Master control device for teleoperation surgery and teleoperation system

Description

DESCRIPTION of the industrial invention entitled: “Master control device for teleoperation surgery and teleoperation system“ By: Medical Microinstruments, Inc. 5 Designated Inventors: Irene Caponigri, Matteo Bagheri Ghavifekr, Massimiliano Simi – all domiciled at Medical Microinstruments, Inc., via E. Giannessi 52 / 54 / 56, loc. Montacchiello, 56121 PISA (ITALY) CPC Classes: A61B 34 / 00, B25J 13 / 02 10 Practical ref: M165 *** DESCRIPTION

[0001] . Field of the invention

[0002] . The subject of this invention is a device 15 master command.

[0003] . The master control device according to the invention It is particularly suitable for a robotic surgery system.

[0004] . The present invention also relates to a system for medical or surgical teleoperation comprising 20 at least one master control device.

[0005] . Furthermore, the invention relates to a method of control to control the degree of freedom of opening / closing with modulation of the clamping / cutting force of a tool surgical slave. 25

[0006] . State of the art

[0007] . Robotic surgery devices are generally known in art and typically include a central robotic tower or a cart and one or more robotic arms extending from the tower / trolley. Each arm includes a system of 5 motorized positioning (or manipulator) to move one surgical instrument that can be attached distally to it, for the purpose to perform surgical procedures on a patient. The patient typically lies on an operating table located in the operating room surgical procedure, in which sterility is guaranteed to avoid 10 bacterial contamination due to non-sterile parts of the robotic apparatus.

[0008] . To control the robotic manipulator and then the “slave” surgical instrument, the surgeon acts on one or more “master” control devices, according to an architecture of 15 master-slave teleoperation.

[0009] . In fact, by means of the opening / closing command of the master control device it is desirable to control at least two functions of the slave surgical instrument: the degree of freedom of opening / closing between the tips (“jaws”) of the 20 surgical instrument of the slave device can also perform, with closed tips (“jaws”), a grip function (“grip”) or cutting (“cut”) and increasing grip or cutting force delivered from the tips of the slave surgical instrument.

[0010] . In the well-known robotic systems for teleoperation 25 surgical instruments are typically provided slave surgical instruments with different degrees of freedom of movement. It is particularly interest in controlling the degree of freedom of opening and closing of the slave terminal clamp, and in particular the gripping ability with adjustable force via a master 5 dedicated controller.

[0011] . There are several known examples of master devices controlled by the user (typically a surgeon) where the grades of freedom of movement can be associated with chains kinematics formed by rigid links connected with movable joints 10 which derive position and orientation together with a degree of freedom to manage opening / closing and modulation of the gripping force of tissues, needles or sutures with an extra stroke of the same movement.

[0012] . In a well-known configuration, disclosed for example by 15 previous document US-6594552, a master device is expected with differentiated stiffness during closing, is where it is shown an elastic mechanism that defines a variation of stiffness associated with the beginning of the modulation phase of the gripping force of the slave surgical instrument. 20

[0013] . Alternatively, devices have also been proposed “flying” masters, that is, kinematically not tied to any master console item (“unconstrained”, “groundless”), where the degrees of freedom of opening / closing and gripping can be derived from dedicated internal sensors or, in other 25 solutions, can be derived from poses, positions or orientations of optical sensors tracked in the workspace, for example, using one or more cameras.

[0014] . Some further examples of master devices are constrained are shown in document WO-2019-099584. 5

[0015] . According to some known examples, they have been disclosed untethered, wireless or wired flying masters, where the degrees of freedom of movement including opening / closing and grip can be derived from pose detection, positions or orientations of magnetometer-type sensors traced in the 10 workspace.

[0016] . In particular, the use of a pair of sensors is known electromagnetic each with 6 degrees of freedom that are mounted on the same right and / or right master device body left and having at least one degree of freedom of movement 15 relative, in which that single relative motion along a trajectory defined controls both the degree of opening and closing and the modulation of grip strength, as shown for example by document WO-2019-220408 in the name of the same Applicant.

[0017] . For example, the document WO-2022-175800 of the same 20 Applicant discloses a control device solution mechanically / kinematically unconstrained master type to the operating console (“groundless” or “unconstrained” according to an English terminology commonly adopted in the sector), that is a “flying” type master device, which is equipped 25 with a pair of sensors or tracking markers in a volume three-dimensional predetermined tracking that can be generated by an electromagnetic emitter. In particular, such note solution shows a strategy according to which the unit of system control verifies the existence of the relationships 5 predefined geometrical shapes between the two sensors, i.e. between two rods rigid hinged parts of the control device body masters that mount in sensors.

[0018] . The known master device solutions, even if partially advantageous from some points of view, they are not 10 not at all without drawbacks.

[0019] . As shown for example in the previous document WO- 2019-220407 in the name of the same applicant, can be expected on a non-constrained master device an element elastic, in this specific case a preloaded trigger in 15 cantilever position between the sticks, which is able to provide a force feedback to the surgeon when the angle of opening / closing between the master device's rods is below a certain predetermined threshold.

[0020] . In these well-known solutions, therefore, a first excursion 20 angle between the master device rods commands the slave device's controlled opening / closing, while a second angular excursion between the rods commands a servo-assisted increase in gripping force (or cutting force).In opening phase, this type of solutions do not fully solve 25 the problem, because when the surgeon opens the chopsticks, that is loosen the grip on the master device so that underneath the action of the spring provided between the rods these tend to to open, a first angular stroke is responsible for commanding the controlled loosening of the degree of freedom of grip (or cutting) 5 of the slave device. Therefore, the surgeon sees the opening master device while the slave device remains closed, and for these reasons the surgeon perceives a sort of delay, which is undesirable, between the command provided for opening and the behavior of the surgical instrument slave to it 10 enslaved.

[0021] . It is felt that it is necessary to manage together with the position, orientation, and opening and closing of a clamp teleoperated robotic surgery, also a modulation of the grip strength. 15

[0022] . It is felt by the user who manipulates the master needed to clearly understand which movement or part of the movement is associated with the closing / opening of the pliers and which to the modulation of grip strength.

[0023] . In addition, the virtual control point that 20 identifies the slave device, where it chases a point in the master workspace which is usually calculated as midpoint between the master device sensors mounted on the chopsticks, necessarily imposes some inconsistencies in the case where the master device is not closed in a manner 25 symmetrical. In other words, for example, when only one of the master device wands are moved relative to the system master reference, then also the midpoint between the wands translates, and this translates into a subservient translation of the control point in slave space. How 5 consequence, it may happen that in response to a command of closure given by the surgeon, observe a closure together with a rotation of the tips (“jaws”) of the instrument surgical slave, to bring the control point of the slave device in the position commanded by the master command. 10

[0024] . Therefore, in such a situation, the following occurs: risk of transmitting an unwanted command to the instrument surgical, in this specific case the joint rotation of the tips, i.e. the involuntary actuation of the yaw joint or “yaw” of the articulated terminal of the surgical instrument as 15 effect of the translation of the midpoint between the sticks of the master device i.e. between the sensors with respect to the origin of the master reference system.

[0025] . There is therefore a strong need to improve and make the control of the degree of 20 opening / closing freedoms of a slave surgical instrument controlled by a master device of the unconstrained type, to allow you to discriminate an opening / closing action from an action of increasing / decreasing the closing force, gripping and / or cutting between the tips (“jaws”) of the surgical instrument 25 of the slave device.

[0026] . It is felt by the user who manipulates the master needed to be associated with a closing / opening movement of the fingers a closing / opening movement of the pliers and associate a movement of greater pressure of the fingers with a 5 grip strength modulation.

[0027] . At the same time, there is a strong need for avoid, or at least reduce to a minimum, the risk of transmission of unwanted commands from the master device to the slave device, during the actuation of the degree of freedom of 10 opening / closing of the slave surgical instrument.

[0028] . There is a strong need to be able to measure the opening / closing movement is distinct from that of Modulation of closing / gripping / cutting force in a device Master's degree in medical or surgical teleoperation. 15

[0029] . There is a need to be able to adequately measure the opening / closing movement and the modulation movement of force with adequate resolution, with adequate robustness, with a simple and economical design, minimizing the number of sensors or on-board electronic components. 20

[0030] . Solution

[0031] . It is an object of the present invention to obviate the inconveniences complained of with reference to the state of the art and provide a solution to the need to provide improved control over the opening and closing of an articulated terminal 25 gripping and / or cutting of a surgical instrument for teleoperation medical or surgical.

[0032] . This and other goals are achieved with a system according to claim 1, as well as with a device according to claim 16, as well as with a method according to 5 claim 18, as well as with a program according to the claim 19, as well as with a system according to the claim 20.

