CN101484086B - 用于控制触觉装置的方法和设备 - Google Patents
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Abstract
提供了一种补偿对象在外科手术期间的运动的方法。所述方法包括确定患者的解剖结构的姿态;确定外科装置的外科工具的姿态;限定所述解剖结构的姿态与所述外科工具的位置、取向、速度和/或加速度之间的关系;关联所述解剖结构的姿态、所述外科工具的姿态和所述关系;和响应所述解剖结构的运动和/或所述外科工具的运动更新所述关联而不用在所述外科手术期间中断所述外科装置的操作。
Description
相关申请的交叉引用
本申请要求2006年5月19日提交的、序列号为No.60/801,378的美国临时专利申请的优先权,上述申请的公开的全部内容被引用于此作为参考。
技术领域
本发明涉及外科系统,尤其涉及用于控制触觉装置的方法和设备。
背景技术
微创手术(MIS)是通过比传统手术进路中使用的切口显著更小的切口执行的手术。例如,在诸如全膝置换手术这样的矫形应用中,MIS切口长度可以在大约4-6英寸的范围内,而在传统全膝手术中的切口长度典型地在大约6-12英寸的范围内。由于更小的切口长度,MIS操作通常比传统手术进路创伤更小,这使软组织损伤最小化、减小了术后疼痛、促进了更早固定、缩短了住院期并且加速了康复。
MIS向外科医生提出了几个挑战。例如,在微创矫形关节置换中,小切口尺寸减小了外科医生观察和接近解剖结构(anatomy)的能力,这增加了雕刻骨和估计正确植入位置的复杂性。结果,可能难以实现植入物的精确放置。用于减少这些问题的常规技术例如包括手术导航、定位腿以获得最佳关节暴露以及利用专门设计的小型的仪器和复杂的外科技术。然而,这样的技术典型地需要大量的专门仪器、长期的训练过程和高度的技能。而且,单个外科医生的手术结果和不同外科医生之间的手术结果不是充分可预测的、可重复的和/或精确的。结果,植入物性能和寿命在患者之间有所不同。
促进性能和提高微创和传统矫形关节操作的结果的常规努力可以包括机器人外科系统的使用。例如,一些常规技术包括自控机器人系统,例如ROBODOC系统(以前可从加利福尼亚州萨克拉曼多市的Integrated Surgical System公司获得)。然而,这样的系统典型地主要用于通过用高速骨锉执行自控切割来增强骨加工。尽管这样的系统允许精确的骨切除以用于提高植入物适配和放置,它们自控地动作(而不是与外科医生协作)并且因此需要外科医生将一定程度的控制让与机器人。自控系统的附加缺点包括机器人的尺寸大,工效学差,为了机器人充分接近增加了切口长度,以及由于系统的自控性质外科医生和管理机构的接受度有限。这样的系统还典型地需要在配准和切割期间刚性地夹紧骨,因此缺少对动态术中实况的实时适应性。
其它常规机器人系统包括与外科医生协作地交互作用的非自控机器人,例如ACROBOT系统(英国伦敦的Acrobot CompanyLimited公司)。然而,常规交互式机器人系统的一个缺点在于这样的系统缺少使手术导航实时地适应动态术中环境的能力。例如,全文被引用于此作为参考的美国专利No.7,035,716公开了一种交互式机器人系统,所述机器人系统被编程有配准患者的三维虚拟约束区域。所述机器人系统包括三个自由度(3DOF)的臂,所述臂具有包含力传感器的手柄。外科医生利用手柄操纵臂和移动切割工具。通过手柄移动臂需要使得力传感器可以测量正由外科医生施加到手柄的力。测量的力然后用于控制马达以帮助或阻止切割工具的移动。例如,在膝置换操作期间,患者的股骨和胫骨相对于机器人系统被固定就位。当外科医生对手柄施加力以移动切割工具时,当工具接近虚拟约束区域的边界时交互式机器人系统施加的阻力程度增加以阻止切割工具移动。以该方式,机器人系统通过将工具保持在虚拟约束区域内引导外科医生预加工骨。然而,与上述自控系统相同,交互式机器人系统主要用于增强骨加工。另外,臂的3DOF构造和外科医生使用力手柄操纵臂的要求导致灵活性和灵巧性有限,使机器人系统不适合于某些MIS应用。交互式机器人系统还需要刚性地约束解剖结构和将机器人系统固定在总体位置,因此缺少对术中实况的实时适应性。
尽管一些交互式机器人系统可能不需要解剖结构的固定,例如VECTORBOT系统(伊利诺斯州Westchester市BrainLAB,Inc.公司),这样的系统不允许骨雕刻,而是相反地仅仅充当智能工具导向器。例如,这样的系统可以控制机器人臂约束钻沿着预先安排的钻孔轨迹移动以允许外科医生在椎骨中钻出孔以用于放置椎弓根螺钉。类似地,其它机器人系统,例如BRIGIT系统(印第安纳州Warsaw市的Zimmer,Inc.公司),简单地定位机械工具导向器。例如,在全文被引用于此作为参考的国际公开文献No.WO2005/0122916中公开的机器人系统公开了一种定位机械工具导向器的机器人臂。使用机器人定位的工具导向器,外科医生手动地操纵常规外科工具例如锯或钻在患者的解剖结构中制造切口,同时机器人约束工具导向器的移动。尽管这样的系统可以增加骨切口的精度和可重复性,它们被限制在执行常规工具导向器的功能,因此缺少允许外科医生在骨中雕刻复杂形状的能力,而这是微创模块化植入物设计所需要的。
有用于骨雕刻的一些非机器人常规外科工具并不需要固定相关解剖结构,例如精密徒手雕刻器(宾夕法尼亚州匹兹堡市Blue BeltTechnologies,Inc.公司)。然而,这样的工具的一个缺点是它们不以对用户透明的方式工作。例如,全文被引用于此作为参考的美国专利No.6,757,582公开了一种手持外科工具,该外科工具可以用于在骨中雕刻目标形状。该手持工具是徒手切割工具,其由外科医生操纵以磨掉部分骨,从而在骨中形成预期目标形状。目标形状例如由与实际骨配准的体素基模型限定。在切割期间,骨和切割工具被跟踪以允许控制器确定切割工具是否正撞击目标形状的边界和因此切掉应当保持完整的骨。如果这样的话,控制器可以切断或缩回切割工具以保护骨。尽管骨被保护,在外科手术期间外科工具的操作被中断并且执行该操作的时间长度会增加。进一步地,切割的中断还会导致粗糙的表面切口。另外,这样的系统仅仅基于工具相对于目标形状的位置禁用切割工具而并非实际约束外科医生操纵切割工具以例如防止切割工具和敏感解剖结构之间的接触,或解决其它不利情况,例如当检测到解剖结构的快速运动时。因此,这样的系统可能不包括保护患者的充分安全措施。而且,包含关闭机构的手持工具可能庞大并且比正常徒手工具或重力补偿交互式臂笨重。因此,外科医生可能难以操纵这样的手持工具产生精细的切割运动,这使这样的工具不适合于需要在骨中雕刻复杂形状的应用,尤其在微创手术环境中,例如当在膝置换操作中在股骨和胫骨之间的间隙中切割而不脱位或牵拉关节时。
鉴于前述内容,需要一种外科系统,其能够与外科医生协作地交互作用以允许外科医生以微创方式在骨中雕刻复杂形状并且具有以保护患者和对外科医生基本透明的方式动态地补偿术中环境中对象的运动的能力。
发明内容
根据本发明的一个方面,一种用于对象在补偿外科手术期间的运动的方法包括确定患者的解剖结构的姿态;确定外科装置的外科工具的姿态;限定所述解剖结构的姿态与所述外科工具的位置、取向、速度和/或加速度之间的关系;关联所述解剖结构的姿态、所述外科工具的姿态和所述关系;和响应所述解剖结构的运动和/或所述外科工具的运动更新所述关联而不用在所述外科手术期间中断所述外科装置的操作。
根据另一方面,一种外科设备包括外科装置、联接到所述外科装置的外科工具和计算系统。所述计算系统被编程以确定患者的解剖结构的姿态;确定外科装置的外科工具的姿态;限定所述解剖结构的姿态与所述外科工具的位置、取向、速度和/或加速度之间的关系;关联所述解剖结构的姿态、所述外科工具的姿态和所述关系;和响应所述解剖结构的运动和/或所述外科工具的运动更新所述关联而不用在所述外科手术期间中断所述外科装置的操作。
附图说明
包含在本说明书中并且构成本说明书的一部分的附图示出了本发明的实施例并且与描述一起用于解释本发明的原理。
图1是根据本发明的外科系统的一个实施例的透视图。
图2A是根据本发明的触觉装置的一个实施例的透视图。
图2B是根据本发明的触觉装置的一个实施例的透视图。
图2C是图2A的触觉装置的透视图,示出了用户正在操作触觉装置。
图3A是根据本发明的末端执行器的一个实施例的透视图。
图3B是图3A的末端执行器的侧视透视图。
图4是根据本发明的解剖结构跟踪器的一个实施例的透视图。
图5是根据本发明的触觉装置跟踪器的一个实施例的透视图。
图6A是根据本发明的末端执行器跟踪器的一个实施例的透视图。
图6B是附连到图3A的末端执行器的图6A的末端执行器跟踪器的透视图。
图7是根据本发明的器械跟踪器的一个实施例的透视图。
图8是股骨和胫骨的透视图,示出根据本发明的触觉对象的图形表示的一个实施例。
图9示出根据本发明的CAS系统的显示的一个实施例。
图10是根据本发明的触觉绘制过程的一个实施例的框图。
图11是根据本发明的3D几何触觉对象的一个实施例的表示。
图12是根据本发明的触觉绘制过程的一个实施例的框图。
图13是示出根据本发明的坐标系和变换的图形表示。
图14是根据本发明的遮挡检测算法的一个实施例的框图。
具体实施方式
在附图中示出了本发明的当前优选实施例。试图使用相同或相似的附图标记表示相同或相似的部件。
图1示出外科系统10的一个实施例。外科系统10包括计算系统20、触觉装置30和跟踪系统40。在一个实施例中,外科系统10是如2006年2月21日提交的、序列号为No.11/357,197、公开号为No.US2006/0142657的美国专利申请中所公开的机器人外科系统,上述申请全文被引用于此作为参考。在一个优选实施例中,外科系统10是可从佛罗里达州劳德代尔堡市的MAKO SURGICAL获得的触觉导向系统(HAPTIC GUIDANCE SYSTEMTM)。
计算系统20包括用于操作和控制外科系统10的硬件和软件并且可以包括计算机21、计算机31、显示装置23、输入装置25和手推车29。计算系统20适于允许外科系统10执行与手术安排、导航、图像导向和/或触觉导向相关的各种功能。计算机21优选地被定制用于手术安排和导航,并且包括与一般操作、数据存储和检索、计算机辅助手术(CAS)和/或任何其它合适的功能相关的算法、编程和软件实用操作。与之相比,计算机31优选地被定制用于控制触觉装置30的执行、稳定性和/或安全性,并且包括允许触觉装置30利用来自跟踪系统40的数据的触觉控制实用程序和程序。
