WO2014127967A1

WO2014127967A1 - Holding device for a surgical instrument and a sheath with an emergency release function

Info

Publication number: WO2014127967A1
Application number: PCT/EP2014/051769
Authority: WO
Inventors: Bernd Gombert; Patrick Rothfuss
Original assignee: Rg Mechatronics Gmbh
Priority date: 2013-02-19
Filing date: 2014-01-30
Publication date: 2014-08-28
Also published as: DE102013002831B4; DE102013002831A1

Abstract

The invention relates to a device (1) for holding a surgical instrument (3) and a sheath (2), said device having a first holder (5) for holding the surgical instrument (3) and a second holder (9) for holding the sheath (2). The holding device (1) according to the invention also comprises a drive unit for moving the second holder (9) in the longitudinal direction (10) of the surgical instrument (3) and a release device for interrupting a transmission of force or torque from a drive of the drive unit to the second holder (9).

Description

Holding device for a surgical instrument and a lock with

Emergency release

The invention relates to a device for holding a surgical instrument and a lock according to the preamble of patent claim 1.

From US 7,955,322 B2 (see Fig. 1) is a robot arm 100 with a

Holding device 101 for a surgical instrument 103, to which a trocar 102 is attached. The holding device 101 further comprises a carriage, by means of which the surgical instrument 103 in its axial direction (arrow 105) is adjustable. The instrument 103 can thus be independent of

Robot arm are adjusted in the axial direction. During a movement of the

Robot arm 100 but both the surgical instrument 103 and the trocar sleeve are always moved simultaneously. If the position of the robot head, for example, adjusted in the longitudinal direction of the surgical instrument 103, makes the trocar 102 with this movement and thus can from the

Patients are pulled out or inserted too far into the body. The freedom of movement of the robot 100 during an operation is therefore limited to pivotal movements. The holding device 101 shown also has the disadvantage that it no longer together with the trocar 102 of the

Patients can be moved away when the robot 100 fails.

DE 696 35 050 T2 discloses a device for holding a surgical instrument and a sluice, comprising a first holder for holding the surgical instrument and a second holder for holding the sluice. The known holding device further comprises a drive unit for driving the first holder and a release device for interrupting a transmission of force and / or torque from a drive to the first holder. Another device for holding a surgical instrument and a lock results from DE 196 09 034 A1. It is therefore the object of the present invention to provide a device for holding a surgical instrument and a lock comprising a first holder for holding the surgical instrument and a second holder for holding the lock and further comprising a drive unit, by means of which the second Holder or the lock relative to the first holder, in

Can be moved longitudinally of the surgical instrument. In case of failure of the robot, the holding device should also be able to be operated manually. This object is achieved according to the invention by the features specified in claim 1. Further embodiments of the invention will become apparent from the dependent claims.

According to the invention, a device for holding a surgical instrument and a sluice is proposed which comprises a first holder for holding the surgical instrument and a second holder for holding the sluice. The holding device according to the invention further comprises a drive unit for driving the second holder in the longitudinal direction of the surgical instrument and a release device for interrupting the transmission of force and / or torque via the drive path between the drive of the drive unit and the second holder. On the one hand, this construction has the advantage that a movement of the robot head in the longitudinal direction of the surgical instrument can be compensated by a corresponding counter-movement of the sluice, so that the sluice can be kept still relative to the body of the patient. On the other hand, it has the advantage that even in the event of a fault, the lock can still be moved relative to the surgical instrument by manually displacing the second holder in the longitudinal direction.

For the purposes of this document, a "lock" is understood in particular to mean any device designed to provide access for one or more surgical instruments to the body of a patient According to the invention, sluices may include, for example, trocar sleeves or any other sleeve-like elements In addition, the terms "lock", "trocar sleeve" and "port" may be used interchangeably. In the context of this document, a "robot" is understood to mean, in particular, a device with one or more articulated arms, which are movable by means of one or more actuators, such as electric motors

The degree of freedom of the robot is determined by the number of its joints.