[0033] . Some advantageous embodiments are the subject of of dependent claims. 10

[0034] . According to one aspect of the invention, a method of control a medical or surgical teleoperation includes the phases of (i) providing at least one master control device to control at least one degree of freedom for opening / closing of a slave surgical instrument, called a control device 15 masters including a first tracking sensor and a second tracking sensor; (ii) detect a first variation of the geometric relationship between the first sensor of tracking and the second tracking sensor of the master control device along a first direction, and on the 20 basis of the first variation of the detected geometric relation, move the slave surgical instrument in opening / closing; (iii) detect a second variation of the geometric relationship between the first tracking sensor and the second tracking sensor tracking of the master control device along a second 25 direction, based on the second variation of the relationship detected geometry, vary the clamping / cutting force of the slave surgical instrument.

[0035] . The control method is also applicable to a Computer simulation of a slave surgical instrument. 5

[0036] . According to one aspect of the invention, there is provided a computer program configured to perform at least some (and preferably all) of the steps of the method of control.

[0037] . According to one aspect of the invention, a system 10 robotic for medical or surgical teleoperation includes at least one slave surgical instrument with at least one degree of freedom of opening / closing, and at least one locking device master command to control at least the degree of freedom of opening / closing of the slave surgical instrument, called 15 master control device comprising a first sensor tracking and a second tracking sensor.

[0038] . According to one aspect of the invention, the system comprises at least one control unit configured to detect a first variation of the geometric relationship between the first 20 tracking sensor and the second tracking sensor of the master control device along a first direction, and on the basis of the first variation of the detected geometric relationship, move a servo instrument in opening / closing surgical slave; detect a second variation of the 25 geometric relationship between the first tracking sensor and the second tracking sensor of the control device master along a different second direction, and on the basis of the second variation of the detected geometric relationship, vary the clamping / shearing force of the slave surgical instrument 5 slaves.

[0039] . According to an implementation option, the variation of the geometric relationship between the first tracking sensor and the second tracking sensor is amplified i.e. multiplied with respect to the variation of the geometric relationship between portions 10 of control device manipulation interface master, suitable to receive the fingers of an operator.

[0040] . According to one aspect of the invention, a device for master command is suitable for controlling one degree of freedom of opening / closing of a slave surgical instrument and includes 15 body having a first working portion and a second portion operational movable relative to each other under the action imparted by the hand of a surgeon to assume at least one open configuration, suitable for controlling at least one slave open configuration of the slave surgical instrument, and 20 at least one closed configuration, suitable for controlling at least one slave closed configuration of the surgical instrument slave.

[0041] . According to one aspect of the invention, the at least one closed configuration of the master device includes a first 25 closed configuration, and a second closed configuration, in which is a transition between the first closed configuration and the second closed configuration is suitable for controlling a variation of the clamping / cutting force of the tool surgical slave. 5

[0042] . The master control device may be of the type kinematically unconstrained to the operating console and object tracking by a dedicated tracking system.

[0043] . According to one aspect of the invention, the device master command also includes a first sensor 10 tracking in operational connection with the first portion operating the master device body, and a second sensor of tracking (32) in operational connection with the second operating portion (11) of the master device body, in where: (i) a transition between the at least one open configuration 15 and the first closed configuration determines a first variation of the geometric relationship between the first tracking sensor and the second tracking sensor; (ii) a transition between the first closed configuration and the second configuration closed determines a second variation of the relationship 20 geometric between the first tracking sensor and the second tracking sensor; (iii) said first variation of the geometric relation and the second variation of the relation geometric occur along two different directions.

[0044] . The master control device may comprise 25 also a first portion of manipulation and a second manipulation portion for the action imparted by the hand of the surgeon; in which the first portion of manipulation is in operational connection with the first operational portion of the body of the master device, and the second portion of manipulation 5 is in operational connection with the second operational portion of the body of the master device, where the first portion of manipulation and the second portion of manipulation are movable with respect to each other along a single third direction, e.g. relative approach / departure. 10

[0045] . According to one aspect of the invention, a system robotic for medical or surgical teleoperation and / or for simulation of a teleoperation includes at least one tool surgical slave with at least one degree of freedom opening / closing, and at least one master control device 15 to control at least the degree of freedom of opening / closing of the slave surgical instrument, called control device master comprising a first tracking sensor and a second tracking sensor.

[0046] . The system may comprise at least one unit of 20 control, configured to detect sensor placement or movement tracking and transferring the movement to at least one instrument surgical slave. By “posing” the sensor means preferably indicate the position (e.g.: xy-coordinates z) and orientation (e.g. roll-pitch-yaw) with respect to a set of three 25 global reference (which can be placed in the console).

[0047] . According to one aspect of the invention, the implementation of a control movement imposed by the user on the device master command according to a single movement trajectory of 5 closing / opening determines: the relative movement between the two sensors of the master control device according to a first relative motion direction detected and transferred by the unit control of the opening and closing of the surgical instrument slave. 10

[0048] . According to one aspect of the invention, the movement relative between the same two sensors of the control device master according to a second direction of relative movement detected and transferred from the control unit alone modulation of grip force of the slave surgical instrument. 15

[0049] . The relative movement between the two sensors according to a first direction of relative motion associated with the opening and closure can be a change in relative distance, and the relative movement between the same two sensors according to a second relative motion direction associated with modulation only 20 of force can be a change in orientation.

[0050] . The relative movement between the two sensors according to a first direction of relative motion associated with the opening and closure can be a first curved trajectory and / or arc of defined circumference, and the relative movement between them 25 two sensors according to a second direction of relative movement associated with the sole modulation of force can be a second and different curved trajectory and / or circumferential arc defined.

[0051] . Said second and different curved trajectory defined 5 of said first direction of relative motion may have concavity opposite to the said first curved trajectory defined by said second direction of relative motion.

[0052] . The control unit can be configured to inhibit any translation induced to the surgical instrument 10 slave or control point, during the phase of varying the clamping / shearing force, translation that would be due to a variation of the geometric relationship between the sensors along the first direction X1 (which controls opening / closing of the slave device). In other words, during modulation 15 of the clamping / shearing force F and / or during second movement relative between the two sensors 31, 32 according to said second direction of relative motion X2, the control unit 104 is configured to inhibit any translation induced to the instrument surgical slave 170 or of a control point 177 caused 20 from any further relative movement between the two sensors 31, 32 according to said first direction of relative motion X1.

[0053] . According to an implementation option, exercising in closing / opening the control movement of the said unique motion trajectory of said master control device, 25 no translation movements are mechanically transferred of the slave surgical instrument or control point and / or the midpoint calculated with distance or relative angle between the sensors is mechanically kept unchanged and constant.

[0054] . According to an implementation option, exercising in 5 closing the control movement of said single trajectory of movement, upon reaching and exceeding said point of contact is mechanically inhibited further relative movement according to the said first direction of relative motion, while it is mechanically made possible only the movement according to the said 10 second direction of relative motion.

[0055] . According to an implementation option, exercising in opening the control movement of said single trajectory of movement upon reaching and passing said point of contact is mechanically inhibited relative movement according to 15 said second direction of relative motion, while it is mechanically made possible only the movement according to the said first direction of relative motion.

[0056] . According to an implementation option, exercising in closing the control movement of said single trajectory of 20 movement, upon reaching and exceeding said point of contact and during movement along said second direction of relative motion it is necessary to exert a force of closing force greater than the force required to move along said first direction of relative motion. 25

[0057] . This single trajectory of movement may be a curve and / or an arc of a circle or it is a straight line.

[0058] . According to an implementation option, the first part of the control movement of said single motion trajectory imposed by the user to the master control device is associated 5 to the implementation of said first direction of relative movement and then closing / opening of said slave surgical instrument, the second part of the movement control of the said unique motion trajectory imposed by the user on the device master command is associated with the implementation of said second 10 direction of relative movement and therefore to vary the force of tightening / cutting of the slave surgical instrument.

[0059] . According to an implementation option, the second variation of the geometric relationship is determined by the elastic deformation of the master device body. 15

[0060] . Thanks to the proposed solutions, it is possible to discriminate a first command aimed at opening / closing the surgical instrument slave from a second command aimed at varying the closing force of the same slave surgical instrument, even if the first and second commands are determined by a 20 same or similar action by the surgeon on the device master, such as approaching or moving away relative between two fingers of the surgeon's hand.

[0061] . Thanks to the proposed solutions, it is possible to manage the opening / closing of a slave robotic surgical forceps and 25 also the modulation of grip strength (“squeeze”). It can be also includes the management of position and orientation of the slave surgical forceps using the same device master command.

[0062] . It is therefore possible for the user who manipulates the 5 master device, to clearly understand which movement or part of the movement is associated with the closing / opening of the Slave grippers and which one instead for grip force modulation of the same Slavic pliers.

[0063] . The user, therefore, becomes able to associate a 10 movement or action of closing / opening the fingers a movement closing / opening of the pliers, and associate with a movement or finger pressure action a modulation of the force of taken.

[0064] . It allows to be able to adequately measure the 15 opening / closing movement and force modulation movement with adequate resolution, robustness, and with a design simple and economical, minimizing the number of sensors on board of the master device.

[0065] . Thanks to the proposed solutions, in a master 20 unconstrained controller, its degrees of freedom of movement including those for opening / closing and force modulation grip (“grip” / ”squeeze”) can be derived from poses of only two sensors tracked in the workspace.

