Robots for RF surgery

Abstract

Robot (2) with several movable arm elements (21, 22), each of which is movably mounted via at least one joint (5), and with a mechanical interface (26) for detachably attaching a surgical instrument (27) comprising a corresponding mechanical interface, a shaft, and an end effector (8), wherein the robot (2) further comprises an RF interface (43, 44) for transmitting an RF current for the surgical instrument (27), characterized in that means for automatically detecting the type of surgical instrument (27) attached to the robot (2) are provided, which in particular can detect whether a monopolar or a bipolar surgical instrument (27) is attached to the robot (2), and a control unit (13) is provided which, depending on the type of surgical instrument (27), controls at least one input and / or one output of an RF generator (4, 4b) in such a manner.that either a monopolar or a bipolar surgical instrument (27) can be operated.

Description

The invention relates to a robot with at least one movable arm element according to the preamble of claim 1. Surgical procedures on the human body are increasingly performed using minimally invasive techniques with the assistance of surgical robots. One specific application of robot-assisted surgery is so-called RF surgery, also known as diathermy or electrocautery. In high-frequency (HF) surgery, a high-frequency current is generated using an HF generator, which is then used to treat the patient. Depending on the application, various modulated currents are used. The most important types of procedures include electrotomy (cutting with an electrosurgical scalpel), coagulation (stopping bleeding through targeted blood clotting), desiccation (desiccation of superficial tissue), and electrofulguration (burning tissue through electrical discharge). The surgical robot is equipped with the appropriate surgical instrument, such as an electrosurgical scalpel, for each procedure. Fig. 1 shows a robot system 1 known from the prior art, comprising a surgical robot 2 equipped with a surgical instrument 27 for high-frequency surgery. The surgical robot 2 has several arm elements 21, 22 that can be rotated and pivoted via joints 5. The arm elements 21, 22 are connected to a stationary base 6. The robot system 1 shown in Fig. 1 further comprises an operating table 3 on which a patient 19 lies and is treated by the surgical robot 2, an RF generator 4 for generating an RF current for the surgical instrument 27, and an input device 9 with which all elements belonging to the robot system 1, in particular the robot 2, the operating table 3, and the RF generator 4, can be controlled. The individual elements 2, 3, 4 are each connected to the input device 9 via a cable 10, 11 or 12 respectively.The control signals for the robot 2 generated by the input device 9 are processed by an associated control unit 13 and converted into corresponding control commands for the individual actuators of the joints 5. The operating table 3 and the RF generator 4 each comprise their own control unit (not shown), which can be integrated into the respective element 3, 4 or elsewhere, such as in the input device 9. The robotic system 1 shown in Fig. 1 is a monopolar RF surgical system in which an RF current is conducted from the instrument 27, through the patient 19, to a neutral electrode 17. The end effector 8 of the surgical instrument 27 forms a first electrode, and the neutral electrode 17, on which the patient 19 lies, forms a second electrode of the circuit. The surgical instrument 27 has an RF connector 15, to which it is connected via a cable 16 to the RF generator 4. The neutral electrode 17 is also connected to the RF generator 4 via a cable 18. In a monoterminal system, a special form of the monopolar system shown, no additional neutral electrode 17 is required. In this case, the operating table 3 and the RF generator 4 would each be connected to earth, so that the RF current can flow through the body of patient 19 and the operating table 3 to earth. In the robotic system 1 of Fig. 1, the surgical instrument 27 must be reconnected to the RF generator after each instrument change. This is relatively time-consuming. Furthermore, the cable can be a nuisance during the operation and poses a tripping hazard. From US patent 2013 / 0041292A1, a surgical instrument (robotic tool 10) with a movable shaft and a mechanical interface for the detachable attachment of a surgical instrument is also known. The surgical instrument is connected to an RF generator via a cable, which can, in turn, interfere with surgery. US Patent 2010 / 0228264A1 concerns an energy control and user interface system for robotic surgical systems. Instruments and external devices (e.g., ESUs, lasers, ultrasound) are automatically detected and assigned via stored tool / device information and smart cables. Foot pedals and master handles are assigned contextually to the active instruments and energy sources, including tool swapping and switching the energy handedness (left / right). Graphical, acoustic, and haptic signals, as well as optional activation delays, are intended to prevent accidental energy activation. It is therefore the object of the present invention to provide a robot intended for minimally invasive RF surgery in which the surgical instrument can be connected more easily to an RF generator. Furthermore, no cumbersome RF cable should be required outside the robot. This problem is solved according to the invention by the features specified in claim 1. Further embodiments of the invention are described in the dependent claims. According to the invention, a robot is proposed comprising several movable arm elements, each movably arranged