SURGICAL SYSTEM AND METHOD FOR CONTROLLING THE SAME

• US 20190328471A1
• Filed: 04/29/2019
• Published: 10/31/2019
• Est. Priority Date: 04/27/2018
• Status: Active Grant

• Current Assignee: Kawasaki Jukogyo Kabushiki Kaisha (Kawasaki Heavy Industries Limited), Medicaroid Corporation (Sysmex Corporation)
• Original Assignee: Kawasaki Jukogyo Kabushiki Kaisha (Kawasaki Heavy Industries Limited)
• Inventors: TOJO, Tsuyoshi, NOGUCHI, Kenji, ITO, Tetsushi, NAKANISHI, Tetsuya
• Granted Patent: US 11,504,198 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 1/00006 of control signals
• CPC Class Codes: A61B 1/00045 Display arrangement
• CPC Class Codes: A61B 1/00149 using articulated arms
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/0016 using motor drive units
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/0034 adapted to be inserted through a working channel of an endoscope
• CPC Class Codes: A61B 2017/2908 Multiple segments connected by articulations
• CPC Class Codes: A61B 2017/2938 Independently actuatable jaw members, e.g. two actuating rods
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas
• CPC Class Codes: A61B 2034/301 for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2034/302 specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/37 Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms

Abstract

A surgical system includes a robot main body, a slave controller, a display device that displays an endoscopic image, and an manipulation input device. The robot main body includes an entry guide having a plurality of guide bores, an entry guide support device that supports the entry guide, an instrument manipulator that has a surgical instrument provided at a distal end and is inserted into the entry guide, and an endoscope manipulator that has an endoscopic camera provided at a distal end and is inserted into the entry guide. The slave controller operates the robot main body such that the surgical instrument advances from an exit of the entry guide after the endoscopic camera advances from the exit of the entry guide and starts capturing in response to a body cavity insertion command received by the manipulation input device.

Claims

1. A surgical system comprising:

a robot main body;

a slave controller configured to control the robot main body;

a display device configured to display an endoscopic image; and

a manipulation input device configured to receive input of a command from a surgeon and transmit the command to the slave controller,

wherein

the robot main body includes;

an entry guide having a plurality of guide bores;

an entry guide support device that supports the entry guide;

an instrument manipulator that has a surgical instrument provided at a distal end and is inserted into one of the guide bores of the entry guide; and

an endoscope manipulator that has an endoscopic camera provided at a distal end and is inserted into another one of the guide bores of the entry guide,

the manipulation input device includes a manipulation tool that receives input of a body cavity insertion command, and

the slave controller operates the robot main body, such that the surgical instrument advances from an exit of the entry guide after the endoscopic camera advances from the exit of the entry guide and starts capturing, in response to the body cavity insertion command received by the manipulation input device.

2. The surgical system according to claim 1, wherein the slave controller operates the robot main body such that a portion of the instrument manipulator advancing from the exit of the entry guide maintains a linear shape after the surgical instrument starts to advance from the exit of the entry guide until the surgical instrument enters a field of view of the endoscopic camera.

3. The surgical system according to claim 1, wherein

in the entry guide, a distal end of the guide bore into which the endoscope manipulator is inserted is positioned closer to a proximal side of the entry guide relative to a distal end of the guide bore into which the instrument manipulator is inserted, and

the slave controller operates the robot main body so as to cause the surgical instrument that starts to advance from an exit of the entry guide to be in a state of being in a field of view of the endoscopic camera, and cause the surgical instrument to advance from an exit of the entry guide while maintaining the state.

4. The surgical system according to claim 1, wherein the slave controller obtains an overhang amount of the instrument manipulator toward a radially outer side of the guide bore from a center line of the guide bore in which the instrument manipulator is inserted, and, when the overhang amount exceeds a predetermined overhang amount threshold, the slave controller performs at least one of processing of outputting a warning to the manipulation input device, processing of temporarily stopping operation of the robot main body, processing of reducing a ratio of a displacement amount of the instrument manipulator corresponding to a manipulation amount received by the manipulation input device, and processing of outputting information to the manipulation input device such that a reaction force is applied to a manipulation force to a radially outer side of the guide bore received by the manipulation input device.

5. The surgical system according to claim 4, wherein the slave controller obtains a change amount per unit time of the overhang amount, and obtains the overhang amount threshold from the change amount based on a predetermined correspondence relationship such that the overhang amount threshold decreases as the change amount increases.

6. The surgical system according to claim 1, wherein

a portion of the instrument manipulator that advances from an exit of the entry guide has six or more degrees of freedom,

the manipulation input device includes a second manipulation tool that receives inputs of a manipulator return command, and

the slave controller operates the robot main body such that a portion of the instrument manipulator advancing from the exit of the entry guide has a linear shape while maintaining a posture of the surgical instrument in response to the manipulator return command received by the manipulation input device.

7. The surgical system according to claim 1, wherein

a portion of the instrument manipulator that advances from an exit of the entry guide has seven degrees of freedom,

the manipulation input device includes a second manipulation tool that receives inputs of a manipulator return command, and

the slave controller operates the robot main body such that a portion of the instrument manipulator advancing from the exit of the entry guide has a linear shape while maintaining a posture of the surgical instrument in response to the manipulator return command received by the manipulation input device.