According to a preferred embodiment of the invention, the drive unit is designed such that, after the drive unit has been released by actuation of the release device (released state), the second holder is manually displaceable in the longitudinal direction of the surgical instrument. As a result, the distance between the lock to the first holder can be adjusted manually and the

Manually pull the lock out of the patient.

The surgical instrument is attached by means of the holding device to a robot and can preferably be moved only by a corresponding control of the robot in the longitudinal direction. The first holder for holding the surgical instrument is thus preferably immobile relative to the robot.

According to one embodiment of the invention, the drive unit for the second holder comprises a nut-spindle drive. In normal operation, the spindle is preferably rotatably mounted and is adjusted by a rotating drive of the nut in the axial direction, so that the spindle connected to the second holder is moved together with the lock relative to the surgical instrument in the longitudinal direction. The nut is fixed in the axial direction. In the released state, ie after an actuation of the release device, the spindle is preferably rotatable. Thus, a rotating movement of the nut can not be translated into an axial movement of the spindle. The drive path of the drive unit of the second holder is thus interrupted and it is possible to adjust the second holder together with the lock manually in the longitudinal direction of the surgical instrument. In a manual operation of the second holder, the force acting in the longitudinal direction of the spindle is then converted into a rotational movement of the spindle, which causes the spindle to move in the axial direction. According to another embodiment of the invention, the drive unit may also have a belt drive, which is powered by an electric motor z. B. is driven via a drive pulley. The release device may in this case comprise, for example, a mechanism by means of which a tensioning wheel for

Tensioning the belt can be adjusted. By releasing the mechanism, the tensioning wheel moves away from the belt and reduces the belt tension. As a result, then also slips through the drive pulley. Now it is possible to adjust the second holder together with the lock manually in the longitudinal direction of the surgical instrument.

According to a preferred embodiment of the invention, the

Release device a rotation lock, which cooperates with the spindle and blocked in normal operation, a rotational movement of the spindle. The rotation lock is preferably arranged displaceably in the longitudinal direction of the spindle.

According to a particular embodiment of the invention, the spindle comprises a first section with a first profile and a longitudinal direction

adjacent second section with a different, second profile. in the

Normal operation, the rotation lock is preferably on the first section, and in the dissolved state on the second section.

The profiles of spindle and rotation lock are preferably designed so that the spindle is secured against rotation during normal operation and can rotate in the dissolved state about its longitudinal axis. For example, the first profile may be a square profile and the second profile may be a round profile with a smaller cross section than the edge profile.

The release device according to the invention may comprise, for example, a probe which is preloaded by means of a spring and which cooperates with the rotation lock. By pressing the button, the rotation lock z. B. in the longitudinal direction of the spindle from the first section with the first profile to the second section with the second profile to be moved. The drive unit for the second holder is preferably formed as a motor-gear unit comprising a motor such as an electric motor and a transmission. The entire engine-transmission unit is preferably in the

integrated holding device according to the invention. Alternatively, the motor could be outside the fixture, e.g. be provided on the robot.

According to a special embodiment of the invention, the holding device may also comprise a second drive unit, by means of which the lock is rotatable about its longitudinal axis or the longitudinal axis of the surgical instrument. The second drive unit preferably also includes a separate motor-gear unit with an electric motor and a mechanical transmission.

The holding device according to the invention is preferably designed as a structural unit which can be mounted via fastening means on a robot and in particular a robot head. The attachment means may be used, for example, as a screw, detent, tension, clamp, or any other known device for releasably connecting two parts, such as e.g. a quick-release connection with movable pins, be formed. The fastening means are preferably operated without tools.

The first holder for holding the surgical instrument is preferably fixed to the robot in the longitudinal direction of the surgical instrument. The first holder can therefore not in the longitudinal direction of the surgical instrument, relative to

Robots are moved. An axial movement of the surgical instrument is therefore possible only by appropriate control of the robot.

