Laser-guided robot, projection method and laser-guided robot system for guiding visual projection of surgical planning

Abstract

The present disclosure relates to a laser-guided robot (1) for visually projecting surgical guidance onto a surgical region of a patient (100). The system comprises: a guide robot (1) having a robot arm (2) and a robot head (4); a tracking system (6) that can detect the position and / or orientation of the robotic head (4) and of the patient (100); a projection laser (8) on the robot head (4) such that the position and orientation of the projection laser (8) can be set by means of the robot head (4); a control unit (12) adapted to determine a target position and a target orientation of the projection laser (8) relative to a surgical region of the patient (100) and to control a robotic arm (2), the projection laser (8) is moved into the target position and the target orientation and at least one guide axis (16) is visually presented by the projection of the laser radiation (12) of the projection laser in the target orientation. The disclosure also relates to a laser-guided robotic system and a projection method.

Description

Technical Field

[0001] The present disclosure relates to a laser-guided robot for visually projecting surgical planning guidance onto a surgical area of ​​a patient. The present disclosure also relates to a projection method for visually projecting guidance and a laser-guided robot system having a laser-guided robot and a medical instrument or product according to the preamble of the parallel claims. Background Art

[0002] In computer-assisted surgery, navigation systems and / or surgical robots are used. When using a navigation system, surgical instruments are detected and tracked / traced. In particular, the position and orientation of the surgical instruments in space are detected. The detected information is correlated and combined with preoperative photographs, which are detected before the operation. These preoperative photographs are in particular models of the patient or the patient's body. The digital model is created, for example, by computed tomography (CT) and / or magnetic resonance tomography (MRT). When using a surgical robot, the surgical instrument is moved to a target position by one or more robot arms, wherein the target position is determined based on the preoperative photographs.

[0003] Both the use of navigation systems and the use of surgical robots have certain disadvantages. The use of navigation systems results in restrictions in the freedom of movement due to the attachment of navigation trackers to the surgical instruments. The use of surgical robots in turn reduces the working space or working area due to the necessary end effectors and is also more complex in terms of the system.

[0004] Solutions have therefore been developed in which the operation is performed conventionally by the surgeon, but the surgeon is supported by projecting the surgical plan calculated preoperatively.

[0005] Prior art

[0006] DE 10 2017 127 791 A1 discloses a medical control system. Here, a projector, for example in the form of a laser, projects surgical instructions onto a patient. The surgical instructions can show the surgical site in the patient and the position of delicate tissues or organs on the patient. The projected surgical instructions assist the surgeon who is performing the treatment, because the surgeon can orient himself according to the projection. The surgical instructions are obtained by scanning the patient before the operation.

[0007] A laser-based system for guiding during surgery is known from EP 3 733 111 A1. The system comprises a semicircular arm (C-type X-ray device) with a laser projector. The X-ray arm scans the patient's body and displays the scan on a screen. The user can edit the surgical information directly on the screen. For example, the user can input the surgical information via a touch screen. A control unit calculates the surgical information and the laser projector projects the surgical information onto the patient's body. However, the system has a large and cumbersome C-arm, which adversely affects the operation during surgery. In addition, the C-arm cannot be moved arbitrarily during surgery and requires strategic repositioning.

[0008] Furthermore, (robotic) systems are known that use high-energy lasers to cut bone. Here, a surgical plan is created based on preoperative data. The effector is controlled by an optical navigation system and cuts the bone by laser based on the surgical plan. This is advantageous because the robot produces very clean cutting edges and laser cutting does not produce chips. However, laser cutting cannot be used for biopsy or other surgical procedures such as screw placement, etc.

[0009] Furthermore, a system with multiple fixed lasers is known from Liao et al. "Precision-guided surgical navigation system using laser guidance and 3D autostereoscopic image superposition". In this case, at least two lasers are arranged at a certain distance. The two lasers project a laser beam onto the surgical surface. The cutting line of the two lasers is the surgical line. For example, the surgical line can be indicated during surgery. However, fixed systems lack the flexibility to be used for multiple surgeries.

[0010] In summary, the known systems in the prior art can indicate to the surgeon where he or she needs to perform the operation and can also mark the surgeon with relevant anatomical orientation points, such as organs that the surgeon must not damage during the operation. However, this information is only projected onto the patient from above. Thus, only a two-dimensional image is presented, without providing spatial information. Summary of the invention

[0011] The object of the present disclosure is therefore to overcome or at least reduce the disadvantages of the prior art and in particular to provide an effective and flexible laser-guided robot as well as a projection method and a laser-guided robot system, which provide the user, in particular the treating surgeon, with further spatial information for guidance and navigation and in particular implement the function of displaying at which part and in particular at which angle the user can perform the operation. A further sub-task can be seen as providing a cost-effective and movable laser-guided robot and a guided robot system, which can in particular be used in a mobile manner and which, as far as possible, only minimally affects the operating room in terms of the required volume. In particular, the operating area should continue to be freely accessible to the surgeon.

[0012] The object of the present disclosure is achieved with respect to a laser-guided robot of the type described according to the invention by the features of claim 1, with respect to a laser-guided robot system of the type described according to the invention by the features of claim 12, with respect to a projection method of the type described according to the invention by the features of claim 13, with respect to a computer-readable storage medium by the features of claim 14, and with respect to a computer program by the features of claim 15.

