A GPS navigation single-arm robot navigation system for PCNL

Abstract

The application discloses a GPS navigation single-arm robot navigation system for percutaneous nephrolithotomy (PCNL), which comprises a reverse laser positioning module for emitting laser from inside to outside of tissue through a laser emitter to assist in positioning a puncture needle insertion point; a single-arm robot execution module for moving based on instructions of a navigation signal tracking and fusion module to drive the puncture needle to reach a body surface puncture point marked by a laser spot along a planned path and perform puncture; the navigation signal tracking and fusion module is used for signal tracking and receiving and processing space position information and medical image data to generate a real-time navigation interface; and a special instrument set comprises an integrated double-mirror sleeve, and the inner diameter of the sleeve allows a standard nephroscope or ureteral flexible scope to simultaneously perform combined lithotripsy or exploration. The application integrates reverse optical positioning, robotics, real-time electromagnetic navigation and special instruments into one, and provides an integrated intelligent solution covering the whole process of preoperative planning, intraoperative navigation, channel establishment and stability.

Description

Technical Field

[0001] This invention relates to the field of medical devices, and more particularly to a GPS-navigated single-arm robot navigation system for PCNL. Background Technology

[0002] Percutaneous nephrolithotomy (PCNL) is currently the gold standard minimally invasive procedure for treating complex upper urinary tract stones, such as kidney stones larger than 2 cm in diameter and staghorn calculi. Its core technique involves percutaneously puncturing the renal collecting system using image-guided localization to create a 6-8 mm diameter percutaneous renal access channel. Using a nephroscope combined with lithotripsy tools such as laser and ultrasound, the procedure is then performed to fragment and remove the stones. This technique is widely used in urological clinics worldwide due to its advantages of minimal trauma, rapid postoperative recovery, and high primary stone removal rate, and is particularly suitable for cases with a large stone burden, hard stones, or abnormalities in the renal pelvis and calyces.

[0003] However, traditional ultrasound or X-ray guidance struggles to achieve real-time three-dimensional positioning, and puncture accuracy is heavily influenced by the surgeon's experience, increasing the risk of accidental damage to renal vessels. Intraoperative respiratory movements can cause kidney displacement, frequently leading to puncture path deviation or failed channel establishment. Existing robot-assisted systems are mostly general-purpose platforms, costly, and not specifically designed for PCNL puncture procedures, lacking the ability for reverse real-time positioning from within the renal pelvis to the body surface. Furthermore, guidewires are prone to slippage during respiration, channel stability is poor, and frequent instrument changes are necessary in multi-scope combined surgeries, prolonging operation time and increasing complexity. These issues limit the widespread adoption of PCNL technology, especially in primary care hospitals, and hinder further improvements in overall surgical safety. Summary of the Invention

[0004] The purpose of this invention is to provide a robotic navigation system for percutaneous nephrolithotomy to solve the problems mentioned in the background art.

[0005] To achieve the above-mentioned objectives, this invention provides a GPS-guided single-arm robot navigation system for PCNL, comprising a reverse laser positioning module, a single-arm robot execution module, a navigation signal tracking and fusion module, and a dedicated instrument kit, wherein:

[0006] The reverse laser positioning module consists of a visual ureteroscope with a laser transmitter integrated at the distal end. It is used to emit a laser from inside the renal pelvis outward through the laser transmitter to form a light spot under the skin to assist in the positioning of the surgical puncture needle insertion point; and to form a light column in the renal pelvis and under the skin to assist in the navigation route of the surgical puncture needle.

[0007] The single-arm robot execution module consists of a robotic arm with an integrated instrument gripper at the end, which is used to move based on the instructions of the navigation signal tracking and fusion module, drive the puncture needle to accurately reach the puncture point marked by the laser spot along the planned path and perform puncture along the optical beam navigation route under the puncture point;

[0008] The navigation signal tracking and fusion module is used to track signals and receive and process spatial location information and medical image data, perform multi-data fusion and three-dimensional reconstruction, and accurately register the actual intraoperative position space with the three-dimensional model space of the preoperative image through the registration algorithm to generate a real-time navigation interface.