[0066] . Thanks to the proposed solutions, it is possible to 25 associate a first relative movement between two sensors to the closing / opening and a second and different relative movement between the two same sensors to the force modulation of tightening / cutting.

[0067] . The relative movement between the two sensors for the 5 modulation of the clamping / cutting force of the tool surgical may be induced to be amplified compared to the movement of a portion of the control interface on which the surgeon's fingers act directly to promote a precise and reliable detection. 10

[0068] . Thanks to the proposed solutions, the relative movement between two sensors according to a first direction of relative movement is associated with the opening and closing while the relative movement between the same two sensors according to a second direction of relative movement is associated with the sole modulation of force 15 tightening / cutting.

[0069] . The relative movement between two sensors according to a first direction of associated relative motion at opening / closing it can be a first curved trajectory defined, while the relative movement between the same two sensors 20 according to a second associated relative motion direction to the modulation of force alone can be a second and different defined curved trajectory, in which for example said second and different curved trajectory defined has a concavity opposite to said first defined curved trajectory and / or the center 25 instant rotation is different for first and second curved trajectory.

[0070] . The relative movement between two sensors according to a first direction of relative motion associated with the opening and closure can be a change in relative distance while 5 the relative movement between the same two sensors according to a second direction of relative motion associated with only force modulation can be a change in orientation.

[0071] . The second direction of relative motion associated with the modulation of the force can only be moved to the 10 reaching the end of the first trajectory of relative movement associated with the closing / opening movement. Reaching the end of the first trajectory can be associated with the fully closed position of the clamp master. In this way, reaching the limit switch is 15 clearly perceived by the user during the implementation of said imposed control movement. The limit switch can be made by the contact between two associated free ends respectively to two sensorized portions of the device master, to be intuitive to an operator. It can be 20 inhibited the possibility of further relative movement according to said first direction of movement upon reaching the goal race, while it can be allowed to move only according to the second direction of movement. In the master device, it can a second, additional end-of-travel position should be provided 25 associated with said second direction of relative motion and to the transfer of maximum force / torque / shearing.

[0072] . It may be foreseen that the first direction of relative movement is called the second direction of movement relative are obtainable by implementing a movement 5 user-imposed manipulation in a single direction of movement, such as a relative approach movement of two parts of the user interface. The movement of manipulation can lie on a defined curve and / or on a line straight line and can be determined by counting the fingers of the 10 surgeon on respective manipulation portions of the device master.

[0073] . A first part of the manipulation movement can be associated with the implementation of the said first direction of relative movement and therefore closing / opening. A second 15 part of the manipulation movement can be associated to the implementation of said second direction of relative movement and therefore of force / tightening / cutting torque modulation.

[0074] . The manipulation movement along said direction of manipulation can be associated with the application 20 of a first force to induce said first direction of motion relative associated with the opening and closing, and a second force to induce said second direction of relative motion associated with the modulation of grip / shearing force only of the slave surgical instrument. The first force can be 25 constant. The second force can grow with the movement of control until the second further is reached end position.

[0075] . The master device can be composed of two parts (e.g. two rods) connected / hinged at a joint 5 rotational and / or translational connection. The joint of connection between the two sides can be preloaded elastically so as to maintain a maximum state opening the master device. A limit switch may be provided opening. Each part can in turn be composed of 10 two rigid sections, one proximal and one distal, connected by a elastic medium. The two parts can be separated and connected from an elastic medium as an additional component, or the two parts are part of the same piece and the elastic medium is a elastic zipper, for example made with a thick section 15 reduced from the same piece, which can have a sheet body folded and / or curved.

[0076] . The proximal part may include portions or areas surfaces where you can rest your fingers (for example in correspondence of the manipulation portions), while the part 20 distal can include portions where sensors can be inserted tracking (e.g. at operational portions).

[0077] . Brief description of the figures

[0078] . Further features and advantages of the invention will appear from the description below of examples 25 favorites of realization, given for information purposes only and not restrictive, with reference to the attached figures which are briefly described below. Note that the references to “an” embodiment in this disclosure is not necessarily referring to the same form of embodiment, 5 and are to be understood as at least one. Furthermore, for reasons of conciseness and reduction of the total number of figures, a certain figure may be used to illustrate the features of more than one embodiment and not all the elements of the figure may be necessary for a certain 10 embodiment.

[0079] . Figure 1A is an axonometric view of a system robotic for medical or surgical teleoperation, according to a embodiment.

[0080] . Figure 1 B is an axonometric view of a system 15 for simulation of a medical or surgical teleoperation, according to one embodiment.

[0081] . Figure 2 is a schematic of a control unit of the system, according to one embodiment.

[0082] . Figure 3 is an axonometric view showing 20 schematically a robotic system for medical teleoperation or surgical, according to one embodiment.

[0083] . Figure 4 is an axonometric view of a device of master control, according to one embodiment.

[0084] . Figures 5 AC are plan views of the device. 25 master command of figure 4, respectively in (A) open configuration, (B) first closed configuration, and (C) second closed configuration.

[0085] . Figures 5 and 6 are schematic views of transitions between the first and second closed configurations and that 5 result from overlaps between details of figures 5 A and 5 B.

[0086] . Figures 6 AC are plan views of a device master control, according to one embodiment, illustrated respectively in (A) open configuration, (B) first 10 closed configuration, and (C) second closed configuration.

[0087] . Figures 7 AC are plan views of a device master control, according to one embodiment, illustrated respectively in (A) open configuration, (B) first closed configuration, and (C) second closed configuration. 15

[0088] . Figures 8 AD are plan views of a device master control, according to one embodiment, illustrated respectively in (A) open configuration, (B) first closed configuration, and (CD) second closed configuration.

[0089] . Figure 9 A shows a schematic plan view of a 20 master control device, according to a form of realization.

[0090] . Figure 9 B shows schematically the device of master command of figure 9 A in open configuration, in which it is shown an enlargement of the portion in the box. 25

[0091] . Figure 9 C shows schematically the device of master command of figure 9 A in closed configuration, in which it is shown an enlargement of the portion in the box.

[0092] . Figure 10 A shows schematically in plan view a master control device, according to a form of 5 realization, illustrated in open configuration.

[0093] . Figure 10 B shows an enlarged view of a detail of figure 10 A.

[0094] . Figure 10 C shows schematically the device master of figure 10 A in closed configuration. 10

[0095] . Figure 10 D shows an enlarged view of a detail of figure 10 C.

[0096] . Figures 11 AC show an axonometric view of a tracking sensor, according to some embodiments.

[0097] . Figure 11 D schematically shows a pair of 15 tracking sensors, according to one embodiment.

[0098] . Figures 12 AC are plan views of a device master control, according to one embodiment, illustrated respectively in (A) open configuration, (B) first closed configuration, and (C) second closed configuration. 20

[0099] . Figure 13 A shows an axonometric view of a master control device, according to a form of realization.

[00100] . Figures 13 BC show schematically in view plan the master device of figure 13 A, illustrated 25 respectively in (B) open configuration and in (C) closed configuration.

[00101] . Figures 14 AD are plan views of a device master control, according to one embodiment, illustrated respectively in (A) open configuration, (B) first 5 closed configuration, and (CD) second closed configuration.

[00102] . Figures 15 AC are schematic views of a slave surgical instrument, according to one embodiment, illustrated respectively in (A) open configuration, (B) gripping configuration, and (C) gripping configuration 10 forceful grasp.

[00103] . Figures 16 AD show block diagrams according to some embodiments of a control method.

[00104] . Figures 17 and 18 show schematically a master control device, according to some forms of 15 realization.

[00105] . Figure 19 shows a known example of a device master command.

[00106] . Figures 20 AC are plan views of a device of master control, according to one embodiment, illustrated 20 respectively in (A) open configuration, (B) first closed configuration, and (C) second closed configuration.

[00107] . Detailed description of some forms of realization

[00108] . Reference throughout this description to “a form 25 of realization” intends to indicate that a particular feature, structure, or function described in relation to the embodiment is included in at least one embodiment of embodiment of the present invention. Therefore, the formulation “in one form of embodiment” in various parts of 5 this description does not necessarily all refer to the same form of embodiment. Furthermore, particular features, structures or functions such as those illustrated in Different figures can be combined in any way suitable in one or more embodiments. 10

[00109] . In accordance with a general embodiment, it is a 100 robotic system is planned for medical teleoperation or surgical.

[00110] . It is understood that the teachings of this disclosure also applies in the case of a system of 15 Simulation of a medical or surgical teleoperation 101.

[00111] . The robotic system 100 comprises at least one surgical instrument slave 170 equipped with one degree of freedom GR opening / closing, and at least one master control device 110 (or “gripper” 110, according to a common English terminology) 20 to control at least the degree of freedom of opening / closing GR of at least one slave surgical instrument 170.