[0013] The core idea of ​​the present disclosure is therefore that by combining a robot as a positioning system and a laser as a display system with a laser radiation having a longitudinal axis, it is not only possible to indicate the site, but also to visually indicate the axis about the site in space for the surgeon, so that the surgeon can use the information about this axis in order to be able to orient the medical product or instrument accordingly. It is decisive here that the robot can control and thus move the laser into a predeterminable position and orientation relative to the patient and therefore relative to the surgical site, in which the laser targets a target point in the surgical area and directs the laser radiation having a longitudinal axis and therefore a guide axis to and visually indicates this target point to be targeted. This enables the surgeon not only to place a medical product such as a biopsy needle or an instrument such as a screwdriver at the indicated location, but also to orient this longitudinal axis according to the indicated guide axis.

[0014] In other words, the disclosure therefore relates to a laser guidance robot for visually projecting a (surgical) guidance, in particular a surgical plan calculated before surgery, onto an operating area of ​​a patient. The laser guidance robot has a (guidance) robot with a robot arm movably articulated or connected to a robot base and a distal / distal robot head / end section connected to the robot arm, and furthermore a tracking system, in particular an optical navigation system or a tracking system based on robot motion (the kinematics of the (guidance) robot is used here in order to preferably determine the position and orientation of the laser, in particular relative to the patient), the tracking system being adapted to detect the position and / or orientation of the robot head and / or the position and / or orientation of the patient and thus the position and / or orientation of the operating area. The laser guidance robot also has a projection laser, the laser radiation emitted by which is preferably in the visible range of the human eye, and which is arranged, in particular fastened, on the robot head, so that the position and orientation of the projection laser can be detected and set indirectly via the robot head. Furthermore, the laser-guided robot has a control unit adapted to determine a target position and a target orientation of the projection laser relative to the surgical area of ​​the patient and to control a robot arm having the robot head and the projection laser such that the projection laser is moved / displaced into the target position and target orientation and at least one guide axis is visually presented on the surgical area by (visual) projection of the laser radiation of the projection laser in the target orientation.

[0015] In particular, the control unit calculates the surgical plan from the preoperative filming and thereby calculates at least one predefined surgical site for performing surgery with the target position and target orientation of the projection laser. In addition, the control unit can be adapted in particular to calculate the surgical axis that is abutted against the surgical site with the calculated surgical angle. The robot arm is movable and has a certain number of degrees of freedom. The projection laser is mounted / fastened on the distal end section or robot head of the robot arm and thus moves with the robot arm and can be controlled by the robot. The tracking system detects the position and orientation of the robot head and thus (in particular by a statically known or predeterminable transformation from the coordinate system of the robot head to the projection laser) detects the position and orientation of the projection laser in space. In this way, it is also possible to not only control but also detect the reaching of the target position and target orientation of the projection laser. The projection laser is arranged / positioned and oriented by the degrees of freedom of the robot arm so that the emitted laser radiation (i.e. the longitudinal axis of the laser radiation) of the projection laser corresponds to the calculated surgical axis with the calculated surgical angle. The laser radiation emitted by the projection laser is directly visually visible because the projection laser emits a wavelength in the visible range or a wavelength in the invisible range but causing fluorescence in the instrument, thus constructing a guide shaft for surgery or intervention.

[0016] The target position and target orientation of the projection laser are here a position and orientation of the projection laser in which the guide axis projected by the laser radiation corresponds to the calculated surgical axis and is oriented in particular to a target point to be targeted in the surgical area.

[0017] The preoperative recordings are preferably acquired before the operation by means of computed tomography recordings (CT recordings) and / or magnetic resonance tomography recordings (MRT recordings).

[0018] The term "tracking system" describes a technical system which enables spatial localization and enables the detection of the position and / or orientation of a target object.

[0019] The term "position" refers to a geometric position in three-dimensional space, which is described in particular with the aid of coordinates of a Cartesian coordinate system. In particular, the position can be described by three coordinates X, Y and Z.

[0020] The term "orientation" again describes the orientation in space (approximately at this position). It can also be said that the orientation is described by the orientation in a direction or rotation in three-dimensional space. In particular, the orientation can be described with the aid of three angles.

[0021] The term “position” includes both the position and the orientation. In particular, the position can be specified using six coordinates, three position coordinates X, Y and Z and three angular coordinates for the orientation.

[0022] In summary, it can be seen that the core of the present disclosure is that the projection laser is positioned and oriented by the robot arm so that the laser radiation emitted by the projection laser corresponds to the surgical axis to be traveled, in particular the surgical axis calculated before surgery for the operation. The surgeon can visually indicate not only the position in the surgical area, but also the axis (with the corresponding surgical angle).

[0023] The laser-guided robot according to the present disclosure enables a user or medical professional, in particular a surgeon, to track the calculated surgical axis as accurately as possible. Therefore, the advantages of a surgical robot, namely, accurate tracking of the surgical trajectory calculated before surgery, can be combined with the high flexibility and simple operation of (traditional) manual surgery. In particular, it indicates to the treating surgeon at which angle the surgeon should perform the surgery. Here, the projected guide axis can, for example, indicate how a biopsy needle should be introduced into the patient's body or at which angle a pedicle screw should be screwed into the patient's spine. By assisting the surgeon with the display / projection of the guide axis, surgery can be performed accurately and the patient's safety can be improved. The trauma associated with surgery is reduced.

