Device and method for assisting laparoscopic surgery—rule based approach

• US 9,757,206 B2
• Filed: 06/29/2015
• Issued: 09/12/2017
• Est. Priority Date: 08/21/2011
• Status: Active Grant

• Current Assignee: Asensus Surgical Europe SARL (Asensus Surgical, Inc.)
• Original Assignee: M.S.T. Medical Surgery Technologies Ltd (Asensus Surgical, Inc.)
• Inventors: Frimer, Motti, Sholev, Mordehai, Pfeffer, Yehuda
• Primary Examiner(s): Tran, Khoi
• Assistant Examiner(s): PECHE, JORGE O
• Application Number:
  US14/753,902
• Publication Number:
  US 20160174817A1
• Time in Patent Office: 806 Days
• Field of Search: 700245, 700259, 700260, 901 1, 901 8, 901 41, 901 46, 901 47
• CPC Class Codes: A61B 1/00006 of control signals
• CPC Class Codes: A61B 1/00149 using articulated arms
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: G05B 15/02 electric
• CPC Class Codes: G05B 19/0426 Programming the control sequence
• CPC Class Codes: G05B 2219/2617 Eye, ophthalmic, surgery system

Abstract

Surgical controlling systems and methods. A surgical controlling system includes: at least one surgical tool adapted to be inserted into a surgical environment of a human body for assisting a surgical procedure; at least one location estimating unit to real-time locate the 3D spatial position of at least one surgical tool at any given time t; and at least one movement detection unit in communication with a movement'"'"'s database and with the location estimating means. The system also includes a controller having a processing unit in communication with a controller'"'"'s database. The controller controls the spatial position of at least one surgical tool.

Claims

1. A surgical controlling system, comprising:

a. at least one surgical tool configured to be inserted into a surgical environment of a human body for assisting a surgical procedure;

b. at least one location estimating means configured to real-time locate a 3D spatial position of said at least one surgical tool at any given time t;

c. at least one movement detection means communicable with a movement'"'"'s database and with said location estimating means;

said movement'"'"'s database is configured to store said 3D spatial position of said at least one surgical tool at time t_f and at time t₀;

where t_f>

t₀;

said movement detection means is configured to detect movement of said at least one surgical tool if the 3D spatial position of said at least one surgical tool at time t_f is different than said 3D spatial position of said at least one surgical tool at time t₀; and

,

d. a controller having a processing means communicable with a controller'"'"'s database, said controller configured to control the spatial position of said at least one surgical tool;

said controller'"'"'s database is in communication with said movement detection means;

wherein said controller'"'"'s database is configured to store a predetermined set of rules according to which ALLOWED and RESTRICTED movements of said at least one surgical tool are determined, such that each detected movement by said movement detection means of said at least one surgical tool is determined as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein said predetermined set of rules comprises at least one fixed point rule;

said fixed point rule comprises a communicable database;

said communicable database configured to receive at least one said 3D position to be tracked;

said fixed point rule is configured to determine said ALLOWED and RESTRICTED movements according to said at least one 3D position to be tracked in said surgical environment, such that said ALLOWED movements are movements in which said at least one surgical tool is located substantially in said at least one 3D position to be tracked, and said RESTRICTED movements are movements in which the location of said at least one surgical tool is substantially different from said 3D at least one 3D position to be tracked.

2. The surgical controlling system according to claim 1, wherein said at least one 3D position to be tracked is defined as a function of a predetermined position within said surgical environment;

said predetermined position is selected from a group consisting of;

a tip of said at least one surgical tool, at least one position on at least one of said surgical tool, at least one position on at least one tissue, at least one tissue, at least one position on at least one organ, at least one organ, at least one 3D position within said surgical environment, and any combination thereof.

3. The surgical controlling system according to claim 2, wherein at least one of the following is being held true (a) said system additionally comprising an endoscope;

said endoscope is configured to provide real-time image of said surgical environment;

(b) at least one of said surgical tools is an endoscope configured to provide real-time image of said surgical environment.