[0009] The specialized instrument kit includes an integrated dual-scope cannula, the inner diameter of which allows for simultaneous combined lithotripsy or exploration using a standard nephroscope or flexible ureteroscope. During PCNL procedures, a flexible ureteroscope is inserted through the cannula to explore other calyces within the kidney or to assist in lithotripsy.

[0010] Furthermore, after the visualization ureteroscope is inserted into the kidney through the urethra, a visible red laser spot with a wavelength of 630nm-650nm and a power of less than 5mW is projected in reverse towards the body surface via a laser emitter. The laser spot is used to visually mark the optimal skin puncture point corresponding to the target renal calyx on the patient's body surface. The laser emitter has a multi-angle adjustment function, which adjusts the angle of the emitted laser in real time according to the projection on the body surface.

[0011] Furthermore, the visualization ureteroscope has a coaxial rotation function, which allows for real-time coaxial rotation in the sagittal plane, and the laser emission point can be angled in the coronal plane and transverse plane to achieve precise three-dimensional positioning.

[0012] Furthermore, the instrument holder at the end of the robotic arm is used to secure the puncture needle or dilator; the puncture needle is equipped with a visual device for tracking signals and observing the situation in front of the puncture and the puncture channel in real time. The robotic arm and the scaffolding on the side of the operating table are provided with locking slots to facilitate the secure fixing of the robotic arm to the operating table.

[0013] Furthermore, the navigation signal tracking and fusion module comprises a mirror positioning device, a robotic arm tracker, and a navigation host, wherein:

[0014] The endoscope positioning device is set on the handle or proximal end of the visualization ureteroscope to track the spatial position of the end of the ureteroscope in the human body in real time.

[0015] The robotic arm tracker is installed at the end of the robotic arm or on the instrument holder to track the spatial position of the puncture needle tip in real time.

[0016] The navigation host is used to receive and fuse real-time spatial position signals from the endoscope positioning device and the robotic arm tracker, as well as receive medical image data. It then performs three-dimensional reconstruction and registration in the same coordinate system to generate a comprehensive navigation interface that includes the target kidney, stones, planned path, and real-time instrument position. Based on the ureteroscope tip position provided by the endoscope positioning device, it calculates and guides the robotic arm in real time, aligning the puncture needle path with the laser spot indication direction, achieving GPS-like real-time navigation and path correction from the inside out.

[0017] Furthermore, the puncture needle visualization device integrates a miniature camera at its front end. The navigation host analyzes the tissue characteristics ahead of the puncture path using a real-time image recognition algorithm. If a pulsating vascular signal is detected, the system issues an audible and visual alarm and automatically locks the needle insertion axis of the robotic arm, limiting further needle insertion until the operator manually adjusts the path to avoid risks. Once the needle is detected entering the renal calyx, insertion can be stopped in real time.

[0018] Furthermore, the navigation signal tracking and fusion module includes a respiratory motion monitoring unit for monitoring the patient's respiratory phase. The navigation host is configured to predict the kidney movement trend based on real-time respiratory phase data and dynamically compensate the robotic arm's motion path accordingly, achieving synchronous respiratory tracking during puncture. The navigation host employs a Kalman filter prediction algorithm to predict target displacement by processing respiratory phase signals in real time, with a system closed-loop response delay of less than 10ms.

[0019] Furthermore, the navigation system also includes a main control console, which integrates a display screen for showing the comprehensive navigation interface and a human-computer interaction device, used to plan paths, adjust parameters, or take over robot control through the human-computer interaction device.

[0020] Furthermore, the robotic arm of the single-arm robot execution module is a serial or parallel robot with at least six degrees of freedom.

[0021] Furthermore, the proximal end of the integrated dual-scope cannula is equipped with a sealing valve. The sealing valve adopts a multi-layer silicone valve structure, which has an elastic adaptive sealing function to prevent pressure rise and negative pressure suction, and is used to maintain the stability of intrarenal pressure and prevent the overflow of perfusion fluid.

[0022] Compared with existing technologies, this system and method have the following advantages:

[0023] Significantly improved puncture accuracy: By combining reverse laser positioning with GPS-style signal tracking, intuitive, real-time, and high-precision navigation is achieved, directly guiding the puncture point on the body surface from the target inside the kidney, improving puncture accuracy to the millimeter level and effectively avoiding vascular damage.