via at least one joint, and which further comprises a mechanical interface for attaching a surgical instrument and an electrical RF interface via which an RF current can be transmitted to a surgical instrument. It is therefore no longer necessary to connect the instrument to an RF generator via a separate cable. The RF interface is preferably arranged such that when the surgical instrument is attached to the robot, it is simultaneously electrically connected to the RF port. The mechanical attachment and electrical connection thus occur simultaneously in a single operation. To enable this, the RF interface is preferably located in the area of ​​the mechanical interface for the surgical instrument. According to a preferred embodiment of the invention, the robotic system is suitable for both monopolar and bipolar applications. For this purpose, the RF interface for the surgical instrument comprises at least two connections for transmitting RF currents. The robot can thus also be equipped with surgical instruments for bipolar applications, such as electrofulguration, in which the phase and neutral conductors both run through the instrument and both electrodes are formed on the instrument. Such an RF interface with multiple RF connections is also suitable for a monopolar surgical instrument. In this case, one of the connections simply remains inactive. The electrical RF connection(s) preferably include at least one socket. That is, the RF connection(s) provided on the robot are designed as "female" connectors, making the RF interface universally applicable to a wide variety of surgical instruments, as it does not impede instrument attachment. The instrument for RF surgery is then equipped with one or two "male" connectors for monopolar or bipolar application, respectively. The robot according to the invention preferably comprises at least one further connection for transmitting an additional quantity, such as a force, a torque, an electrical quantity, a physical quantity such as pressure or coolant, and / or for transmitting data. The mechanical interface, the RF interface, and the further interface are preferably arranged such that a surgical instrument can be connected to all interfaces simultaneously in a single operation. According to a preferred embodiment of the invention, the robot comprises an RF generator. The RF generator can, in principle, be integrated into any component of the robot, such as an arm element, joint, or base. It can also be distributed across multiple components, such as several arm elements. In the latter case, different arm elements can each house individual components of the RF generator. Integrating the RF generator into the robot has the advantage that all connecting cables of the RF generator can be routed along or within the robot arm, so that they no longer obstruct operations. The connecting cables for the RF generator are preferably routed within the individual arm elements of the robot. According to the invention, the robot comprises means for automatically recognizing the type of surgical instrument attached to the robot, wherein the means are particularly capable of recognizing whether a monopolar, bipolar, or other surgical instrument is present, or whether no surgical instrument is attached to the robot. The means for automatically recognizing the instrument type can, in principle, comprise any suitable, known sensor technology, such as an RFID sensor. The instrument attached to the robot could, for example, also be recognized by electronic querying or by means of image acquisition. Automatic instrument detection basically offers the possibility of controlling the RF generator depending on the type of surgical instrument and / or the presence or absence of a surgical instrument. According to the invention, the type of connected surgical instrument is determined, and the RF generator is controlled accordingly to operate in either a monopolar or bipolar mode (when a monopolar or bipolar instrument is detected). If an instrument not intended for RF surgery or no instrument is connected, the RF generator is preferably deactivated or remains inactive. A control unit comprising a corresponding software algorithm is preferably provided to carry out this method. According to a particular embodiment of the invention, the RF generator includes separate inputs for the return of the RF current in monopolar and bipolar applications. The RF current can therefore flow back into the RF generator via either a first or a second input, depending on whether a monopolar or bipolar instrument is connected to the interface. In the case of automatic instrument detection, a control unit can switch the different inputs of the RF generator accordingly. The surgical robot according to the invention preferably comprises an input device at which a user can input control commands for controlling the robot, for actuating the surgical instrument, and / or for controlling an optionally integrated RF generator. According to a preferred embodiment of the invention, a common data line is provided via which both the control commands generated by the input device for the individual actuators of the robot and the control signals for the RF generator and / or the surgical instrument are transmitted. In the minimal case, therefore, only a single control line is required. According to a preferred embodiment of the invention, the robot arm has a modular design, meaning that the individual arm elements preferably each include the same interfaces at their ends and can therefore be replaced quickly and easily. According to a particular embodiment of the invention, an arm element includes an interface with a connection for a control line, a