4. The surgical controlling system according to claim 3, wherein said predetermined set of rules further comprises at least one rule selected from a group consisting of:

most used tool rule, right tool rule, left tool rule, field of view rule, no fly zone rule, a route rule, environmental rule, operator input rule, proximity rule;

collision prevention rule, history-based rule, tool-dependent ALLOWED and RESTRICTED movements rule, preferred volume zone rule, preferred tool rule, movement detection rule, tagged tool rule, change of speed rule and any combination thereof;

further wherein at least one of the following is being held true (a) said right tool rule is configured to determine said ALLOWED movement of said endoscope according to the movement of the surgical tool positioned to right of said endoscope;

further wherein said left tool rule is configured to determine said ALLOWED movement of said endoscope according to the movement of the surgical tool positioned to left of said endoscope;

(b) said tagged tool rule comprises means configured to tag at least one surgical tool within said surgical environment and to determine said ALLOWED movement of said endoscope to constantly track the movement of said tagged surgical tool;

(c) said field of view rule comprises a communicable database comprising n 3D spatial positions;

n is an integer greater than or equal to 2;

the combination of all of said n 3D spatial positions provides a predetermined field of view;

said field of view rule is configured to determine said ALLOWED movement of said endoscope within said n 3D spatial positions so as to maintain a constant field of view, such that said ALLOWED movements are movements in which said endoscope is located substantially in at least one of said n 3D spatial positions, and said RESTRICTED movements are movements in which the location of said endoscope is substantially different from said n 3D spatial positions;

(d) said preferred volume zone rule comprises a communicable database comprising n 3D spatial positions;

n is an integer greater than or equal to 2;

said n 3D spatial positions provides said preferred volume zone;

said preferred volume zone rule is configured to determine said ALLOWED movement of said endoscope within said n 3D spatial positions and RESTRICTED movement of said endoscope outside said n 3D spatial positions, such that said ALLOWED movements are movements in which said endoscope is located substantially in at least one of said n 3D spatial positions, and said RESTRICTED movements are movements in which the location of said endoscope is substantially different from said n 3D spatial positions;

(e) said preferred tool rule comprises a communicable database, said database stores a preferred tool;

said preferred tool rule is configured to determine said ALLOWED movement of said endoscope to constantly track the movement of said preferred tool; and

any combination thereof;

(f) said most used tool rule comprises a communicable database counting the amount of movement of each of said surgical tools;

said most used tool rule is configured to constantly position said endoscope to track the movement of the most moved surgical tool;

(g) said movement detection rule comprises a communicable database comprising the real-time 3D spatial positions of each of said surgical tool;

said movement detection rule is configured to detect movement of said at least one surgical tool when a change in said 3D spatial positions is received, such that said ALLOWED movements are movements in which said endoscope is re-directed to focus on the moving surgical tool;

(h) in said change of speed rule, said system constantly monitors the distance between said endoscope'"'"'s tip and at least one object within the surgical environment, such that the speed of said endoscope varies as a function of said distance; and

any combination thereof.

5. The surgical controlling system according to claim 1, wherein said predetermined set of rules further comprises at least one rule selected from a group consisting of:

most used tool rule, right tool rule, left tool rule, field of view rule, no fly zone rule, a route rule, environmental rule, operator input rule, proximity rule;

collision prevention rule, history-based rule, tool-dependent ALLOWED and RESTRICTED movements rule, preferred volume zone rule, preferred tool rule, movement detection rule, tagged tool rule, change of speed rule and any combination thereof.

6. The surgical controlling system according to claim 5, wherein said route rule comprises a communicable database storing predefined route in which said at least one surgical tool is configured to move within said surgical environment;

said predefined route comprises n 3D spatial positions of said at least one surgical tool;

n is an integer greater than or equal to 2;

said ALLOWED movements are movements in which said at least one surgical tool is located substantially in at least one of said n 3D spatial positions of said predefined route, and said RESTRICTED movements are movements in which said location of said at least one surgical tool is substantially different from said n 3D spatial positions of said predefined route.

7. The surgical controlling system according to claim 5, wherein said environmental rule comprises a communicable database;

said communicable database configured to receive at least one real-time image of said surgical environment and is configured to perform real-time image processing of the same and to determine a 3D spatial position of hazards or obstacles in said surgical environment;

said environmental rule is configured to determine said ALLOWED and RESTRICTED movements according to said hazards or obstacles in said surgical environment, such that said RESTRICTED movements are movements in which said at least one surgical tool is located substantially in at least one of said 3D spatial positions, and said ALLOWED movements are movements in which the location of said at least one surgical tool is substantially different from said 3D spatial positions;

further wherein said hazards or obstacles in said surgical environment are selected from a group consisting of tissue, a surgical tool, an organ, an endoscope and any combination thereof.

