SURGERY ASSISTANCE SYSTEM FOR GUIDING A SURGICAL INSTRUMENT

• US 20110028992A1
• Filed: 03/20/2009
• Published: 02/03/2011
• Est. Priority Date: 03/28/2008
• Status: Active Grant

• Current Assignee: Aktormed GmbH
• Original Assignee: Aktormed GmbH
• Inventors: Scherr, Jürgen, Geiger, Robert
• Granted Patent: US 8,433,389 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 2017/3409 including needle or instrument drives
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: B25J 9/1664 characterised by motion, path, trajectory planning
• CPC Class Codes: G05B 2219/39389 Laparoscopic surgery, camera on center of operated part, view around, scale
• CPC Class Codes: G05B 2219/40415 Semi active robot, cobot, guides surgeon, operator to planned trajectory, constraint
• CPC Class Codes: G05B 2219/45123 Electrogoniometer, neuronavigator, medical robot used by surgeon to operate
• CPC Class Codes: G05B 2219/45166 Tomography

Abstract

The invention relates to a surgery assistance system for guiding a surgical instrument, in particular a camera system (2) having an endoscope (3) dependant on manual actuation of at least one function key (T1-T6) of a control element (BE). The surgical instrument (3) is fastened to an arm system (10, 12, 14) of the surgery assistance system (1) having an instrument mount (15) and at least the tip (S) of the surgical instrument (3) can be moved in a controlled manner by means of the arm system (10, 12, 14) in a Cartesian patient coordinate system (PKS), whereby at least one of the three spatial axes (x, y, z) of the Cartesian patient coordinate system (PKS) extends through the surgical opening or the trocar point (T) receiving the surgical instrument (3). Advantageously, the angle of inclination (w) of the surgical instrument (3) is determined with respect to the spatial axis (z) of the Cartesian patent coordinate system (PKS) extending through the trocar point (T) and the angle of inclination (w) so determined is compared with a predetermined set angle of inclination (w_S). When the determined angle of inclination (w) exceeds the set angle of inclination (w_S), the tip (S) of the surgical instrument (3) is guided on a semi-spherical surface (TK) which concentrically surrounds the trocar point (T) and which receives the tip (S) of the instrument (3), and when the determined angle of inclination (w) is below the set angle of inclination (w_S), the tip (S) of the surgical instrument (3) is guided along a tangent (TG) which extends through the tip (S) of the instrument (3) and which rests on the semi-spherical surface (TK).

Claims

1. A surgery assistance system for guiding a surgical instrument, comprising an endoscope, the surgery assistance system comprises an arm system comprising an instrument mount and a control apparatus provided for controlling said arm system, control apparatus is connected to a computer system (CS) connected to a control element (BE), the computer system is for guiding the surgical instrument based on manual actuation of at least one function key (T1-T6), whereby at least the tip (S) of the surgical instrument can be moved in a controlled manner by means of the arm system in a Cartesian patient coordinate system (PKS) and at least one of the three spatial axes (x, y, z) of the Cartesian patient coordinate system (PKS) extends through a surgical opening or a trocar point (T) receiving the surgical instrument, wherein

a control and analysis routine (SAR) is provided, which is for determining an angle of inclination (w) of the surgical instrument in relation to the spatial axis (z) of the Cartesian patient coordinate system (PKS) extending through the trocar point (T) and for comparing the angle of inclination (w) so determined with a predetermined set angle of inclination (wS), whereby if the determined angle of inclination (w) exceeds the set angle of inclination (wS) the tip (S) of the surgical instrument is guided on a semi-spherical surface (TK) receiving the tip (S) and when the determined angle of inclination (w) is below the set angle of inclination (wS) the tip (S) of the surgical instrument (3) is guided along a tangent (TG) extending through the tip (S) of the surgical instrument (3) on the semi-spherical surface (TK).