8. The surgical system according to claim 1, wherein

the instrument manipulator has at least one bending joint in which a tactile sensor is disposed on periphery, and

when pressure detected by the tactile sensor exceeds a predetermined pressure threshold, the slave controller performs at least one of processing of outputting a warning to the manipulation input device, processing of temporarily stopping operation of the robot main body, processing of reducing a ratio of a displacement amount of the instrument manipulator corresponding to a manipulation amount received by the manipulation input device, and processing of outputting information to the manipulation input device such that a reaction force is applied to a manipulation force toward a radially outer side of the entry guide received by the manipulation input device.

9. The surgical system according to claim 1, wherein

the instrument manipulator includes a wrist connected to the surgical instrument, an elbow connected to the wrist with a distal link interposed therebetween, a shoulder connected to the elbow with a middle link interposed therebetween, and a proximal link connected to the shoulder,

the shoulder bendably and rotatably connects the middle link and the proximal link, and

the slave controller restricts a bending movable range of the shoulder to a range in which the middle link is rotated toward an outer peripheral side of the entry guide by 0 degrees or more and less than 90 degrees and to a range in which the middle link is rotated toward an inner peripheral side of the entry guide by 0 degrees or more and less than 30 degrees where an extension of a center line of the proximal link is set to 0 degrees.

10. The surgical system according to claim 1, wherein

the instrument manipulator includes a wrist connected to the surgical instrument, an elbow connected to the wrist with a distal link interposed therebetween, a shoulder connected to the elbow with a middle link interposed therebetween, and a proximal link connected to the shoulder,

the wrist bendably and rotatably connects the distal link and the wrist, and

the slave controller restricts a bending movable range of the wrist to a range in which the surgical instrument is rotated toward an inner peripheral side of the entry guide by 0 degrees or more and less than 100 degrees where an extension of a center line of the distal link is set to 0 degrees.

11. The surgical system according to claim 1, wherein

the instrument manipulator includes a wrist connected to the surgical instrument, an elbow connected to the wrist with a distal link interposed therebetween, a shoulder connected to the elbow with a middle link interposed therebetween, and a proximal link connected to the shoulder,

the proximal link includes a first proximal link, a second proximal link, and an auxiliary joint bendably and rotatably connecting the first proximal link and the second proximal link, and

the slave controller restricts operation of the auxiliary joint such that the auxiliary joint does not rotate during surgery after the surgical instrument is inserted into the body cavity.

12. The surgical system according to claim 11, wherein the auxiliary joint is positioned at one of a portion of the proximal link not inserted into the entry guide and a portion of the proximal link advancing from the exit of the entry guide.

13. The surgical system according to claim 1, wherein the surgical instrument includes a pair of jaws that operate independently of one another.

14. A method for controlling a surgical system including a robot main body, a display device that displays an endoscopic image, and a manipulation input device that receives input of a command from a surgeon,

the robot main body including:

an entry guide having a plurality of guide bores;

an entry guide support device that supports the entry guide;

an instrument manipulator that has a surgical instrument provided at a distal end and is inserted into one of the guide bores of the entry guide; and

an endoscope manipulator that has an endoscopic camera provided at a distal end and is inserted into another one of the guide bores of the entry guide,

the method comprising the steps of;

receiving a body cavity insertion command via the manipulation input device;

causing the endoscopic camera to advance from an exit of the entry guide in response to the body cavity insertion command;

causing the endoscopic camera to start capturing; and

causing the surgical instrument to advance from the exit of the entry guide after the endoscopic camera starts capturing.

15. The method for controlling a surgical system according to claim 14, wherein the step of causing the surgical instrument to advance from an exit of the entry guide includes causing the surgical instrument to advance from an exit of the entry guide in response to start of capturing by the endoscopic camera.

16. The method for controlling a surgical system according to claim 14, further comprising a step of operating the instrument manipulator such that a portion of the instrument manipulator advancing from an exit of the entry guide maintains a linear shape after the surgical instrument starts to advance from the exit of the entry guide until the surgical instrument enters a field of view of the endoscopic camera.

17. The method for controlling a surgical system according to claim 14, wherein in the entry guide, a distal end of the guide bore into which the endoscope manipulator is inserted is positioned closer to a proximal side of the entry guide than a distal end of the guide bore into which the instrument manipulator is inserted.

18. The method for controlling a surgical system according to claim 14, further comprising the steps of:

obtaining an overhang amount of the instrument manipulator toward a radially outer side of the guide bore from a center line of the guide bore in which the instrument manipulator is inserted; and

when the overhang amount exceeds a predetermined overhang amount threshold, performing at least one of processing of outputting a warning to the manipulation input device, processing of temporarily stopping operation of the robot main body, processing of reducing a ratio of a displacement amount of the instrument manipulator corresponding to a manipulation amount received by the manipulation input device, and processing of outputting information to the manipulation input device such that a reaction force is applied to a manipulation force to a radially outer side of the guide bore received by the manipulation input device.

19. The method for controlling a surgical system according to claim 14, wherein the manipulation input device includes a manipulation tool that receives input of the body cavity insertion command.

20. The method for controlling a surgical system according to claim 14, wherein the manipulation input device includes a manipulation tool that receives input of a manipulator return command,

the method further comprising the steps of:

receiving the manipulator return command via the manipulation input device; and

operating the instrument manipulator such that a portion of the instrument manipulator advancing from an exit of the entry guide has a linear shape while a posture of the surgical instrument is maintained.