The first holder is preferably designed such that the surgical

Instrument can be releasably attached to the holding device. The second holder for the lock preferably comprises a cantilevered arm, which is arranged to be movable relative to the first holder. On this arm are preferably holding means, such. As a terminal provided, to which the lock is attached. In this embodiment, the entire

cantilevered arm including the retaining means and the lock of the first Drive device driven in the longitudinal direction of the surgical instrument. The cantilevered arm is preferably mounted displaceably in the longitudinal direction in the region of the first holder. The arm is preferably designed so that it does not protrude beyond the holding means for holding the lock at the distal end of the holding device. As a result, the sheath can be inserted deeper into the patient.

The second holder may be formed, for example, as a clip or clamp. Preferably, it is designed such that the lock can be releasably secured.

Brief description of the drawings

The invention will now be described by way of example with reference to the accompanying drawings. Show it:

Fig. 1 is a known from the prior art holding device for a

surgical instrument and a lock mountable to a robot;

Fig. 2 is a perspective view of a holding device for holding

a surgical instrument and a lock according to an embodiment of the invention; 3 shows a longitudinal section through the holding device of Fig. 2.

Fig. 4 is an enlarged view of an integrated in the holding device

Release device in a normal state; FIG. 5 shows the release device of FIG. 4 in a released state; FIG.

Fig. 6 viewed the spindle of the holding device in the longitudinal direction; 7 shows a robot with a holding device attached thereto according to one of FIGS. 2 to 5;

Fig. 8 shows the robot of Fig. 7, after the surgical instrument from the

Holding device has been removed; and the robot of Fig. 8 after a lock holder has been manually moved to a patient remote position. Embodiments of the invention

With regard to the explanation of Figure 1, reference is made to the introduction to the description. FIG. 2 shows a perspective view of a holding device 1 for holding a surgical instrument 3 and a trocar sleeve 2.

The holding device 1 comprises a first holder 5 for a surgical

Instrument 3 and a second holder 9 for a lock 2. The surgical instrument 3 can, for. B. a gripping, holding, cutting, sawing, grinding, Verbinde-, Verfüge- or another tool, ie z. As a scalpel, a Pott'sche scissors, a pair of pliers, a trocar, etc .. Also the use of optical and image processing tools such. As lights, laparoscopes or cameras is possible. The lock 2 is here a trocar, but can also be another device, such. Example, a port, which is adapted to receive the shaft 30 of the surgical instrument 3 and to guide in the longitudinal direction 6.

The holder 5 for the surgical instrument 3 is located in FIG. 2 at a proximal end (in the image on the right) of the holding device 1. The holder 5 comprises a receptacle into which the surgical instrument 3 can be inserted. The holder 5 or the instrument 3 is protected by a housing with a lid to the outside. When inserted, the surgical instrument 3 is fixed longitudinally with respect to the robot head 28 '(see Fig. 7), but may optionally be rotated about its longitudinal axis 6, e.g. B. the shaft 30 of the surgical instrument 3, which passes through the trocar sleeve 2, is rotationally moved.

The first holder 5 preferably includes an interface over which all

required physical quantities, such. For example, forces, torques, currents or information may be transmitted to actuate the surgical instrument 3, including the end effector.

The second holder 9 is designed here as a clamping device and comprises two opposing clamping jaws, in which the trocar sleeve 2 is clipped. The holding device 1 shown in Fig. 2 further comprises fastening means 4 for fastening the holding device 1 to a robot 25, in particular a robot head 28 '(see, for example, Fig. 7). When the robot head 28 'is moved, for example, in the longitudinal direction 6 of the surgical instrument 3, the entire holding device 1 including the two holders 5, 9 is moved with. The