[0024] Intelligent response to respiratory motion: By monitoring and compensating for respiratory motion in real time through the navigation system, the core problem of channel displacement is solved, significantly improving the stability and safety of the operation.

[0025] The visualization ureteroscope tip has an angle adjustment function, which can be rotated coaxially in the sagittal position, and the laser emission angle can be adjusted in the coronal position and cross-section, allowing for real-time three-dimensional angle adjustment without blind spots.

[0026] Simplified dual-scope combined surgery: The integrated dual-scope channel design eliminates the need to change channels during surgery, making the combined application of PCNL and ureteroscope more smooth and efficient.

[0027] The visual puncture needle design allows for real-time observation of the puncture channel and avoidance of blood vessels, as well as real-time observation of the needle tip. Once the needle enters the target calyx, the insertion can be stopped immediately.

[0028] Lowering the technical threshold: Transforming complex operations that rely on experience into standardized, visualized robot-assisted processes greatly shortens the learning curve and facilitates the promotion and application of this technology in hospitals at all levels, especially in primary hospitals.

[0029] Systematic Solution: Creatively integrating reverse optical positioning, robotics, real-time electromagnetic navigation, and specialized instruments, it provides an integrated intelligent solution covering the entire process of preoperative planning, intraoperative navigation, channel establishment, and stabilization. Attached Figure Description

[0030] Figure 1 This is a schematic diagram illustrating the working principle of a robotic navigation system used in percutaneous nephrolithotomy. Detailed Implementation

[0031] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0032] like Figure 1 The diagram illustrates the working principle of this invention. This invention provides a robot navigation system for PCNL, aiming to systematically solve the core problems of insufficient puncture accuracy, respiratory motion affecting channel stability, and cumbersome dual-scope combined operation in traditional PCNL surgery by integrating reverse laser positioning, precise robot execution, and real-time signal navigation. The specific embodiments of this invention will be described in detail below with reference to the accompanying drawings.

[0033] The system mainly includes: a reverse laser positioning module, a single-arm robot execution module, a navigation signal tracking and fusion module, a special instrument kit, and a main control console. The modules communicate and work collaboratively via a network or data bus.

[0034] The reverse laser positioning module is key to achieving precise inside-out positioning in this system. Its core component is a modified visualization ureteroscope. The distal end of the ureteroscope integrates a low-power, specific-wavelength laser emitter. In this embodiment, the laser wavelength is preferably visible red light to ensure a clearly visible spot on the body surface while maintaining tissue safety.

[0035] The specific implementation process is as follows: In the initial stage of the surgery, the surgeon inserts a flexible ureteroscope integrated with a laser emitter through the urethra and manipulates it to reach the target renal calyx. After confirming that the lens is in the ideal position in the fornix of the target renal calyx through the imaging channel of the endoscope and by adjustment (coaxial rotation in the sagittal plane), the laser emitter is activated (the laser beam angle is adjusted by cross-sectional and coronal rotation). Subsequently, the surgeon issues a command to activate the laser emitter through the main control panel. In this embodiment, the angle adjustment mechanism is driven by a miniature piezoelectric motor, which drives the reflective lens of the laser head to deflect precisely, realizing multi-dimensional adjustment of the laser beam in the coronal and cross-sectional planes. The laser beam is projected retrogradely from inside the renal calyx to the body surface, penetrating the renal parenchyma, fat, and skin tissue. This approach uses a laser with a wavelength of 630nm-650nm, utilizing its low scattering rate and high penetration in biological tissues to form a clearly visible red spot with a diameter of 2-5mm on the patient's body surface, while ensuring no thermal damage to the tissue, and forming a beam of light within the tissue. The projection position of this light spot represents the theoretically shortest puncture point from the body surface to the target renal calyx, and this light beam represents the theoretical shortest puncture path, providing an intuitive visual reference and path guidance for subsequent robot-assisted puncture. By combining reverse laser positioning with GPS-like signal tracking, intuitive, real-time, and high-precision navigation is achieved, directly guiding the puncture point on the body surface from the intrarenal target, improving puncture accuracy to the millimeter level and effectively avoiding vascular damage.

