Device and method for assisting laparoscopic surgery—rule based approach

• US 9,937,013 B2
• Filed: 07/30/2015
• Issued: 04/10/2018
• 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 H
• Assistant Examiner(s): PECHE, JORGE O
• Application Number:
  US14/813,170
• Publication Number:
  US 20160007826A1
• Time in Patent Office: 985 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 1/000096 using artificial intelligence
• CPC Class Codes: A61B 1/00147 Holding or positioning arrangements
• CPC Class Codes: A61B 1/00149 using articulated arms
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 1/06 with illuminating arrangements
• 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 2017/00075 Motion
• CPC Class Codes: A61B 2017/00132 Setting operation time of a device A61B2017/00123 takes precedence
• CPC Class Codes: A61B 2017/00225 Systems for controlling multiple different instruments, e.g. microsurgical systems
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2057 Details of tracking cameras
• CPC Class Codes: A61B 2034/2059 Mechanical position encoders
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2034/2074 Interface software
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/371 : with simultaneous use of two cameras
• CPC Class Codes: A61B 2090/3945 : Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/3983 : Reference marker arrangements for use with image guided surgery
• 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 34/32 : operating autonomously
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61B 90/98 : using electromagnetic means, e.g. transponders
• CPC Class Codes: G05B 15/02 : electric

Abstract

A surgical controlling system comprising: a location estimating means to real-time locate the 3D spatial position of surgical tools, a movement detection means and movement database in communication with the location estimating means and with a control database and controller to control the position of surgical tools. The movement database stores 3D spatial positions of the surgical tools at the present time and at at least one previous time; movement has occurred if a present position is different from a previous position. In the control database are rules identifying tool movement as allowed or restricted, selected from: most used tool rule, right or left tool rule, field of view rule, no fly zone rule, route rule, environmental rule, operator input rule, proximity rule, collision prevention rule, history-based rule, tool-dependent allowed and restricted movement rule, preferred volume zone, preferred tool, movement detection rule, tagged tool rule, and change of speed rule.

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 to;

where t_f >

to;

said movement detection means is adapted 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 to; 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, 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 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;

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;

wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

2. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein an environmental rule comprises a 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, said RESTRICTED movements being 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.

3. The surgical controlling system according to claim 2, 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.

4. The surgical controlling system according to claim 2, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

5. The surgical controlling system according to claim 4, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

6. The surgical controlling system according to claim 2, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

7. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein an 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;

said operator input rule being configured to convert 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, said ALLOWED movements being 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, said spatial position of said at least one surgical tool being controllable 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.

8. The surgical controlling system according to claim 7, 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.

9. The surgical controlling system according to claim 7, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

10. The surgical controlling system according to claim 9, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

11. The surgical controlling system according to claim 7, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

12. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determined determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein a 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.

13. The surgical controlling system according to claim 12, 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.

14. The surgical controlling system according to claim 12, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

15. The surgical controlling system according to claim 14, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

16. The surgical controlling system according to claim 12, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

17. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein a 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.

18. The surgical controlling system according to claim 17, 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.

19. The surgical controlling system according to claim 17, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

20. The surgical controlling system according to claim 19, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

21. The surgical controlling system according to claim 17, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

22. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein a 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.

23. The surgical controlling system according to claim 22, 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.

24. The surgical controlling system according to claim 22, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

25. The surgical controlling system according to claim 24, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

26. The surgical controlling system according to claim 22, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

27. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

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.

28. The surgical controlling system according to claim 27, 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.

29. The surgical controlling system according to claim 27, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

30. The surgical controlling system according to claim 29, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

31. The surgical controlling system according to claim 27, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

32. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein a 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, said RESTRICTED movements being 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.

33. The surgical controlling system according to claim 32, 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.

34. The surgical controlling system according to claim 32, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

35. The surgical controlling system according to claim 34, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

36. The surgical controlling system according to claim 32, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

37. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein a history-based rule comprises a communicable database storing each 3D spatial position of each of said surgical tool, each movement of each surgical tool being 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, said ALLOWED movements being 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.

38. The surgical controlling system according to claim 37, 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.

39. The surgical controlling system according to claim 37, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

40. The surgical controlling system according to claim 39, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

41. The surgical controlling system according to claim 37, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

42. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein a 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 ALLOWED movements being movements of said endoscope which track 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.

43. The surgical controlling system according to claim 42, 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.

44. The surgical controlling system according to claim 42, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

45. The surgical controlling system according to claim 44, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

46. The surgical controlling system according to claim 42, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.

47. 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 said 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 t_O; 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, each detected movement by said movement detection means of said at least one surgical tool being determinable as either an ALLOWED movement or as a RESTRICTED movement according to said predetermined set of rules;

wherein, in a change of speed rule, said system constantly monitors distance between said surgical tool'"'"'s tip and at least one object within the surgical environment, speed of said surgical tool being variable as a function of said distance.

48. The surgical controlling system according to claim 47, 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.

49. The surgical controlling system according to claim 47, wherein said system is configured to alert the physician of said RESTRICTED movement of said at least one surgical tool.

50. The surgical controlling system according to claim 49, wherein said alert is selected from a group consisting of audio signaling, voice signaling, light signaling, flashing signaling and any combination thereof.

51. The surgical controlling system according to claim 47, wherein said ALLOWED movement is permitted by said controller and said RESTRICTED movement is denied by said controller.