Axial movement of the robot head 28 'is indicated by an arrow 10. This has the consequence that the trocar sleeve 2 moves at the puncture point relative to the surrounding tissue. This could hurt the patient or at least damage the tissue. In order to avoid a relative movement of the trocar sleeve 2 relative to the surrounding tissue, the holding device 1 shown here comprises at least one drive unit 1 1 (see FIG. 3), through which the trocar sleeve 2 can compensate for an axial movement 10 of the robot head 28 '. In the best case, therefore, the trocar sleeve 2 can be kept still relative to the patient. The holder 9 comprises for this purpose a cantilevered arm 8, which extends approximately over a distance corresponding to the adjustment of the holder 9 in the longitudinal direction. The holding means (at 9) and the arm 8 form a uniform, mechanically firmly connected component, relative to the holder. 5 is movable. The arm 8 is guided in the region of the first holder 5 and mounted there by means of a sliding bearing 7 movable.

By appropriate control of the drive unit 1 1, the holder 9 or the trocar sleeve 2 can thus partially or completely compensate for an axial movement 10 of the robot head 28 '. The trocar sleeve 2 is then fixed in the best case in the longitudinal direction 6, so that between the trocar sleeve 2 and the

surrounding tissue no relative movement takes place. The arm 8 is here designed such that it does not protrude beyond the actual holding means for holding the lock 2 at the distal end of the holding device 1. As a result, the sheath 2 can be inserted deeper into the patient.

Fig. 3 shows a sectional view of the holding device of Fig. 2, in which the drive unit 1 1 can be seen more accurately. The drive unit 1 1 comprises in the illustrated embodiment, a motor-gear unit with a

Electric motor 12 which drives a spindle 14 via a gear 14 whose

Longitudinal axis substantially parallel to the longitudinal axis 6 of the surgical instrument 3 extends. Preferably, gear 13 and spindle 14 are formed as a mother-spindle unit. The spindle rod 14 is mounted at its two ends axially fixed in the arm 8 of the holder 9 and is rotated by a

Movement of the spindle nut driven in the longitudinal direction 6. In a mechanical or electrical defect in the drive unit 1 1, it may happen that the drive unit 1 1 blocked and the second holder 9 can not be moved in the axial direction 6. In order to be able to adjust the second holder 9 nevertheless, the holding device 1 according to the invention comprises a release device 16 for interrupting a force and / or torque transfer between the drive 12 and the second holder 9. An embodiment of such a release device 16 is shown by way of example in FIGS. 4 and 5 ,

Fig. 4 shows an enlarged detail view of the rear end of the arm 8 with a release device 16. The release device 16 comprises in the illustrated embodiment, a push-button 17 which is arranged in the arm 8 and in unactuated state protrudes outwardly beyond the arm 8. The push button 17 is movable in the longitudinal direction 6 and can be brought by manual pressing in the position shown in Fig. 5. The push button 17 cooperates with a rotation lock 19, which is displaced in an axial direction 6 of the spindle 14 when the push button 17 is actuated. The rotation lock 19 is rotatably mounted in the arm 8 and has a

Recess in which a portion of the spindle 14 is arranged. When the push button 17 is pressed, the anti-rotation device 19 moves from a first portion 18 of the spindle 14, which has a edge profile, towards an adjacent second portion 21, which has a round profile.

In normal operation, the rotation lock 19 is located on the first section 18 of the spindle rod 14. The edge profile of the first section 18 is arranged in a form-fitting manner in the recess of the rotation lock 19, whereby the spindle 14 is fixed in the direction of rotation. That the torque of the spindle 14 can thus be fully supported on the rotation lock 19. Now, if the nut 13 of the nut spindle unit 13, 14 is driven by the electric motor 12 rotating, the spindle 14 and thus on the arm 8 and the entire holder 9 moves together with the lock 2 in the longitudinal direction 6 forward or backward become. The rotational movement of the nut 13 is thereby converted into a translational movement of the spindle 14.

If the pushbutton 17 is then pressed, as shown in FIG. 5, the rotation lock 19 moves in the longitudinal direction 6 from the first section 18 with the edge profile to the second section 21 with the round profile, the rotation lock 19 being guided in the axial direction 6 by means of a longitudinal guide 20 becomes. This will be the

Positive locking between the spindle 14 and anti-rotation 19 lifted and the spindle 14 can rotate freely. The impressions of the push button 17 can be limited by a stop 24 which is formed on the arm 8 of the second holder 9.