2. The surgery assistance system according to claim 1, wherein when the determined angle of inclination (w) exceeds the set angle of inclination (wS), the tip (S) of the instrument is guided on a circular path (KB) which concentrically surrounds the trocar point (T).

3. The surgery assistance system according to claim 1, wherein the coordinates (xT, yT, zT) of the zero point or of the origin of the Cartesian patient coordinate system (PKS) are allocated to the trocar point (T).

4. The surgery assistance system according to claim 1, wherein for registration of the surgery assistance system a registration sensor rigidly affixed to the arm system is guided to the trocar point (T) and the coordinates (X, Y, Z) of the axes of the arm system are defined in a Cartesian reference coordinate system (BKS).

5. The surgery assistance system according to claim 3, wherein for calculation of the starting point of the guiding, the coordinates (X, Y, Z) of the axes of the arm system are determined in the Cartesian reference coordinate systems (BKS) and based thereon the current Cartesian coordinates (xS, yS, zS) of the tip (S) of the instrument are determined.

6. The surgery assistance system according to claim 5, wherein based on the Cartesian coordinates (xS, yS, zS) of the tip (S) of the instrument in the Cartesian patient coordinates system (PKS) the corresponding spherical coordinates (rS, φ

S, θ

S) of the tip (S) of the instrument are determined.

7. The surgery assistance system according to claim 6, wherein the angle of inclination (w) is determined by analysis of at least one of the spherical coordinates (rS, φ

S, θ

S) of the tip (S) of the instrument.

8. The surgery assistance system according to claim 6, wherein the set position of the tip (S′

) of the instrument to be approached by means of the arm system of the surgery assistance system, which lies on the semi-spherical surface (TK) or tangent (TG) based on the determined angle of inclination (w), is determined.

9. The surgery assistance system according to claim 8, wherein the set position of the tip (S′

) of the instrument (3) is determined in the form of updated spherical coordinates (r′

S, φ

′

S, θ

′

S).

10. The surgery assistance system according to claim 9, wherein the updated spherical coordinates (r′

S, m′

S, θ

′

S) of the tip (S′

) of the instrument are first converted to updated Cartesian coordinates (x′

S, y′

S, z′

S) of the patient coordinate system (PKS), from which the updated Cartesian coordinates (X′

, Y′

, Z′

) of the axes of the arm system in the reference coordinate system (BKS) required for control of the arm system of the surgery assistance system are derived.

11. The surgery assistance system according to claim 1, wherein the surgery assistance system is registered by means of a registration routine (RR) in at least one trocar point (T).

12. The surgery assistance system according to claim 11, wherein corresponding axis velocity set values (V) are determined based on the updated Cartesian coordinates (X′

, Y′

, Z′

) of the axes of the arm system.

13. The surgery assistance system according to claim 1, wherein the instrument is inserted via the surgical opening into a patient'"'"'s body so that the longitudinal axis (L) of the instrument extends through the zero point of the Cartesian patient coordinate system (PKS) and encloses with the z-axis the angle of inclination (w).

14. The surgery assistance system according to claim 1, further comprising a camera system whereby images (B) are generated and are displayed on a monitor unit (ME).

15. The surgery assistance system according to claim 11, whereby an image horizon of the images (B) displayed on the monitor unit (ME) is calibrated prior to minimally invasive surgery, namely by rotating the camera system on its longitudinal axis (L).

16. The surgery assistance system according to claim 12, whereby the image horizon of the images (B) displayed on the monitor unit (ME) remains essentially constant during the minimally invasive surgery.

17. The surgery assistance system according to claim 2, wherein by actuating a first or a second function key (T1, T2) the tip (S) is guided leftward or rightward on a circular path (KB) extending concentrically around the z-axis (z), causing a leftward or rightward movement of the image (B) displayed on the monitor unit (ME).

18. The surgery assistance system according to claim 1, wherein the set angle of inclination (wS) is between 10°

and 25°

.