[0024] The object of the present disclosure is also solved by a projection method according to the present disclosure for projecting a guide (with a guide axis), in particular a surgical plan (calculated before surgery), by means of a projection laser fastened to a robot head. The projection method has the following steps. A tracking system detects the position and / or orientation of the robot head and thus (by means of a determinable transformation between the robot head and the projection laser) detects the position of the projection laser in space. The control unit calculates the guide axis, in particular based on a pre-operative photograph. In addition, the control unit calculates a target position and a target orientation of the projection laser based on the calculated surgical axis, in particular from the pre-operative photograph. The robot arm then moves the robot head to the calculated and predetermined target position and target orientation using the projection laser. The projection laser projects laser radiation in the target orientation so that at least one guide axis is visually presented on the surgical field. In particular, the projected guide axis corresponds to the calculated surgical axis.

[0025] Preferably, the control unit calculates the surgical plan based on the preoperatively detected recordings. Here, the calculated surgical plan has at least one surgical site (target point) and a surgical axis and / or a surgical angle. In particular, the surgical plan has a straight line trajectory.

[0026] By means of the projection method according to the present disclosure, the calculated surgical axis of the planned surgery can be presented as a projected guide axis. Thus the surgeon can perform the surgery with high precision by following the guide axis and thus the surgical axis.

[0027] Advantageous developments of the disclosure are the subject matter of the dependent claims and are explained in particular below.

[0028] Preferably, the control unit calculates at least one first target position and a target orientation of the projection laser based on the surgical plan stored in the storage unit. The control unit can manipulate the robot arm so that the projection laser projects its laser radiation at the target position and target orientation onto the calculated surgical site and visually presents the guide axis with the calculated target orientation. The laser radiation and therefore the guide axis indicate the surgical site calculated by the control unit.

[0029] The memory unit can be embodied as part of the control unit or as part of an external control device.

[0030] Advantageously, the control unit controls, i.e. positions and orients the projection laser via the robot arm relative to the predefined surgical site in such a way that the guide axis reaches the predefined surgical site (or a target point of the surgical site) at a preset angle. The laser radiation emitted by the projection laser thus indicates the surgical angle. The surgical angle is hereby calculated, in particular, as an angle of an optimal angle for the surgical intervention. The surgical angle can be calculated based on a preoperative data set.

[0031] According to another optional aspect of the present disclosure, the surgical plan has a preferably straight (surgical) trajectory, (intermediate) target points (especially target points on the straight surgical trajectory, for example to indicate the axis and target position for the instrument) and / or the contour of the (surgical) target. In addition, the surgical plan preferably has at least one surgical site, surgical axis and / or surgical angle. The control unit can set the target orientation of the projection laser (together with the associated target position) so that the guide axis corresponds to the surgical axis. The calculated surgical axis is thereby indicated to the user via the projected guide axis. The guide axis can correspond to the (arbitrary) surgical axis, because the projection laser can be moved to almost any position and orientation via the (movable) robot arm. The surgeon only needs to follow the projected guide axis during the operation in order to place his (medical) instrument or product at the correct surgical angle. This increases the probability that the surgeon will reach the calculated surgical axis.

[0032] Preferably, the laser radiation emitted by the projection laser is adapted so that it visually indicates the focal point at the predetermined surgical depth or indicates the focal point. The surgical depth can be the object of the calculated surgical plan and can be calculated by the control unit based on pre-operative filming. If the projection laser indicates the calculated surgical depth during the operation, the probability that the surgeon inadvertently operates at the wrong depth is minimized. Complications and trauma can thereby be avoided. The operation is gentler for the patient and the recovery time after the operation is shortened.

[0033] It may be advantageous that the laser radiation projected by the projection laser constructs a conical structure with a focus, wherein the focus indicates the surgical depth. The surgical depth is visually presented by the focus of the projection laser away from the tip of the conical structure, so that a ring or elliptical shape is constructed in the surgical area above the surgical depth (i.e., toward the projection laser), which converges to the focus in the surgical depth. That is, the emitted laser radiation is circularly (with a varying diameter) constructed in the cross section and is not point-shaped. The laser radiation intersects each other at the intersection of the tip forming the cone. The intersection represents the optimal (calculated) surgical depth. When the surgeon has not yet reached the desired surgical depth, the laser radiation is displayed as a ring on the projection surface. The size of the ring can indicate the distance that the surgeon is still away from the surgical depth. The larger the projected ring, the farther the distance from the desired surgical depth. When the surgeon follows the surgical axis, the laser radiation can be constructed as concentric rings. If the surgeon deviates from the surgical axis during surgery, that is, the surgical direction is tilted to the laser radiation and the projection surface on the patient is not orthogonal to the longitudinal axis, the laser radiation can be indicated as an elliptical shape. This indicates to the surgeon that the surgical direction does not coincide with the calculated surgical axis.

[0034] Preferably, the medical instrument or product may have a predetermined projection area or device on which the user can see the projection of the projection laser.