[00112] . As shown for example in figure 2, the system robotic system 100 (and / or simulation system 101) comprises also at least one control unit 104. The degree control 25 of freedom of opening / closing GR or GR grip of the instrument surgical slave 170 includes two modes, a first mode (“OPEN / CLOSE MODE” i.e. opening / closing mode) which concerns the control of the relative movement of the two tips 171, 172 approaching (closing) or moving away 5 (opening) relative, and a second mode (“SQUEEZE MODE” i.e. tightening mode (here also meaning cutting) which concerns the modulation of the clamping / shearing force between the operating portions 175 of said two tips and which do not necessarily determines a relative movement between the two tips 10 171, 172. The master control device 110 of the system robotized 100 is configured to control both GR opening / closing degree of freedom mode of the surgical instrument slave 170.

[00113] . As shown for example in figure 15-A, a tool 15 surgical slave 170 may comprise two tips 171, 172 or jaws 171, 172 constrained in a rotational joint 173 to rotate relatively around a common axis. Each tip or jaw may include an operating portion 175, such as example a gripping surface and / or a blade and / or a counter- 20 blade. For example, the slave 170 surgical instrument can be an instrument such as forceps, dilator, needle-holder forceps- scissors, surgical scissors, electrocautery, and / or others.

[00114] . The at least one slave surgical instrument 170 may belong to a slave robotic assembly 120 of the system 25 robotic for teleoperation. As shown for example in Figure 3, the slave robotic assembly 120 may comprise, in addition to at least one slave surgical instrument 170, at least one 130 robotic manipulator operated under the control of the 110 master control device movable in the workspace 5 master 144 to control the slave surgical instrument 170 in the slave workspace 174. A can be foreseen 127 camera or 127 microscope to view the site surgical on a dedicated 128 display.

[00115] . In accordance with a preferred embodiment, 10 when in operating conditions, the robotic system 100 is configured to control at least one slave device 170 based on the detection of information on location and / or orientation of the at least one master device 110. For example, a control point 177 is defined with multiple degrees of 15 freedoms with respect to the global slave reference system SFO, the checkpoint 177 being belonging or rigidly associated with the surgical instrument slave 170, which can be located between the operating portions 175 of the tips 171, 172, and which is controlled on the basis of the detection of 20 device position and / or orientation information master 110 in master workspace 144 compared to the system global reference master MFO.

[00116] . To detect position information and / or orientation of the master device 110, a may be provided 25 tracking field emitter 142, e.g. an emitter of electromagnetic field, which defines a volume of tracking where the master workspace 144 is obtained. The tracking of the master device 110 can be of type optical, and / or by infrared sensors, and / or by 5 accelerometers, and / or via inertial platform (IMU), and / or any combination of the above.

[00117] . Not necessarily at least one master device 100 It is a master device of the flying type, i.e. non-constrained kinematically (“kinematically unconstrained” “groundless”) 10 to the operating console 140, although in accordance with a form preferred embodiment, the at least one master device 100 It is a master device of the flying type, i.e. non-constrained.

[00118] . The master control device 110 may be a master device of the type kinematically constrained to the 15 operating console using a support 111 (for example: gymbal and / or motorized kinematic chain), as shown for example in figure 17, where sensors 31, 32 are used to detect position and / or orientation information for the purpose of check at least the degree of freedom of opening / closing GR 20 of the slave surgical instrument 170, and in which for example information about the device's global orientation and position master 110 can be controlled by means of support 111 or constraint 111.

[00119] . The master control device 110 comprises at least 25 two tracking sensors 31, 32 comprising a first sensor of tracking 31 and a second tracking sensor 32. Well understood, with the terminology “tracking sensors 31, 32” or “tracking sensors 31, 32” is intended to indicate both sensors electromagnetic (figures 11 AB) and optical sensors (“markers”, 5 figure 11 C), as well as accelerometers, as well as platforms inertial, as well as infrared sensors, and any of their combination. As shown for example in figure 11 D, it can be a first sensor 31 is foreseen which is an infrared transmitter and a second sensor 32 which is a strip of detectors 10 comprising a plurality of detectors 33 for example arranged longitudinally, so that from the time of flight detection (“time-of-flight”) of the return signal provides information on the distance between sensors 31, 32, while the localization of the point or detector 33 irradiated on the detector strip 15 provides information on the angle between sensors 31, 32.

[00120] . Advantageously, the first tracking sensor 31 and the second tracking sensor 32 are respectively associated, for example fixed, to portions of the master device 110 which are movable relative to each other under the action 20 imparted by the hand of the surgeon 150. In this way, the action imparted by the hand of the surgeon 150 determines that the relationship geometric between the two tracking sensors 31, 32 various i.e. is modified, as a result of this manipulation action of the master control device 110. 25

[00121] . With an added advantage, the control unit 104 of the 100 robotic system for medical or surgical teleoperation It is configured to detect a first change in the relationship geometrical connection between the first tracking sensor 31 and the second tracking sensor 32 of master control device 110 5 along a first direction X1, and to move in open / close (OPEN / CLOSE MODE) a slave tool surgical slave 170, based on the first variation of the detected geometric relation. In this way, the detection of a movement between the two tracking sensors 31, 32 along 10 the first direction X1 is interpreted by the control unit of the system as a command aimed at moving in opening or in closing the surgical instrument slave 170, for example by moving the tips 171, 172 or jaws closer or further apart 171, 172 of the slave surgical instrument. 15

[00122] . With an added advantage, the control unit 104 of the 100 robotic system for medical or surgical teleoperation is configured to detect a second change in the geometric relationship between the first tracking sensor 31 and the second tracking sensor 32 of the control device 20 master 110 along a second direction X2, and vary that is modulate (SQUEEZE MODE) the tightening / shearing force / torque of the slave surgical instrument slave 170, based on the second variation of the detected geometric relationship. In this way, the detection of a movement between the two 25 tracking sensors 31, 32 along the second direction X2 is interpreted by the system control unit as a command aimed at modulating the closing / gripping / cutting force (or opening) of the surgical instrument slave 170, for example by tightening the working portions 175 of the 5 tips 171, 172 or jaws 171, 172 of the surgical instrument slave.

[00123] . Such a system is therefore able to recognize and discriminate an opening / closing movement command of the degree of freedom of opening / closing slave GR from a command 10 modulation of the force applied by the surgical instrument slave 170, based on the relative direction of movement X1, X2 between two sensors 31, 32 operationally associated with the body of the master device 110.

[00124] . In particular the relative movement between the two sensors 15 according to a first direction of relative motion X1 can be associated with the opening and closing of the slave while the relative movement between the same two sensors according to a second different direction of relative motion X2 can be associated with the slave's grip force modulation only. 20

[00125] . In a preferential form both the first direction of relative movement according to a trajectory or relation X1 that the second direction of relative motion along a trajectory or X2 relationship between the two sensors are both obtainable by implementing an imposed control movement 25 by the user in a single direction of movement or trajectory X3.

[00126] . This trajectory X3 can be identified by the special manipulation portions 21 and 22 and their movement relative exercisable at these points directly by the 5 user fingertips.

[00127] . The relative position from the surface areas where place your fingers on the master 21, 22 can define said unique direction of movement X3.

[00128] . In a preferred form called movement of 10 control lies on a defined curve or arc.

[00129] . In a different form called movement of control lies on a straight line.

[00130] . ​​A first part of the control movement can be associated with the implementation of said first direction of movement 15 relative and therefore closing / opening.

[00131] . A second part of the control movement can be associated with the implementation of said second direction of movement relative and therefore of grip strength modulation.

[00132] . The detected position and / or orientation information 20 from tracking sensors 31, 32 can be used for also check the position and orientation (TRACKING MODE) of the surgical instrument slave 170, for example of the point of control 177.

[00133] . The translations of control point 177 of the 25 surgical instrument slave 170 can be avoided or inhibited from the system control unit 104 during a condition of clamping / cutting force modulation (SQUEEZE MODE) characterized by the relative movement X2 of the two sensors.

[00134] . The system can store the expected displacement of the 5 checkpoint 177 due to master device command during the force modulation mode (SQUEEZE MODE) and in particular to the deformation of the device body master.

[00135] . The possibility of further relative movement according to 10 said first direction of movement X1 can be mechanically inhibited when the P1 limit switch is reached, while it can be it is possible to move only the second direction of movement relative X2

[00136] . The midpoint calculated with the distance or with the angle 15 relative between sensors can be maintained mechanically unchanged and constant throughout the implementation of the said second direction of relative motion associated with the force modulation.

[00137] . Control point 177 of the slave associated with the 20 master position may be that it does not move during the actuation and control of the closing / opening degree only and force modulation

[00138] . The midpoint calculated with the distance or with the angle relative between sensors can be kept unchanged and constant 25 during the entire implementation of the said second direction of relative movement associated with force modulation.