8. The surgical controlling system according to claim 5, wherein said operator input rule comprises a communicable database;

said communicable database is configured to receive an input from the operator of said system regarding said ALLOWED and RESTRICTED movements of said at least one surgical tool;

such that said operator input rule converts an ALLOWED movement to a RESTRICTED movement and a RESTRICTED movement to an ALLOWED movement;

further wherein at least one of the following is being held true (a) said input comprises n 3D spatial positions;

n is an integer greater than or equal to 2;

wherein at least one of which is defined as ALLOWED location and at least one of which is defined as RESTRICTED location, such that said ALLOWED movements are movements in which said at least one surgical tool is located substantially in at least one of said n 3D spatial positions, and said RESTRICTED movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions;

(b) said input comprises at least one rule according to which ALLOWED and RESTRICTED movements of said at least one surgical tool are determined, such that the spatial position of said at least one surgical tool is controlled by said controller according to said ALLOWED and RESTRICTED movements;

said predetermined set of rules comprises at least one rule selected from a group consisting of;

most used tool, right tool rule, left tool rule, field of view rule, no fly zone rule, route rule, environmental rule, operator input rule, proximity rule;

collision prevention rule, preferred volume zone rule, preferred tool rule, movement detection rule, history-based rule, tool-dependent ALLOWED and RESTRICTED movements rule, and any combination thereof.

9. The surgical controlling system according to claim 5, wherein said proximity rule is configured to define a predetermined distance between at least two surgical tools;

said ALLOWED movements are movements which are within the range or out of the range of said predetermined distance, and said RESTRICTED movements which are out of the range or within the range of said predetermined distance.

10. The surgical controlling system according to claim 5, wherein said proximity rule is configured to define a predetermined angle between at least three surgical tools;

said ALLOWED movements are movements which are within the range or out of the range of said predetermined angle, and said RESTRICTED movements which are out of the range or within the range of said predetermined angle.

11. The surgical controlling system according to claim 5, wherein said collision prevention rule is configured to define a predetermined distance between said at least one surgical tool and an anatomical element within said surgical environment;

said ALLOWED movements are movements which are in a range that is larger than said predetermined distance, and said RESTRICTED movements are movements which is in a range that is smaller than said predetermined distance;

wherein said anatomical element is selected from a group consisting of tissue, organ, another surgical tool and any combination thereof.

12. The surgical controlling system according to claim 5, wherein said no fly zone rule comprises a communicable database comprising n 3D spatial positions;

n is an integer greater than or equal to 2;

said n 3D spatial positions define a predetermined volume within said surgical environment;

said no fly zone rule is configured to determine said RESTRICTED movement if said movement is within said no fly zone and ALLOWED movement if said movement is outside said no fly zone, such that said RESTRICTED movements are movements in which said at least one of said surgical tool is located substantially in at least one of said n 3D spatial positions, and said ALLOWED movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions.

13. The surgical controlling system according to claim 5, wherein said history-based rule comprises a communicable database storing each 3D spatial position of each of said surgical tool, such that each movement of each surgical tool is stored;

said history-based rule is configured to determine said ALLOWED and RESTRICTED movements according to historical movements of said at least one surgical tool, such that said ALLOWED movements are movements in which said at least one surgical tool is located substantially in at least one of said 3D spatial positions, and said RESTRICTED movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions.

14. The surgical controlling system according to claim 5, wherein said tool-dependent ALLOWED and RESTRICTED movements rule comprises a communicable database;

said communicable database is configured to store predetermined characteristics of at least one of said surgical tool;

said tool-dependent ALLOWED and RESTRICTED movements rule is configured to determine said ALLOWED and RESTRICTED movements according to said predetermined characteristics of said surgical tool;

such that ALLOWED movements as movements of said endoscope which tracks said surgical tool having said predetermined characteristics;

wherein said predetermined characteristics of said surgical tool are selected from a group consisting of;

physical dimensions, structure, weight, sharpness, and any combination thereof.

15. The surgical tracking system of claim 5, wherein, in said change of speed rule, said system constantly monitors the distance between said surgical tool'"'"'s tip and at least one object within the surgical environment, such that the speed of said surgical tool varies as a function of said distance.