Since located in section 21 anti-rotation 19 (due to the lack of positive engagement) can not support torque of the spindle 14, which is Drive path between the electric motor 12 and the second holder 9 thus interrupted. The spindle 14 will then rotate freely in the arm 8 with a rotating drive of the nut 13, without performing a translational movement with respect to the nut 13, which axially displaces the arm 8 and the holder 9, respectively. The loosened state shown in Fig. 5 now provides the ability to manually adjust the holder 9 in the axial direction 6, even if the nut 13 blocks due to an error. If a sufficiently strong force is exerted in the longitudinal direction 6 on the arm 8 or the second holder 9, the arm 8 can be moved manually along the guide 7. The axially fixed in the arm 8 spindle 14 is taken. If the nut 13 is blocked, the axial force resulting from the translational movement of the arm 8 on the spindle 14 causes the spindle 14 to rotate in accordance with the spindle thread pitch. Ie. the spindle 14 performs with respect to the nut 13 a screwing movement. For this purpose, the nut-spindle unit 13, 14 is preferably designed not self-locking. In order to support the movement of the spindle 14 in the arm 8 and the second holder 9, at least one bearing 22, such as a rolling bearing, in the arm 8 of the holder 9 is provided.

The anti-rotation device 19 is biased outwardly by means of a spring 23, which is supported on the arm 8. If the button 17 is released again - or a possible locking canceled - the button 17 jumps outward again into the locked position of Fig. 4th

Fig. 6 shows the spindle rod 14 viewed in the longitudinal direction 6, wherein the various profiles of the spindle rod 14 are clearly visible. As can be seen, the edge profile of the first portion 18 has a square cross-section and the circular profile of the second portion 21 has a circular cross-section whose radius is smaller than the smallest distance from the longitudinal axis 6 of the spindle 14 to an outer edge of the first profile. As an alternative to the square shape of the first profile, it goes without saying that other profiles can also be selected, for example the profile 18 'shown in dashed lines. FIGS. 7, 8 and 9 each show a robot 25 with a plurality of arm elements 29, which are connected to one another via joints 28. Of the

Robot head 28 'is also designed as a hinge. The robot head 28 'is that described in the preceding figures

Holding device 1 mounted. The robot 25 further includes a base 26 in which a controller 27 may be integrated. The skilled person is clear that the

Control 27 could also be provided at any other location. The robot 25 shown in FIGS. 7 to 9 has a total of six

Degrees of freedom - namely two per joint 28 or 28 '- and is thus able to move the holding device 1 and the surgical instrument 3 firmly connected thereto freely in space. In surgery, the sheath 2 is in the body of the patient, e.g. at a distance X from a reference point (see Fig. 7). The lock 2 usually retains the distance X during the operation. When the robot 25 is moved during the operation, the lock 2 usually performs only pivotal movements about the puncture point.

In order to move the surgical instrument 3 deeper into or out of the body of the patient, the robot head 28 'has to perform a lowering or lifting movement in the longitudinal direction 6 of the surgical instrument 3. Such axial movements of the robot 25 are, as described above, compensated by a corresponding counter-movement of the lock 2. In a lowering movement of the robot head 28 ', the lock 2 is adjusted in the opposite direction by the same path, so that compensate for the two movements. The same applies to the case in which the robot head 28 'raises the instrument 3 in the axial direction 6 and continues to pull it out of the body of the patient. By a compensating movement of the holder 9 thus the distance X of the lock 2 can be maintained.

In the case of a defect on the robot 25 or on the holding device 1, this becomes

Instrument 3 is removed from its holder 5, as shown in Fig. 8. The instrument 3 can for this purpose z. B. manually released from the holder 5 and pulled out of the body of the patient. After that, the release mechanism becomes 16 is actuated by pressing the button 17. Thereby, the drive path of the drive unit 1 1 is interrupted, as described above, and the arm 8 and the second holder 9 can be manually adjusted in the longitudinal direction 6. The lock 2 can thus together with the entire second holder 9 z. B. are moved to a position as shown in Fig. 9.

