBH Apparatus and method for robot-assisted surgery as well as positioning device
CN109009443A (zh) * 2018-08-15 2018-12-18 苏州大学张家港工业技术研究院 腹腔微创外科手术机器人
CN113855254A (zh) * 2021-10-24 2021-12-31 北京歌锐科技有限公司 一种医疗设备以及基于所述医疗设备的手术方法
CN113925615A (zh) * 2021-10-26 2022-01-14 北京歌锐科技有限公司 一种微创手术设备及其控制方法
CN216257380U (zh) * 2021-10-24 2022-04-12 北京歌锐科技有限公司 一种医疗设备

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20160361128A1 (en) * 2015-06-12 2016-12-15 avateramedical GmBH Apparatus and method for robot-assisted surgery as well as positioning device
CN109009443A (zh) * 2018-08-15 2018-12-18 苏州大学张家港工业技术研究院 腹腔微创外科手术机器人
CN113855254A (zh) * 2021-10-24 2021-12-31 北京歌锐科技有限公司 一种医疗设备以及基于所述医疗设备的手术方法
CN216257380U (zh) * 2021-10-24 2022-04-12 北京歌锐科技有限公司 一种医疗设备
CN113925615A (zh) * 2021-10-26 2022-01-14 北京歌锐科技有限公司 一种微创手术设备及其控制方法

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