Surgical / medical instrument for a surgical robot and a supporting structure for an end effector for supporting-access of

Abstract

The present disclosure relates to a medical instrument for a medical robot (1) or for a medical robot, having a support structure (116; 216; 216; 316) for supporting and accommodating at least one selectively replaceable end effector (18) of the medical instrument, the support structure having a proximal coupling section (30; 230), which is provided and configured for coupling with a distal end section (10) of the robot (1), and which has a distal coupling section (32), which is provided and configured for coupling with a selectively exchangeable end effector (18), in which the carrier structure (116; 216; 216; 316) is or has a connecting part which extends in one piece at least between a proximal coupling section (30) and a distal coupling section (32), whereby a coupling-free and / or tolerance-chain-free connection is produced between the proximal coupling section and the distal coupling section (30, 32). The present disclosure also relates to a load bearing structure (116; 216; 216; 316) for a surgical / medical instrument or for a surgical / medical instrument, for a surgical / medical robot or for a surgical / medical instrument of a surgical / medical robot, for supporting at least one selectively replaceable end effector (18) of an instrument.

Description

Field of the Invention

[0001] The present disclosure relates to a surgical / medical instrument for a surgical robot or of a surgical robot, and to a carrier structure for supportingly receiving an end effector of a surgical / medical instrument for a surgical robot or of a surgical robot. Background Art

[0002] In surgical operations, the robot-assisted manipulation of surgical / medical instruments is becoming increasingly important. The advantages are manifold, in particular the minimally invasive use of end effectors such as tools, HF tips, lighting devices, optics, cameras, pedicle screws and other working devices, which can be controlled with high precision and high reproducibility accuracy in the area of intervention on the patient (surgical area). At the same time, high precision and high reproducibility accuracy are basic prerequisites for performing interventions with a robot, especially in the case of minimally invasive interventions without vision in the surgical area.

[0003] Therefore, continuously knowing the position and orientation of the working point relative to the surgical area is of decisive importance. For this purpose, devices for 3D tracking of the working point - "rigid-bodys" - are provided on the robot-guided medical / surgical instrument, which are captured by a 3D camera and can be analyzed by means of triangulation, so that the position and orientation of the working point can be determined. With the help of the rigid body, the initial calibration is also carried out on-site in the operating room. Starting from the calibrated initial state, the rigid body is tracked, both for the rigid body of the instrument and, if necessary, for the rigid body at the patient. If the surgical robot has to be repeatedly removed from the surgical area to replace the end effector, time-consuming recalibration may be required after the replacement. In principle, any stationary or drivable medical / surgical tool, product or auxiliary device that can be applied in a medical / surgical instrument can be understood as an end effector. Exemplarily listed are: drills, milling cutters, scalpels, HF tips for coagulation, pedicle screws, overview cameras, microscopes, endoscopes, optics, light sources, sensors, neuron sensors, etc.

[0004] Prior Art Documents

[0005] A surgical robot has an end effector connected to a surgical instrument. In current systems, the end effector disposed distally is at the end of a chain of a drive assembly and a housing assembly of a medical / surgical instrument. Of course, each of the above components has an "inherent tolerance" and also has a mounting tolerance for mating with an adjacent component, resulting in a tolerance chain. The more components (assemblies) the tolerance chain has, the more difficult it is to keep the maximum extension (deviation) to be observed at the working point (the so-called target area) within its specific specifications for intervention. Such a tolerance chain caused especially by the number of successive mounting sites and mating sites of a medical device is disclosed, for example, by the "Mako" system of the manufacturer Stryker.

[0006] According to the applicant of the present disclosure, in the known prior art, for example, a first housing part of a medical / surgical instrument is hinged to a mounting interface of a robot by a first adapter, the first housing part is connected in series with other housing parts of the end effector, and a receiving chuck for the end effector that can move relative thereto is supported on the last housing part, and the receiving chuck has an internal adapter for receiving the end effector. The applicant also recognizes that this type of design solution in principle requires general calibration during surgery. Additionally, it also results in complex calibration of the surgical instrument relative to the robot and an expansion of the target area due to each additional component of the tolerance chain as exemplarily explained above. If the end effector repeatedly exits the surgical area for replacement, it will result in a decrease in the reproducibility accuracy of the target area, such that ultimately time-consuming and surgery-interfering recalibration is required. Summary of the Invention

[0007] Correspondingly, the object of the present disclosure is to avoid or at least mitigate the disadvantages in the prior art, and in particular to provide a medical / surgical instrument for a surgical / medical robot or a surgical / medical robot, by which the position and extension (deviation) of the working point of the end effector can be better reproduced. Another object is to provide a carrier structure, in particular a housing, for supporting and accommodating the end effector of a medical / surgical instrument for a surgical / medical robot or a surgical / medical robot.

[0008] The first object is achieved by a medical / surgical instrument having the features of claim 1. The second object is achieved by a carrier structure, in particular a housing, having the features of claim 15. Advantageous expansion schemes are part of the dependent claims, and these dependent claims should also be claimed separately if necessary.

[0009] A surgical / medical instrument for a robot or of a robot, having a carrier structure for supporting and accommodating a selectively replaceable stationary or drivable end effector, preferably for supporting and accommodating the end effector and a drive of the end effector. The carrier structure has a proximal coupling section which is provided and configured for coupling with a distal end section of the robot. Furthermore, the carrier structure has a distal coupling section which is provided and configured for connection to a selectively replaceable end effector. Here, the carrier structure is or has a connecting part which extends monolithically, preferably materially monolithically, at least between the proximal coupling section and the distal coupling section. Thereby, a connection without a coupling and / or without a tolerance chain is created between the proximal coupling section and the distal coupling section.