connection for an electrical return conductor, and optionally also a connection for transmitting further control signals, e.g., for the robot's actuators. In a minimal configuration, the interfaces of an arm element comprise only two connections. A joint attached to such an arm element preferably includes a corresponding interface. As mentioned at the outset, a robot system equipped for a monopolar application includes a neutral electrode. According to the invention, the robot has a connection provided on the robot arm or base to which such a neutral electrode can be connected. According to a particular embodiment of the invention, the neutral electrode is designed such that it can be connected directly to the robot—that is, without an intervening cable connection. The robot and the neutral electrode are physically positioned so close to each other that a connection located on the neutral electrode can be directly connected to a corresponding connection on the robot arm. Automatic instrument recognition can also be used to monitor the configuration of the robot system. According to the invention, for example, a control unit can be provided that determines whether a monopolar or bipolar surgical instrument is connected to the robot. If the control unit detects that a bipolar surgical instrument and a neutral electrode are connected to the robot, or that a monopolar surgical instrument but no neutral electrode is connected, a warning and / or error message can be generated. The warning message can, for example, be an acoustic, visual, or haptic signal intended to alert the user to a systematic error. The error signal can, for example, block further use of the RF generator. Brief description of the drawings The invention is explained in more detail below with reference to the accompanying drawings. These show: Fig. 1 a robot system known from the prior art, equipped for RF surgery; Fig. 2 a robot system equipped for RF surgery with an RF generator integrated into the robot; Fig. 3 various views of arm elements and joints of the robot of Fig. 2, showing the interfaces of the individual elements; Fig. 4 an interface provided on the robot of Fig. 2 for a surgical instrument, as well as an example of a surgical instrument; and Fig. 5 a robot system equipped for a monopolar RF application according to a particular embodiment of the invention. Embodiments of the invention For an explanation of Fig. 1, please refer to the introductory description. Fig. 2 shows an embodiment of a robot system 1 suitable for monopolar and / or bipolar RF surgery, comprising a robot 2 whose robot head 46 is, for example, equipped with a monopolar surgical RF instrument 27. The robot system 1 further includes an operating table 3 on which a patient 19 lies, an RF generator 4 for generating an RF current for the surgical instrument 27, and an input device 9 with which all elements belonging to the robot system 1, in particular the robot 2, the operating table 3, and the RF generator 4, can be controlled. The input device 9 can thus also be used to activate or deactivate the RF generator 4. The robot 2 comprises several arm elements 21, 22, which are connected to each other via joints 5, and also has a base 6, which can be, for example, firmly anchored to the ground or attached to another object. A joint 5 is also provided or designed as a joint 5 on the robot head 46. The robot 2 has so many degrees of freedom that the surgical instrument 27 can be moved freely in space, i.e., translational movement in all three spatial axes and pivoting movements about all three spatial axes of a Cartesian coordinate system can be performed. An input device 9 is also provided for manual control of the robot 2. The RF current required by the surgical instrument 27 is transmitted to the surgical instrument 27 via an interface 26 provided on the robot head 46. Such an interface 26 is shown by way of example in Fig. 4. The interface 26 serves for the detachable attachment of a surgical instrument 27 and, in this embodiment, also includes several connections for transmitting a force, a torque, an electrical quantity, and / or a physical quantity, such as pressure or coolant, and / or for transmitting data to the surgical instrument 27 or in the reverse direction. Furthermore, the interface 26 includes an RF interface with two RF connections 43, 44 for transmitting an RF current to the surgical instrument 27. In the case of a bipolar surgical instrument 27, one of the connections, e.g., 43, serves to transmit a high-frequency current to the surgical instrument 27, and the other connection, e.g., 44, serves to transmit a high-frequency current to the surgical instrument 27.44, for transmitting the return current to the robot 2. In the case of a monopolar surgical instrument 27 (as shown here in Fig. 2), only one of the two connections 43, 44 is required. Thus, for example, the RF current can be routed to the surgical instrument 27 via connection 43; the other connection 44 remains inactive. In the illustrated embodiment, the connections 43, 44 are designed as plug sockets, and the RF connections 39, 40 provided on the surgical instrument 27 are designed as corresponding male plugs. A reversed arrangement of plugs and sockets is also possible. However, the design shown in Fig. 4 has the advantage that the interface 26 can be used universally for bipolar, monopolar, and other surgical instruments 27, since the RF connections 43, 44 have no protruding parts that would impede the attachment of an instrument 27. Depending on whether one or both terminals 43, 44 are connected, the robot 2 can automatically detect whether a monopolar or bipolar RF instrument 27 is connected to interface 26. If