16. The surgical controlling system according to claim 1, wherein said system further comprising a maneuvering subsystem communicable with said controller, said maneuvering subsystem is configured to spatially reposition said at least one surgical tool during a surgery according to said predetermined set of rules;

further wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool;

wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

17. The surgical controlling system according to claim 1, wherein at least one of the following is being held true (a) said at least one location estimating means comprises at least one endoscope configured to acquire real-time images of said surgical environment within said human body;

and at least one surgical instrument spatial location software configured to receive said real-time images of said surgical environment and to estimate said 3D spatial position of said at least one surgical tool;

(b) said at least one location estimating means are comprises (i) at least one element selected from a group consisting of optical imaging means, radio frequency transmitting and receiving means, at least one mark on said at least one surgical tool and any combination thereof; and

, (ii) at least one surgical instrument spatial location software configured to estimate said 3D spatial position of said at least one surgical tool by means of said element;

(c) said at least one location estimating means are an interface subsystem between a surgeon and the at least one surgical tool, the interface subsystem comprises;

(i) at least one array comprising N regular or pattern light sources, where N is a positive integer;

(ii) at least one array comprising M cameras, each of the M cameras, where M is a positive integer;

(iii) optional optical markers and means for attaching the optical marker to the at least one surgical tool; and

;

(iv) a computerized algorithm operable via the controller, the computerized algorithm configured to record images received by each camera of each of the M cameras and to calculate therefrom the position of each of the tools, and further configured to provide automatically the results of the calculation to the human operator of the interface.

18. A method for assisting an operator to perform a surgical procedure, comprising steps of:

a. providing a surgical controlling system, comprising;

(i) at least one surgical tool;

(ii) at least one location estimating means;

(iii) at least one movement detection means; and

, (iv) a controller having a processing means communicable with a controller'"'"'s database;

b. inserting said at least one surgical tool into a surgical environment of a human body;

c. real-time estimating the location of said at least one surgical tool within said surgical environment at any given time t; and

,

d. detecting if there is movement of said at least one surgical tool if a 3D spatial position of said at least one surgical tool at time t_f is different than said 3D spatial position of said at least one surgical tool at time t₀;

e. controlling the spatial position of said at least one surgical tool within said surgical environment by means of said controller;

wherein said step of controlling is performed by storing a predetermined set of rules in a controller'"'"'s database;

said predetermined set of rules comprises ALLOWED and RESTRICTED movements of said at least one surgical tool, such that each detected movement by said movement detection means of said at least one surgical tool is determined as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein said predetermined set of rules comprises at least one fixed point rule;

said fixed point rule comprises a communicable database;

said communicable database configured to receive at least one 3D position to be tracked;

said fixed point rule is configured to determine said ALLOWED and RESTRICTED movements according to said at least one 3D position to be tracked in said surgical environment, such that said ALLOWED movements are movements in which said at least one surgical tool is located substantially in said at least one 3D position to be tracked, and said RESTRICTED movements are movements in which the location of said at least one surgical tool is substantially different from said 3D at least one 3D position to be tracked.

19. The method according to claim 18, wherein said at least one 3D position to be tracked is defined as a function of a predetermined position within said surgical environment;

said predetermined position is selected from a group consisting of;

a tip of said at least one surgical tool, at least one position on at least one of said surgical tool at least one position on at least one tissue at least one tissue, at least one position on at least one organ at least one organ, at least one 3D position within said surgical environment, and any combination thereof.

20. The method according to claim 18, further comprising a step of selecting said predetermined set of rules from a group consisting of:

most used tool, right tool rule, left tool rule, field of view rule, no fly zone rule, a route rule, an environmental rule, an operator input rule, a proximity rule;

a collision prevention rule, preferred volume zone rule, preferred tool rule, movement detection rule, a history-based rule, a tool-dependent ALLOWED and RESTRICTED movements rule, tagged tool rule, change of speed rule and any combination thereof.

21. The method according to claim 20, wherein said route rule comprises a communicable database storing predefined route in which said at least one surgical tool is configured to move within said surgical environment;

said predefined route comprises n 3D spatial positions of said at least one surgical tool;

n is an integer greater than or equal to 2;

said ALLOWED movements are movements in which said at least one surgical tool is located substantially in at least one of said n 3D spatial positions of said predefined route, and said RESTRICTED movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions of said predefined route.

22. The method according to claim 20, wherein said environmental rule comprises a communicable database;

said communicable database is configured to received real-time image of said surgical environment and is configured to perform real-time image processing of the same and to determine the 3D spatial position of hazards or obstacles in said surgical environment;

said environmental rule is configured to determine said ALLOWED and RESTRICTED movements according to said hazards or obstacles in said surgical environment, such that said RESTRICTED movements are movements in which said at least one surgical tool is located substantially in at least one of said 3D spatial positions, and said ALLOWED movements are movements in which the location of said at least one surgical tool is substantially different from said 3D spatial positions;

further wherein said hazards or obstacles in said surgical environment are selected from a group consisting of tissue, a surgical tool, an organ, an endoscope and any combination thereof.