[00139] . In accordance with a preferred embodiment, the control unit 104 of the robotic system for teleoperation is configured to detect a change in 5 distance X1 between the first tracking sensor 31 and the second 32 tracking sensor, and move in opening / closing the slave surgical instrument slave 170, based on the variation of distance X1 detected. In accordance with this form of implementation, the control unit 104 is further configured 10 to detect a change in relative orientation X2 between the first tracking sensor 31 and the second tracking sensor tracking 32, and based on the orientation change relative to varying the closing / gripping / cutting force / torque of the surgical instrument slave 170. 15

[00140] . The relative movement between two sensors according to a first direction of relative movement X1 associated with the opening and closure can be a first defined curved trajectory while the relative movement between the same two sensors according to a second direction of relative motion X1 associated with the 20 only force modulation is a second and different trajectory defined curve

[00141] . In one embodiment the second and different defined curved trajectory has a concavity opposite to the first one defined curved trajectory. 25

[00142] . In one embodiment the relative motion between two sensors according to a first direction of relative movement associated with the opening and closing is a variation in distance relative while the relative movement between the same two sensors according to a second associated direction of relative motion 5 just the modulation of force is a change in orientation.

[00143] . In one embodiment the relative motion between two sensors according to a first direction of relative movement associated with the opening and closing is a variation of orientation described by a first mathematical relation 10 geometric and relative movement between the same two sensors according to a second associated direction of relative motion to the modulation of force alone is a second variation of orientation described by a second mathematical relation different geometry. 15

[00144] . The master control device 110 suitable for control a degree of freedom of opening / closing GR of one surgical instrument slave 170 can take on various shapes.

[00145] . In accordance with a preferred embodiment, The master control device 110 is a master device of the 20 type not kinematically constrained to any element of the operating console 140, that is, it is of the flying or “groundless” type.

[00146] . The master device 110 comprises a body having a first operational portion 11 and a second operational portion 12, which are movable relative to each other under the action 25 imparted by the hand of a surgeon 150.

[00147] . The surgeon150 is not necessarily in contact with the operating portions 11, 12, which for example can be found at a certain longitudinal distance from other appropriate portions of manipulation 21, 22 of the master device 110 which are precisely 5 destined to be directly manipulated by the fingers of the surgeon 150 when in operating condition.

[00148] . The master control device 110 further comprises a first tracking sensor 31 in operational connection with the first operating portion 11 of the device body 10 master 110 and a second tracking sensor 32 in operational connection with the second operational portion 11 of the body of the master device 110. For example, the sensors of tracking 31, 32 can be fixed, even in a removable, to the respective operating portions 11, 12 of the body 15 of the master device 110.

[00149] . Not necessarily the body of the master device 110 comprises in a single piece the first operating portion 11 and the second operational portion 12, although in accordance with a form of realization the master device 110 comprises in piece 20 unique the first operational portion 11 and the second portion operational 12.

[00150] . In accordance with one embodiment, the first operational portion 11 and the second operational portion 12 of the master device 110 are made in separate piece and are 25 assembled together.

[00151] . As shown for example in figure 4, the sensors of tracking 31, 32 may include a data link 23 to control unit 104.

[00152] . In accordance with a preferred embodiment, 5 the first operational portion 11 and the second operational portion 12 of the master device 110 are movable with respect to each other to the other under the action imparted by the hand of a surgeon 150 to assume at least one open configuration, in which the first operational portion and the second operational portion are among them 10 spaced by a distance X1, as shown for example in figure 5-A.

[00153] . Said at least one open configuration between the first operating portion 11 and the second operating portion 12 is preferably suitable for controlling, by means of the unit of 15 control 104, at least one slave open configuration of the slave surgical instrument 170, for example in which the tips 171, 172 form between them an opening angle greater than a certain theshold.

[00154] . The system can be configured to allow 20 transitions between a plurality of open configurations of the master device 110 to which correspond slave devices open configurations of the slave surgical instrument 170.

[00155] . In accordance with one embodiment, when in operating conditions, the opening angle between the tips 171, 25 172 of the slave surgical instrument 170 in the workspace slave 174 follows, in phase relation, the distance detected between the operating portions 11, 12 of the master device 110 in the master workspace 144. In other words, to control the transitions between the open slave configurations of the 5 slave surgical instrument 170, control unit 104 can be configured to detect information on the change distance X1 between sensors 31, 32 and transmit control signals to the surgical instrument slave 170 aimed at moving in opening / closing the tips 171, 172 or jaws 171, 172. 10

[00156] . In accordance with a preferred embodiment, the first operational portion 11 and the second operational portion 12 of the master device 110 are movable with respect to each other to the other under the action imparted by the hand of a surgeon 150 to assume at least one closed configuration, in which the first 15 operating portion 11 and the second operating portion 12 are each in contact with a respective contact surface (for example formed by the other operating portion or by a third element for example that extends between the portions operational 11, 12). At least one point of 20 contact 17 when in closed configuration.

[00157] . Said at least one closed configuration of the device master 110 is preferably suitable for controlling at least one slave closed configuration of the slave surgical instrument 170, for example where the working portions 175 of the tips 25 171, 172 of the slave surgical instrument 170 are among them contact or in contact with a body to be grasped 178.

[00158] . The second direction of relative motion X2 associated with the modulation of force can be moved only when reaching the end of travel P1 of the first trajectory 5 of relative movement X1 associated with the movement of closing / opening or also called contact point 17.

[00159] . When the first stroke reaches its limit trajectory P1 or contact point 17 can be associated with the fully closed position of the clamp. 10

[00160] . The robotic system can be configured to allow transitions between a plurality of configurations closed of the master device 110 to which they correspond slave closed configurations of the surgical instrument 170. Preferably, the at least one closed configuration of the 15 master device 110 includes an initial configuration closed, as shown for example in figure 5-B, and a second closed configuration, as shown for example in figure 5-C.

[00161] . A transition between the first closed configuration and the second closed configuration can be suitable to control 20 a variation in the closing / cutting / gripping force of the surgical instrument slave 170. In other words, the modulation of the closing force exerted by the operating portions 175 of the tips 171, 172 or jaws of the slave surgical instrument 170 is controlled by the transition between the first and second 25 closed configuration of the master device 110.The body of the master device 110 is designed to make a transition between at least one open configuration and the first configuration closed determines a first variation of the geometric relationship between the first tracking sensor 31 and the second tracking sensor 5 tracking 32 and for a transition between the first closed configuration and the second closed configuration determines a second variation of the geometric relationship between the first tracking sensor 31 and the second tracking sensor tracking 32. 10

[00162] . Said first variation of the geometric relation and the second variation of the geometric relationship occurs along two different directions X1, X2.

[00163] . When the limit switch P1 is reached, the two parts of the master are in contact at said contact point 17 and such 15 contact can be felt by the user during implementation of the control movement imposed X3 because it is characterized by greater stiffness.

[00164] . There may be an associated P2 end position to the said second direction of relative motion X2 and to the 20 maximum grip force transfer.

[00165] . The control movement along said direction of control is associated with the application of a force F1 for induce said first direction of associated relative motion at the opening and closing and a force F2 to induce said second 25 relative movement direction associated with modulation only of strength.

[00166] . In one construction form F1 is constant.

[00167] . In a construction form F2 grows with the movement of control until the end position is reached 5 P2.

[00168] . In accordance with a preferred embodiment, the body of the master device 110 further comprises a first manipulation portion 21 and a second portion of manipulation 22 for the action imparted by the surgeon's hand 10 150, wherein the first manipulation portion 21 is in operational connection with the first operational portion 11 of the body of the master device and the second portion of manipulation 22 is in operational connection with the second operating portion 12 of the master device body. When 15 in operating conditions, the surgeon 150 holds the master device 110 so as to manipulate, with its own fingers, for example, the manipulating portions 21, 22 of the body of the master device 110 which through the body of the master device itself determines a variation of the 20 geometric relationship between tracking sensors 31, 32 respective. Between a portion of manipulation 21, 22 and the respective operating portion 11, 12, the body of the device master 110 may comprise various means of transmission of an action given by the surgeon 150, such as: 25 elastic devices 18, curved / bent sections 19, and others.

[00169] . In accordance with a preferred embodiment, The master device 110 also includes a device elastic 15 between the first manipulation portion 21 and the second manipulation portion 22 of the device body 5 master 110. The elastic device 15 is preferably configured to influence the first portion of manipulation 21 and the second portion of manipulation 22 in moving away relative. In this way, the surgeon 150 moves closer relating to the manipulation portions 21, 22 contrasting 10 the action of the elastic device 15. The elastic device 15 can be made in one piece with the body of the device master 110 and for example it is made up of an elastic section deformable body of the master device 110. The device elastic 15 may comprise a helical axial spring and / or a 15 torsion spring.

[00170] . In accordance with a preferred embodiment be the first direction of relative motion according to a trajectory or relation X1 that a second direction of movement relative according to a trajectory or relationship X2 between the two sensors 20 are both obtainable by performing a movement user-imposed control in a single direction movement or trajectory X3.

[00171] . In particular, the first portion of manipulation 21 and the second manipulation portion 22 are both movable 25 at different and distinct times and portions exercising a single direction of movement X3 for example a direction of relative approach / distance or opening / closing of the user manipulation points.

[00172] . . The third direction X3 can be a direction of 5 rectilinear translation and / or a circular arc, and / or a rotational direction.