[0010] Thus, in the region between the end section of the robot and the selectively replaceable / insertable end effector, due to the monolithic nature of the connecting part, there are only two coupling sites with tolerances. The coupling site where the proximal coupling section is coupled to the end section of the robot and the coupling site where the end effector is coupled to the distal coupling section. Thus, the tolerance chain and the resulting play are minimal in this region. Thus, the position and extent of the working point defined at the tip of the end effector, or the size of the target area (TZ), depend only on the tolerances of the connecting part, - of course also on the tolerances of the end section and the tolerances of the end effector used -. Different from the solutions according to the prior art, the internal tolerances of the instrument itself no longer have an impact on the position and extent. The manufacturing effort for the manufacturing technology of the working point for achieving high-precision positioning with minimal extent can thus be concentrated on the manufacturing of the connecting part. Under the condition that the connecting part is fixed on the end section and has been initially calibrated, and with the sizes and tolerances of the newly introduced end effector being known during replacement, the possibility arises of dispensing with recalibration after replacement, since only the known sizes and tolerances of the new end effector are reintroduced into the system during replacement.

[0011] Preferably, the target area according to the present disclosure has a diameter of less than 2 mm to greater than 1 mm.

[0012] Particularly preferably, the target area according to the present disclosure has a diameter of less than 1 mm.

[0013] Due to the short tolerance chain according to the present disclosure, this small diameter of the target area is achievable with a reduced manufacturing complexity compared to the prior art.

[0014] As already mentioned above, the concept of the target area refers to the maximum extension or deviation of the working point. In other words, the concept of the target area refers to the maximum envelope volume in which the tip of the end effector, i.e., the tool tip, is arranged due to tolerances.

[0015] The concept of "monolithic" in the sense of the present disclosure at least means that - especially in the force flow - no other coupling sections / no other joining parts are provided between the proximal coupling section and the distal coupling section. This is preferably implemented such that the proximal coupling section and the distal coupling section are on one part of the connecting component, preferably made of continuous material. Alternatively, for example, a plurality of parts of the connecting component can be fixedly joined, especially welded or glued, and then the coupling sections are manufactured in sequence on the joined parts.

[0016] In principle, any medical / surgical tool, product or auxiliary device that can be applied in a medical / surgical instrument, can be coupled to a medical / surgical instrument, and is stationary or drivable can be understood as an end effector. Exemplarily listed are: driven end effectors, such as drills or milling cutters; stationary or fixed end effectors, such as scalpels, HF tips for coagulation, overview cameras, microscopes, endoscopes, optical devices, light sources, sensors or sensor arrangements, neuron sensors; products to be used, such as pedicle screws, etc. According to the invention, the possible drive types are of course not limited to the above-mentioned rotational structures, but include any drive types commonly used in surgical operations, such as oscillating drives.

[0017] Preferably, the surgical / medical instrument is loaded with a selectively replaceable end effector by coupling the end effector to the distal coupling section (32). Preferably, the surgical / medical instrument has a set of selectively replaceable end effectors of different designs and / or nominal sizes, where one is used and the others are held.

[0018] The narrower the tolerances of the connecting component are manufactured, especially the tolerances of the proximal coupling section and the distal coupling section of the connecting component, the more prominent the mentioned advantages are. In an extended embodiment, the connecting component preferably has high-precision shape tolerances, positioning tolerances and position tolerances at least in the coupling sections.

[0019] According to an extended embodiment, the coupling section has a fixed orientation, angle or attitude relative to each other. In this way, the main axis or working axis of the end effector is fixedly arranged at a predetermined angle relative to the main axis or working axis of the end section of the robot. Depending on the type of end effector and the requirements for its operation, the connecting part can have a fixed parallel orientation or a fixed angled, in particular right-angled, orientation of the coupling sections relative to each other. The orientation can be defined by the abutment planes of these coupling sections or by their main axes.

[0020] In order to be able to orient the end effector relative to the end section without replacing the connecting part, the connecting part is in one variant designed and constructed for adjusting the abutment plane or the main axis of the coupling sections relative to each other.

[0021] In a preferred extended embodiment, the connecting part is the housing or at least one housing section of a medical device, in particular the housing or housing section of a drive of the medical device that can be coupled to the end effector. Thus, the same part can perform two functions: on the one hand, enabling a tolerance-free chain connection between the proximal coupling section and the distal coupling section, and on the other hand, performing the conventional protective function of the housing.

[0022] In order to at least sectionally accommodate and support the drive shaft of the end effector or the drive and the end effector coupled to the drive shaft, in an extended embodiment, the housing has a rod housing section on which the distal coupling section is formed. Preferably, the rod housing section extends rod-shaped or sleeve-shaped. Thereby, the rod housing section has an elongated structural form and requires little construction space.

[0023] In order to introduce the end effector or the drive shaft and the end effector coupled thereto, the rod housing section preferably has a proximal inlet. The rod housing section preferably has an outlet at the distal end, which is passed through by the end effector in normal operation, i.e., when the end effector is installed.

[0024] As already explained above, in order to optimize the manipulation of the end effector, the orientation (parallel, angled) of the coupling sections of the connecting part can be predetermined in different ways. In one possible extended embodiment, this orientation can be predetermined by the shaping of the rod housing section. In a particularly simple variant, the rod housing section extends straight from its inlet to the distal coupling section, which results in parallelism. Alternatively, the rod housing section can extend at least sectionally curved in this area, which results in an angle.

[0025] In order to introduce the end effector into the rod housing section in a reliably reproducible and careful manner, the rod housing section preferably has an introduction aid, and preferably has an introduction aid in the region of the inlet. The introduction aid is preferably configured as a continuous taper of the inner cavity or receiving cavity of the rod housing section, and the continuous taper is preferably funnel-shaped. The inner cavity or receiving cavity preferably extends from the inlet to the outlet.

[0026] According to an expansion scheme, the rod housing section has a radial constriction or an inner radial flange, and the axial stop of the distal coupling section is formed by the constriction or the inner radial flange. The axial stop is arranged and configured such that the correspondingly shaped axial stop of the end effector is placed in axial abutment with this axial stop.

[0027] The axial abutment can be configured directly or indirectly. In the case of an indirect configuration, for example, by means of at least one axial sliding bearing or axial rolling bearing, the axial sliding bearing or axial rolling bearing is placed on the radial taper or the inner radial flange.