触觉装置30是一种外科装置,其构造成由用户(例如外科医生)操纵以移动外科工具50,从而对患者执行操作,例如雕刻骨的表面以接收植入物。在该操作期间,触觉装置30向外科医生提供触觉导向例如以将工具50保持在预定虚拟边界内。如上面参考的公开文献No.US2006/0142657中所公开的,虚拟边界可以由虚拟触觉对象限定,所述虚拟触觉对象由计算系统20生成并且与患者的解剖结构配准(关联)。触觉对象建立解剖结构和工具50之间的预期关系,例如工具50相对于解剖结构的预期位置、取向、速度和/或加速度。在操作中,当外科医生以违反预期关系的方式移动工具50时(例如当工具50接触虚拟边界时),触觉装置30以可触知的反馈(例如振动)和/或力反馈(例如力/扭矩)的形式向外科医生提供触觉导向。触觉导向可以由外科医生体验为例如阻止沿着虚拟边界的方向进一步移动工具。结果,外科医生可以感觉到好象工具50遇到了物理对象,例如墙。以该方式,虚拟边界充当虚拟切割导向。因此,外科系统10通过基于解剖结构和触觉装置30的一部分例如工具50的位置、取向、速度和/或加速度之间的关系执行控制参数而限制外科医生物理地操纵触觉装置30(例如通过对触觉装置30的用户操纵提供触觉导向和/或限制)的能力。除了触觉对象以外,所述关系可以基于预定参数,例如限制工具50的总行程的预定深度。
来自与计算机辅助手术(CAS)联接的触觉装置30的导向允许外科医生主动地和精确地控制手术动作(例如骨切割)和局部疗法的输送(例如在脑中)。在矫形应用中,触觉装置30可以通过引导外科医生正确地雕刻骨而被应用于骨预加工中不精确、不可预测和不可重复的问题,由此允许精确的、可重复的骨切除,同时保持外科医生紧密地参与骨预加工过程。而且,由于触觉装置30在切割期间引导外科医生,外科医生的技能水平不是太关键。因此,技能水平和经验不同的外科医生能够执行精确的、可重复的骨切除。
触觉装置30可以是机器人系统、非机器人系统或机器人和非机器人系统的组合。在一个实施例中,触觉装置30是如上面参考的公开文献No.US2006/0142657中所公开的机器人系统。在一个优选实施例中,触觉装置是可从佛罗里达州劳德代尔堡市的MAKOSURGICAL获得的触觉导向系统。如图2A中所示,触觉装置30包括底座32、臂33、末端执行器35、用户接口部件(user interface)37和平台39。
底座32提供用于触觉装置30的基座。底座32支撑臂33并且还可以容纳其它部件,例如控制器、放大器、致动器、马达、传动部件、离合器、制动器、电源、传感器、计算机硬件和/或任何其它公知的机器人部件。
臂33布置在底座32上并且适于允许触觉装置30由用户操纵。臂33可以是铰接连杆机构,例如串联装置、并联装置或混合装置(即具有串联和并联元件的装置)。在一个优选实施例中,臂33是具有四个或四个以上自由度(运动轴)的串联装置,例如当前由BarrettTechnology,Inc.公司制造的被称为“全臂操纵器(Whole-ArmManipulator)”或WAMTM的机器人臂。臂33包括布置在底座32上的近端和包括末端执行器35的远端,外科工具50联接到所述末端执行器。为了操纵触觉装置30,用户160简单地抓握和移动臂33(如图2C中所示),这导致工具50移动。在一个实施例中,如图2A中所示,臂33包括第一节段33a、第二节段33b和第三节段33c。第一节段33a和第二节段33b在第一关节33d(例如肩关节)处连接,并且第二节段33b和第三节段33c在第二关节33e(例如肘关节)处连接。如图2B中所示,臂33具有第一自由度DOF1、第二自由度DOF2、第三自由度DOF3和第四自由度DOF4。臂33的灵巧性可以通过增加额外的自由度被增强。例如,臂33可以包括如图2A中所示布置在第三节段33c上的腕部36。腕部36包括一个或多个自由度,例如自由度DOF5,从而补充自由度DOF1、DOF2、DOF3和DOF4。腕部36例如可以是由Barrett Technology,Inc.公司制造的一个或三个自由度的WAMTM腕部或一个或三个自由度的直接驱动腕部。
为了允许触觉装置30向用户提供触觉导向,臂33包含驱动系统,例如在上面参考的公开文献No.US2006/0142657中公开的驱动系统。驱动系统包括致动器(例如马达)和机械传动设备。在一个典型实施例中,驱动系统包括高速电缆传动设备和零侧隙、低摩擦、有缆差速器。电缆传动设备例如可以是在当前由Barrett Technology,Inc.公司制造的WAMTM机器人臂中使用的电缆传动设备和/或如美国专利No.4,903,536中所述的电缆传动设备,上述专利全文被引用于此作为参考。
臂33还包括用于确定臂33的位置和取向(即姿态(pose))的位置传感器(未示出),例如安装在关节33d和33e上的编码器和/或解算器和/或安装在每个马达的轴上的编码器和/或解算器。
末端执行器35包括触觉装置30的工作端。如图2A中所示,末端执行器35包括连接到臂33的近端部分和包括工具50和工具保持器51的远端部分。工具50例如可以是外科工具(例如锉、钻、探针、锯等)。在一个实施例中,工具50和工具保持器51包括空气冷却的电动外科工具,该外科工具当前由制造并且具有产品编号EMAX2(马达)、L-2SB(2mm槽纹球(fluted ball))、L-4B(4mm槽纹球)、L-6B(6mm槽纹球)和L-1R(12)(1.2mm×12.8mm槽式刨槽机(fluted router))。外科工具还可以包括附加部件,例如用户输入装置(例如诸如产品编号为EMAX2-EP的脚踏开关)、控制平台(例如产品编号为SC2000)等等。进一步地,工具50可以被集成到外科系统10中,使得切割信息(例如速度、扭矩、温度等)可用于外科系统10和/或使得外科系统10可以控制工具50的操作。
在一个实施例中,工具保持器51包括保持装置151,该保持装置构造成将外科工具50联接到触觉装置30。如图3B中所示,保持装置151包括第一元件151a和第二元件151b。第一元件151a构造成接收工具50的至少一部分(例如工具50的轴50a)和接合第二元件151b。第二元件151b构造成将第一元件151a和外科工具50联接到触觉装置30的末端执行器35,以便当工具50联接到末端执行器35时将工具50保持在预期位置并且基本防止工具50相对于末端执行器35移动。如图3A和3B中所示,保持装置151的第一元件151a可以是套管或鞘,其尺寸制成为接收工具50的轴50a和插入第二元件151b中。例如,在一个实施例中,第一元件151a在第一端(即轴50a插入其中的一端)具有在大约5.9mm至大约6.1mm范围内的直径,并且在第二端(即插入第二元件151b中的一端)具有在大约11.38mm至大约11.48mm范围内的直径。保持装置151的第二元件151b可以是适合于以安全、稳定并且允许相对于第二对象可重复地定位第一对象的方式将第一对象(例如工具或工件)联接到第二对象(例如机器或机器人)的任何连接器。在一个实施例中,第二元件151b包括夹头。在其它实施例中,第二元件151b可以包括螺纹、夹紧装置、固定螺钉等。
在一个实施例中,保持装置151构造成使得当保持装置151布置在触觉装置30上时保持装置151的轴线对应于工具50的预期轴线。例如,在一个实施例中(图3A和3B中所示),保持装置151的第二元件151b包括连接器,该连接器包括夹头151c、夹头旋钮151d和夹头螺母151e。在该实施例中,夹头151c包括阳莫氏锥形特征,并且末端执行器35的开孔52包括相应的阴莫氏锥形特征。夹头151c与开孔52匹配并且用夹头螺母151e拧紧到末端执行器35上。该锥形连接建立轴线H-H,该轴线对应于外科工具50的预期轴线。如图3B中所示,当工具50通过保持装置151联接到末端执行器35时,工具50的轴线与轴线H-H对准。以该方式,保持装置151以相对于末端执行器35的预期构造对准工具50。在夹头151c与末端执行器35匹配之后,第一元件151a插入夹头151c中。工具50的轴50a插入第一元件151a中直到工具50的尖端50b处于预期位置。一旦尖端50b被正确地定位,夹头旋钮151d被向下拧紧到夹头151a的指状件或柄脚上。由夹头指状件施加在第一元件151a和工具50上的夹紧力将第一元件151a和工具50固定就位。以该方式,保持装置151基本防止第一元件151a和工具50相对于末端执行器35移动。一旦安装在末端执行器35上,工具50的一部分50c(图3B中所示)从末端执行器35突出并且可以附连到用于驱动工具50的马达。另外,由于保持装置151和工具50可以与末端执行器35脱开联接,因此部件在需要更换、消毒等时可以被拆卸。
用户接口部件37允许用户和触觉装置30之间的物理交互作用。接口部件37构造成使得用户可以抓握接口部件37并且操纵工具50,同时接收来自触觉装置30的触觉导向。接口部件37可以是固定到触觉装置30的独立部件(例如手柄或把手)或者可以简单地是触觉装置30的现有结构的一部分(例如臂33)。由于接口部件37固定到或是触觉装置30的一体部分,当用户与接口部件37接触时由触觉装置30输出的任何触觉反馈直接被传递到用户。因此,接口部件37有利地允许触觉装置30与外科医生协作地保持工具50(如图2C中所示)并且同时提供触觉导向。
外科系统10的跟踪系统40构造成在外科手术期间跟踪一个或多个对象以检测对象的运动。如上面参考的公开文献No.US2006/0142657中所述,跟踪系统40包括检测装置,该检测装置获得对象相对于检测装置41的参考坐标系的姿态(pose)(即位置和取向)。当对象在参考坐标系中移动时,检测装置跟踪对象。对象的姿态变化表明对象已经移动。作为响应,计算系统20可以对触觉装置30的控制参数进行适当调节。例如,当解剖结构移动时,计算系统20可以对与解剖结构配准的虚拟触觉对象(例如虚拟切割边界)进行相应调节。因此,虚拟切割边界随着解剖结构移动。
来自跟踪系统40的姿态数据还用于例如使用坐标变换过程使一个空间中的坐标与另一空间中的坐标配准(即映射或关联)以获得空间对准。配准可以包括任何已知的配准技术,例如图像到图像配准;图像到物理空间配准;和/或图像到图像和图像到物理空间组合配准。在一个实施例中,解剖结构和工具50(在物理空间中)如上面参考的公开文献No.US2006/0142657中所公开和如图9中所示与解剖结构的表示(representation)(例如图像空间中的图像614)配准。基于配准和跟踪数据,外科系统10可以确定(a)解剖结构和图像614之间的空间关系和(b)解剖结构和工具50之间的空间关系使得计算系统20可以在图像614上叠加和连续更新工具50的虚拟表示616。虚拟表示616和图像614之间的关系与工具50和实际解剖结构之间的关系是基本相同的。
跟踪系统40可以是允许外科系统10连续确定(或跟踪)患者的相关解剖结构的姿态和工具50(和/或触觉装置30)的姿态的任何跟踪系统。例如,跟踪系统40可以包括非机械跟踪系统、机械跟踪系统或适合用于手术环境中的非机械和机械跟踪系统的任何组合。