[00173] . In accordance with one embodiment, the first manipulation portion 21 and the second portion of manipulation 22 are bound to move relative to each other 10 to the other along a single third direction, for example of relative approach / detachment. For example, it can be a guide 14 and / or a rotational constraint 16 is provided to constrain the relative movement between the manipulation portions 21, 22.

[00174] . In accordance with one embodiment, the first 15 manipulation portion 21 and the second portion of manipulation 22 are movable relative to each other along a manipulation stroke having a certain amount of stroke length manipulation, in which the first variation of the relationship geometrical connection between the first tracking sensor 31 and the second 20 tracking sensor 32 defines a first run of tracking having a certain first run size of tracking, and in which the second variation of the relationship geometrical connection between the first tracking sensor 31 and the second tracking sensor 32 defines a second stroke of 25 tracking having a certain amount of second stroke of tracking. Preferably, the sum of the first run of tracking and the second tracking run is greater of the manipulation race.

[00175] . This improves the system resolution. 5 robotic teleoperation in degree of freedom control of opening / closing and of the modulation of the force of grip / cut / closure because the amount of relative movement of the operating portions 11, 12 equipped with sensors 31, 32 is more wide of the extent of the relative movement of the portions of 10 manipulation 21, 22. For example, the variation of angle between the manipulation portions 21, 22 of the master device 110 between the open configuration and the second closed configuration is a certain angular entity that is smaller than the corresponding one variation of angle between the operating portions 11, 12. In others 15 terms, such a master device 110 allows to mechanically amplify the magnitude of the command given by the surgeon in terms of opening / closing and modulation of the grip / closure / shearing force, unlike the notes master device solutions (figure 19). 20

[00176] . This can be achieved by the fact that selectively detect different modes of variation of the geometric relationship between tracking sensors 31, 32.

[00177] . In accordance with a preferred embodiment, the master device 110 comprises between a portion of 25 manipulation 21, 22 and the respective operating portion 11, 12 a curved line 19 which describes a change of direction and is preferably made flexible. In other words, the master device body comprises a flexible portion which describes a change of direction between the portion of 5 manipulation and the respective operational portion.

[00178] . Said curved section 19 which describes a change of direction can have a spring back, and / or can be a stretch folded, and / or may describe a broken line and / or may be a line that describes a curved arc. 10

[00179] . In accordance with a preferred embodiment, the two different directions X1, X2 are respectively distance between sensors and angle between sensors.

[00180] . As shown for example in figure 5-A, where it is an open configuration of the master device 110 is illustrated, 15 The robotic system 100 can be configured to check the GR opening / closing degree of the instrument surgical slave 170 based on distance X1 (i.e. the first direction X1) detected between the two tracking sensors 31, 32. Not necessarily the operating portions 11, 12 of the device 20 master 110 each include a free end 13, although in accordance with a preferred embodiment each of the operating portions 11, 12 comprises a free end 13. The distance between sensors 31, 32 can be a measure of the distance between the free ends 13 of the first portion 25 operational 11 and the second operational portion 13.

[00181] . As shown for example in figures 5-B and 5-C, at decrease the distance X1 (i.e. the first direction X1) between the tracking sensors 31, 32, the robotic system 100 can be configured to carry the slave surgical instrument 170 5 in a closed configuration, where the force of tightening / closing / gripping / cutting is in phase relation with the angle X2 (i.e. the second direction X2) between the orientations between tracking sensors 31, 32.

[00182] . Alternatively, the system can be configured 10 so that the first direction X1 is associated with a detection of the variation of the angle between the orientations of the sensors tracking 31, 32 and the second direction X2 is associated a detection of the variation in distance between the sensors of tracking 31, 32, e.g. variation of distance along a 15 longitudinal direction of the master device body 110.

[00183] . Of course, during the detection of the variation of the distance between the tracking sensors, called themselves tracking sensors 31, 32 can also vary their relative orientation. 20

[00184] . As shown for example in figures 5-D and 5-E, the angular travel Y performed by the manipulation portion 22 of the master device 110 during a transition between the first closed configuration (hatching indicated by the letter B) and the second closed configuration (dashed line indicated with the 25 letter C) is much smaller than the angular travel Z performed by the respective operating portion 12 i.e. from the sensor 32, for increase resolution in controlling the modes of modulation of grip / shear force (SQUEEZE MODE). for example, the ratio between the Y and Z angular travels can be 5 1 to 5, 1 to 10 or greater than 1 to 10, and for example the race angular Y is essentially equal to 5° while the angular stroke Z is essentially equal to 45°, 60° or 90°.

[00185] . As shown for example in figures 6-A, 6-B and 6-C, the operating portions 11, 12 of the master device 110 can 10 be bound to translate one another with respect to the other, so as to keep the relative orientation between the two constant tracking sensors 31, 32 during a transition between at least one open configuration and the first configuration closed, while during a transition between the first and second 15 closed configuration varies the relative orientation between the tracking sensors 31, 32.

[00186] . As shown for example in figures 7-A, 7-B and 7-C, the tracking sensors 31, 32 may have a rigid body (e.g. example, they can be mounted on rigid rods). In this 20 example shows guides 34 for longitudinal sliding of the rigid body sensors 31, 32 and their respective portions operational 11, 12. Two first portions can be foreseen operational 11 (or second) with a first portion of manipulation 21 (or second) among them. 25

[00187] . The operating portions 11, 12 of the master device 110 can have a tied end, to form a figure closed, for example, of the articulated parallelogram type.

[00188] . As shown for example in figures 8-A, 8-B, 8-C and 8-D, the manipulation portions 21, 22 can travel a 5 relative approach / departure path along a third direction X3 curve defining: a variation of the distance X1 between sensors 31, 32 when the operating portions 11, 12 are in open configuration, and a variation of the angle between the orientations of the two sensors 31, 32 when the 10 operating portions 11, 12 are in closed configuration.

[00189] . As shown for example in figures 9-A, 9-B and 9-C, the first variation of the geometric relationship between the sensors of tracking 31, 32 occurs along a first direction X1 which is a curved direction, and preferably a circular arc 15 centered in the constraint 16 between the manipulation portions 21, 22 of the body of the master device 11, while the second variation of the geometric relationship between the tracking sensors 31, 32 occurs along a second direction X2 which is always a direction curve, but with concavity opposite to the first curved direction X1. 20 Preferably, the second curved direction X2 is an arc of circumference centered at the point of contact 17 between the portions operating 11, 12 of the master device 110.

[00190] . The second variation of the geometric relationship between sensors 31, 32 can be determined by the deformation 25 elastic of said first operating portion 11 and / or of said second operating portion 12 of the master device body 110.

[00191] . For example, the first operating portion 11 and the second operating portion 12 may include elastic cuffs which 5 mount said tracking sensors 31, 32 and which are suitable to deform elastically during manipulation of the master device 110.

[00192] . The articulated joint connecting the two parts of the master can be elastically preloaded to be kept in 10 a state of maximum opening the master and at the stop near the said end point.

[00193] . Each part can also be composed of two rigid sections, one proximal and one distal connected by a medium elastic or a reduced thickness elastic hinge. 15

[00194] . As shown for example in figures 10-A, 10-B and 10- C, the operating portions 11, 12 of the master device 110 they can be linked to each other to translate one with respect to the other to the other, so as to keep the relative orientation constant between the two tracking sensors 31, 32 during a transition 20 between at least one open configuration and the first configuration closed, while during a transition between the first and second closed configuration varies the relative orientation between the tracking sensors 31, 32. Guidance may be provided transverse 14 preloaded with an elastic device 15 for 25 guide the movement between the two manipulation portions 21, 22 of the master device.

[00195] . The contact point 17 between the operating portions 11, 12 of the master device 110 can be determined by a relative sliding contact between the operating portions 11, 5 12.

[00196] . As shown for example in figures 11-A and 11-B, each of the tracking sensors 31, 32 may be capable to detect six degrees of freedom, of which three degrees of freedom orientation and three degrees of freedom of position with respect to a 10 reference point of a master global reference system MFO.

[00197] . The master device 110 may comprise an element elastic 18 associated with at least one, and preferably both, the operating portions 11, 12. In accordance with a form of 15 realization, an elastic element 18 is foreseen between each manipulation portion 21, 22 and the respective portion operational 11, 12 equipped with tracking sensor 31, 32.

[00198] . At least one of the tracking sensors 31, 32 may be a fiber optic sensor, such as a fiber optic sensor 20 Bragg grating type deformation.

[00199] . As shown for example in figures 12-A, 12-B and 12- C, the body of the master device 110 may comprise in piece unique both manipulation portions 21, 22 and both the operating portions 11,12, where the body of the device 25 master 110 comprises a plurality of deformable portions elastically 15, 18, of which a first portion is deformable elastically 15 between the interface portions 21, 22 and a second elastically deformable portion 18 between each interface portion 21, 22 and the respective operating portion 5 11, 12 equipped with sensor 31, 32 and / or belonging to each operational portion 11, 12.