[0036] The single-arm robotic execution module is responsible for the physical execution of puncture and channel establishment operations. It includes a high-precision, high-stability robotic arm. This robotic arm is preferably a tandem robotic arm with six or more degrees of freedom, and its end effector is a multi-functional instrument gripper. The gripper is designed with a quick-change interface, allowing for the sequential or selective secure clamping of standard PCNL instruments such as puncture needles, dilation sheaths, and guidewires.

[0037] The robotic arm incorporates a high-precision encoder and receives real-time control commands from the navigation signal tracking and fusion module. Its workflow is as follows: After the reverse laser positioning module generates a light spot on the body surface, the robotic arm, guided by the navigation module, automatically moves to a predetermined position, initially aligning the axis of the puncture needle it holds with the direction indicated by the laser beam (light column). Subsequently, under precise real-time correction of the navigation signal, the robotic arm drives the puncture needle along the planned path (i.e., the light column) to complete the puncture, until the needle tip is confirmed to have reached the target renal calyx on the navigation image.

[0038] The robotic arm's execution module integrates a highly sensitive pressure sensor. During the insertion of the visual puncture needle, the navigation unit monitors the puncture resistance in real time. If an abnormally increased resistance is detected (indicating potential contact with bone or dense fascia) or a sudden drop (indicating entry into a cavity), the system will immediately trigger a protective brake and prompt the surgeon for confirmation.

[0039] The navigation signal tracking and fusion module is responsible for real-time perception, fusion, and intelligent guidance of all spatial locations. This module includes hardware sensors and software algorithm systems.

[0040] The hardware components mainly include:

[0041] Endoscope positioning device: A miniature electromagnetic sensor fixed to the proximal end of the handle of the visualization ureteroscope. In conjunction with an external electromagnetic generator, it can track the precise X, Y, Z coordinates and direction of the ureteroscope tip, i.e., the laser emission point, in three-dimensional space in real time and continuously.

[0042] Robotic arm tracker: Another electromagnetic sensor, mounted on the end effector gripper of the robotic arm, is used to track the position and orientation of the tip of the puncture needle or dilator in real time.

[0043] Respiratory Motion Monitoring Unit: This unit collects the patient's respiratory rate and abdominal wall displacement data at 100Hz. The navigation host establishes a state transition model using a Kalman filter algorithm, calculating in real time the potential displacement vector ΔD(t+1) of the kidney due to respiratory motion at the next moment. The robotic arm controller dynamically corrects the execution path based on this vector to compensate for deviations caused by breathing. Because the system employs a high-speed data processing link, the total time delay from sensing to the completion of the robotic arm's compensation action is controlled within 10ms, ensuring the dynamic static state of the puncture needle relative to the moving target point. Through real-time monitoring and compensation of respiratory motion by the navigation system, the core problem of channel displacement is solved, significantly improving surgical stability and safety.

[0044] The software runs on the navigation host, and the specific implementation logic includes the following steps:

[0045] First, multi-source data fusion and 3D reconstruction are performed. The navigation host receives preoperative CT or MRI image data, performs 3D reconstruction, and generates digital models of the kidneys, stones, surrounding blood vessels, and bones. Simultaneously, it receives signals in real time from the endoscope locator, robotic arm tracker, and respiratory monitoring unit.

[0046] Then, spatial registration is performed. Using point or area registration algorithms, the patient's actual intraoperative position space is precisely registered with the preoperative 3D model space, establishing a unified coordinate system. A real-time navigation interface is then generated. On the host display screen, the following information is integrated and displayed: ① Preoperative 3D model; ② Real-time updated position of the ureteroscope tip (represented by a virtual endoscope model); ③ Real-time updated position of the puncture instrument tip (represented by a virtual needle tip model); ④ Optimal puncture path calculated from the reverse laser spot (represented by a bright straight line or conical channel); ⑤ Respiratory motion waveform. This forms a comprehensive navigation screen integrating all key information.

[0047] Then, respiratory motion compensation and robot guidance are performed. The navigation software analyzes the respiratory motion waveform and predicts the movement trend of the kidney in the next respiratory phase. Combined with the real-time intrarenal target point position provided by the endoscope positioning device, the software dynamically adjusts the motion commands sent to the robotic arm, so that the movement of the puncture needle is synchronized with the respiratory movement of the kidney, realizing dynamic tracking puncture and effectively compensating for the target point displacement caused by breathing.