23. The method according to claim 20, wherein said operator input rule comprises a communicable database;

said communicable database is configured to receive an input from the operator of said system regarding said ALLOWED and said RESTRICTED movements of said at least one surgical tool;

said operator input rule converts said ALLOWED movement to said RESTRICTED movement and said RESTRICTED movement to said ALLOWED movement;

further wherein at least one of the following is being held true (a) said input comprises n 3D spatial positions;

n is an integer greater than or equal to 2;

wherein at least one of which is defined as ALLOWED location and at least one of which is defined as RESTRICTED location, such that said ALLOWED movements are movements in which said at least one surgical tool is located substantially in at least one of said n 3D spatial positions, and said RESTRICTED movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions;

(b) said input comprises at least one predetermined rule according to which ALLOWED and RESTRICTED movements of said at least one surgical tool are determined, such that the spatial position of said at least one surgical tool is controlled by said controller according to said ALLOWED and RESTRICTED movements;

said predetermined rules is selected from a group consisting of;

most used tool, right tool rule, left tool rule, field of view rule, no fly zone rule, preferred volume zone rule, a preferred tool rule, a route rule, an environmental rule, an operator input rule, a proximity rule;

a collision prevention rule, a history-based rule, a tool-dependent ALLOWED and RESTRICTED movements rule, and any combination thereof.

24. The method according to claim 20, wherein said proximity rule is configured to define a predetermined distance between at least two surgical tools;

said ALLOWED movements are movements which are within the range or out of the range of said predetermined distance, and said RESTRICTED movements which are out of the range or within the range of said predetermined distance.

25. The method according to claim 20, wherein said proximity rule is configured to define a predetermined angle between at least three surgical tools;

said ALLOWED movements are movements which are within the range or out of the range of said predetermined angle, and said RESTRICTED movements which are out of the range or within the range of said predetermined angle.

26. The method according to claim 20, wherein said collision prevention rule is configured to define a predetermined distance between said at least one surgical tool and an anatomical element within said surgical environment;

said ALLOWED movements are movements which are in a range that is larger than said predetermined distance, and said RESTRICTED movements are movements which is in a range that is smaller than said predetermined distance;

wherein said anatomical element is selected from a group consisting of tissue, organ, another surgical tool and any combination thereof.

27. The method according to claim 20, wherein said no fly zone rule comprises n 3D spatial positions;

n is an integer greater than or equal to 2;

said n 3D spatial positions define a predetermined volume within said surgical environment;

said no fly zone rule is configured to determine said RESTRICTED movement if said movement is within said no fly zone and said ALLOWED movement if said movement is outside said no fly zone, such that said RESTRICTED movements are movements in which said at least one of said surgical tool is located substantially in at least one of said n 3D spatial positions, and said ALLOWED movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions.

28. The method according to claim 20, wherein said most used tool rule comprises a database counting the amount of movement of each of said surgical tools;

said most used tool rule is configured to constantly position said endoscope to track the movement of the most moved surgical tool.

29. The method according to any of claim 20, additionally comprising step of alerting said physician of a RESTRICTED movements of said at least one surgical tool;

said step of alerting is performed by at least one selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

30. The method according to claim 20, wherein said history-based rule comprises a communicable database storing each 3D spatial position of each of said surgical tool, such that each movement of each surgical tool is stored;

said history-based rule is configured to determine said ALLOWED and RESTRICTED movements according to historical movements of said at least one surgical tool, such that said ALLOWED movements are movements in which said at least one surgical tool is located substantially in at least one of said 3D spatial positions, and said RESTRICTED movements are movements in which the location of said at least one surgical tool is substantially different from said n 3D spatial positions.

31. The method according to claim 20, wherein said tool-dependent ALLOWED and RESTRICTED movements rule comprises a communicable database;

said communicable database is configured to store predetermined characteristics of at least one of said surgical tool;

said tool-dependent ALLOWED and RESTRICTED movements rule is configured to determine said ALLOWED and RESTRICTED movements according to said predetermined characteristics of said surgical tool;

said predetermined characteristics of said surgical tool are selected from a group consisting of;

physical dimensions, structure, weight, sharpness, and any combination thereof.