[0028] The closer the axial stop is configured to the end section of the distal end of the rod housing section, the simpler the manufacture of the axial stop in the interior of the rod housing section. Therefore, in a preferred expansion scheme, the radial taper or the inner radial flange is formed by the end wall of the distal end of the rod housing section and is penetrated by the outlet.

[0029] In order to be able to keep the extension of the working point of the end effector also minimal in the radial direction, according to an expansion scheme, the rod housing section has an inner circumferential surface, and the radial stop of the distal coupling section is formed by the inner circumferential surface. The radial stop is arranged and configured such that the correspondingly shaped radial stop of the end effector is placed in radial abutment with this radial stop. The radial abutment can be configured directly or indirectly. In the case of an indirect configuration, for example, by means of at least one radial sliding bearing or radial rolling bearing, the radial sliding bearing or radial rolling bearing is placed on the inner circumferential surface.

[0030] A combination of sliding bearings and rolling bearings is possible.

[0031] According to an expansion scheme, a radial stop and / or an axial stop coaxial with the inlet is provided at the proximal end of the rod housing section, and the radial stop and / or the axial stop is arranged and configured to support the end effector or the drive shaft of the drive of the end effector.

[0032] The components of the drive are, for example, a motor, a transmission coupled to the motor, and a drive shaft coupled to the transmission, and the drive shaft can in turn be coupled to the end effector. Depending on the design of the transmission, using the transmission can achieve arranging the motor aligned or non-aligned with respect to the end effector.

[0033] In the smallest design, the drive includes a motor which is arranged and constructed to be directly coupled to the end effector, preferably to the shaft of the end effector. Especially in the case of a rotatable end effector, this results in the possibility of an aligned arrangement of the motor relative to the shaft housing section. The aligned arrangement has the advantage that the drive can be constructed narrow. However, this construction results in the drive being constructed relatively long.

[0034] To minimize the structural length of the drive and its housing, according to a variant, at least one component of the drive is arranged transversely to the shaft housing section. According to a preferred expansion, for this purpose, the housing has a motor housing section transversely to the inlet, which is arranged and constructed to accommodate at least the motor.

[0035] Preferably, the main axes of the shaft housing section and the motor housing section are parallel. In other words: the drive shaft of the motor is parallel to the drive shaft of the end effector accommodated in the shaft housing section or parallel to the shaft of the end effector. This has the advantage that a simple spur gear transmission can be provided in terms of device technology for torque transmission.

[0036] Alternatively, the main axes of the shaft housing section and the motor housing section can be adjusted relative to each other. In this way, the structural space required for the drive can be optimized for applications in OP (operation).

[0037] Preferably, the motor housing section is constructed to be substantially cylindrical.

[0038] According to an expansion, the housing has a transmission housing section which is arranged and constructed to accommodate at least sectionally the transmission of the drive of the end effector. The transmission housing section can be formed as an independent part, or be formed by sections of the motor housing section, sections of the shaft housing section, or by both.

[0039] According to a first variant of the housing, the motor housing section is connected aligned with the shaft housing section. The connection is either direct, i.e. without a transmission and a corresponding transmission housing section, or the connection is indirect, in such a way that all three housing sections are connected aligned. As already mentioned above, this results in a relatively narrow but long structural shape of the housing and thus a relatively narrow but long structural shape of the medical device.

[0040] Alternatively, the motor housing section is laterally connected to the rod housing section via the transmission housing section. The lateral connection of the motor housing section to the rod housing section has the advantage that for the replacement of the end effector (the replacement is conditional on the end effector being pulled out towards the proximal end from the rod housing section), the removal of the motor is no longer necessary. Thus, compared to an aligned arrangement, this variant enables a simplified replacement of the end effector.

[0041] According to an expansion scheme for the housing of a drive with a transmission, at least one step-shaped taper is constructed in the rod housing section in the insertion direction, and the taper is provided and configured to rotatably support the driven element of a transmission stage of the transmission of the drive. The driven element can be a friction wheel of a belt transmission or a gear of a gear transmission. The support of the driven element can be achieved directly on the step or indirectly via a sliding bearing or a rolling bearing there.

[0042] According to an expansion scheme, for a multi-stage constructed transmission, a series of such step-shaped tapers are constructed, and the rod housing section gradually narrows in the insertion direction via the tapers, wherein each taper is provided and configured to support the driven element of another transmission stage among the multiple transmission stages of the transmission.

[0043] Alternatively, a series of such driven elements can be arranged stacked in exactly one radial and step-shaped taper of the rod housing section.

[0044] According to the foregoing description, the advantage of the connecting component according to the invention having only two tolerance-bearing connection sites is that under certain conditions, recalibration during OP intervention can be dispensed with after replacing the end effector. A necessary condition is to know the dimensions and tolerances of the performance characteristics of the newly inserted end effector. Then, based on the dimensions and tolerances of the initially calibrated connecting component and the new end effector, the new position and new extension of the working point can be calculated. Recalibration in OP is no longer compulsorily required.

[0045] Thus, in a preferred expansion scheme, the instrument has at least one end effector, preferably a set of selectively replaceable end effectors, and the end effectors are measured and recorded in terms of the dimensions and tolerances of their performance characteristics. This measurement is preferably carried out outside the OP, preferably during the manufacture of the end effector on the factory side, especially during its manufacturing process, such that the dimensions and tolerances can be pulled by the control unit by introducing the corresponding end effector into the instrument or coupling the end effector to the instrument. The control unit is designed to calculate the position and extension of the working point. In this way, the new position and new extension of the working point can be calculated after the end effector is introduced / coupled, and recalibration does not have to be carried out. Thus, in this way, the complexity of performing measurements or calibrations in the field during the OP is eliminated, and - as already mentioned - instead, it is carried out on the factory floor, which is a great advantage compared to the prior art.