[0048] This achieves GPS-style closed-loop calibration. The system continuously compares the planned path, laser indication direction, and actual instrument position. Once a deviation is detected, it immediately calculates the required calibration amount for the robotic arm and issues a command to drive the robotic arm to make fine adjustments, ensuring that the instrument always moves along the correct path.

[0049] The specialized instrument kit is an innovative tool designed to address the pain points of PCNL surgery.

[0050] This integrated dual-scope operating cannula, with its carefully designed inner diameter (e.g., F24 or F26), allows for the smooth passage of a standard nephroscope for lithotripsy and stone retrieval, while its working channel is also compatible with the insertion of a flexible ureteroscope. A sealing valve at the proximal end of the cannula provides a flexible, self-adaptive seal, monitoring pressure and preventing pressure spikes and negative pressure suction to maintain stable intrarenal pressure and prevent extravasation of perfusion fluid. Using this cannula, the operator can directly insert a flexible ureteroscope through the same channel during PCNL intervals to explore other calyces or assist in lithotripsy, without removing the nephroscope or changing the sheath, simplifying the procedure and shortening the operation time.

[0051] The main control console is the center of human-computer interaction, including input devices such as a high-resolution touch screen, a 3D mouse, and a foot switch. The operator can observe the integrated navigation interface on the screen, use the input devices to plan the preoperative path, set safety boundaries, switch between automatic navigation and manual teleoperation modes, and, when necessary, take complete control of the robotic arm.

[0052] The workflow of this invention is briefly described as follows:

[0053] Step S1: The patient is placed in a prone or semi-recumbent position and anesthesia is administered.

[0054] Step S2: Insert the integrated laser-guided ureteroscope into the target renal calyx (sagittal coaxial rotation adjustment), turn on the laser to mark the puncture point on the body surface, and adjust the laser beam angle in the coronal and cross-sectional positions.

[0055] Step S3: The navigation system performs multi-source information fusion and spatial registration to generate a real-time navigation screen.

[0056] In step S4, under navigation guidance, the robotic arm drives the puncture needle to precisely puncture the light spot on the body surface, and dynamically compensates for respiratory movements along the navigation path (i.e., the light column) until the needle tip reaches the target renal calyx.

[0057] In step S5, the robotic arm sequentially inserts the expander and the integrated dual-mirror operating sleeve to establish a stable working channel.

[0058] In step S6, the surgeon performs nephroscopic lithotripsy through this channel. If a flexible ureteroscope is required, it can be inserted directly through the sealing valve of the same channel for seamless switching.

[0059] The entire surgery can be monitored via the navigation interface on the main control panel.

[0060] This invention transforms complex, experience-based operations into standardized, visualized robot-assisted procedures, significantly shortening the learning curve and facilitating the widespread application of this technology in hospitals at all levels, especially at the grassroots level. This invention innovatively integrates reverse optical positioning, robotics, real-time electromagnetic navigation, and specialized instruments, providing an integrated intelligent solution covering the entire process from preoperative planning and intraoperative navigation to channel establishment and stabilization.

[0061] Although embodiments of the invention have been shown and described, it will be understood by those skilled in the art that various changes, modifications, substitutions and alterations can be made to these embodiments without departing from the principles and spirit of the invention, the scope of which is defined by the appended claims and their equivalents.

Claims

1. A GPS navigation single arm robotic navigation system for PCNL, characterized in that, It includes a reverse laser positioning module, a single-arm robot execution module, a navigation signal tracking and fusion module, and a special instrument kit, among which: The reverse laser positioning module consists of a visualization ureteroscope with a remotely integrated laser transmitter. It is used to emit a laser from inside the renal pelvis outward through the laser transmitter to form a light spot under the skin to assist in locating the insertion point of the surgical puncture needle; and to form a light column in the renal pelvis and under the skin to assist in the navigation route of the surgical puncture needle. The single-arm robot execution module consists of a robotic arm with an integrated instrument gripper at the end, which is used to move based on the instructions of the navigation signal tracking and fusion module, drive the puncture needle to accurately reach the puncture point marked by the laser spot along the planned path and perform puncture along the optical beam navigation route under the puncture point; The navigation signal tracking and fusion module is used to track signals and receive and process spatial location information and medical image data, perform multi-data fusion and three-dimensional reconstruction, and accurately register the actual intraoperative position space with the three-dimensional model space of the preoperative image through the registration algorithm to generate a real-time navigation interface. The specialized instrument kit includes an integrated dual-scope cannula, the inner diameter of which allows for simultaneous combined lithotripsy or exploration using a standard nephroscope or flexible ureteroscope.