[0035] In particular, the laser radiation projected by the projection laser forms a hyperbolic / bi-conical structure (e.g., an hourglass) with a focus for visually presenting the surgical depth at the common tip of the bi-conical structure, so that a ring or elliptical shape is constructed in the surgical area above the surgical depth, which converges to the focus in the surgical depth and diverges again as a ring or elliptical shape below the surgical depth. If the surgeon penetrates too deeply during surgery, the laser radiation may appear as a ring that grows larger with increasing distance from the desired surgical depth.

[0036] Preferably, the projection laser emits at least two straight laser beams, which are at an angle relative to each other and intersect each other, and the intersection of the at least two laser beams indicates the calculated surgical depth. As mentioned above, the laser radiation can be emitted by the projection laser non-parallel or converging with each other. Thereby, multiple emitted laser beams (straight and not fanned out) intersect and form an intersection. The calculated surgical depth is indicated by this intersection. In particular, two points can be projected by two straight laser beams, the distance between the two points decreases towards the focus and converges to a single overlapping point.

[0037] According to a further optional aspect of the present disclosure, the laser-guided robot has an input and output unit, in particular a (touch) display, for inputting control commands and / or outputting information to a medical professional, in particular a surgeon. The user can, for example, select the desired final position and final orientation of the robot head and / or the target position and target orientation of the projection laser via the input and output unit, and the robot moves the projection laser accordingly. The user, in particular a medical professional or a surgeon, can also input the trajectory of the surgery via the input and output unit.

[0038] Preferably, the tracking system comprises an optical navigation system with a navigation camera and one or more optical trackers. The tracker is prepared and configured to be fastened to the distal end section of the robot arm or the robot head and / or the patient so that its position and orientation in space are detected by the navigation camera of the navigation system so as to move the projection laser to the detected position and / or orientation relative to the patient and thereby to the calculated target position and target orientation relative to the surgical area. In particular, the robot head has a rigid body with reflective markers as a robot tracker. For example, one tracker is mounted on the patient and one tracker is mounted on the robot head. The navigation camera is preferably a stereo camera capable of detecting the position and orientation of the tracker. The position and orientation of the patient and thereby the surgical area and the position and orientation of the robot head and thereby the projection laser can thereby be detected. In particular, the patient's alignment can be performed based on the patient tracker, or the control unit can be adapted to perform the patient's alignment with the aid of the tracking system. The optical navigation system can in particular detect the initial position of the robot head and move the robot head to the target position and orient it relative to the surgical area of ​​the patient and to the target orientation. The optical navigation system recognizes the arrival of the target position and the target orientation.

[0039] Preferably, the position and orientation of the robot head can be detected by the servomotors of the guide robot (via the corresponding robot kinematics). Thus, no optical tracking or navigation system with cameras and trackers is required to detect the position and orientation of the robot head. Precisely controllable servomotors are already present in the guide robot.

[0040] Furthermore, the projection laser can preferably be moved relative to the robot head by means of a servo motor in order to actively set the orientation of the projection laser relative to the robot head. The projection laser thus also has at least one degree of freedom relative to the robot head. The orientation of the projection of the laser radiation by means of the projection laser is thereby still more flexible.

[0041] According to a further optional aspect of the disclosure, preoperative recordings of the patient, in particular in the form of computed tomography and / or magnetic resonance tomography (CT recordings and / or MRT recordings), are stored in the storage unit / data provision unit. The control unit calculates the surgical axis and the best possible associated target position and target orientation that are incorporated into the preoperative recordings based on the registered patient and moves / displaces the projection laser accordingly so that the guide axis is indicated as best as possible and is in particular aligned coaxially with the surgical axis and thus with the surgical axis.

[0042] Preferably, the guidance robot has at least one projection laser, preferably two projection lasers, and the projection laser or lasers are adapted to emit at least two different wavelengths in order to display two different colors and to color-code different targets, in particular in the surgical field. Different relevant orientation points, such as organs or different targets, such as biopsies and / or tumors or medical products, can be indicated by the different colors of the lasers.

[0043] Furthermore, according to a further optional aspect of the present disclosure, when the (optical) navigation system detects the current position and / or orientation of the projection laser during the manual movement and indicates that the calculated target position and / or target orientation has been reached, the projection laser can be brought to the calculated final position by manually moving the robot arm. The robot arm can thereby also be positioned manually by the surgeon and the surgeon can see, for example, how far it is from its target position and target orientation via a presentation device.

[0044] In particular, the target position can be set and in particular presented on the longitudinal axis of the laser beam. In other words, the guide axis can be oriented in space, but in the case of parallel laser beams it can be moved along the longitudinal axis and still indicate the guide axis.

[0045] In particular, the projection laser can be adapted to adapt the laser radiation in the form of intersecting laser beams, so that the distance between the projection laser and the intersecting laser beams is changed to set the focus. In particular, the control unit can be adapted to maintain the focus when the robot head is moved together with the projection laser in a translational manner along the longitudinal axis of the laser radiation by correspondingly changing the distance between the projection laser and the intersecting laser beams together.