[0046] In order to be able to determine the dimensions and tolerances for each insertable end effector, or to be able to pull them as mentioned above, in a preferred expansion scheme, the surgical / medical instrument, preferably the connecting part, preferably the housing, has a detection unit which is designed such that at least one ID and / or the characteristics and / or dimensions and tolerances of the performance characteristics of the end effector passing through the detection unit, preferably the sensor, can be read by the detection unit during insertion. The prerequisite for this is preferably that the insertable end effector has a corresponding emitter or a corresponding tag on which the ID or the mentioned data is stored.

[0047] Preferably, the detection unit is constructed as a sensor, especially as an NFC antenna for reading the RFID tag of the end effector. The data stored in the RFID tag is preferably the article number, serial number, type, kind and nominal dimensions of the end effector, and especially the dimensions and tolerances of its performance characteristics, especially the distance between the working point and the performance characteristics of the axial stop of the end effector, the nominal dimensions of the end effector, its concentricity, its coaxiality, etc. Preferably, the detection unit is arranged in the area of the above-mentioned inlet or insertion aid. Preferably, the detection unit has a receiving capacitance which covers at least one cross-section of the rod housing section, preferably which covers at least one cross-section of the inlet or insertion aid. Preferably, the detection unit extends over the entire circumference of the rod housing section, or the detection unit extends at least partially circumferentially, preferably evenly distributed.

[0048] In a preferred embodiment, the coupling section at the proximal end of the connecting part is constructed as straight and beam-shaped, or the proximal coupling section is constructed as pincer-shaped or clip-shaped. Depending on the construction, other advantageous coupling movements result for attaching the connecting part to the end segment of the robot.

[0049] In order to define the position and orientation of the proximal coupling section relative to the end segment in the simplest manner, in a preferred embodiment, the proximal coupling section has three point-shaped proximal coupling elements, which define the proximal coupling plane. The three coupling elements are particularly designed and configured to engage with three matching coupling elements on the end segment side. Preferably, the arrangement of the three coupling elements forms the corners of an equilateral triangle.

[0050] According to one possible development, at least one of the proximal coupling elements has a centering hole or a centering groove, and the other coupling element has a centering pin or a centering ball.

[0051] According to one possible embodiment, at least one of the proximal coupling elements has a stop which acts transversely to the proximal coupling plane.

[0052] Based on the design scheme according to the present disclosure, the connecting component extends as a single piece to the stop portion at the distal end, that is, to the vicinity of the working point of the end effector. This makes it possible to simply guide the supply channel into this area. According to an advantageous expansion scheme, the connecting component has at least one such channel, which guides toward the distal end or leads to the distal end, preferably to the distal end side and / or the distal peripheral surface of the connecting component, in particular the distal end of the rod housing section. Here, the channel preferably extends in and along the wall of the rod housing section. The corresponding channels can be provided and constructed for light guides for illuminating the OP area, optical devices for observing the OP area, coolants for cooling the end effector or its support, data lines for cameras that can be placed at the distal end or sensors that can be placed at the distal end, in particular force sensors for detecting the force and / or torque of the working end, or the channels are provided and constructed for aspirating liquids in the surgical area.

[0053] Preferably, the connecting component has a fastening interface which is designed such that the wool fabric can be fastened thereto.

[0054] In a preferred embodiment, the connecting parts are sterile.

[0055] The drive may be manual or motor driven, or the drive may be manual and assisted by a servo motor.

[0056] In manual or servo-assisted designs, the drive comprises a handpiece. In manual designs, the handpiece is preferably arranged and configured to be directly coupled to the end effector. In servo-assisted designs, the handpiece is preferably arranged and configured to be coupled to a specific transmission stage of the transmission.

[0057] In a preferred design, the transmission of the drive has a plurality of transmission stages. If the drive has a plurality of transmission stages, the drive is particularly flexible with respect to speed and torque. Preferably, a driven element axially and peripherally supported on the stepped taper of the rod housing section is assigned to each of the transmission stages and the driven element is rotatably supported.

[0058] In order to simply couple one of the driven elements to the end effector assigned to the driven element, in particular to the rod of the end effector, the driven element preferably has a centrally located through recess which has an inner circumferential coupling section.

[0059] If, according to an expansion scheme, the inner diameter of the through recess decreases stepwise in the insertion direction, a particularly simple assignment and coupling of the corresponding transmission stage to the end effector assigned to the transmission stage can be achieved.

[0060] The drive preferably has a set of replaceable and selectively usable end effectors, each of which is constructed with an axis of the same length. The end effectors each have an outer circumferential coupling section at the same height - measured from the coupling section of the end effector as the starting point - which is provided and constructed for coupling to one of the inner circumferential coupling sections.

[0061] If, according to an expansion scheme, the outer circumferential coupling sections each have a defined tuple of outer diameter and length, then a targeted coupling of a specific end effector among the end effectors to the transmission stage specifically assigned to the end effector, that is, to a specific driven element, is achieved in a simple manner: Here, the smallest length is assigned to the largest outer diameter among the outer diameters, and the largest length is assigned to the smallest outer diameter among the outer diameters. The outer diameters between them decrease stepwise in the insertion direction and the lengths increase stepwise. Description of the Drawings

[0062] Figure 1 A surgical robot according to the prior art is shown in a perspective view, the surgical robot having a surgical instrument coupled thereto.

[0063] Figure 2 The housing-shaped connecting part of the surgical / medical instrument of the surgical robot according to the first embodiment is shown in a perspective view.