32. The method according to claim 20, wherein said movement detection rule comprises a communicable database comprising the real-time 3D spatial positions of each of said surgical tool;

and to detect movement of said at least one surgical tool when a change in said 3D spatial positions is received, such that said ALLOWED movements are movements in which said endoscope is directed to focus on the moving surgical tool.

33. The method according to claim 18, wherein at least one of the following is being held true (a) said system additionally comprising an endoscope;

said endoscope is configured to provide real-time image of said surgical environment;

(b) at least one of said surgical tools is an endoscope configured to provide real-time image of said surgical environment.

34. The method according to claim 33, wherein said predetermined set of rules further comprises at least one rule selected from a group consisting of:

most used tool rule, right tool rule, left tool rule, field of view rule, no fly zone rule, a route rule, environmental rule, operator input rule, proximity rule;

collision prevention rule, history-based rule, tool-dependent ALLOWED and RESTRICTED movements rule, preferred volume zone rule, preferred tool rule, movement detection rule, tagged tool rule, change of speed rule and any combination thereof;

further wherein at least one of the following is being held true (a) said right tool rule is configured to determine said ALLOWED movement of said endoscope according to the movement of the surgical tool positioned to right of said endoscope;

further wherein said left tool rule is configured to determine said ALLOWED movement of said endoscope according to the movement of the surgical tool positioned to left of said endoscope;

(b) said tagged tool rule comprises means configured to tag at least one surgical tool within said surgical environment and to determine said ALLOWED movement of said endoscope to constantly track the movement of said tagged surgical tool;

(c) said field of view rule comprises n 3D spatial positions;

n is an integer greater than or equal to 2;

the combination of all of said n 3D spatial positions provides a predetermined field of view;

said field of view rule is configured to determine said ALLOWED movement of said endoscope within said n 3D spatial positions so as to maintain a constant field of view, such that said ALLOWED movements are movements in which said endoscope is located substantially in at least one of said n 3D spatial positions, and said RESTRICTED movements are movements in which the location of said endoscope is substantially different from said n 3D spatial positions;

(d) said preferred volume zone rule comprises a communicable database comprising n 3D spatial positions;

n is an integer greater than or equal to 2;

said n 3D spatial positions provides said preferred volume zone;

said preferred volume zone rule is configured to determine said ALLOWED movement of said endoscope within said n 3D spatial positions and RESTRICTED movement of said endoscope outside said n 3D spatial positions, such that said ALLOWED movements are movements in which said endoscope is located substantially in at least one of said n 3D spatial positions, and said RESTRICTED movements are movements in which the location of said endoscope is substantially different from said n 3D spatial positions;

(e) said preferred tool rule comprises a communicable database, said database stores a preferred tool;

said preferred tool rule is configured to determine said ALLOWED movement of said endoscope to constantly track the movement of said preferred tool;

(f) and any combination thereof.

35. The method according to claim 33, wherein controller'"'"'s database comprises n 3D spatial positions;

n is an integer greater than or equal to 2;

the combination of all of said n 3D spatial positions provides a predetermined field of view;

said field of view rule is configured to relocate said endoscope if movement of at least one of said surgical tools has been detected by said detection means, such that said field of view is maintained.

36. The method according to claim 18, wherein at least one of the following is being held true (a) said at least one location estimating means comprises at least one endoscope configured to acquire real-time images of a surgical environment within said human body;

and at least one surgical instrument spatial location software configured to receive said real-time images of said surgical environment and to estimate said 3D spatial position of said at least one surgical tool;

(b) said at least one location estimating means are comprises (i) at least one element selected from a group consisting of optical imaging means, radio frequency transmitting and receiving means, at least one mark on said at least one surgical tool and any combination thereof; and

, (ii) at least one surgical instrument spatial location software configured to estimate said 3D spatial position of said at least one surgical tool by means of said element;

(c) said at least one location estimating means are an interface subsystem between a surgeon and the at least one surgical tool, the interface subsystem comprises;

(i) at least one array comprising N regular or pattern light sources, where N is a positive integer;

(ii) at least one array comprising M cameras, each of the M cameras, where M is a positive integer;

(iii) optional optical markers and means for attaching the optical marker to the at least one surgical tool; and

, (iv) a computerized algorithm operable via the controller, the computerized algorithm configured to record images received by each camera of each of the M cameras and to calculate therefrom the position of each of the tools, and further configured to provide automatically the results of the calculation to the human operator of the interface; and

any combination thereof.