neither terminal is closed, it can be detected that no RF instrument 27 is connected to interface 26. This means that terminals 43, 44 serve not only as a means of power transmission but also for the automatic detection of the instrument type. As already mentioned, the robot 2 comprises an RF generator 4, 4b, which in the illustrated embodiment is distributed across several arm elements 21, 22. As shown in Fig. 2, a first component 4 of the RF generator is located in arm element 22, and a second component 4b is located in arm element 21. However, the RF generator 4, 4b could also be integrated as a whole into a single arm element 21, 22 or a joint 5, provided there is sufficient space. The RF generator 4, 4b, the actuators located in the joints 5 (not shown), and optionally also the surgical instrument 27 are controlled here via a common control line 29, which is arranged between the input device 9 and the robot 2. The control commands generated by the input device 9 are processed by a controller 13 and then also transmitted via a single control line 23 to the various controlled elements, namely the RF generator 4, 4b, the actuators of the robot 2, and / or the surgical instrument 27. According to another embodiment, however, more than one control line 23 could also be provided. The control line(s) 23 preferably run through the arm elements 21, 22.In addition, robot 2 also has a return conductor 25 leading to the RF generator 4, 4b, through which the return current of a neutral electrode 17 can flow back to the RF generator 4, 4b in a monopolar application of the robot system 1. In a monopolar application, the RF current generated by the RF generator 4, 4b flows via a line 24 to the interface 26 and from there into the surgical instrument 27 to the end effector 8. From the end effector 8 of the instrument 27, the RF current then flows further through the body of the patient 19 to a neutral electrode 17, which is connected to the robot 2 via a cable 18, and finally back to the RF generator 4, 4b via the return conductor 25. Thus, the circuit is closed in a monopolar application. In the case of a bipolar application, the RF current generated by the RF generator 4, 4b flows via conductor 24 to interface 26 and from there into the bipolar instrument 27 to the end effector 8. From the end effector 8, the current then flows back through the instrument 27 to interface 26 and through conductor 24 back to the RF generator 4, 4b. In this case, conductor 24 can be a multi-core conductor. The robot system 1 preferably comprises means (not shown) for automatically detecting the type of surgical instrument 27 attached to the robot 2, wherein the means are particularly capable of detecting whether a monopolar or a bipolar instrument 27 is connected to the robot 2. For this purpose, the surgical instrument 27 can, for example, be equipped with an RFID chip. Alternatively, any other technology known from the prior art could be used, such as optical recognition by means of a barcode or image processing software that can identify the respective instrument 27. Depending on the type of surgical instrument, the control unit 13 can switch the RF generator to either a monopolar or a bipolar operating mode. If the surgical instrument 27 is removed from the robot head, and this is detected by the control unit 13, the RF generator 4, 4b can also be switched off. The RF generator 4, 4b is preferably designed such that both monopolar and bipolar RF surgical procedures can be performed. The respective procedure can be selected, for example, at the input device 9. However, the operating mode of the RF generator could also be set automatically, as described above. The RF generator 4, 4b comprises two inputs for the RF current return: a first input (to the left of the RF generator 4, 4b in Fig. 2) for the current return via line 25 in a monopolar application, and a second input (to the right of the RF generator 4, 4b in Fig. 2) for the current return via line 24 in a bipolar application. Depending on the technique used, the RF generator 4, 4b can switch between the two inputs. That is, the RF current can be returned to the RF generator 4, 4b via line 25 in the case of a monopolar instrument and via line 24 in the case of a bipolar instrument. If the robot system 1 has automatic instrument detection, it can switch automatically between the different inputs. The robot 2 shown in Fig. 2 is preferably modular in design, which allows individual arm elements 21, 22 or joints 5 to be replaced easily and quickly. In Fig. 2, the replacement of an arm element 22 with an identical arm element 22' is indicated by arrows 28. As shown in Fig. 3, each joint 5 and each arm element 21, 22 comprises two electrical interfaces 29A, 29B and 30A, 30B, respectively, each with multiple terminals. The left part of Fig. 3 shows a side view of a joint 5 from direction B, and the right part of Fig. 3 shows side views of the arm element 21 from directions A and B. The joint 5 comprises an interface 29B with three terminals 31B, 32B, and 33B, which can be electrically connected to corresponding terminals 34A, 35A, and 36A of the interface 30A of the arm element 21. One of the terminals, e.g., 31B, can be configured as a plug, and the other, e.g., 34A, as a socket. The arm element 21 has another interface 30B on its right side in the image (index B), which is identical in design to the interface 29B of joint 5. In the illustrated embodiment, terminals 31B, 34A, and 34B are used to connect the control line 23. Terminals 33B, 36A, and 36B, on the other hand, are used to connect the return conductor 25 and / or the line 24. Furthermore, each of the interfaces 29B, 30A, and 30B includes an additional