[0046] The object of the present invention is also achieved by a laser-guided robot system, which has a laser-guided robot according to the present disclosure, in particular according to one of the aforementioned aspects, and has a medical instrument, in particular a surgical instrument, in particular a screwdriver and / or a medical product, in particular a biopsy needle or a pedicle screw. The laser-guided robot projects a guide axis onto the surgical area by means of a projection laser. The medical instrument or product can be oriented along the guide axis with a longitudinal axis in such a way that a preferably proximal section (along the longitudinal axis) of the instrument or product has a projection surface onto which the projection laser projects laser radiation when the instrument or product is oriented with its longitudinal axis substantially parallel to, in particular coaxially to, the guide axis.

[0047] Preferably, the medical product has an optical marking on the proximal end, which indicates whether the surgical product is oriented on the surgical axis. The proximal marking can be, for example, concentric circles. If the laser radiation is irradiated on the proximal marking in such a way that the point-shaped projection is located in the center of the marking or the annular projection is arranged concentrically with the circle of the marking, the surgical product is oriented along the guide axis or the surgical axis. Other rings can display a certain angle, which helps the surgeon to decide whether the surgical axis of the selected instrument or product is still within the tolerance range of the optimal surgical axis. In particular, a target disk or a target disk-shaped ring can be drawn on the projection surface, so that when the laser point is illuminated in the center of the target disk, it indicates to the surgeon whether it is coaxial with the guide axis.

[0048] The laser-guided robot according to the present disclosure can be modified, in particular, according to at least one of the following embodiments: the robot head can have a surgical microscope; the laser-guided robot can be combined with a known navigation system; the laser-guided robot can be combined with a surgical robot system; the projection laser can be integrated into the optical device of the surgical microscope; the projection laser can be fastened to the robot head or can be mounted on the robot head; the laser-guided robot can be used as a robot laser pointer controlled by an external user; the navigation system can be based on an infrared system with an infrared camera and / or can be based on electromagnetic tracking (EM) and / or can be based on a computer vision system.

[0049] Here, laser-guided robots and projection methods can be used as follows. The following applications are exemplary in nature. The enumeration is not exhaustive. The planned surgical site / entry site can be projected onto the patient's skin. A path or (especially a straight) trajectory from the surgical site to the tumor can be projected. Critical structures such as blood vessels can be marked to avoid unintentional damage. The outer boundaries / borders of the tumor can be marked. The trajectory of the biopsy can be marked and indicated via a guide shaft. The trajectory of a (planned) bone screw can be marked by a guide shaft. The laser can be used as a remotely controlled laser pointer, which an assisting surgeon uses to indicate anatomical orientation points to guide the surgeon performing or conducting the operation.

[0050] The object is achieved with respect to a computer-readable storage medium and a computer program in that they each comprise instructions which, when executed by a computer, cause the computer to carry out the steps of the projection method according to the disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0051] The present disclosure is explained in more detail below based on preferred embodiments with the aid of the accompanying drawings.

[0052] Figure 1 A laser-guided robot according to a preferred embodiment of the present disclosure is shown;

[0053] Figure 2 A schematic diagram showing a laser-guided robot according to another embodiment of the present disclosure;

[0054] Figure 3 shows a partial cut-away portion of a laser-guided robot having a robot head with a projection laser;

[0055] Figure 4 A schematic diagram showing a display view with a surgical axis in tissue;

[0056] Figure 5 A system according to a preferred embodiment of the present disclosure is shown having a medical product in the form of an instrument and a robotic head;

[0057] Figure 6a A schematic diagram showing intersecting laser radiation of a projection laser, thereby producing a double cone projection;

[0058] Figure 6b Schematic diagram showing simple straight laser radiation of a projection laser;

[0059] Figure 6c A schematic diagram showing the parallel laser radiation of a projection laser in order to create a hollow cylindrical projection; and

[0060] Figure 7 A flowchart of a projection method according to a preferred embodiment of the present disclosure is shown.

[0061] The accompanying drawings are merely schematic in nature and are only useful for understanding the present disclosure. Identical elements are provided with identical reference numerals. The features of the various embodiments may be substituted for one another. DETAILED DESCRIPTION

[0062] Figure 1 A laser-guided robot 1 is shown, which is arranged next to a patient 100. The laser-guided robot 1 has a guiding robot with a (movable) robot arm 2, which is movably articulated or fastened to a robot base 3. The robot arm 2 has a distal robot head 4 connected to the robot arm 2. The laser-guided robot 1 also has a tracking system 6, a projection laser 8 and an input and output unit 10 in this embodiment. The tracking system 6 detects the position and orientation of the robot head 4 and the position and orientation of the patient 100 and thus of the surgical field. The projection laser 8 is fastened to the robot head 4, and the position and orientation of the projection laser 8 can be set indirectly via the robot head 4. The projection laser 8 emits laser radiation 12, which in this embodiment lies in the range between 380 nm and 750 nm visible to the human eye.

[0063] The laser guided robot 1 also has a control unit 14 (in Figure 2), the control unit 14 is adapted to determine a target position and a target orientation of the projection laser 8 relative to the surgical area of ​​the patient 100. The control unit 14 controls the robot arm 2 with the robot head 4 and the projection laser 8 in such a way that the projection laser 8 is moved / displaced into the target position and the target orientation. By the (visual) projection of the laser radiation 12 of the projection laser 8 in the target orientation, at least one guide axis 16 and also the surgical site (target point) acting on the surgical area are visually presented. In this way, in contrast to the known prior art, the surgeon is not only provided with a projection of the surgical point on the patient, but also with a visual presentation of the guide axis.