[0064] Figure 3 Shown in a perspective partial cross-section is the housing according to Figure 2

[0065] Figure 4 Shown in a perspective view is the drive according to the first embodiment, the drive having according to Figure 2 andFigure 3 the housing of

[0066] Figure 5 is shown in a longitudinal sectional view according to Figure 2 and Figure 3 the housing of

[0067] Figure 6 is shown in a longitudinal sectional view the connecting member designed as a housing of a surgical / medical instrument of a surgical robot according to a second embodiment

[0068] Figure 7 is shown in a proximal perspective according to Figure 6 the housing of

[0069] Figure 8 is shown in a partial sectional view according to Figure 5 the housing of, the housing having an end effector inserted therein

[0070] Figure 9 is shown in a longitudinal sectional view the driver of a surgical / medical instrument according to a second embodiment

[0071] Figure 10 is shown in a longitudinal sectional view the driver of a surgical / medical instrument according to a third embodiment

[0072] Figure 11 is shown in a longitudinal sectional view the driver of a surgical / medical instrument according to a fourth embodiment

[0073] Figure 12 shows the same end effector having different coupling sections for coupling to different transmission stages of a driver of a surgical / medical instrument

[0074] Figure 13 is shown in a perspective view according to Figure 11 the details of the driver of

[0075] Figure 14 is shown in a perspective view according to Figure 13 the driver of, the driver having an end effector inserted therein

[0076] Figure 15 is shown in a longitudinal sectional view the driver having a housing according to a fifth embodiment according to Figure 5 the housing of

[0077] Figure 16 shows according to Figure 15 the driver having an end effector to be introduced

[0078] Figure 17The drive of a surgical / medical instrument according to a seventh embodiment is shown in a longitudinal sectional view. The drive has a housing according to Figure 6 and Figure 7 and,

[0079] Figure 18 A drive according to Figure 15 and Figure 16 is shown. The drive has a channel extending in the housing. DETAILED DESCRIPTION

[0080] Figure 1 The robotic arm of a surgical robot 1 having an end effector 18 with a drive according to the prior art is shown. The end effector 18 has a housing 16. The robotic arm has segments 2, 4, 6, 8, 10 and an end segment 10 that are articulated to one another. A surgical instrument 14 is coupled to the end segment 10 by a coupling arm 12. Here, the instrument 14 is fixed to the housing 16 of the coupling arm in the receiving portion of the coupling arm. The end effector 18 or the working end of the instrument 14 projects out at the distal end of the housing 16. The working point 20 of the instrument 14 is located at the tip of the instrument and acts in the surgical area. Starting from the end segment 10 to the end effector 18, the instrument 14 has a chain of engagement sites 22, 24, 26, 28. In Figure 1 In the system shown, the components of the drive of the end effector 18 and the components of the housing 16 are connected between the end segment 10 and the end effector 18 by a chain of engagement sites 22, 24, 26, 28. This results in a tolerance chain and thus also in a clearance, due to which the spherical extension of the working point, i.e., the target area, is enlarged. This effect needs to be minimized or eliminated.

[0081] For this purpose, a preferably highly precise connecting component for a medical / surgical instrument is proposed. Embodiments of the connecting component are described below in Figures 2 to 18 The connecting component is designed in the embodiment as a housing-shaped molded part and is hereinafter referred to as "housing" for simplicity. The connecting component is characterized in particular by dispensing with a plurality of engagement sites, which minimizes the tolerance chain. Thus, the target area of the end effector 18 can be strongly restricted and optimized.

[0082] Figure 2 A connecting component designed as a housing 116 for a medical / surgical instrument having an end effector 18 is shown in a perspective view. The housing 116 has an interface with the end segment 10 (reference Figure 1) A coupling section 30 of the proximal end that can be coupled and a coupling section 32 of the distal end that is coupled to the end effector 18. The housing 116 extends in a single piece between the coupling sections 30 and 32, i.e., without any additional joints in the force coupling between the end segment 10 and the end effector 18. The number of joints is thus reduced to a minimum of "2". Thus, compared to solutions in the prior art, internal joints of the drive of the end effector 18 or joints of the housing 116 that exist in other ways have no influence on the position of the working point 20. Only the tolerances of the coupling sections 30 and 32 determine the target area. Therefore, in order to minimize the extension of the target area, the coupling sections 30, 32 are manufactured with high precision in terms of shape tolerance, orientation tolerance and position tolerance.

[0083] according to Figure 2 The housing 116 has a tubular or sleeve-shaped rod housing section 34, through which the connector 36 of the proximal end of the end effector 18 passes. The connecting arm 12 is attached laterally to the rod housing section 34 at an obtuse angle. The connecting arm 12 is optimized in terms of weight by means of the recess 38. The connecting section 30 is bifurcated into two connecting legs 40, on which a spherical connecting element 42 (one is hidden) of the connecting section 30 is respectively constructed radially inwardly. At the apex of the bifurcation, the connecting section 30 has another connecting element 44, which is constructed as a through hole and leads in the direction of the recess 38. The advantage of the present invention lies in the accuracy of the relative position of the connecting plane opened by the connecting elements 42, 44 and the connecting plane opened by the connecting section 32.

[0084] refer to Figure 2 The housing 116 also has a transmission housing section 46 , which is described further below.

[0085] Figure 3 The longitudinal section is shown in a perspective view according to Figure 2 The housing 116 of FIG. 1 is shown in longitudinal section without the end effector 18. The gearbox housing section 46 is shown uncut. The distal coupling section 32 arranged on the inside is visible and the sleeve-shaped extension of the rod housing section 34 is apparent. The distal coupling section 32 has an axial stop in the extension direction of the end effector 18, which in the embodiment shown is formed by a radial constriction on the end side of the rod housing section 34. The constriction forms the edge of the outlet 48 of the rod housing section 34, the end effector 18 (see FIG. 1 ). Figure 1 ) emerges through outlet 48.

[0086] Figure 4 A manual, servo motor assisted drive 50 is shown having a Figure 2 and Figure 3housing 116. The drive 50 has a handpiece 52 by means of which the rotation of the end effector 18 can be initiated. The handpiece 50 is designed to be pluggable and is in operative connection with a not-shown transmission mechanism of the drive 50 inside the transmission housing section 46. The rotation of the handpiece 52 thus results in the assistance of the service motor. In this way, for example, the insertion of a pedicle screw can be assisted motorically and the surgeon still retains the feeling of the torque applied.