Fig. 9 shows the robot 25 in a state in which the second holder 9 is in a retracted position. The lock 2 has been removed from the patient's body and is now at a greater distance (above distance X) to the patient's body. When the push button 17 is released (and possibly unlocked) after manual actuation of the second holder 9, the spring 23 presses the anti-rotation device 19 back into the locked state. The holder 9 is then secured against further, possibly unintentional axial adjustment.

The lock 2 can now be removed from the receptacle 9. Alternatively or additionally, the entire holding device 1 can be removed from the robot head 28 '. In an alternative embodiment of the invention, the second holder 9 and the lock 2 form a solid structural unit. In this case, the lock 2 and the arm 8 can then be inextricably linked.

Claims

claims

1 . Device (1) for holding a surgical instrument (3) and a lock (2), comprising a first holder (5) for holding the

surgical instrument (3) and a second holder (9) for holding the sheath (2), characterized by

- A drive unit (1 1) for driving the second holder (9) in

Longitudinal direction (6) of the surgical instrument (3); and

- A release device (16) for interrupting a force and / or

Transmission of torque from a drive (12) of the drive unit (1 1) to the second holder (9).

2. Device (1) according to claim 1, characterized in that the second holder (9) in a released state manually in the longitudinal direction (6) of the surgical instrument (3) is displaceable.

3. Device (1) according to claim 1 or 2, characterized in that the drive unit (1 1) comprises a nut-spindle unit (13, 14).

4. Device (1) according to claim 3, characterized in that an element of the nut-spindle unit (13, 14) at unconfirmed release device (16) a rotationally fixed state, and actuated release device (16) assumes a rotatable state.

5. Device (1) according to claim 3 or 4, characterized in that the release device (16) comprises a rotation lock (19) which cooperates with the spindle (14).

6. Device (1) according to claim 5, characterized in that the

Anti-rotation lock (19) in the longitudinal direction (6) of the spindle (14) is slidably disposed.

7. Device (1) according to claim 6, characterized in that the spindle (14) has a first section (18) with a first profile and an in

Longitudinal (6) adjacent the second section (21) having a second profile, and that the rotation lock (19) when unactuated

Release device (16) on the first section (18) and actuated

Release device (16) on the second portion (21) is arranged.

8. Device (1) according to claim 7, characterized in that the profiles and the rotation lock (19) are formed so that an element of the nut-spindle unit (13, 14) secured in the unactuated release device (16) against rotation is and can rotate about its longitudinal axis with actuated release device (16).

9. Device (1) according to claim 7 or 8, characterized in that the first profile is a edge profile and the second profile is a round profile with a smaller cross-section than the edge profile.

10. Device (1) according to one of the preceding claims 5 to 9, characterized in that the release device (16) comprises a button (17) which cooperates with the anti-rotation device (19).

1 1. Device (1) according to one of the preceding claims, characterized

in that the drive unit (1 1) comprises a motor-gear unit (12, 13, 14) which is integrated in the holding device (1).

12. Device (1) according to one of the preceding claims, characterized

characterized in that the device (1) as a structural unit is formed, which is mountable via fastening means (4) to a robot (25) and in particular to a robot head.

13. Device (1) according to one of the preceding claims, characterized

characterized in that the second holder (18) comprises a cantilevered arm (35) which is movably arranged relative to the first holder (26).

14. Device (1) according to one of the preceding claims, characterized

characterized in that the second holder (9) in the region of the first holder (5) by means of a sliding bearing (7) is mounted.

15. Device (1) according to one of the preceding claims, characterized

characterized in that the manual displacement of the arm (8) and the second holder (9) causes a screw movement of the spindle (14) of the nut-spindle unit (13, 14).