[0064] The robot base 3 of the laser-guided robot 1 is preferably arranged on a rolling or movable cart in order to provide a mobile laser-guided robot 1 that can be moved to different positions in the operating room. The control unit 14 is arranged in the cart (in Figure 1 Not shown, but in Figure 2 ), a power source (not shown) and optionally a battery (not shown) for backup power. In addition, a storage unit 17 (not shown) is placed in the vehicle.

[0065] The robot arm 2 has a plurality of robot arm segments and joints, so that the robot arm 2 can move with different translational degrees of freedom and at least one rotational degree of freedom. The robot head 4 is articulated rotatably about an axis at the distal end of the robot arm 2. The robot head 4 and thus the projection laser 8 are thus at least translationally movable in space and can be rotated about the longitudinal axis of the distal end of the robot arm 2 in order to set a target position in space (relative to the patient) and a target orientation with a corresponding guide axis.

[0066] Figure 2 A schematic diagram of a laser-guided robot 1 is shown with a robot arm 2 together with a robot head 4, a tracking system 6, a projection laser 8 and a control unit 14. The tracking system 6 has an optical navigation system 18 with a navigation camera 19 having at least two spaced-apart camera lenses 20 and a number of (optical) trackers 22 (markers). The trackers 22 each have three or four arms 24 protruding from a common point in different directions. Here, the individual arms 24 are preferably arranged perpendicularly or at an angle of 120° to each other. A tracking ball 26 is arranged on the outer end of each arm. The tracking ball 26 is designed so that the tracking ball can be easily detected by the navigation camera 19 and can also emit light signals. The individual tracking balls 26 of the trackers 22 are located in a common plane. By orienting the plane in space, the navigation system 8 can calculate how the respective tracker 22 is arranged on the object. Such trackers 22 are known.

[0067] The laser tracker 28 is fastened to the robot head 4 at the distal end of the robot arm 2. This enables detection of the position and orientation of the robot head 4 in space. The patient tracker 30 is mounted on the patient 100 to detect the position and orientation of the patient 100 in space for patient registration.

[0068] The input and output unit 10 is a touch screen display, via which information can be output to a user and information can be input from a user to the laser guided robot 1 .

[0069] The control unit 14 of the laser-guided robot 1 can determine the target position and target orientation of the projection laser 8 relative to the surgical area of ​​the patient and control the robot arm 2. In particular, the control unit 14 can control the robot arm 2 so that the projection laser 8 is moved / displaced into the target position and target orientation. The control unit 14 calculates the target position and target orientation as well as the surgical axis 32 based on the preoperative imaging of the patient. The preoperative imaging is detected by computer tomography and / or magnetic resonance tomography of the patient and is provided to the control unit 14 via a data provision unit. The control unit 14 moves the projection laser 8 accordingly so that the guide axis 16 corresponds to the surgical axis 32.

[0070] The robot head 4 has, for example, a (surgical) camera 34, by means of which the user can examine the intervention site or the surgical site. A projection laser 8 is mounted on the robot head 4, which emits laser radiation 12. The laser radiation 12 emitted by the projection laser 8 displays a guide axis 16 or a surgical plan at the surgical area. The surgical plan can, for example, be the surgical site at which the surgeon is to make an incision. The surgical plan can also be a trajectory from the incision site to the target, such as a biopsy area, a tumor or a (surgical) screw, and this trajectory can be visualized at least in sections via the corresponding guide axis.

[0071] Figure 3 The distal end of the robot arm 2 is shown with the robot head 4, the tracker 22 and the projection laser 8. By means of the tracker 22, in particular a laser tracker, the (optical) navigation system 18 can detect in real time the position and orientation in space of the robot head 4. The control unit 14 can thereby recognize when the robot head 4 has reached a target position and a target orientation.

[0072] Figure 4The calculated surgical axis 32 in the preoperative photograph of the patient 100 is shown. For this purpose, the body or tissue 102 of the patient 100 is detected or scanned before the operation. The control unit 14 or an external computing unit (not shown) calculates a surgical plan with at least one surgical trajectory 50 based on these preoperative photographs. Here, the surgical axis 32 is also calculated and the target point is currently also calculated on the surgical axis of the surgical trajectory at a corresponding distance. The goal of the operation is that the medical instrument or product 36 follows the calculated surgical axis 32 as accurately as possible and stops accordingly at the target depth so that the corresponding manipulation can then be performed there. For this purpose, the calculated surgical axis 32 must be visible so that the surgeon can follow the surgical axis 32 with the medical product 36. This is achieved by the present disclosure. In particular, the target point can be shown in the target depth by means of intersecting laser beams.