[0087] Figure 5 The housing 116 is shown in a longitudinal sectional view. The transmission housing section 46 is not shown here. As a supplement to the Figures 2 to 4 illustration, the inlet 54 at the proximal end of the rod housing section 34 can be seen therefrom, through which the end effector 18 can be introduced into the housing 116. The inlet 54 is relatively wide. In the insertion direction, the rod housing section has a relatively thick, stepped taper 56 in the vicinity of the inlet 54. This forms a cylindrical receiving space 58 for a set of driven elements (not shown) of the transmission. A funnel-shaped taper 60 is connected to the stepped taper 56, and the taper 60 serves as an insertion aid when inserting the end effector 18. The axial stop 62 and the radial stop 64 of the distal coupling section 32 are shown in a sectional view at the distal end of the rod housing section 34. The axial stop 62 is a precisely machined inwardly directed annular end face that forms the edge of the outlet 48, and the radial stop 64 is the section of the inner peripheral surface of the rod housing section 34 that adjoins the annular end face.

[0088] Figure 6 and Figure 7 A second embodiment of the housing 216 of the end effector of the surgical instrument of the surgical robot is shown, wherein only the differences from the first embodiment should be discussed so as not to overload this text. Different from the Figures 2 to 5 housing 116, the rod housing section 34 extends from its inlet 54 to the outlet 48 by virtue of only one radial taper 56. The insertion aid (see 60, Figure 5 ) is dispensed with here. The stepped radial taper 56 of the housing 216 is kept relatively flat. Thus, the taper 56 is adapted to accommodate only one driven element of one transmission stage. Alternatively, the taper serves as a bearing site for the proximal end of the shaft of the end effector or the drive motor, and the shaft can be coupled to the drive motor, which is further elaborated below in Figure 17 . In the illustrated embodiment, the proximal coupling section 230 of the housing 216 has an axial coupling face 66 for positively abutting the corresponding coupling face of the end segment 10, and a transverse coupling face 68 for transversely abutting the corresponding coupling face of the end segment 10. According toFigure 6 and Figure 7 The dimension H, dimension L, and dimension d are manufactured with high precision in terms of form tolerance, orientation tolerance, and position tolerance. The dimension H defines the distance between the axial coupling surface 66 of the proximal coupling section 230 and the axial stop 62. The dimension L defines the distance between the lateral coupling surface 68 of the proximal coupling section 230 and the midpoint of the radial stop 64. And the dimension d defines the diameter of the radial stop in the region of the inlet 54.

[0089] Figure 8 is shown in detail Figures 2 to 7 of the distal coupling section 32 of the corresponding rod housing section 34, with the attached end effector 18. The end effector 18 has a rod 70 extending inside the rod housing section 34, a radial flange 72 connected to the rod 70 at the distal end, and a working end 74 emerging from the outlet 48, the working end 74 having a working point 20 at the tip. It can be clearly seen that the annular end face 76 of the radial flange 72 oriented towards the distal end slidably abuts against the axial stop 62 of the distal coupling section 32. The centering of the end effector 18 can be achieved by the peripheral surface of the radial flange 72, which is supported on the inner peripheral surface forming the radial stop 64, or by a partially tapered centering flange 78, which sinks into the outlet 48.

[0090] As already mentioned above, according to the present disclosure, a target region with a diameter of less than 2 mm, particularly preferably less than 1 mm, can be achieved with low manufacturing technical complexity, since fewer surfaces are to be processed through a shortened tolerance chain compared to solutions according to the prior art. Irrespective of the corresponding embodiments according to the present disclosure, reference Figure 8 The concept of the target region refers to the envelope volume / extended tolerance space extending around the tip of the end effector 18, in which, after installation of the end effector 18, the tip of the end effector 18 is tolerancedly arranged.

[0091] Figure 9The actuator 150 of the end effector of a surgical robot according to a second embodiment is shown in a longitudinal sectional view. Different from the previous description, the housing 316 has a motor housing section 80 that is laterally connected to the rod housing section 34. A drive motor 82 having a drive shaft 84 parallel to the rod 70 is accommodated in the motor housing section 80. The housing sections 34 and 80 are connected by a transmission housing section 46, and a transmission 88 configured as a spur gear transmission is accommodated in the transmission housing section in sections. The transmission 88 has a drive spur gear 90 coupled to the drive shaft 84 and a driven spur gear 94 coupled to the rod 70 and torsionally connected to the drive spur gear through a gear 92. The gears 90, 92, and 94 form a transmission stage 91 with a fixed transmission ratio of the actuator 150. For connection, the rod 70 of the end effector 18 has an outer circumferential connection section 96, and the connection section 96 is torsionally connected to the inner circumferential connection section 98 of the through notch of the driven spur gear 94. Different from the foregoing embodiments, the end effector 18 is not supported by a radial flange, but is supported on the axial stop 62 of the distal connection section 32 by the annular end face 76 of the rod 70 and two ball bearings.

[0092] Figure 10 The actuator 250 of the end effector 18 of a surgical robot according to a third embodiment is shown in a longitudinal sectional view. Different from the embodiment according to Figure 9 , the rod housing section 34 does not extend linearly, but extends curvedly. The rod housing section 34 is rigidly constructed and is adapted to specific requirements in the OP region by means of the bend. Here, the rod 70 needs to be flexible.

[0093] Figure 11 The actuator 350 of the end effector 18 of a surgical robot according to a fourth embodiment is shown in a longitudinal sectional view. Different from the embodiment according to Figure 9 or Figure 10 , in addition to the first transmission stage 91, a second transmission stage 93 is additionally provided. The drive spur gear 95 of the second transmission stage 93 is fixedly coupled to the drive shaft 84 in the same way as the drive spur gear 90 of the first transmission stage 91. Therefore, the two spur gears 90 and 95 always rotate together with the drive shaft 84 and drive their respective driven spur gears 94 (first transmission stage 91) and driven spur gear 99 (second transmission stage 93). Here, different rotational speeds are generated on the driven spur gears 94, 99. Then, the end effector 18 that can be coupled to the corresponding inner circumferential connection sections 98, 100 can be driven at different rotational speeds depending on which connection section 98, 100 it engages with.