在一个实施例中,跟踪系统40包括如图1中所示的非机械跟踪系统。非机械跟踪系统是包括检测装置41和可跟踪元件(或跟踪器)的光学跟踪系统,所述可跟踪元件构造成布置在被跟踪对象上并且可由检测装置41检测。在一个实施例中,检测装置41包括基于可见光的检测器,例如微米跟踪器,其检测跟踪元件上的图案(例如棋盘形图案)。在另一实施例中,检测装置141包括对红外辐射敏感并且可定位在将执行外科手术的手术室中的立体照相机对。跟踪器构造成以牢靠和稳定的方式固定到被跟踪对象并且包括与被跟踪对象有着已知几何关系的标记物的阵列(例如图4中的阵列S1)。众所周知,标记物可以是有源的(例如发光二极管或LED)或无源的(例如反射球面、棋盘形图案等)并且具有独特的几何条件(例如标记物的独特几何布置),或者在有源的、有线的标记物的情况下,具有独特的点引图案。在操作中,检测装置41检测标记物的位置,并且外科系统10(例如使用嵌入电子装置的检测装置41)基于标记物的位置、独特的几何条件和与被跟踪对象的已知几何关系计算被跟踪对象的姿态。跟踪系统40包括用户想要跟踪的每个对象的跟踪器,例如解剖结构跟踪器43(跟踪患者解剖结构)、触觉装置跟踪器45(跟踪触觉装置30的整体或总体位置)、末端执行器跟踪器47(跟踪触觉装置30的远端)和器械跟踪器49(跟踪由用户手持的器械)。
解剖结构跟踪器43布置在患者的解剖结构上并且允许检测装置41跟踪解剖结构。解剖结构跟踪器43包括用于附连到解剖结构的固定装置,例如骨销、外科U形钉、螺钉、夹子、髓内杆等。在一个实施例中,解剖结构跟踪器43构造成在膝置换手术期间用于跟踪患者的股骨F和胫骨T。在该实施例中,如图1中所示,解剖结构跟踪器43包括适于布置在股骨F上的第一跟踪器43a和适于布置在胫骨T上的第二跟踪器43b。如图4中所示,第一跟踪器43a包括具有骨销P的固定装置、夹子400和标记物(例如反射球面)的独特阵列S1。除了第二跟踪器43b被安装在胫骨T上并且具有它自己的标记物的独特阵列之外,第二跟踪器43b与第一跟踪器43a相同。当安装在患者上时,第一和第二跟踪器43a和43b允许检测装置41跟踪股骨F和胫骨T的位置。
触觉装置跟踪器45布置在触觉装置30上并且允许外科系统10监视触觉装置30在物理空间中的整体或总体位置使得外科系统10可以确定触觉装置30是否已相对于手术环境中的其它对象例如患者移动,或者检测装置41是否已相对于触觉装置30移动。这样的信息是重要的,原因是工具50附连到触觉装置30。例如,如果用户在用工具50切割股骨F时重定位或意外地碰撞触觉装置30,跟踪系统40将检测触觉装置跟踪器45的运动。作为响应,外科系统10可以对在计算系统20上运行的操作进行适当调节以补偿触觉装置30(和附连的工具50)相对于股骨F的运动。结果,保持了骨预加工过程的完整性。
触觉装置跟踪器45包括标记物(例如反射球面)的独特阵列S3并且适于以一种方式安装在触觉装置30的底座32上,所述方式允许跟踪器45相对于底座32固定在固定位置。在触觉装置配准校准(下面所述)期间固定位置与触觉装置30校准使得外科系统10知道跟踪器45相对于底座32位于哪里。一旦被校准,在外科手术期间保持固定位置。在一个实施例中,如图2A和5中所示,跟踪器45被安装在臂34上,所述臂具有连接到底座32的近端(例如通过螺钉、铆钉、焊接、夹子、磁体等)和携带标记物的阵列S3的远端。臂34可以包括具有刚性结构的一个或多个支撑元件(例如托架、支柱、连杆等)使得触觉装置跟踪器45相对于触觉装置30固定在永久位置。然而优选地,臂34适于可调节使得阵列S3可相对于触觉装置30移动。因此,在被固定在固定位置之前阵列S3可以独立于底座32被定位。结果,阵列S3的位置可以被定制用于每个外科情况(例如基于患者尺寸、手术床高度等)并且被设置成在外科手术期间不阻碍外科医生。
可调性可以以任何已知方式(例如铰接连杆机构、挠性颈部等)被赋予臂34。例如,在图5的实施例中,臂34包括球窝关节34b,触觉装置跟踪器45布置在所述球窝关节上。球窝关节34b包括由手柄34a致动的锁定机构。在操作中,用户可以旋松手柄34a以释放球窝关节34b,操纵球窝关节34b直到跟踪器45处于预期位置,和拧紧手柄34a直到球窝关节34b被固定不动。以该方式,跟踪器45可以被固定在预期位置。作为将跟踪器45固定在固定位置和将固定位置与触觉装置30校准的可供选择的方案,臂34可以包括与臂33的位置传感器类似的位置传感器(例如编码器)以提供臂34相对于底座32的姿态的测量。当位置传感器被包含在臂34中时,触觉装置配准校准(下面所述)可以被消除,原因是外科系统10可以基于由位置传感器提供的臂34的姿态确定跟踪器45相对于底座32的定位。
末端执行器跟踪器47允许外科系统10确定触觉装置30的远端的姿态。跟踪器47优选地构造成在臂33的远端(例如在节段33c、末端执行器35、工具50和/或工具保持器51上)布置在触觉装置30上。在一个实施例中(图6B中所示),跟踪器47布置在工具保持器51上。如图6A中所示,跟踪器47可以包括标记物(例如反射球面)的独特阵列S4并且可以适于以任何已知方式,例如用夹紧装置、螺纹连接、磁体等固定到触觉装置30。在图6A的实施例中,跟踪器47用夹子1500固定到触觉装置30。夹子1500可以与阵列S4形成一体或者以任何常规方式,例如用机械硬件、粘合剂、焊接等固定到阵列S4。夹子1500包括第一部分1505、第二部分1510和指拧螺钉1515。第一和第二部分1505和1510被成型为接收触觉装置30的一部分,例如工具50和/或工具保持器51的圆柱形部分。在一个实施例中,圆柱形部分是工具保持器51的保持装置151的第一元件151a(图3A和3B中所示)。为了允许夹子1500夹持圆柱形部分,第一部分1505可以具有V形凹槽(图6A中所示)并且第二部分1510可以具有平表面使得当拧紧在一起时第一和第二部分1505和1510可以牢固地接收圆柱形部分。在一个实施例中,夹子1500构造成使得外科系统10可以确定在跟踪器47布置在触觉装置30上的位置的触觉装置30的点和/或轴线。例如,当跟踪器47用夹子1500固定到圆柱形部分时,外科系统10能够基于跟踪器47的几何条件,具体地说基于阵列S4上的反射球面和夹子1500的第一部分1505上的V形凹槽之间的几何关系,确定圆柱形部分的点和/或轴线(例如图3B中所示的轴线H-H)。
为了将末端执行器跟踪器47安装在触觉装置30上,夹子1500的第一和第二部分1505和1510围绕工具50或工具保持器51的圆柱形部分被布置并且使用指拧螺钉1515被拧紧在一起。执行器47可以包括构造成帮助相对于末端执行器35定位跟踪器47的特征。例如,跟踪器47可以包括一个或多个表面1503(图6B中所示),所述表面适于邻接触觉装置30上的相应表面。在一个实施例中,表面1503构造成邻接工具保持器51的一部分,例如如图6B中所示的夹头151c的指状件或柄脚。在操作中,用户沿着工具保持器51的圆柱形部分滑动夹子1500直到表面1503邻接夹头151c的指状件或柄脚并且然后拧紧指拧螺钉1515。可以通过松动指拧螺钉1515和从圆柱形部分滑脱跟踪器47拆卸跟踪器47。以该方式,跟踪器47可以在相对于末端执行器35的已知位置可拆卸地和可重复地被固定。跟踪器47还可以包括诸如图6B中所示的缺口47a这样的特征以便于跟踪器47相对于末端执行器35的定向,例如以避免倒装跟踪器47。在安装跟踪器47之后,用户可以通过松动夹子1500和围绕圆柱形部分旋转跟踪器47重定向跟踪器47(如果需要的话)。因此,夹子1500允许跟踪器47相对于末端执行器35的可调性。在触觉装置配准校准(下面所述)期间可调性特别有用于定向跟踪器47以面对检测装置41,由此提高跟踪精度和可见度。
备选地,代替独立末端执行器跟踪器47,触觉装置30可以包含在末端执行器35上的基准物。所述基准物可以类似于标记物的独特阵列S4并且例如可以包括反射球面。与末端执行器跟踪器47相比,在手术之前所述基准物不从末端执行器35被去除。不去除基准物的一个缺点在于在手术期间血液和碎屑会污染基准物,这遮蔽基准物并且降低它们将光反射到检测装置41的能力。因此,所述基准物优选地包括平滑塑料涂层使得任何表面污染物可以容易地被去除。所述基准物应当安装在末端执行器35上的一个位置,在触觉装置配准校准(下面所述)期间所述位置是检测装置41可见的,但是在外科手术期间将不阻碍外科医生。例如,所述基准物可以安装在末端执行器35的下侧。备选地,所述基准物可以安装在可调节连杆机构上,所述可调节连杆机构可以被定位在基准物和检测装置41之间有清楚的位点线的配准校准位置和在外科手术期间基准物将不阻碍外科医生的隐藏位置。
在一个实施例中,末端执行器跟踪器47仅仅在触觉装置配准校准(下面所述)期间被使用并且在执行外科手术之前被去除。在该实施例中,末端执行器跟踪器47布置在末端执行器35上并且触觉装置跟踪器45安装到底座32(例如通过可调节臂34)使得触觉装置跟踪器45相对于触觉装置30的位置可调节。由于触觉装置跟踪器45的位置可调节,外科系统10并不知道触觉装置跟踪器45相对于触觉装置30的定位。为了确定触觉装置30和触觉装置跟踪器45之间的几何关系,配准校准过程利用末端执行器跟踪器47(如下面所述)。尽管末端执行器跟踪器47可以为了外科手术保持在触觉装置30上并且可以连续地被监视,有利的是当配准校准完成时去除末端执行器跟踪器47以防止跟踪器47在外科手术期间阻碍外科医生。去除跟踪器47的另一优点是当跟踪系统40检测和处理跟踪器47的运动时在外科手术期间跟踪器47的运动会由于延迟或有限带宽导致外科系统10的性能下降。
在一个备选实施例中,末端执行器跟踪器47可以被消除。在该实施例中,触觉装置跟踪器45固定在触觉装置30上的永久位置。由于触觉装置跟踪器45永久地固定在触觉装置30上,触觉装置跟踪器45和触觉装置30的坐标系之间的关系是已知的。因此,外科系统10不需要末端执行器跟踪器47用于配准校准以建立触觉装置跟踪器45和触觉装置30的坐标系之间的关系。在该实施例中,触觉装置跟踪器45可以在任何位置刚性地安装到触觉装置30上,所述位置允许跟踪系统40看到触觉装置跟踪器45的阵列S3,足够靠近手术部位以不降低精度,并且将不阻碍用户或干扰手术环境中的其它人员或对象。
在另一备选实施例中,触觉装置30紧紧地锁定就位。例如,触觉装置30可以螺栓连接到手术室的地板或以另外方式固定就位。结果,触觉装置30的整体或总体位置基本不会变化,因此外科系统10不需要跟踪触觉装置30的整体或总体位置。因此,触觉装置跟踪器45可以被消除。在该实施例中,末端执行器跟踪器47可以用于确定触觉装置30被锁定就位之后触觉装置30的初始位置。消除触觉装置跟踪器45的一个优点在于外科系统10不需要包括在控制环中监视触觉装置跟踪器45的数据。结果,控制环中的噪声和误差被减小。备选地,触觉装置跟踪器45可以被保留但是仅仅为了检测底座32或跟踪系统40的过度运动被监视而不包括在控制环中。
在另一备选实施例中,跟踪系统40在永久固定位置附连到触觉装置30。例如,跟踪系统40(包括检测装置41)可以直接安装到触觉装置30上或通过刚性安装臂或托架连接到触觉装置30使得跟踪系统40相对于触觉装置30固定就位。在该实施例中,触觉装置跟踪器45和末端执行器跟踪器47可以被消除,原因是跟踪系统40相对于触觉装置30的位置被固定并且可以在例如在制造或设置触觉装置30时被执行的校准操作期间被建立。