[0073] Figure 5 A laser-guided robot system of the present disclosure is shown with a laser-guided robot 1 and a medical product or instrument 36. A projection laser 8 emits laser radiation 12, which presents a guide axis 16. The longitudinal axis of the medical product 36 is oriented along the projected guide axis 16. If the longitudinal axis of the medical product 36 corresponds to the guide axis 16, the medical product 36 is also oriented along the calculated surgical axis 32. The degrees of freedom of the robot arm 2 allow the projection laser 8 to be oriented and positioned in such a way that the emitted laser beam 12 corresponds to the projected guide axis 16. The positioning and / or orientation of the robot head 4 is detected by means of the projection laser 8 by means of a tracker 22, whereby the target position and the target orientation can be precisely manipulated. The proximal section 40 of the medical product 36 has a marking in the form of concentric rings, which indicates whether the medical product 36 is oriented with the longitudinal axis 42 in the guide axis 16. If the straight laser beam of the projection laser is displayed centrally in the concentric rings, it can be assumed that the surgical axis 32 and the guide axis 16 are oriented coaxially.

[0074] Figures 6a to 6c Different embodiments of a projection laser 8 with differently configured laser radiation are shown, which laser radiation can be used in the laser-guided robot 1 or laser-guided robot system of the present disclosure, respectively.

[0075] Figure 6aA projection laser 8 according to a first embodiment is shown. Here, a laser beam 12 is emitted by the projection laser 8 in the form of a double cone. The ring-shaped laser beams 12 are at an angle to one another and therefore intersect at an intersection 38. The calculated surgical depth can be indicated by the intersection 38 of the laser beams 12 which form the contour of the double cone. More precisely, the laser beams 12 converge in the form of a cone. The tip of the cone marks the calculated / desired surgical depth. As long as the surgical depth has not been reached, these projections indicate a ring or elliptical shape during surgery. Only a point can be seen when the surgical depth is reached. If the surgical depth is to be entered deeper than the calculated surgical depth, the ring becomes larger again as the distance from the surgical depth increases.

[0076] Figure 6b A projection laser 8 is shown according to a second embodiment. Here, the projection laser 8 is designed as a point laser or a line laser. If the projection laser 8 is to be designed as a line laser, the projection laser 8 has a special lens (not shown) which fans out the point laser into a line laser (i.e. a constant cross-sectional profile along the longitudinal axis of the laser radiation as a line). In this design, the laser radiation 12 cannot indicate any calculated or desired depth of the incision. However, the guide axis 16 can be indicated very precisely by the laser radiation 12.

[0077] Figure 6c A projection laser 8 according to a third embodiment is shown. In this case, a hollow cylindrical laser beam 12 marks a predetermined area with the aid of a circle. By means of the marked area, a tumor to be removed can be marked, for example.

[0078] Figure 7 A flow chart of a projection method according to the present disclosure is shown, which is used to visually project a surgical plan guide onto a surgical area of ​​a patient 100 using a projection laser 8 fastened to a robot head 4 of a robot arm 2 .

[0079] In a first step S1 , the tracking system 6 detects the position and orientation of the robot head 4 and the projection laser 8 in space.

[0080] In step S2 , the control unit 14 plans / calculates the surgical axis 32 based on the preoperative imaging.

[0081] In step S3 , the control unit 14 calculates the target position and the target orientation of the projection laser 8 .

[0082] In step S4 , the robot arm 2 uses the projection laser 8 to move the robot head 4 to a predetermined target position and target orientation.

[0083] In step S5 , the projection laser 8 projects the laser radiation 12 in its target orientation such that the guide axis 16 projected by the projection laser 8 corresponds to the surgical axis 32 .

[0084] In this way, the projection method can indicate an axis to the surgeon.

[0085] Reference numerals list

[0086] 1 Projection device

[0087] 2 Robotic Arm

[0088] 3 Robot base

[0089] 4 Robot Head

[0090] 6 Tracking system

[0091] 8 Projection Laser

[0092] 10 Input and output units

[0093] 12 Laser radiation

[0094] 14 Control Unit

[0095] 16 Guide shaft

[0096] 18 Navigation System

[0097] 19 Navigation Camera

[0098] 20 Camera Lenses

[0099] 22 Tracker

[0100] 24 Arm

[0101] 26 Tracking Ball

[0102] 28 Laser Tracker

[0103] 30 Patient Tracker

[0104] 32 surgical axis

[0105] 34 Surgical Camera

[0106] 36 Medical products

[0107] 38 intersection

[0108] 40 Proximal segment

[0109] 42 Vertical axis

[0110] 50 Surgical Trajectory

[0111] 100 patients

[0112] 102 Organization.

Claims

1. A laser-guided robot (1) for visually projecting a guide axis, in particular a surgical plan calculated before surgery, onto a surgical area of ​​a patient (100), comprising: A guide robot (1) having a robot arm (2) movably articulated on a robot base (3) and a robot head (4) connected to the robot arm (2) and located at the end; a tracking system (6), in particular an optical navigation system, adapted to detect the position and / or orientation of the robot head (4) and preferably also the position and / or orientation of the patient (100) and thereby the operating area; a projection laser (8), the emitted laser radiation (12) of which is preferably in the range visible to the human eye and which is arranged, in particular statically fastened, on the robot head (4) so ​​that the position and orientation of the projection laser (8) can be set indirectly via the robot head (4); as well as A control unit (14) is adapted to determine a target position and a target orientation of the projection laser (8) relative to an operating area of ​​the patient (100), in particular based on a surgical plan calculated before surgery or a preset surgical axis (32), and to control a robot arm (2) having the robot head (4) and the projection laser (8) so that the projection laser (8) moves into the target position and the target orientation and at least one guide axis (16) is visually presented on the operating area by projection of the laser radiation (12) of the projection laser in the target orientation.