[0094] Figure 12illustrates the possibility that different, peripheral coupling sections 96, 101 are provided for the end effector 18 and that the end effector 18 is brought into engagement and thus driven at different rotational speeds. Depending on the peripheral coupling sections 96, 101 used in accordance with Figure 12 the end effector 18 is driven by the first transmission stage 91 at the rotational speed n1 of the first transmission stage 91 itself or by the second transmission stage 93 at the rotational speed n2 of the second transmission stage 93 itself.

[0095] Figure 13 The drive 350 in accordance with Figure 11 is shown in a perspective view from above in the region of the driven spur gears 94 and 99.

[0096] Figure 14 The drive in accordance with Figure 13 is shown, in which the end effector 18 with the peripheral coupling section 96 on the left in Figure 12 is applied. Due to its smaller diameter and greater height, the coupling section 96 only couples with the lower, inner peripheral coupling section 98 of the driven spur gear 94 of the first transmission stage 91. The second transmission stage 93 thus remains disengaged and only rotates, that is, no torque is transmitted to the end effector 18.

[0097] Figure 15 The drive 450 is shown, which differs from the drives in Figure 11 and 13 and 14 only in its higher number of transmission stages - three instead of just two -. This can be seen from the three-layer group of the driven spur gears 94, 99 and 103, where the driven spur gears 94, 99 represent the previously described first transmission stage 91 and second transmission stage 93, and the driven spur gear 103 represents an additional third transmission stage.

[0098] Figure 16Another detail of the actuator 450 is elucidated. The actuator 450 enables the clearly identifiable imported end effector 18 and the data record of its ID or other performance characteristics to be sent to the control unit of the surgical robot. Here, an RFID antenna or an NFC antenna 104 is involved. The RFID antenna or the NFC antenna 104 extends over the entire circumference in an axially restricted section in the region of the import assistance section 60 and inside the wall of the rod housing section 34. The imported end effector 18 has an RFID chip 106, which is read by the antenna 104 when being guided past. The end effector 18 can have any type of surgical working end. According to the present disclosure, during its manufacture, the calibrated dimensions of its performance characteristics are detected along with production, and the dimensions according to the present disclosure that affect the position of the working point in space, such as the distance from the annular end face / axial stop 76 to the working point 20 and its tolerance, and the circular machining accuracy of the working point 20 (see Figure 8 ) or other information such as diameter, surface roughness, sharpness, etc. As the minimum data record, the RFID chip 106 can record, for example, the article number and serial number of the end effector 18. When being guided past the antenna 104, this information is read and transmitted to the above-mentioned control unit. In the pullable database, the type of the end effector 18 is clearly assigned to the article number and serial number. Then, by drawing the article number, all other dimensions and tolerances of the imported end effector 18 can be pulled and used - without re-calibration - to clearly calculate the position of the new working point. Alternatively, of course, the mentioned data can already be stored on the RFID chip 106 itself and directly read and transmitted to the control unit.

[0099] Figure 17 Shows a housing 216 according to Figure 6 and Figure 7 and an actuator 550 with a motor 582. The motor 582 is not transverse to the rod housing section 34 but is designed to be aligned with the rod housing section 34. Accordingly, in order to replace the end effector 18 here, the motor 582 must first be removed from the housing 216. Therefore, the rod 70 is separated from the motor 582, and the new end effector 18 is placed into the rod housing section 34 until the radial flange 72 of the end effector 18 is in axial stop with the axial stop of the distal coupling section 32 (see Figure 17 in the middle). Finally, the motor 582 is connected to the adapter 36.

[0100] Figure 18 Shows a housing according to Figure 15 , Figure 16The housing 316 is provided with channels 108, 110, 112, 114 which extend from the proximal coupling section 30 to the distal coupling section 30 within the solid material of the housing 316 (see FIG. Figure 18 left) and to the distal end (see Figure 18 The housing 316 is configured as a blind channel (right side). Due to the single-piece design of the housing 316 according to the present disclosure, light, data, image data, coolant, etc. can be arranged, transmitted, or conveyed in these channels without interference and safely. In the illustrated embodiment, for example, four light guide channels 108 for illuminating the OP area, a sensor channel 110 for sensors, as well as cooling channels 112 and heating channels 114 are connected, and the supporting force of the end effector 18 can be detected by the sensors.