[00200] . The first direction X1 of variation of the relation geometrical connection between the tracking sensors 31, 32 can be approach direction while the second direction X2 of 10 variation of the geometric relationship between the sensors of tracking 31, 32 can be direction of departure between the sensors.

[00201] . As shown for example in figures 13-A, 13-B and 13-C, the second operating portion 12 of the master device 110 can 15 comprise a rotating organ 36 of radius R2, and the first operating portion 11 of master device 110 may comprise a striking and dragging surface 35, suitable for forming a rolling contact with the rotating member 36 of the master device 110. 20

[00202] . The striking and driving surface 35 is preferably a curved and convex surface. The surface of striking and dragging 35 may include a portion toothed that engages with a respective counter-portion toothed part of the rotating organ. 25

[00203] . For example, a first portion of the closure of the master device before contact between rotating organ and surface and drag is defined a trajectory X1 of relative movement between the sensors and a relationship that can be associated with the opening and closing of the slave. 5

[00204] . Detection of the second direction of movement relative X2 and relative relationship associated with the modulation of force, can be the detection of the relative orientation between sensors 31 and 32, where a sensor 32 is placed on the organ rotatable 36. Preferably, the sensor 32 is placed on the axis of 10 RR rotation of the rotating organ 36. The sensor 32 can be placed on the edge of the rotating organ near or in correspondence of the point of contact with the surface of dragging 35 of the first relative portion 11.

[00205] . When in operating conditions along the second 15 direction X2, the master device body closure 110 expresses the rotational drag of the rotating organ and the transfer of a proportional modulation of force to the slave.

[00206] . The radius R2 of the rotating organ can advantageously 20 be chosen so that it is less than the distance Y2 between the constraint 16 and the rotation axis RR of the rotating member, allowing you to increase the stroke or angular excursion of the sensor 32 associated with it and gaining an adequate resolution for force modulation. 25

[00207] . In one embodiment the rotatable member may be preloaded by a torsional spring in a defined position when not dragged by the striking surface and dragging. For example, with an aligned sensor axis to the direction of the first operational portion. 5

[00208] . Other tracking sensors may be provided.

[00209] . The striking and driving surface 35 can be mounted on a preload elastic element 18 which guarantees during contact with the rotating organ an adequate force of friction and ensure drag along its entire stroke 10 from a first contact point P1 where the movement ends along trajectory X1 and starts along X2 at a point P2 in where the movement along X2 ends.

[00210] . The striking and driving surface 35 can be curved and convex. The rotatable member 36 may comprise 15 RR rotation axis which is fixed with respect to the first portion operational 11.

[00211] . As shown for example in figures 14-A, 14-B, 14-C and 14-D, the first direction X1 of variation of the relationship geometric between sensors 31, 32 is an angular direction and the 20 second direction X2 of the geometric relationship between the sensors 31, 32 is a distance.

[00212] . As shown for example in figure 18, the device of master command 110 can be of the unconstrained type and include in addition to the "gripper" or tongs portion 25 control the degree of freedom of opening / closing GR of the surgical instrument 170, a wearable element 113 (e.g. example a bracelet or a ring) that can be connected to the body of the master device 110 by means of a joint 112 or swivel 112. Alternatively or in addition to the wearable element 113, 5 a knob or handle may be provided.

[00213] . The master device 100 may include elements for improve ergonomics, for example designed supports specifically for the palm of the surgeon's hand 150 which holds the master device, and the like. 10

[00214] . As shown for example in figures 20-A, 20-B and 20- C, the first operating portion 21 may comprise a surface of beat and drag 35 which extends on an appendix to overhang extending from the first operating portion 21 towards the second operating portion 22 which mounts a rotating organ 36. 15 An elastic element 18 may be provided between the sensor tracking 31 and the striking and dragging surface 35 of the first operational portion 21.

[00215] . With reference to the preceding description, of A control method for a system will be described below 20 robotic 100 for medical or surgical teleoperation.

[00216] . The control method is to control a degree of freedom of opening / closing GR of a surgical instrument slave 170 controlled by a master control device 110.

[00217] . The control method comprises the steps of detecting 25 a variation of the geometric relationship between a first sensor of tracking 31 and a second tracking sensor 32 of the master device 110 along a first direction X1 and move in opening / closing GR a slave surgical instrument 170. 5

[00218] . Advantageously, the method further comprises the steps to detect a variation in the geometric relationship between the said first tracking sensor 31 and said second tracking sensor 32 master device tracking along a second direction X2 and vary or modulate the force / torque of 10 clamping / cutting of the slave surgical instrument 170.

[00219] . The degree of freedom of opening / closing GR of the surgical instrument slave 170 chases the variation of the geometric relationship between sensors 31, 32 along the first direction X1, while the force / torque modulation of 15 tightening / cutting of the same surgical instrument slave 170 tracks the variation of the geometric relationship between the sensors 31, 32 along the second direction X2.

[00220] . The control method may comprise the step further to perform one or more checks on the information 20 detected on the variation of the geometric relationship between the sensors 31, 32, and enable control transitions between the OPEN / CLOSE MODE and Clamping / Cutting mode (SQUEEZE MODE) only if one or more of the above are successfully passed more checks. 25

[00221] . In accordance with one embodiment, said one or more checks include checking that the detected value of the variation of the geometric relationship along the direction X1 belongs to a set of admissible values, for example predetermined or determined iteratively in real time. 5

[00222] . In accordance with one embodiment, said one or more checks include verification of structural integrity of the master device. This verification may include verification of the existence of predefined mathematical relationships between the sensors 31, 32, for example imposed by the geometry of the body of the 10 master device 110.

[00223] . The method may comprise, during the varying step the clamping / shearing force, the phase of entering a state of limited teleoperation, in which a subset of the degrees of freedom is not transmitted to the surgical instrument slave 170 15 or at checkpoint 177. Preferably, during the squeeze mode, the gripping forces are inhibited checkpoint 177 translations to avoid undesirable repositionings of the kinematic chain of positioning of the slave device which may include a 20 articulated terminal and / or motorized robotic axes. For example, Checkpoint translations are inhibited only if belonging to a specific direction, for example the direction longitudinal L of the master device 110 in the workspace master and then of the surgical instrument 170 in the space of 25 slave labor.

[00224] . With reference to the above, the directions X1 and X2 are different directions and, for example, can be: linear distance variation and angular distance variation that is, angle between the orientations, or vice versa; rotation with respect to 5 to a first center of rotation and rotation with respect to a second center of rotation, the first and second centers of rotation can define very different radii, variation of distance along a first direction and variation of distance along a second direction incident to it and for example orthogonal. 10

[00225] . The control method is suitable for implementation by means of a system for medical or surgical teleoperation 100 comprising at least one master control device 110 seconds any of the embodiments above described. 15

[00226] . Of course, the phase of detecting a movement, as well as the phase of detecting a pose, as well as the phase of detecting a variation of the geometric relationship between the sensors tracking 31, 32 may include the phases of: detecting information on the position and orientation of each sensor 20 tracking 31, 32; and process the information processed by the sensors (e.g. calculating) to obtain information about movement / pose / variation of the geometric relationship.

[00227] . In accordance with one embodiment, as shown for example in figure 16-C, the method includes the 25 following steps:

[00228] . - detect a movement and / or a change in relative position or orientation of sensors 31,32 along before trajectory X1;

[00229] . - command Opening / Closing of tips 171, 172 5 of the surgical instrument 170,

[00230] . – if the detected quantity is less than a threshold defined, then:

[00231] . - detect movement and / or changes in position or relative orientation of sensors 31,32 along second 10 trajectory X2.

[00232] . - modulate the clamping force of the tool surgical 170.

[00233] . The method may further comprise the step of perform a closing and / or opening movement on the device 15 of master command 110 according to said movement trajectory X3.

[00234] . The master device 110 can be configured to control an electrosurgical instrument, such as a active monopolar and / or bipolar surgical instrument. In this case case, the clamping / cutting force modulation mode 20 (SQUEEZE MODE) can be implemented to manage the intensity of electricity supply through the instrument surgical slave 170.

[00235] . In accordance with a general embodiment, it is a computer program configured to run 25 stages of the control method, according to any of the embodiments described above.