在另一备选实施例中,跟踪系统40以可调节方式附连到触觉装置30。例如,跟踪系统40(包括检测装置41)可以用臂,例如可调节臂34(在上面结合触觉装置跟踪器45所述)连接到触觉装置30使得跟踪系统40相对于触觉装置30可从第一位置移动到第二位置。在臂和跟踪系统40被锁定就位之后,校准可以被执行以确定跟踪系统40相对于触觉装置30的位置。确定跟踪系统40相对于触觉装置30的位置的校准例如可以通过用跟踪系统40观察末端执行器跟踪器47被执行。
器械跟踪器49适于联接到被手持在用户的手中的器械150。器械150例如可以是探针,例如配准探针。如图7中所示,器械跟踪器49可以包括标记物(例如反射球面)的独特阵列S5,所述阵列以任何已知方式,例如用机械硬件、粘合剂、焊接、螺纹连接、夹紧装置、夹子等与器械150形成一体或固定到器械150。当器械跟踪器49例如用夹子或夹紧装置可拆卸地连接到器械150时,器械跟踪器49应当与器械150校准以确定器械跟踪器49和器械150的几何条件之间的关系。校准可以以任何合适的方式实现,例如用具有缺口或V形凹槽的工具校准器(例如如美国专利申请公开文献No.US2003/0209096中所述,该专利全文被引用于此作为参考)。已知阵列S5和器械150之间的几何关系,外科系统10能够计算物理空间中的器械150的尖端的位置。因此,器械150可以用于通过使器械150的尖端接触对象的相关部分配准对象。例如,器械150可以用于通过接触骨的表面上的界标或点配准患者的骨。
跟踪系统40可以附加地或备选地包括机械跟踪系统。与非机械跟踪系统(其包括远离跟踪器43,45,47和49的检测装置41)相比,机械跟踪系统可以构造成包括检测装置(例如具有关节编码器的铰接连杆机构),该检测装置物理地连接到被跟踪对象。跟踪系统40可以包括任何已知的机械跟踪系统,例如如全文被引用于此作为参考的美国专利No.6,033,415、美国专利No.6,322,567和/或公开文献No.US2006/0142657中所述的机械跟踪系统,或光纤跟踪系统。
在操作中,计算系统20、触觉装置30和跟踪系统40相互协作以允许外科系统10在外科手术期间向用户提供触觉导向。触觉导向表现为用户与触觉绘制过程生成的虚拟环境交互作用的结果。触觉绘制过程可以包括任何合适的触觉绘制过程,例如如全文被引用于此作为参考的美国专利No.6,111,577中所述的触觉绘制过程。在一个优选实施例中,触觉绘制过程包括如上面参考的公开文献No.US2006/0142657和2006年12月27日提交的美国专利申请No.11/646,204中所公开的触觉绘制算法,上述专利全文被引用于此作为参考。在该优选实施例中,外科系统10利用点基触觉交互作用,其中只有一个虚拟点或触觉交互作用点(HIP)与虚拟环境中的虚拟对象交互作用。HIP对应于触觉装置30上的物理点,例如工具50的尖端。HIP通过虚拟弹簧/阻尼器模型联接到触觉装置30上的物理点。HIP与之交互作用的虚拟对象例如可以是触觉对象705(图11中所示),该触觉对象具有表面707和触觉力法向矢量Fn。穿透深度di是HIP和表面707上的最近点之间的距离。穿透深度di代表HIP穿透到触觉对象705中的深度。
触觉绘制过程的一个实施例大体在图10中被表示。在操作中,触觉装置30(方框2500)的位置传感器(方框2502)向前向运动学过程(方框2504)提供数据。前向运动学过程的输出被输入到坐标变换过程(方框2506)。触觉绘制算法(方框2508)接收来自坐标变换过程的数据并且向力映射过程(方框2510)提供输入。基于力映射过程的结果,触觉装置30的致动器(方框2512)被致动以将适当的触觉力旋量(即力和/或扭矩)传送到用户。
在一个实施例中,外科系统10包括如图12中所示的触觉绘制过程。图12的虚线对应于图10的方框。如图12中所示,坐标变换过程2506利用解剖结构和触觉装置30的配准和跟踪信息和来自前向运动学过程2504的输入来确定坐标变换(或变换),所述坐标变换允许外科系统10计算触觉装置30的端点相对于解剖结构的指定部分的定位。例如,坐标变换过程2506允许外科系统10计算工具50的尖端相对于解剖结构上的预期切割表面的定位。
如图13中所示,坐标变换过程2506包括限定各种坐标系,包括与跟踪系统40的检测装置41关联的第一坐标系X1,与解剖结构(例如骨或固定到骨的解剖结构跟踪器43a或43b)关联的第二坐标系X2,与触觉装置跟踪器45关联的第三坐标系X3,与触觉装置30(例如触觉装置的底座32)关联的第四坐标系X4和与虚拟环境(例如解剖结构的表示,包括限定用于安装植入物的预期切割表面的虚拟(或触觉)对象)关联的第五坐标系X5。然后确定允许一个坐标系中的坐标被映射或变换到另一坐标系的坐标变换。
第一坐标变换T1(图12和13中所示)是从解剖结构的坐标系(第二坐标系X2)变换到虚拟环境的坐标系(第五坐标系X5)。因此,在虚拟环境包括限定植入物的形状的虚拟对象的实施例中,变换T1使物理解剖结构与用于安装植入物的预期切割位置相关。如图12中的方框4500所表示,可以通过使患者的物理解剖结构与解剖结构的表示配准(如下面所述)和相对于解剖结构的表示定位虚拟对象确定变换T1。相对于解剖结构的表示定位虚拟对象例如可以使用任何合适的安排过程,例如如上面参考的公开文献No.US2006/0142657中所公开的植入物安排过程实现。例如,限定虚拟切割边界的虚拟模型(例如待植入骨中的植入物的模型)可以相对于显示在显示装置23上的解剖结构的表示(例如解剖结构的图像)被定位。
第二坐标变换T2(图12和13中所示)是从检测装置41的坐标系(第一坐标系X1)变换到解剖结构的坐标系(第二坐标系X2)。如图12中的方框4502所表示,当检测装置41监视解剖结构的运动时跟踪系统40在外科手术期间输出变换T2。由于检测装置41连续监视解剖结构,变换T2定期被更新以反映解剖结构的运动。
第三坐标变换T3(图12和13中所示)是从触觉装置跟踪器45的坐标系(第三坐标系X3)变换到触觉装置30的坐标系(第四坐标系X4)。在该实施例中,触觉装置跟踪器45通过臂34联接到触觉装置30的底座32(如图2A中所示)。因此,变换T3使触觉装置跟踪器45的位置与触觉装置30的底座32相关。如图12中的方框4504所表示,变换T3例如可以通过执行如下所述的触觉装置配准校准被确定。
第四坐标变换T4(图12和13中所示)是从检测装置41的坐标系(坐标系X1)变换到触觉装置跟踪器45的坐标系(坐标系X3)。如图12中的方框4506所表示,当检测装置41监视触觉装置跟踪器45的运动时跟踪系统40在外科手术期间输出变换T4。由于检测装置41连续监视触觉装置跟踪器45,变换T4定期被更新以反映触觉装置跟踪器45的运动。
第五坐标变换T5(图12和13中所示)是由前向运动学过程2504产生的变换。前向运动学过程2504根据关节角计算触觉装置30的臂33的笛卡尔端点位置。如图12中的方框4508和4510所表示,前向运动学过程2504接收来自臂33的关节中的位置传感器的输入。基于该输入,前向运动学过程2504计算臂33的远端相对于触觉装置30的底座32的位置。基于工具50和臂33的远端之间的已知几何关系,工具50的尖端相对于触觉装置30的底座32的位置然后可以被计算。由于位置传感器连续监视关节位置,变换T5定期被更新以反映臂33的运动。
第六坐标变换T6(图12和13中所示)通过按照适当的顺序将第一至第五坐标变换相乘在一起获得。在一个实施例中,T6=T1 -1T2 -1T4T3 -1T5。变换T6的结果(由图12中的变量x表示)是虚拟点或触觉交互作用点(HIP)相对于虚拟环境的定位。在该实施例中,HIP对应于触觉装置30上的物理点(例如工具50的尖端)相对于由虚拟对象限定的预期切割表面的定位。由于解剖结构的运动,触觉装置跟踪器45和触觉装置30的臂33连续被监视,变换T6定期被更新以反映解剖结构、触觉装置30的底座32和触觉装置30的臂33的运动。以该方式,外科系统10在外科手术期间补偿对象的运动。
本发明的一个优点在于外科系统10能够在外科手术期间以对用户透明的动态方式补偿对象的运动。具体而言,外科系统10通过连续监视解剖结构、触觉装置跟踪器45和臂33的运动和连续更新变换T2、T4和T5而不中断触觉装置30的操作而同步地操作。与之相比,常规外科系统典型地例如通过在被跟踪对象的运动被检测时要求用户停止和重设系统或配准被跟踪对象而非同步地操作。结果,使用常规系统,当被跟踪对象的运动被检测时系统的操作会被中断或阻碍。尽管本发明可以同步地操作而不中断触觉装置30的操作,有利的是例如当外科系统10检测到异常运动时,例如当被跟踪对象移动太快和/或太远时,不时地约束触觉装置30的操作。
在一个实施例中,一种在外科手术期间补偿对象的运动的方法包括(a)确定解剖结构的姿态;(b)确定工具50的姿态;(c)确定工具50的位置、取向、速度和加速度中的至少一个;(d)关联解剖结构的姿态、工具50的姿态和解剖结构的姿态与工具50的位置、取向、速度和加速度中的至少一个之间的关系;和(e)响应解剖结构的运动和/或工具50的运动更新所述关联而不用在外科手术期间中断外科装置的操作。所述方法还可以包括基于所述关系向用户提供触觉导向以约束用户操纵外科工具的步骤。所述关系例如可以基于解剖结构与工具50的位置、取向、速度和/或加速度之间的预期交互作用。在一个实施例中,所述关系由虚拟对象或参数限定,所述虚拟对象或参数相对于解剖结构被定位并且表示植入物和/或用于安装植入物的切割表面的预期定位。关联解剖结构的姿态、工具50的姿态和所述关系的步骤例如可以使用配准过程、坐标变换过程(例如图10的方框2506)和植入物安排过程(例如如上面参考的公开文献No.US2006/0142657中所述)实现。在一个实施例中,关联步骤包括(a)限定用于将解剖结构的坐标系变换到解剖结构的表示的坐标系的第一变换;(b)限定用于将工具50的坐标系变换到解剖结构的表示的坐标系的第二变换;和(c)使所述关系与解剖结构的表示的坐标系关联。为了使所述关系与解剖结构的表示的坐标系关联,用户例如可以相对于解剖结构的图像定位虚拟对象(例如如上面参考的公开文献No.US2006/0142657中所述)。为了允许外科系统10在外科手术期间补偿对象的运动,更新关联的步骤可以包括响应解剖结构的运动和/或工具50的运动更新第一变换和/或第二变换。