[0101] Reference Signs List

[0102] 1. Surgical Robot

[0103] Segments 2, 4, 6, and 8

[0104] 10 End segments

[0105] 12 Connecting arm

[0106] 14 Surgical instruments

[0107] 16; 116; 216; 316 housing

[0108] 18 End effector

[0109] 20 working points

[0110] 22, 24, 26, 28 joints

[0111] 30; 230 proximal connection section

[0112] 32 Remote connection section

[0113] 34 Rod housing section

[0114] 36 adapter

[0115] 38 recess

[0116] 40 connecting legs

[0117] 42, 44 connecting elements

[0118] 46 Transmission housing section

[0119] 48 Exit

[0120] 50; 150; 250; 350; 450; 550 drives

[0121] 52 Handheld part

[0122] 54 Inlet

[0123] 56 Radial tapered portion

[0124] 58 Accommodating space

[0125] 60 Introduction assisting part

[0126] 62 Axial stop

[0127] 64 Radial stop

[0128] 66 Axial connection surface

[0129] 68 Transverse connection surface

[0130] 70 Rod

[0131] 72 Radial flange

[0132] 74 Working end

[0133] 76 Axial stop

[0134] 78 Centering flange

[0135] 80 Motor housing section

[0136] 82 Driving motor

[0137] 84 Drive shaft

[0138] 88 Transmission

[0139] 90 Driving spur gear

[0140] 91 First transmission stage

[0141] 92 Gear

[0142] 93 Second transmission stage

[0143] 94 Driven spur gear

[0144] 95 Driving spur gear

[0145] 96 Connection section

[0146] 98 Connection section

[0147] 99 Driven spur gear

[0148] 100 Connection section

[0149] 101 Connection section

[0150] 103 Driven spur gear

[0151] 104 NFC antenna

[0152] 106 RFID chip

[0153] 108 light guide channel

[0154] 110 sensor channel

[0155] 112 coolant channel

[0156] 114 heating agent channel

[0157] H Axial stop distance

[0158] L Distance from the rotation axis to the lateral stop

[0160] d Radial stop diameter

Claims

1. A medical device for or of a medical robot (1), having a carrier structure (116; 216; 316) for supportingly receiving at least one selectively replaceable end effector (18) of the medical device, preferably for supportingly receiving the end effector (18) and a drive (50; 150; 250; 350; 450; 550) of the end effector (18), the carrier structure having a proximal coupling section (30; 230) which is arranged and configured for coupling to a distal end section (10) of the robot (1), and having a distal coupling section (32) which is arranged and configured for coupling to the selectively replaceable end effector (18), wherein, The load-bearing structure (116; 216; 316) is or has a connecting member that extends monolithically, preferably materially monolithically, at least between the proximal coupling section (30) and the distal coupling section (32), whereby a connection without a coupling and / or without a tolerance chain is created between the proximal coupling section and the distal coupling section (30, 32).

2. The medical device according to claim 1, wherein The connecting member forms the housing (116; 216; 316) or a housing section of the medical device, or alternatively, the connecting member forms a frame structure that is arranged parallel to the housing of the medical device and thus determines the relative position of the distal coupling section with respect to the proximal coupling section.

3. The medical device according to claim 1 or 2, wherein, The connecting member (116; 216; 316) has at least high-precision form tolerances, orientation tolerances, and / or position tolerances with respect to the coupling sections (30, 32).

4. The medical device according to any one of the preceding claims, wherein, The abutment planes or main axes of the coupling sections (30, 32) are oriented relative to each other as fixedly parallel, angled, or at right angles.

5. The medical device according to any one of the preceding claims, having a rod housing section (34) on which the distal coupling section (32) is constructed, the rod housing section having an inlet (54) through which the end effector (18) can be introduced and having a distal outlet (48) through which the end effector (18) passes during normal operation.

6. The medical device according to claim 5, wherein, The rod housing section (34) has a radial constriction or an inner radial flange at the distal end, and an axial stop (62) for the distal coupling section (32) is formed by the constriction or the inner radial flange, and the axial stop is used for axial coupling with the axial stop (76) of the end effector (18).

7. The medical device according to claim 5 or 6, wherein, The rod housing section (34) has an inner circumferential surface, and a radial stop (64) for the distal coupling section (32) is formed by the inner circumferential surface, and the radial stop is used for radial coupling with the radial stop of the end effector (18).

8. The medical device according to any one of claims 5 to 7, wherein, A radial stop coaxial with the inlet (54) and / or an axial stop (56) for the drive or the drive train of the drive is provided.

9. The medical device according to any one of claims 5 to 8, having a motor housing section (80) arranged transversely to the inlet (54), the motor housing section being provided and constructed to at least sectionally accommodate the motor (82) of the drive.

10. The medical device according to any one of the preceding claims, having a transmission housing section (46), the transmission housing section being provided and constructed to at least sectionally accommodate the transmission (88) of the drive.

11. The medical device according to at least claim 10, wherein, The motor housing section (80) is connected to the rod housing section (34) in an aligned manner (116) or transversely (316) via the transmission housing section.

12. The medical device according to at least claim 5, wherein, At least one step-shaped taper (56) running in the insertion direction is formed in the rod housing section (34), said taper serving for rotatably supporting at least one driven element (94; 91, 93) of at least one gear stage (91; 91, 93) of the transmission of the drive.

14. The medical device according to at least claim 12, wherein, 13. The medical device according to any one of the preceding claims, having a sensor (104) by means of which at least one ID, a characteristic property representing a feature and / or dimensions and tolerances of the end effector (18) can be read.

15. A load-bearing structure (116; 216; 316), preferably a housing, for a surgical / medical instrument or as a load-bearing structure for a surgical / medical instrument, which surgical / medical instrument is for a surgical / medical robot or a surgical / medical instrument of a surgical / medical robot, the load-bearing structure being adapted to supportively receive at least one selectively replaceable end effector (18) of the instrument, preferably for supportively receiving the end effector (18) and a drive (50; 150; 250; 350; 450; 550) of the end effector (18), the load-bearing structure having a proximal coupling section (30; 230) which is provided and configured for coupling to a distal end section (10) of the robot (1), and having a distal coupling section (32) which is provided and configured for coupling to the selectively replaceable end effector (18) of the surgical / medical instrument, wherein, In the region of the step-shaped taper (56), driven elements (94, 99; 94, 99, 103) of a plurality of gear stages of the transmission of the drive (350; 450) are rotatably supported, wherein the respective driven elements (94, 99; 94, 99, 103) have preferably centrally arranged through recesses which have inner circumferential connection sections (98, 100; 98, 100, 105), wherein the inner diameter of the through recesses decreases stepwise in the insertion direction, and the medical device has a set of selectively replaceable end effectors, each of which has a rod which has outer circumferential, preferably cylindrical connection sections (96, 101) which terminate at the same height in the insertion direction, wherein the outer circumferential connection sections (96, 101) each have a defined pair of values consisting of an outer diameter and a length, such that the smallest length (101) is assigned to the largest outer diameter among the outer diameters, and the largest length (96) is assigned to the smallest outer diameter among the outer diameters, and the outer diameters therebetween decrease stepwise in the insertion direction and the lengths therebetween increase stepwise in the insertion direction. The load-bearing structure (116; 216; 316) is or has a connecting part which extends at least monolithically, preferably materially monolithically, between the proximal connection section (30) and the distal connection section (32), as a result of which a connection without a connection chain and / or without tolerances is produced between the proximal connection section and the distal connection section (30, 32).

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