[00236] . Thanks to the features described above, foreseen separately or jointly with each other in particular forms of realization, it allows us to answer the above mentioned 5 needs, obtaining the above-mentioned advantages, and in particular:

[00237] . – it allows to decouple, on the master side, the open / close command from the modulation command clamping / shearing force;

[00238] . – consequently, it allows for a better 10 resolution of detection of said commands given by the surgeon on the master device;

[00239] . – it also allows for easier control and precise of the critical variables (position / orientation of tracking sensors), which can result in processing 15 of the data faster and more efficient, and for these reasons provide a more secure solution than known examples of systems surgical or microsurgery teleoperation;

[00240] . – a master control device is provided flying type, or not kinematically constrained to any element 20 of the operating setup, improved performance compared to known solutions, particularly with regard to control of the opening / closing and the clamping / cutting force of the surgical instrument;

[00241] . – the same tracking sensors (e.g. two 25 tracking sensors) can also be used for check the position and orientation of the surgical instrument slave, which may include an actuated articulated terminal by means of actuation cables, and which for example can be equipped of pitch, yaw and / or roll rotational joints 5 (pitch, yaw, roll), and may also include a mechanism “snake” type positioning comprising a plurality of stacked vertebrae;

[00242] . -furthermore, in the case of micro-surgical teleoperation, the surgeon may find it desirable to be able to control 10 the opening / closing and then the gripping / cutting of the device slave through minimal movements of his fingers, in a similar manner as it happens in traditional microsurgical practice, that is unassisted by robotic systems; therefore, thanks the present invention allows us to answer this question 15 requirement, providing increased side detection resolution master, which requires less movement of the portions of interfaces manipulated by the device body surgeon master to obtain the desired degree of opening / closing grip / shear force, compared to known solutions; 20

[00243] . – in particular, thanks to the modality of the geometric variations between the sensors, as described above, are provides better reading resolution for the system master device tracking;

[00244] . – at the same time, the positive feeling of control for 25 the surgeon has also improved, thanks to the fact that the first closed configuration of the master device body actually corresponds to a closed configuration of the slave device, and thus increasing the clamping force on the master device, determining the second variation of the 5 geometric relationship between the sensors, an increase in the clamping / shearing force of the slave device, so intuitive;

[00245] . – a closed master device corresponds to a slave device closed, while a master device open 10 corresponds to an open slave device, and the modulation of the closing force occurs with the master device closed, in intuitive way for an operator;

[00246] . – the shape of the master control device can be designed to maximize surgeon or patient familiarity 15 micro-surgeon, and can be essentially a reproduction of traditional surgical or microsurgical instruments (i.e. for operate directly without robotic mediation).

[00247] . It is understood that the combinations of characteristics of the attached claims form an integral part and 20 integral to this description.

[00248] . In the embodiments described above, a technician in the field, in order to satisfy contingent needs and specifications, will be able to make numerous changes, adaptations and replacement of elements with functionally equivalent ones, 25 without however departing from the scope of the attached claims. LIST OF NUMERICAL REFERENCES 11 First operational portion of the master device 12 Second operational portion of the master device 13 Free end 14 Guide or constraint 15 Elastic device 16 Rotational constraint 17 Point of contact 18 Elastic device 19 Curved or folded stroke 21 First portion of master device manipulation 22 Second portion of master device manipulation 23 Data cable 31 First tracking sensor 32 Second tracking sensor 33 Detector strip detector 34 Guide or track 35 Striking and dragging surface 36 Rotating organ 100 Robotic system for medical teleoperation or surgical 101 Medical teleoperation simulation system or surgical 104 System Control Unit 110 Master control device of the system for teleoperation, or master device 111 Master Device Operation Console Support 112 Master device joint 113 Master Device Wearable Element 120 System slave assembly for teleoperation 127 Camera or microscope 128 Display 130 Slave robotic manipulator 140 Master Console 142 Tracking field emitter 144 Master Workspace 150 User, or operator, or surgeon 170 Slave surgical instrument 171 Tip or jaw of the slave surgical instrument 172 Tip or jaw of the slave surgical instrument 173 Rotational joint of the slave surgical instrument 174 Slave workspace 175 Working portion of the tip or jaw 177 Checkpoint 178 Body to be tightened MFO Master Global Reference System SFO Slave Global Reference System GR Degree of freedom of opening / closing of the instrument surgical slave X1 First direction X2 Second direction X3 Third direction P1 Limit switch P2 Limit switch L Longitudinal direction of the master device RR Axis of rotation of the rotating organ R2 Radius of the rotating organ B Orientation of the first closed configuration C Orientation of the second closed configuration Y2 Distance Y Angular stroke Z Angular stroke F Clamping / Cutting Force

Claims

- 1 CLAIMS 1. Master control device (110) for a robotic medical or surgical teleoperation system, suitable for controlling one degree of freedom of opening / closing (GR) of a slave surgical instrument (170), comprising a body having a first operating portion (11) and a second operating portion (12) movable with respect to each other under the action imparted by the hand of a surgeon (150) to assume: - at least one open configuration, in which the first operating portion (11) and the second operating portion (12) are spaced apart from each other by a distance (X1), said at least one open configuration being suitable for controlling at least one slave open configuration of the slave surgical instrument, - at least one closed configuration, in which the first operating portion (11) and the second operating portion (12) are each in contact with a respective contact surface, said at least one closed configuration being suitable for controlling at least one slave open configuration of the slave surgical instrument,slave closed configuration of the slave surgical instrument, wherein the at least one closed configuration comprises: - a first closed configuration, and - a second closed configuration, wherein a transition between the first closed configuration and the second closed configuration is adapted to control a modulation of a clamping / shearing force (F) of the slave surgical instrument; and wherein the master control device further comprises: - a first tracking sensor (31) in operative connection with the first operative portion (11) of the body of the master device; - a second tracking sensor (32) in operative connection with the second operative portion (11) of the body of the master device; wherein: - a transition between the at least one open configuration and the first closed configuration determines a first change of a geometric relationship between the first tracking sensor and the second tracking sensor; - a transition between the firstclosed configuration and the second closed configuration determines a second variation of the geometric relationship between the first tracking sensor and the second tracking sensor; and wherein: - said first variation of the geometric relationship and said second variation of the geometric relationship occur along two different directions (X1, X2).

2. Master control device (110) according to claim 1, further comprising a first manipulation portion (21) - 3 and a second manipulation portion (22) for the action imparted by the surgeon's hand; wherein: - the first manipulation portion (21) is in operative connection with the first operational portion (11) of the body of the master device, - the second manipulation portion (22) is in operative connection with the second operational portion (12) of the body of the master device, - the first manipulation portion (21) and the second manipulation portion (22) are constrained to move relative to each other along a single third direction (X3), e.g. relative approach / distance.

3. Master control device (110) according to claim 2, wherein a first part of the manipulation motion is associated with the actuation of said first direction of relative motion, and a second part of the manipulation motion is associated with the actuation of said second direction of relative motion.

4. Master control device (110) according to claim 1, 2 or 3, wherein the two different directions (X1, X2) are respectively: distance between sensors and angle between sensors.

5. Master control device (110) according to any one of the preceding claims, wherein the first direction (X1) of variation of the geometric relationship between the tracking sensors (31, 32) is an approaching direction while the second direction (X2) of variation of the geometric relationship between the tracking sensors (31, 32) is a receding direction between the sensors.

6. Master control device (110) according to any of the preceding claims, wherein the relative movement between two sensors according to a first relative movement direction (X1) associated with opening and closing is a first defined curved trajectory while the relative movement between the same two sensors according to a second relative movement direction (X2) associated with force modulation alone is a second and different defined curved trajectory; wherein the second and different defined curved trajectory has a concavity opposite to said first defined curved trajectory.

7. Master control device (110) according to any of the preceding claims, wherein said master device is a master device of the flying type or not constrained to the operating console; and wherein, preferably, said tracking sensors (31, 32) comprise: electromagnetic sensors, optical sensors, accelerometers, inertial platforms, infrared sensors, combinations of the previous; - 5 and / or wherein at least one of the tracking sensors is a fiber optic sensor; and / or wherein each of the tracking sensors (31, 32) is capable of detecting six degrees of freedom, of which three orientation degrees of freedom and three position degrees of freedom with respect to a reference point of a master global reference system; and / or wherein the tracking sensors (31, 32) are fixed, even in a removable manner, to the respective operating portions (11, 12) of the body of the master control device.

8. Master control device (110) according to any of the preceding claims, wherein the second operating portion (12) comprises a rotatable member (36) having a radius (R2) and the first operating portion (11) comprises a contact and driving surface (35), adapted to form a rolling contact with the rotatable member (36).

9. Robotic system (100) for medical or surgical teleoperation and / or for simulating a teleoperation comprising: - at least one slave surgical instrument (170) with at least one opening / closing degree of freedom (GR), - at least one master control device (110) for controlling at least the opening / closing degree of freedom (GR) of the - 6 slave surgical instrument (170), said master control device (110) comprising a first tracking sensor (31) and a second tracking sensor (32); wherein the system further comprises at least one control unit (104), configured to: - detect a first variation of a geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) of the master control device (110) along a first direction (X1), - based on the first variation of the detected geometric relationship, move an interlocked slave surgical instrument (170) in opening / closing;- detect a second change in the geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) of the master control device (110) along a different second direction (X2), - based on the second change in the detected geometric relationship, modulate a clamping / shearing force (F) of the slave surgical instrument (170).; 10. A robotic system (100) according to claim 9, wherein the control unit (104) is configured to detect a change in distance (X1) between the first tracking sensor (31) and the second tracking sensor (32), and open / close the slave surgical instrument (170) - 7 based on the detected change in distance; and wherein the control unit (104) is further configured to detect a change in relative orientation (X2) between the first tracking sensor (31) and the second tracking sensor (32), and 5 based on the change in relative orientation vary the closing / gripping / cutting force / torque of the slave surgical instrument (170).