在该实施例中,通过确定工具50所联接的触觉装置30的第一部分的姿态,确定触觉装置30的第二部分的姿态,和至少部分基于触觉装置30的第一和第二部分的姿态和工具50与触觉装置30的第一部分之间的已知几何关系计算工具50的姿态,从而确定工具50的姿态。在一个实施例中,触觉装置30的第一部分包括臂33的远端,并且触觉装置30的第二部分包括触觉装置30的底座32。在另一实施例中,触觉装置30的第二部分包括臂33的中间部分(例如节段33a,33b,或33c)。在一个实施例中,不同于将末端执行器跟踪器35安装到臂的远端,末端执行器跟踪器35可以安装到臂的中间部分,例如肘部。确定触觉装置30的第二部分的姿态的步骤包括确定触觉装置跟踪器45(其安装在触觉装置30的第二部分上,例如安装到底座32或臂33的中间部分)的姿态。由于工具50的姿态基于触觉装置30的第一和第二部分的姿态被确定并且由于外科系统10连续更新第一和第二部分的姿态(例如基于关节编码器数据和触觉装置跟踪器45的位置),工具50的姿态被更新以解释第一和第二部分的运动。结果,工具50的运动基于第一和第二部分的运动被确定。以该方式,外科系统10能够在外科手术期间补偿对象的运动。
在一个实施例中,跟踪系统40是以不同于触觉装置30的更新速度操作的非机械跟踪系统(例如如上面结合跟踪系统40所述)。例如,触觉装置30可以以2000Hz更新,而跟踪系统40以15-30Hz更新。跟踪系统40的较低更新速度限制了运动补偿的动态性能,原因是15-30Hz更新分隔1/15至1/30秒,在此期间不可获得跟踪信息。另外,被跟踪对象的较高频率的运动将不存在于跟踪系统40的输出数据中。不良动态性能的一个缺点在于外科系统10可能不具有足够的数据以与物理解剖结构同步地精确移动触觉对象。结果,外科医生制造的任何切口可能具有减小的精度。例如,当外科系统10正提供触觉导向以引导外科医生用球形锉切割平骨表面,与不良动态性能组合的被跟踪对象之一的瞬时运动可以导致最终切割表面中的缺口或尖峰。动态性能越差,缺口和尖峰将越大。如果骨切口用于胶粘植入物,小缺口是可接受的,原因是胶粘剂将简单地填充缺口。然而对于压配合植入物,缺口导致植入物和骨之间的间隙,所述间隙会潜在地抑制骨向内生长到植入物中。尖峰与缺口相比不太重要,原因是它们容易用锉去除,但是将增加完成骨预加工所需的时间量。
对于运动补偿应用,几种技术在最大化性能中受益于带有动态性能的跟踪系统。首先,由于不同的更新速度,如果坐标变换过程2506使用直接来自跟踪系统40的数据,由虚拟对象限定的预期切割表面响应被检测的解剖结构的运动陡然地移动。结果,当与触觉对象交互作用时操纵触觉装置30的用户可以体验粗糙或“跳动”的感觉。为了解决该问题,外科系统10可以包括插值或其它适当的滤波器(由图12中的方框4512表示)。滤波器还用于减小跟踪系统的输出噪声,当与触觉对象交互作用时所述输出噪声将另外地导致用户感觉振动,或导致具有粗糙表面的切口。在一个优选实施例中,滤波器是截止频率在5-10Hz范围内的三阶巴特沃思(Butterworth)滤波器,该滤波器以2000Hz从跟踪系统40采样数据并且产生滤过输出。滤过输出减小了切割表面相对于解剖结构的“跳动”,所述跳动来自从跟踪系统输出的“阶梯”和在跟踪系统输出更新中固有的噪声。巴特沃思滤波器由通带中的平坦频率表征并且容易使用常用的滤波设计软件进行设计,例如Mathwork’s Matlab信号处理工具箱“butter”函数,其基于预期的阶和截止频率输出数字或模拟滤波系数。使用的阶越高将导致截止特性越陡,但是需要附加计算。较低截止频率将提高离散跟踪系统更新和跟踪系统噪声的滤波,但是降低跟踪的动态性能。备选地,切比雪夫(Chebychev)、反向切比雪夫(Inverse Chebychev)、椭圆(Elliptic)、贝塞尔(Bessel)(汤姆森(Thomson))滤波器,或其它滤波器可以用于代替巴特沃思滤波器。在另一实施例中,可以使用有限脉冲响应(FIR)滤波器。FIR滤波器可以被设计成是“线性相位”的,使得所有频率被延迟相同量,这使滤波器延迟补偿更容易。FIR滤波器还良好地适合于“多速率”应用。对于本发明的跟踪应用,插值可以用于将低频跟踪信号转换成触觉装置30的高频速率。对于多速率应用来说FIR滤波器比无限脉冲响应(IIR)滤波器更好,原因是FIR滤波器不具有反馈,即它们的输出仅仅是输入信号的函数,而不是滤波器的输出的函数。而且,计算仅仅需要用于低频信号样本,而不是用于每个高频样本。
在它们的传统实现方式中,所有以上滤波器被设计用于标量输入信号。然而,跟踪系统40将通常输出多个位置和取向信号。在一个优选实施例中,滤波器4512接收被表示成大小为四乘四的齐次变换矩阵的跟踪系统输出,所述矩阵包含位置和取向信息。直接过滤该矩阵的元素是非理想的,原因是结果将不是有效齐次矩阵并且取向将不会被正确过滤。相反地,齐次变换首先被转换成三元位置矢量和四元数,所述四元数是代表取向信息的四元矢量。对于样本之间的小运动,这七个值然后可以独立地被过滤。在取滤过值和将它们转换回齐次变换之前四元数可以被归一化,所述齐次变换然后从滤波器4512被输出。
在多数情况下,跟踪系统40的位置输出代表在过去的某一点相关被跟踪对象的位置。潜伏时间是跟踪系统40采样被跟踪对象的位置的时间与外科系统10接收该位置输出的时间之间的时段。该时段可以包括跟踪系统40的处理时间,通信延迟,和跟踪系统40的采样时间的一小部分或多倍。滤波器4512基于选择的特定滤波器的相位延迟增加额外的潜伏时间。所有这些潜伏时间来源组合以降低动态跟踪性能并且导致触觉表面滞后于它们关联的被跟踪对象的运动。然而,这些潜伏时间值通常是已知的并且可以相当精确地被测量或估计。因此潜伏时间效应可以部分被补偿。例如,如果跟踪系统40和滤波器4512的组合潜伏时间是tl,则滤过位置输出p可以通过Δp=vtl被校正。速度值v可以通过连续位置值的(可能滤过)差值或用如下所述的清洗滤波器计算。在另一实施例中,如控制理论领域的技术人员所公知的,包括解剖结构和/或触觉装置30的底座32的简单模拟模型并且在内部计算被跟踪对象的位置和速度的状态估计器、状态观察器或卡尔曼(Kalman)滤波器可以用于消除滤波器4512的潜伏时间。备选地,可以通过利用较高频率的跟踪系统,例如基于编码器的机械跟踪系统或高速光学跟踪系统消除滤波器4512。
当被跟踪对象正相对于照相机(即检测装置41)移动时,一些跟踪系统特别是光学跟踪系统可能不产生精确的输出。误差例如可能由照相机的曝光时间或扫描速率导致的运动模糊产生。如果使用上述方法之一计算被跟踪对象的速度并且作为速度和/或位置的函数的跟踪系统的误差模型是已知的或被确定,可以通过将该误差值加入滤过位置输出校正这些误差。
只有当触觉装置30能够有效地绘制移动触觉对象时跟踪系统40的动态性能才是相关的。触觉装置30的触觉绘制能力受到使用的触觉控制模式的类型影响。触觉装置30可以利用任何合适的触觉控制模式,例如导纳控制,阻抗控制,或混合控制。在导纳控制模式中,触觉装置30接收力输入并且产生位置(或运动)输出。例如,触觉装置30测量或感测在触觉装置30上的特定位置(例如用户接口部件37)的力旋量并且用于修改触觉装置30的位置。在阻抗控制模式中,触觉装置30接收位置(或运动)输入并且产生力旋量输出。例如,触觉装置30测量、感测和/或计算工具50的位置(即位置、取向、速度和/或加速度)并且施加适当的相应力旋量。在混合控制模式中,触觉装置30利用导纳和阻抗控制。例如,触觉装置30的工作空间可以被分成第一子空间和第二子空间,在第一子空间中使用导纳控制,在第二子空间中使用阻抗控制和/或可以使用位置和力输入计算力或位置输出。例如,在基本阻抗控制装置中,力输入可以用于抵偿系统的一些自然摩擦。在一个优选实施例中,触觉装置30被设计用于阻抗控制,其中触觉装置30读取用户操纵外科工具50的位置和/或取向并且输出适当的力和/或扭矩。阻抗控制装置具有的优点是简单(不需要力传感器),当工具接触物理对象时(例如当切割骨时)稳定性更好,和当在自由空间中移动时性能更好。然而,导纳控制装置具有的优点是它们可以比阻抗控制装置更容易地用很硬的壁绘制触觉对象。关于运动跟踪,阻抗控制装置是有利的,原因在于它们的性能与开环力带宽和物理系统动力学相关。与之相比,导纳控制装置的性能取决于闭环位置控制性能,这倾向于比开环力和物理系统动力学更慢。
返回图10的触觉绘制算法,由坐标变换过程2506确定的HIP位置x如图12中所示作为输入被提供给触觉绘制算法2508。冲突检测/代理定位触觉绘制过程(由图12中的方框2514表示)接收作为输入的HIP位置x并且输出预期位置xd。从预期位置xd减去HIP位置x,并且结果Δx乘以触觉硬度Kp以确定位置相关力指令Fspring。还可以通过取预期位置xd的导数确定预期速度。预期速度在阻尼力Fdamping的计算中被使用。
如图12中所示,通过从触觉装置30的笛卡尔端点速度减去预期速度并且将结果乘以阻尼增益KD计算阻尼力Fdamping。使用来自臂33的马达中的位置传感器的数据计算笛卡尔端点速度。如上面结合触觉装置30所述,触觉装置30的臂33优选地包括电缆传动设备和在臂33的马达和关节中的位置传感器。在一个优选实施例中,关节编码器(由图12的方框4508表示)用于获得关节位置测量值,并且马达编码器(由图12的方框4516表示)用于计算速度测量值。关节位置测量值在前向运动学过程2504中用于确定变换T5并且还作为输入被提供给重力补偿算法(由图12中的方框4518表示)。重力补偿算法根据关节角计算抵消作用在臂33的节段上的重力负荷所需的重力扭矩τgrav_comp。与之相比,马达位置测量值被微分和过滤以计算马达速度测量值。清洗滤波器(由图12中的方框4520表示)将微分和平滑组合到一个滤波器中。清洗滤波器在拉普拉斯域中可以被表示成: 其中s是拉普拉斯变换变量,并且其中p确定极的位置并且通常应当比最快的系统极快大约二至三倍被定位。在一个实施例中,所述极被放置在大约80Hz。滤过速度然后乘以雅可比(Jacobian)矩阵J以获得触觉装置30的笛卡尔端点速度。
清洗滤波器限制高频增益,由此限制在导数或微分操作中固有的噪声并且去除采样速率伪影。清洗滤波器具有单一参数p,与分离的速度微分和平滑操作相比这简化了滤波器的设计和调谐。上面给出的拉普拉斯域表示可以使用公知的双线性变换或z变换被变换成适合于在数字计算机上执行的离散时间表示。在清洗滤波器的一个备选实施例中,可以用上述的巴特沃思或其它滤波器过滤简单微分位置信号以提供速度测量值。备选地,滤过位置信号可以再次使用上述滤波器中的任何一个被微分和可能地被过滤。
如图12中所示,在映射过程2510中求和Fdamping和Fspring以获得预期触觉力Fhaptic。预期触觉力乘以转置雅可比矩阵JT以计算生成预期触觉力所需的马达扭矩τhaptic。将重力扭矩τgrav_comp加入马达扭矩τhaptic以获得总扭矩τtotal。命令触觉装置30向臂33的马达施加总扭矩τtotal。以该方式触觉绘制过程允许外科系统10控制触觉装置30,然后所述触觉装置响应指令扭矩、用户交互作用和与解剖结构交互作用。