2. A GPS navigation single-arm robot navigation system for PCNL according to claim 1, characterized in that, After the visualization ureteroscope is inserted into the kidney through the urethra, a visible red laser spot with a wavelength of 630nm-650nm and a power of less than 5mW is projected in reverse towards the body surface through a laser emitter. The laser spot is used to visually mark the optimal skin puncture point corresponding to the target renal calyx on the patient's body surface. The laser emitter has a multi-angle adjustment function, which adjusts the angle of the emitted laser in real time according to the projection on the body surface.

3. The GPS navigation system for a single-arm robot used in PCNL according to claim 1, characterized in that, The visualization ureteroscope has a coaxial rotation function, which can rotate coaxially in real time in the sagittal position, and the laser point can be adjusted in the coronal position and cross-section to achieve precise three-dimensional positioning.

4. A GPS-navigated single-arm robot navigation system for PCNL according to claim 1, characterized in that, The instrument holder at the end of the robotic arm is used to fix the puncture needle or dilator; the puncture needle is equipped with a visual device for tracking signals and observing the situation in front of the puncture and the puncture channel in real time.

5. A GPS-navigated single-arm robot navigation system for PCNL according to claim 1, characterized in that, The navigation signal tracking and fusion module consists of a mirror positioning device, a robotic arm tracker, and a navigation host, wherein: The endoscope positioning device is set on the handle or proximal end of the visualization ureteroscope to track the spatial position of the end of the ureteroscope in the human body in real time. The robotic arm tracker is installed at the end of the robotic arm or on the instrument holder to track the spatial position of the puncture needle tip in real time. The navigation host is used to receive and fuse real-time spatial position signals from the endoscope positioning device and the robotic arm tracker, as well as receive medical image data, and perform three-dimensional reconstruction and registration in the same coordinate system to generate a comprehensive navigation interface that includes the target kidney, stone, planned path and real-time instrument position. Based on the position of the ureteroscope end provided by the endoscope positioning device, it calculates and guides the robotic arm in real time to align the puncture needle path with the laser spot and beam indication direction.

6. A GPS-navigated single-arm robot navigation system for PCNL according to claim 4, characterized in that, The front end of the puncture needle visualization device is equipped with a miniature camera. The navigation host analyzes the tissue characteristics in front of the puncture path through a real-time image recognition algorithm. If a pulsating blood vessel signal is detected, the system will issue an audible and visual alarm and automatically lock the needle insertion axis of the robotic arm to limit further needle insertion until the operator manually adjusts the path to avoid risks.

7. A GPS-navigated single-arm robot navigation system for PCNL according to claim 1, characterized in that, The navigation signal tracking and fusion module includes a respiratory motion monitoring unit for monitoring the patient's respiratory phase; the navigation host is configured to predict the kidney movement trend based on real-time respiratory phase data and dynamically compensate the movement path of the robotic arm accordingly to achieve synchronous respiratory tracking puncture.

8. A GPS-navigated single-arm robot navigation system for PCNL according to claim 1, characterized in that, The navigation system also includes a main control console, which integrates a display screen showing the comprehensive navigation interface and a human-computer interaction device, used to plan paths, adjust parameters, or take over robot control through the human-computer interaction device.

9. A GPS-navigated single-arm robot navigation system for PCNL according to claim 1, characterized in that, The robotic arm of the single-arm robot execution module is a serial or parallel robot with at least six degrees of freedom.

10. A GPS-navigated single-arm robot navigation system for PCNL according to claim 1, characterized in that, The proximal end of the integrated double-scope cannula is equipped with a sealing valve. The sealing valve adopts a multi-layer silicone valve structure, which has an elastic adaptive sealing function to prevent pressure rise and negative pressure suction, and is used to maintain the stability of intrarenal pressure and prevent the overflow of perfusion fluid.

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