2. The laser-guided robot (1) according to claim 1, characterized in that The control unit (14) is adapted to calculate at least one first target position and target orientation of the projection laser (8) based on a surgical plan stored in a storage unit (17) and to control the robot arm (2) accordingly so that the projection laser (8) moves to the target position and target orientation and the laser radiation (12) of the projection laser is projected onto the calculated surgical site so as to visually indicate the guide axis (16).

3. The laser-guided robot (1) according to any one of the preceding claims, characterized in that The control unit (14) positions and orients the projection laser (8) via the robot arm (2) relative to a predefined surgical site in such a way that the longitudinal axis of the laser radiation (12) and therefore the guide axis (16) extends at a predefined angle to the predefined surgical site.

4. The laser-guided robot (1) according to any one of the preceding claims, characterized in that The surgical plan having an outline of a surgical trajectory, intermediate target points, and / or a surgical target; and / or having at least one surgical site, a surgical axis (32) and / or a surgical angle, The control unit (14) sets the target orientation of the projection laser (8) such that The guide axis (16) through which the laser radiation is projected corresponds to the surgical trajectory, or The guide axis (16) corresponds to the surgical axis (32).

5. The laser-guided robot (1) according to any one of the preceding claims, characterized in that The laser radiation (12) emitted by the projection laser (8) is adapted in such a way that it visually displays a focus at a predetermined operating depth and indicates the focus in particular in a direction-dependent manner.

6. The laser-guided robot (1) according to any one of the preceding claims, characterized in that The laser radiation (12) projected by the projection laser (8) forms a double cone having a focus for visually presenting the surgical depth at the common tip of the double cone, so that a ring or ellipse shape is formed in the surgical area above the surgical depth, which converges to the focus at the surgical depth and diverges again as a ring or ellipse shape below the surgical depth.

7. The laser-guided robot (1) according to any one of the preceding claims, characterized in that The projection laser (8) emits at least two laser beams (12) which are at an angle to each other and intersect each other, wherein an intersection point of the at least two laser beams indicates a calculated surgical depth.

8. The laser-guided robot (1) according to any one of the preceding claims, characterized in that The tracking system (6) has an optical navigation system (18), which has a navigation camera (19) and at least one optical tracker (22), which is arranged at least on the robot head (4) and can also be fastened to the patient, so that the position and orientation in space can be accurately detected by the navigation camera (19) in order to move the projection laser (8) to a calculated target position and target orientation relative to the operating area.

9. The laser-guided robot (1) according to any one of the preceding claims, characterized in that The position and orientation of the robot head (4) and thus the position of the projection laser (8) are detected by means of the servomotors of the guide robot (1).

10. The laser-guided robot (1) according to any one of the preceding claims, characterized in that The projection laser (8) can be oriented relative to the robot head (4) via at least one bearing and can in particular be actively adjusted via a servo motor to a predetermined orientation relative to the robot head (4).

11. The laser-guided robot (1) according to any one of the preceding claims, characterized in that Preoperative images of the patient (100), in particular CT images and / or MRT images, are stored in a storage unit (17), and a surgical axis (32) connected to the preoperative images is calculated based on the registered patient (100) by the control unit (14) to have a target position and a target orientation, and the projection laser (8) is moved to the target position and the target orientation, so that the guide axis (16) corresponds to the surgical axis (32).

12. A laser-guided robot system comprising a laser-guided robot (1) according to any one of claims 1 to 11 and a medical, in particular surgical instrument or a medical product (36), wherein: The laser-guided robot (1) projects the guide axis (16) onto the operating area via the projection laser, and the medical instrument or product (36) can be oriented along the guide axis (16) with a longitudinal axis (42), preferably, a particularly proximal section (40) of the instrument or product (36) has a projection surface onto which the projection laser (8) projects the laser radiation (12) when the medical product (36) is oriented with its longitudinal axis (42) essentially coaxially with the guide axis (16).

13. A projection method for visually projecting a guide axis, in particular a surgical plan calculated before surgery, onto a surgical area of ​​a patient (100) using a projection laser (8) arranged on a robot head (4) of a robot arm (2), comprising the following steps: - detecting (S1) the position and / or orientation of the projection laser (8) in space by means of a tracking system (6), in particular indirectly via the position of the robot head (4); - calculating (S2) the surgical axis (32), in particular based on preoperative recordings by the control unit (12); - calculating (S3) a target position and a target orientation of the projection laser (8) by means of a control unit (12), the control unit being close to, in particular located on, the surgical axis (32); - moving (S4) the robot head (4) into a predetermined target position and target orientation by means of the robot arm (2) using the projection laser (8); and - Projecting laser radiation (12) by means of the projection laser (8) at the target orientation, so that the guide axis (16) is projected by means of the projection laser (8) and the calculated surgical axis (32) is displayed.

14. A computer-readable storage medium comprising instructions, which, when executed by a computer, cause the computer to implement the steps of the projection method according to claim 13.

15. A computer program comprising instructions which, when executed by a computer, cause the computer to implement the steps of the projection method according to claim 13.

Images