触觉装置30优选地构造成在各种操作模式下操作。例如,触觉装置30可以被编程以在输入模式、保持模式、安全模式、自由模式、进路模式、触觉(或锉磨)模式和/或任何其它合适的模式中操作。操作模式可以由用户手动选择(例如使用在显示装置23上图形表示的选择按钮或位于触觉装置30和/或计算系统20上的模式开关)和/或由控制器或软件过程自动选择。在输入模式中,触觉装置30被允许用作输入装置以将信息输入到外科系统10。当触觉装置30处于模式时,用户可以作为例如如上面结合末端执行器35和/或在全文被引用于此作为参考的美国专利申请No.10/384,078(公开号No.2004/0034282)中所述的操纵杆或其它输入装置操作触觉装置30。
在保持模式中,触觉装置30的臂33可以被锁定在特定姿态。例如,臂33可以使用制动器、控制伺服技术和/或用于固定臂33的任何其它合适的硬件和/或软件被锁定。用户在诸如骨切割这样的活动期间可能想要将触觉装置30放置在保持模式以休息,与同事商量,允许清洁和冲洗手术部位等。在安全模式中,可以通过例如切断工具50的动力禁用联接到触觉装置30的工具50。在一个实施例中,安全模式和保持模式可以同时被执行使得当触觉装置30的臂33被锁定在原位时工具50被禁用。
在自由模式中,触觉装置30的末端执行器35在触觉装置30的工作空间内可自由移动。工具50的动力优选地被停用,并且触觉装置30可以适于让用户感觉无重量。例如可以通过计算作用在臂33的节段33a,33b和33c上的重力负荷和控制触觉装置30的马达抵消重力负荷而实现无重量感觉(例如如下面结合图12的方框4518所述)。结果,用户不必支撑臂的重量。触觉装置30可以处于自由模式直到例如用户准备将工具50引导到患者的解剖结构上的手术部位。
在进路模式中,触觉装置30构造成将工具50引导到目标对象,例如手术部位,患者的解剖结构上的感兴趣特征,和/或与患者配准的触觉对象,同时避开危险的结构和解剖结构。例如,在一个实施例中,进路模式允许在全文被引用于此作为参考的美国专利申请No.10/384,194(公开号No.US2004/0034283)中所述的工具50的交互作用触觉定位。在另一实施例中,触觉绘制应用可以包括限定进路体积(或边界)的触觉对象,所述进路体积约束工具50朝着目标对象移动,同时避开敏感特征,例如血管、腱、神经、软组织、骨、现有的植入物等。例如,如图1中所示,进路体积可以包括触觉对象300,该触觉对象为大体圆锥形,沿着朝着目标对象(例如胫骨T的近端或股骨F的远端)的方向呈漏斗形从大直径渐缩到小直径。在操作中,用户可以在进路体积的边界内自由移动工具50。然而,当用户通过进路体积移动工具50时,渐缩漏斗形状约束工具移动使得工具50不会穿透进路体积的边界。以该方式,工具50直接被引导到手术部位。
在图8中示出进路模式的另一实施例,该图示出了对应于膝假体的股骨部件的触觉对象208和对应于膝假体的胫骨部件的触觉对象208。在该实施例中,触觉绘制应用产生虚拟对象,该虚拟对象表示从第一位置到第二位置的路径。例如,虚拟对象可以包括触觉对象310,该触觉对象是限定从第一位置(例如在物理空间中的工具50的位置)到包括目标(例如诸如触觉对象206或208这样的目标对象)的第二位置的路径的虚拟导丝(例如线)。在进路模式中,触觉对象310被启动使得工具50的移动沿着触觉对象310所限定的路径被约束。当工具50到达第二位置并且启动目标对象(例如触觉对象206或208)时外科系统10停用触觉对象310。当触觉对象206或208被启动时工具50可以被自动放置在触觉(或锉磨)模式中。在一个优选实施例中,触觉对象310可以被停用以允许工具50偏离路径。因此,用户可以超控与触觉对象310关联的触觉导向以偏离导丝路径和围绕未跟踪对象(例如牵开器、灯等)操纵工具50,当虚拟导丝被生成时这不能产生。因此,进路模式允许用户快速地将工具50输送到目标对象,同时避开危险的结构和解剖结构。在进路模式中,工具50的动力优选地被停用使得例如当用户正在通过切口插入工具或在关节中导航软组织时工具不会意外地被赋能。进路模式通常在触觉模式之前。
在触觉(或锉磨)模式中,触觉装置30构造成在手术活动例如骨预加工期间向用户提供触觉导向。在一个实施例中,如图8中所示,触觉绘制应用可以包括在胫骨T上限定切割体积的触觉对象206。触觉对象206可以具有与胫骨部件的表面的形状基本对应的形状。例如当工具50的尖端接近与感兴趣特征相关的预定点时触觉装置30可以自动进入触觉模式。在触觉模式中,如全文被引用于此作为参考的美国专利申请No.10/384,194(公开号No.US2004/0034283)中所述,当雕刻复杂形状或带有大曲率的形状时,触觉对象206还可以动态地被修改(例如通过启用和禁用触觉表面的部分)以提高触觉装置30的性能。在触觉模式中,工具50的动力被启动,并且工具50的尖端被约束以停留在切割体积内,从而允许精确的骨切除。在另一实施例中,如果用户靠近触觉体积例如可以通过生成缓慢增加的力以将用户用户牵引到触觉体积内部而实现取向约束。另外,在该实施例中,无论何时工具50在触觉体积的外部工具50都可以被禁用。在另一实施例中,工具50可以被禁用,除非触觉装置30正在生成触觉反馈力。
在操作中,外科系统10可以用于如上面参考的公开文献No.US2006/0142657中所公开的手术安排和导航。外科系统10例如可以用于执行膝置换操作或涉及植入物的安装的其它关节置换操作。植入物可以包括任何植入物或假体设备,例如全膝植入物;单髁膝植入物;模块化膝植入物;用于其它关节的植入物,包括髋、肩、肘、腕、踝和脊柱;和/或任何其它矫形和/或肌肉骨骼植入物,包括常规材料的植入物和更异种植入物,例如矫形生物制品、药物输送植入物和细胞输送植入物。在执行操作之前,触觉装置30被初始化,这包括复位过程、运动学校准和触觉装置配准校准。
复位过程初始化触觉装置30的臂33中的位置传感器(例如编码器)以确定臂33的初始姿态。复位可以以任何已知方式实现,例如通过操纵臂33使得每个关节编码器旋转直到读出编码器上的索引标记。索引标记是编码器上的绝对基准,其与关节的已知绝对位置互相关。因此,一旦索引标记被读出,触觉装置30的控制系统知道关节处于绝对位置。当臂33继续移动时,基于绝对位置和编码器的后续位移计算关节的后续位置。
运动学校准确定前向运动学过程2504(图10中所示)的运动学参数的误差。前向运动学过程2504基于测量的臂33的关节角和设计的触觉装置30的几何性质(例如臂33的节段33a、33b和33c的长度和偏差)计算末端执行器35的笛卡尔位置和取向。然而由于制造不精确,触觉装置30的实际几何性质可能偏离设计的几何性质,这导致前向运动学过程2504的输出的误差。为了确定误差,运动学校准固定设备附连到触觉装置30。在一个实施例中,所述固定设备是具有固定的已知长度的校准棒。为了执行运动学校准,用具有一个或多个球窝关节(例如被布置成形成十字形的四个球窝关节,其中十字形的每个端点有一个球窝关节)的校准末端执行器代替末端执行器35,并且臂34(触觉装置跟踪器45安装在其上)被拆卸并且在水平构造中被再安装。校准棒的第一端与臂34上的球窝关节磁接合,并且校准棒的第二端与校准末端执行器上的球窝关节之一磁接合。当数据由外科系统10俘获时校准末端执行器然后移动到多个位置(手动地或自动地)。在足够的数据被收集之后(例如100个数据点),校准棒的第二端与校准末端执行器上的不同球窝关节磁接合。重复该过程直到俘获校准末端执行器上的每个球窝关节的数据。使用现有的运动学参数和测量的关节角,所述数据用于计算校准棒的长度。校准棒的计算长度与已知实际长度比较。计算长度和已知长度之间的差值为误差。一旦误差被确定,可以例如使用诸如Levenberg-Marquardt这样的数值非线性最小化算法调节运动学参数以最小化前向运动学过程2504中的累积误差。
触觉装置配准校准建立触觉装置跟踪器45的坐标系(例如图13中所示的坐标系X3)和触觉装置30的坐标系(例如图13中所示的坐标系X4)之间的几何关系或变换。如果触觉装置跟踪器45被固定在触觉装置30上的永久位置,配准校准是不必要的,原因是跟踪器45和触觉装置30之间的几何关系是固定的和已知的(例如从制造或设置期间执行的初始校准)。与之相比,如果跟踪器45可以相对于触觉装置30移动(例如如果跟踪器45安装在其上的臂34是可调节的),配准校准必须被执行以确定跟踪器45和触觉装置30之间的几何关系。
配准校准涉及将触觉装置跟踪器45固定在触觉装置30上的固定位置和例如用图6A中所示的夹子1500暂时将末端执行器跟踪器47固定到末端执行器35。为了使触觉装置跟踪器45与触觉装置30配准,末端执行器35(因此和末端执行器跟踪器47)移动到解剖结构附近的各种位置(例如在膝关节之上和之下的位置,在膝关节内侧和外侧的位置),同时跟踪系统40在每个位置采集跟踪器45和47相对于跟踪系统40的姿态数据。多个数据点被收集和平均以最小化传感器噪声和其它测量误差的影响。配准校准期间姿态数据的采集可以是自动的。备选地,用户可以使用诸如脚踏开关这样的输入装置开始数据的收集。
在一个实施例中,当末端执行器35处于自由模式时用户手动地将末端执行器35移动到各种位置。在另一实施例中,外科系统10控制触觉装置30以将末端执行器35自动移动到各种位置。在又一实施例中,触觉装置30提供触觉导向以引导用户将末端执行器35移动到触觉装置30的工作空间中的预定点。为了提高配准校准的精度,预定点优选地位于手术部位附近(例如靠近实际骨预加工部位)。预定点例如可以包括诸如二或三维多胞形(例如多边形或多面体)这样的形状的顶点。在一个实施例中,所述形状是以相关解剖结构例如膝关节为中心的立方体。顶点优选地与指示末端执行器35的可容许运动方向的箭头一起显示在显示装置23上。利用触觉导向引导用户将末端执行器35移动到预定点的一个优点在于用户能够以可重复方式将末端执行器35移动到多个位置,这提高了配准校准的精度。
除了将关于跟踪器45和47的姿态的数据俘获到跟踪系统40之外,外科系统10基于来自臂33中的位置传感器(例如关节编码器)的数据确定末端执行器35相对于触觉装置30的姿态。外科系统10使用配准校准期间获得的数据计算触觉装置跟踪器45和触觉装置30的坐标系(例如图54中所示的坐标系X4)之间的几何关系。
在一个实施例中,如下计算触觉装置跟踪器45相对于触觉装置30的底座32的变换TR B。当末端执行器35移动到各种位置时,外科系统10记录(a)末端执行器跟踪器47(例如末端执行器35上的已知位置)相对于跟踪系统40的位置PC E,其从跟踪系统40获得;(b)触觉装置跟踪器45相对于跟踪系统40的位置和取向TC B,其从跟踪系统40获得;和(c)末端执行器跟踪器47相对于触觉装置30的底座的位置r,其从触觉装置30的关节编码器获得。如果噪声存在于跟踪系统输出中,可以在每个末端执行器位置取多个样本。在触觉装置30在数据采样期间移动的情况下,外科系统10可以向用户发警报。另外,任何受影响数据应当被丢弃,原因是在来自跟踪系统40的数据和来自触觉装置30的关节编码器的数据之间将有潜伏时间。对于每个测试位置i,末端执行器跟踪器47相对于触觉装置跟踪器45的位置被计算为 在每个测试位置i,末端执行器跟踪器47相对于触觉装置30的底座32的位置被表示为ri。
在数据收集完成之后,触觉装置跟踪器45相对于触觉装置30的底座32的变换TR B被分离成取向和位置项, 通过解方程 得到取向分量。对于该方程,根据bi=bi-bm和ri=ri-rm位置误差矢量bi和ri,其中 并且 使用奇异值分解的最小二乘估计量用于解出RR B。然后可以从方程 得到位置矢量PR B。然后可以根据 重建触觉装置跟踪器45相对于触觉装置30的底座32的变换TR B。
在配准校准完成之后,从触觉装置30去除末端执行器跟踪器47。在手术期间,外科系统10可以基于(a)工具50和末端执行器35之间的已知几何关系,(b)末端执行器35相对于触觉装置30的姿态(例如从臂33中的位置传感器),(c)在配准校准期间确定的触觉装置30和触觉装置跟踪器45之间的几何关系,和(d)触觉装置30的整体或总体位置(例如从触觉装置跟踪器45相对于跟踪系统40的姿态)确定工具50的姿态。如果触觉装置跟踪器45不相对于触觉装置30移动则不需要执行配准校准,原因是先前的配准校准和先前采集的配准校准数据仍然是可靠的。
在一个实施例中,一种用于执行配准校准的方法包括(a)采集第一数据,所述第一数据包括在第一位置布置在触觉装置30上的第一对象的位置和取向中的至少一个;(b)采集第二数据,所述第二数据包括在第二位置布置在触觉装置30上的第二对象的位置和取向中的至少一个;(c)确定第三数据,所述第三数据包括第一对象相对于第二位置的位置和取向中的至少一个;和(d)至少部分基于第一数据、第二数据和第三数据确定第二对象相对于第二位置的位置和取向中的至少一个。所述方法还包括(e)将第一对象(例如布置在触觉装置30的臂33上的末端执行器跟踪器47)移动到多个位置;(f)提供触觉导向(例如力反馈)以引导用户将第一对象移动到所述多个位置中的至少一个;(g)当第一对象处于所述多个位置的每一个中时采集第一数据或第二数据;和(h)如果在第一数据、第二数据和/或第三数据的采集期间第一对象、第二对象、第一位置和/或第二位置移动则向用户发警报。
在一个实施例中,第一对象是末端执行器跟踪器47,并且第二对象是触觉装置跟踪器45。在该实施例中,采集第一数据和第二数据的步骤包括用检测装置41检测跟踪器45和47。备选地,第二对象可以包括跟踪系统40的一个或多个组成部分,例如检测装置41。如上面结合末端执行器跟踪器47所述,末端执行器跟踪器47可以布置在触觉装置30上的一个位置(例如第一位置),该位置包括定位特征,例如工具50或工具保持器51的圆柱形特征。在该情况下,采集第一数据的步骤可以包括确定圆柱形特征的点和/或轴线(例如图3B中所示的轴线H-H或其上的任何点)的位置和/或取向。如上面结合触觉装置跟踪器45所述,触觉装置跟踪器45(或检测装置41)可以布置在触觉装置30上的一个位置(例如第二位置),例如底座32(例如通过臂34),臂33的近端布置在其上。备选地,触觉装置跟踪器45(或末端执行器跟踪器47)可以位于臂33的中间部分上。在触觉装置配准校准期间,第一对象和第二对象的位置和/或取向分别相对于第一和第二位置被固定。固定例如可以通过用夹子1500将末端执行器跟踪器47夹紧到末端执行器35和通过固定触觉装置跟踪器47(或检测装置41)安装在其上的臂34的位置而实现。为了确定第一对象相对于第二位置的位置和取向(即第三数据),外科系统10例如基于来自关节编码器的数据确定臂33的构造。
在初始化触觉装置30之后,外科医生可以基于手术安排使患者和外科工具50与解剖结构的表示(例如CT图像)配准并且执行外科手术,例如预加工骨以接收植入物。配准、植入安排和手术导航例如可以如上面参考的公开文献No.US2006/0142657所述被实现。在整个外科手术期间,外科系统10监视骨的位置以检测骨的运动和对在计算机21和/或计算机31上运行的操作进行相应的调节。例如,外科系统10可以响应检测的骨的运动调节骨的表示(或图像)。类似地,外科系统10可以响应检测的外科工具50的运动调节外科工具50的表示(或图像)。因此,当骨和外科工具50在物理空间中移动时在显示装置23上的骨和外科工具的图像实时地动态移动。外科系统10还可以响应检测的骨的运动调节与骨关联的虚拟对象。例如,虚拟对象可以限定对应于植入物的表面的形状的虚拟切割边界。当骨移动时,外科系统10调节虚拟对象使得虚拟切割边界与物理骨一致地移动。以该方式,即使骨正在移动外科医生还可以进行精确的骨切割。另外,图像和触觉对象的调节对外科医生是透明的使得在外科手术期间外科医生对触觉装置30的操作不会中断。
为了提高外科系统10的安全性,外科系统10可以包括安全特征,当不安全条件存在时所述安全特征适于约束用户对工具50的操作。例如,如果检测到不安全条件,外科系统10可以发出故障信号。如果有系统问题(例如硬件或软件的问题),如果遮挡检测算法(例如如下所述)检测到遮挡条件,如果被跟踪对象移动太快以致于跟踪系统不能处理(例如当患者的腿或触觉装置跟踪器45突然下落),当跟踪数据可疑时,当用户太难推动接口部件37时和/或如果工具50处于非理想位置,可能存在故障条件。在一个实施例中,外科系统10被编程,从而当解剖结构和工具50的位置、取向、速度和/或加速度之间的关系不对应于预期关系时和/或当检测装置41不能检测解剖结构的位置或外科工具50的位置时发出故障。响应故障信号,外科系统10可以对触觉装置30施加约束。约束例如可以包括向用户提供触觉导向(例如防止用户以不安全方式移动工具50)或改变触觉装置30的模式(例如从触觉模式到自由模式)。在优选实施例中,约束被应用于接口部件37,所述接口部件由用户操纵并且在手术部位的近端。对于遥控操作触觉装置,其包括由外科医生操作并且典型地远离手术部位的“主控”装置和在手术部位的近端保持外科工具并且由主控装置控制的“从属”装置,约束可以应用于主控装置、从属装置或两者。
在一个实施例中,如果触觉绘制算法确定工具50在触觉边界中的穿透深度超过预定阈值则可以发出故障信号。预定阈值例如可以是在大约1mm至大约1.25mm的范围内的穿透深度。在一个实施例中,触觉绘制算法基于正由触觉装置30施加到用户的触觉力旋量(即力和/或扭矩)确定是否超过预定阈值。例如,触觉绘制算法可以包括力与位置的关系的线性曲线,其中触觉力被设置成大约20,000N/m(或20N/mm)。因此,如果用户将工具50的尖端移动到1mm的穿透深度,触觉装置30输出大约20N的触觉力。类似地,如果用户将工具50的尖端移动到1.25mm的穿透深度,触觉装置30输出大约25N的触觉力。在该实施例中,当触觉力达到大约22.5N时,其对应于大约1.125mm的穿透深度,故障信号被触发。另外,触觉力阈值可以用于防止触觉装置30生成过高的力。例如,触觉对象可以被设计成独立基元(例如简单几何形状)并且在触觉绘制期间被组合。如果基元的累积效应是非理想的(例如总触觉力太高),可以发出故障信号。
在另一实施例中,如果检测到解剖结构的快速运动例如由解剖结构跟踪器43a和43b指示则发出故障信号。例如当解剖结构移位或跟踪元件或检测装置41被碰撞时可以导致快速运动。在一个实施例中,如果解剖结构跟踪器43a的速度大于大约40mm/s或解剖结构跟踪器43b的速度大于大约26mm/s则发出故障信号。快速运动的指示还可以基于位置(与速度相对),例如当解剖结构跟踪器43a或43b的位置陡然显著变化时。例如如果从跟踪系统40报告的上一个已知良好位置到跟踪系统40报告的当前位置的变化超出预定阈值则可以指示陡然变化。除了解剖结构的快速运动以外,如果检测到触觉装置跟踪器45的快速运动则可以发出故障信号,例如当触觉装置跟踪器45具有高速度或位置的陡然变化,这可以指示跟踪器45已被碰撞或未牢固地固定到臂34。
外科系统10可以具有不同水平或等级的故障。例如,在一个实施例中,有三个故障等级。当工具50的尖端太深地穿透到触觉边界之中或之外时第一故障等级适用。当检测到解剖结构的快速运动时第二故障等级适用。当系统故障存在时第三故障等级适用。外科系统10通过对触觉装置30施加约束响应故障等级。例如,外科系统10可以通过禁用工具50响应第一故障等级。外科系统10可以通过禁用工具50和触觉导向响应第二故障等级。当检测到解剖结构的快速运动时(例如当患者的腿从手术台跌落时)禁用触觉导向有利地防止限定触觉切割体积的虚拟触觉表面随着下落骨移动和拖曳工具50。与之相比,如果当骨快速地移动时不禁用触觉表面,触觉表面将跟随骨并且触觉装置30将对臂33施加大力以将工具50保持在下落触觉体积内。结果,当骨下落时臂33将被向下拖曳。禁用触觉导向避免了该危险情况。外科系统10可以通过禁用工具50、切断臂33的动力和锁定臂33的制动器响应第三故障等级。在一个实施例中,外科系统10通过禁用工具50和将触觉装置30放置在自由模式中(而不是应用制动器)响应故障信号使得臂33不会牵拉解剖结构或对解剖结构施加应力。以该方式,外科系统10通过当不安全条件存在时防止用户操作工具50和/或臂33而避免了损伤解剖结构。
在一个实施例中,外科系统10的安全特征包括工具禁用特征。例如,如果工具50是电动工具,外科系统10可以包括继电器,该继电器沿着工具50和用于控制工具50的用户输入装置之间的电连接布置。例如,继电器可以位于脚踏开关和工具控制平台(例如上面结合工具50所述的脚踏开关和平台)之间。备选地,继电器可以沿着用于手持器械的控制电缆布置。在气动工具的情况下,气动截流阀可以布置在用户输入装置和工具马达之间的空气连接中。代替继电器,外科系统10可以将数字或模拟信号提供给工具控制平台上的“禁用输入”端口。在一个实施例中,外科系统10包括继电器,在正常操作条件下所述继电器被关闭使得当用户下压脚踏开关时工具50被启动。如果检测到故障条件,外科系统10发出故障信号并且命令继电器打开使得即使用户下压脚踏开关工具50还不能被启动。在另一实施例中,继电器是“常开”继电器使得工具50将保持断开或禁用,除非工具50特别地由外科系统10启用。“常开”继电器的一个优点在于如果触觉装置30完全关闭,工具50将被禁用。作为通过命令继电器或截流阀而禁用工具50的备选或附加,故障条件可以通过命令切断到平台或到驱动工具50的电源或放大器的动力而触发外科系统10禁用工具50。
在一个实施例中,一种基于工具禁用特征控制触觉装置30的方法包括(a)启用触觉装置30的操作;(b)操纵触觉装置30以对患者执行操作;(c)确定患者的解剖结构和触觉装置30的工具50的位置、取向、速度和/或加速度之间的关系是否对应于预期关系;和(d)如果所述关系不对应于预期关系或者如果检测装置41不能检测解剖结构或工具50则发出故障信号和/或对触觉装置30施加约束。所述关系例如可以基于解剖结构和工具50之间的预期交互作用。在一个实施例中,所述关系由虚拟对象限定,所述虚拟对象相对于解剖结构被定位并且表示植入物和/或用于安装植入物的切割表面的预期定位。所述方法可以进一步包括基于所述关系执行用于控制触觉装置30的控制参数以提供对用户的触觉导向和对用户操纵外科装置的限制中的至少一个。在一个实施例中,响应故障信号,外科系统10禁用触觉装置30的操作,将触觉装置30的一部分锁定在原位和/或将触觉装置10放置在安全模式中。在安全模式中,触觉装置30的操作和/或操纵可以被阻碍或约束。为了确定所述关系是否对应于预期关系,外科系统10例如可以确定工具50在与解剖结构关联的虚拟边界中的穿透深度是否超出预期穿透深度,确定触觉装置30是否已违反操作约束(例如由触觉绘制算法生成的参数)和/或确定检测装置41是否能够检测解剖结构的位置和/或工具50的位置。
在另一实施例中,外科系统10的安全特征包括遮挡检测算法,该遮挡检测算法适于在切割操作期间在与触觉装置30和/或解剖结构关联的跟踪元件(例如跟踪器43a、43b、45)变得遮挡的情况下减小风险。例如当检测装置41不能检测跟踪元件时(例如当人或对象介于跟踪元件和检测装置41之间时),当检测装置41的透镜被遮挡时(例如由灰尘)和/或当跟踪元件上的标记物的反射率被降低时(例如由血液、组织、灰尘、骨碎屑等),可能存在遮挡状态。如果检测到遮挡状态,遮挡检测算法例如通过导致警告消息显示在显示装置23上,导致可听警报发声和/或导致生成可触知的反馈(例如振动)向用户发警报。遮挡检测算法还可以向外科系统10发出控制信号例如指令以切断动力或以另外方式禁用工具50或对触觉装置30施加约束(例如提供触觉导向,改变触觉装置30的模式等)。以该方式,当跟踪系统40不能精确地确定工具50和解剖结构的相对位置时遮挡检测算法防止工具50损伤解剖结构。
在一个实施例中,遮挡检测算法考虑工具50相对于触觉边界的位置。在该实施例中,如果遮挡检测算法检测到遮挡状态,外科系统10确定工具50是否正接触触觉对象的触觉边界。如果在遮挡事件发生时工具50未与触觉边界接触,遮挡检测算法禁用工具50并且将触觉装置30放置在自由模式中使得工具50将随着患者移动,并且必要时可以从患者缩回。当遮挡状态结束时(例如当所有遮挡跟踪器变得可见时),外科系统10将触觉装置30放置在进路模式中使得用户可以继续操作。以该方式,如果在遮挡事件发生时用户不正在推动触觉壁则遮挡检测算法允许停用触觉边界。与之相比,如果在遮挡事件发生时外科系统10确定工具50正在接触触觉边界和/或超出触觉边界,遮挡检测算法等待预定时间(例如1秒)以了解遮挡跟踪器(一个或多个)是否变得可见。在此期间,工具50被禁用,并且警告用户跟踪器(一个或多个)被遮挡(例如通过视觉、可听或可触知的信号)。如果触觉装置跟踪器45和解剖结构跟踪器43a和43b在预定时间内都变得可见,继续触觉(或锉磨)模式。否则,触觉装置30被放置在自由模式中使得工具50将随着患者移动,并且必要时可以从患者缩回。如前所述,当遮挡状态结束时(例如当所有遮挡跟踪器再次变得可见时),外科系统10将触觉装置30放置在进路模式中使得用户可以继续操作。利用预定时间(或时段)的一个优点在于遮挡检测算法允许触觉壁在暂时遮挡事件期间保持有效。另外,避免了触觉壁的突然去除,这在切割期间可能导致来自外科医生的突然动作。另外,如果遮挡条件在预定时间内停止存在,用于动态跟踪(运动补偿)的低通滤波器被重设以防止跟踪系统40将小运动理解为不连续运动。
图14示出遮挡检测算法的一个实施例的图示。在步骤S3500中,触觉装置30处于触觉(或锉磨)模式。在步骤S3502中,该算法确定触觉装置跟踪器45和相关解剖结构跟踪器是否都为检测装置41可见(即未被遮挡)。相关解剖结构跟踪器是与感兴趣的骨关联的解剖结构跟踪器。因此,对于膝置换操作,如果外科医生正在预加工股骨F,相关解剖结构跟踪器是解剖结构跟踪器43a。类似地,如果外科医生正在预加工胫骨T,相关解剖结构跟踪器是解剖结构跟踪器43b。尽管附加解剖结构跟踪器还可以被监视,遮挡检测算法优选地仅仅监视相关解剖结构跟踪器以避免不必要的错误触发(例如基于与不是感兴趣的骨的解剖结构部分关联的跟踪器的遮挡而触发)。如果触觉装置跟踪器45和相关解剖结构跟踪器是可见的,该算法进入步骤S3504并且启用外科工具50。外科工具50例如可以通过将动力提供给工具50被启用使得工具50可以由用户,例如通过下压脚踏开关被启动。如图14中的环(步骤S3500、S3502和S3504)所示,只要两个跟踪器可见,触觉装置30继续处于触觉模式,并且外科工具50被启用。
与之相比,如果在步骤S3502中检测装置41不能检测触觉装置跟踪器45和/或相关解剖结构跟踪器,该算法推断至少一个跟踪器被遮挡并且进入步骤S3506。外科工具50例如可以通过切断工具50的动力被禁用使得即使用户试图例如通过下压脚踏开关启动工具50,工具50还不能由用户启动。当工具50被禁用之后,该算法进入步骤S3508并且向用户提供遮挡状态存在的指示。所述指示可以是任何合适的信号,例如在显示装置23上的视觉信号、可听信号(例如嘟嘟声、警报或其它警报声)、可触知的信号(例如振动)和/或控制信号(例如命令触觉装置30将臂33锁定在原位的控制信号)。在步骤S3510中,该算法确定是否检测到触觉力。例如当触觉装置30正向用户提供力反馈(例如触觉导向和/或对用户操纵臂33的限制)时检测到触觉力。如果在步骤S3510中未检测到触觉力,该算法进入步骤S3518,停用触觉模式,并且启用自由模式。当触觉装置30处于自由模式时,工具50将随着患者移动,并且必要时可以从患者缩回。当遮挡状态结束时,外科系统10将触觉装置30放置在进路模式中使得外科医生可以继续操作。
与之相比,如果检测到触觉力,该算法进入步骤S3512并且将触觉装置30保持在触觉模式中。在步骤S3514中,该算法确定触觉装置跟踪器45和/或相关解剖结构跟踪器是否仍然被遮挡。如果跟踪器未被遮挡,该算法返回步骤S3500,在该步骤触觉装置30保持在触觉模式30中使得外科医生可以继续操作。与之相比,如果至少一个跟踪器仍然被遮挡,该算法进入步骤S3516并且确定从检测到遮挡状态开始是否耗用了时间t。时间t可以基于应用被选择。在一个实施例中,时间t为大约1秒。如果时间t还未耗用,该算法返回步骤S3514。如果时间t已耗用,该算法进入步骤S3518,停用触觉模式,并且启用自由模式。当触觉装置30处于自由模式时,工具50将随着患者移动,并且必要时可以从患者缩回。当遮挡状态结束时,外科系统10将触觉装置30放置在进路模式中使得外科医生可以继续操作。以该方式,当外科系统10不能确定触觉装置30和解剖结构的相对位置时遮挡检测算法有利地限制用户启动工具50的能力。结果,减小了损伤解剖结构的风险。
遮挡检测算法的另一实施例包括一种用于控制触觉装置30的方法,该方法包括以下步骤:(a)用检测装置41检测第一对象,所述第一对象包括解剖结构和与解剖结构关联的跟踪元件中的至少一个;(b)用检测装置41检测第二对象,所述第二对象包括触觉装置30和与触觉装置30关联的跟踪元件中的至少一个;和(c)如果检测装置41不能检测第一对象和/或第二对象则向用户提供指示。所述指示例如可以是信号,例如视觉、可听、可触知的和/或控制信号,或者可以通过禁用触觉装置30的至少一部分例如工具50被提供。在一个实施例中,所述方法包括对触觉装置30施加约束,例如限制触觉装置30的至少一部分(例如臂33、工具50)的运动或限制触觉装置30的操作(例如切断动力或以另外方式禁用工具50,改变触觉装置的模式等)。优选地在预定时段(例如如上面结合图55的步骤S3516所述的1秒)之后解除约束。所述方法还包括仅仅当检测装置41能够检测第一对象和第二对象两者时启用触觉装置30。
在一个实施例中,遮挡检测算法确定触觉装置30是否正在向用户提供触觉导向和/或对用户操纵触觉装置30的限制。触觉导向和/或对用户操纵的限制例如可以基于与解剖结构关联的虚拟边界。如果触觉导向和/或对用户操纵的限制正被提供,触觉导向和/或对用户操纵的限制优选地被保持以避免对解剖结构的损伤(例如当用户正在用工具50推动虚拟边界时通过突然去除虚拟边界或触觉壁导致的损伤)。因此,如果触觉装置30的一部分(例如工具50的尖端)接近、接触或超出虚拟边界则虚拟边界优选地被保持。所述方法还可以包括如果触觉装置30的所述部分不正在与虚拟边界交互作用(例如如果工具50不与虚拟边界或触觉壁接触)则停用虚拟边界。在该情况下,由于用户未正在用工具50推动虚拟边界,如果虚拟边界突然被去除,工具50不大可能损伤解剖结构。结果,减小了损伤解剖结构的风险。
因此,本发明的实施例提供了一种外科系统,所述外科系统能够与外科医生协作地交互作用以允许外科医生以微创方式在骨中雕刻复杂形状并且具有以保护患者和对外科医生基本透明的方式动态地补偿术中环境中对象的运动的能力。
在2007年5月18日由Louis Arata、Sherif Aly、Robert VanVorhis、Sandi Glauser、Timothy Blackwell、Rony Abovitz和MauriceR.Ferre提交的、发明名称为“用于检验外科装置的校准的系统和方法”、序列号为__________(代理人档案号No.051892-0247)的美国专利申请中公开了一种用于检验外科装置的校准的系统和方法,上述申请全文被引用于此作为参考。
Claims (7)
1.一种外科设备,所述外科设备包括:
外科装置;
联接到所述外科装置的外科工具;和
计算系统,其被编程以便:
确定患者的解剖结构的姿态;
确定所述外科装置的外科工具的姿态;
限定所述被确定的解剖结构的姿态与所述被确定的外科工具的姿态、速度和加速度中的至少一个之间的关系,其中所述关系至少部分地由限定切割边界的虚拟对象限定;
关联所述被确定的解剖结构的姿态、所述被确定的外科工具的姿态和所述被限定的关系;和
响应检测到的解剖结构的运动来更新所述关联,而不用在所述外科手术期间中断所述外科装置的操作,其中更新所述关联包括与所述检测到的解剖结构的运动相应地移动所述虚拟对象。
2.根据权利要求1所述的外科设备,其中所述外科装置包括第一部分和第二部分,并且其中第一部分构造成能相对于第二部分移动,并且第二部分构造成能相对于所述解剖结构移动。
3.根据权利要求2所述的外科设备,所述外科设备进一步包括联接到所述外科装置的检测装置。
4.根据权利要求2所述的外科设备,所述外科设备进一步包括:
跟踪元件,其能由检测装置检测并且构造成布置在所述外科装置的第二部分上。
5.根据权利要求1所述的外科设备,其中所述计算系统被进一步编程以便:
控制所述外科装置以基于所述关系向用户提供触觉导向以约束用户对所述外科工具的操纵。
6.根据权利要求2所述的外科设备,其中所述计算系统被进一步编程以便:
至少部分基于所述外科装置的第一部分的姿态、所述外科装置的第二部分的姿态和所述外科工具与所述外科装置的第一部分之间的已知几何关系确定所述外科工具的姿态。
7.根据权利要求1所述的外科设备,其中所述计算系统被进一步编程以便:
表示所述解剖结构、所述外科工具和所述关系中的至少一个;和
响应所述解剖结构的运动和所述外科工具的运动中的至少一个来更新所述表示。
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