terminal 32B, 35A, and 35B, respectively, through which further signals, e.g., for controlling the surgical instrument 27, can be transmitted. The individual components 5, 21, and 22 can also include more or fewer terminals. According to a preferred embodiment of the invention, the individual arm elements 21, 22 of the robot 2 and / or joints 5 of the robot 2 each comprise at least two interfaces 29B, 30A, 30B for electrical contact with adjacent components of the robot 2. Each interface 29B, 30A, 30B preferably comprises a first connection 31B, 34A, 34B for transmitting a control signal for controlling the RF generator 4, 4b integrated in the robot 2 and / or at least one actuator of the robot 2 and / or the surgical instrument 27, as well as a second connection 33B, 36A, 36B for returning the return current from a neutral electrode 17 to the RF generator 4, 4b and / or for supplying the RF current from the RF generator 4, 4b to the interface 26 or to the RF instrument 27. The control line 23 and the return conductor 25 are looped through the base 6, at least one joint 5, and an arm element 21, 22. Figure 3 shows that the control line 23 connects terminals 34A and 34B, and the return conductor 25 (or line 24) connects terminals 36A and 36B. Furthermore, another electrical conductor 37 is looped through the arm element 21, connecting the two corresponding terminals 35A and 35B. All interfaces 29B, 30A and 30B are preferably designed uniformly, so that components 5, 21 and 22 can be combined with each other as desired. Fig. 5 shows a special embodiment of a robot system 1, which is also equipped for a monopolar surgical application. Similar to Fig. 2, the robot system 1 comprises a multi-segmented robot 2, to whose robot head 46 a monopolar surgical instrument 27 is attached, and an operating table 3 on which a patient 19 to be treated lies. In contrast to the embodiment of Fig. 2, however, the robot 2 here is attached directly to the operating table 3 and contacted directly with a neutral electrode 17b via a connection 45. The neutral electrode 17b is designed such that the electrical contact between the robot 2 and the neutral electrode 17b is established immediately by attaching the robot 2 to the operating table 3. That is, both elements 2, 17b are automatically connected to each other when the robot 2 is attached. For this purpose, the neutral electrode 17b can extend to the robot 2 and be connected directly – i.e.,without an intervening cable – to be connected to robot 2. Robot 2 and neutral electrode 17b each include a connector element for this purpose. Since the robot 2 forms a fixed unit when coupled to the operating table 3, it is possible according to the invention to relocate and integrate the RF generator 4, 4b or components of the RF generator 4, 4b into the operating table 3. That is, the operating table 3 can then be used as a component analogous to the elements 5, 6, 21 and 22. For this purpose, the operating table 3 and the base 6 can have an interface as shown in Fig. 3 to transmit the necessary currents, signals and / or physical quantities. The controller 13 is preferably designed to detect errors in the configuration of the robot system 1, and in particular in the electrical wiring, as a monopolar or bipolar system. For this purpose, the controller 13 determines whether a neutral electrode 17, 17b is connected to terminal 45. This can be done, for example, by electronic querying in a known manner. Furthermore, the controller 13 determines whether the connected instrument 27 is a monopolar or bipolar RF instrument. The instrument type may, for example, have been previously entered by the user, or the robot system 1 may include automatic instrument recognition that provides the corresponding information to the controller 13.If it is detected that a neutral electrode 17, 17b is connected to the robot 2, but a bipolar instrument 27 is attached to interface 26, the control unit 13 can generate a warning and / or error signal to alert the user to a configuration error and / or to deactivate a part of the robot system 1, such as the RF generator 4, 4b. The same can also occur if a monopolar instrument 27 is attached to interface 26, but no neutral electrode 17, 17b is connected.

Claims

Robot (2) with several movable arm elements (21, 22), each of which is movably mounted via at least one joint (5), and with a mechanical interface (26) for detachably attaching a surgical instrument (27) comprising a corresponding mechanical interface, a shaft, and an end effector (8), wherein the robot (2) further comprises an RF interface (43, 44) for transmitting an RF current for the surgical instrument (27), characterized in that means for automatically detecting the type of surgical instrument (27) attached to the robot (2) are provided, which in particular can detect whether a monopolar or a bipolar surgical instrument (27) is attached to the robot (2), and a control unit (13) is provided which, depending on the type of surgical instrument (27), controls at least one input and / or one output of an RF generator (4, 4b) in such a manner.that either a monopolar or a bipolar surgical instrument (27) can be operated. Robot (2) according to claim 1, characterized in that the mechanical interface (26) and the RF interface (43, 44) are arranged such that the surgical instrument (27), when attached to the robot (2), is also simultaneously electrically connected to the RF interface (43, 44). Robot (2) according to claim 1 or 2, characterized in that the RF interface has at least two electrical connections (43, 44) for transmitting an RF current. Robot (2) according to one of the preceding claims, characterized in that the RF interface (43, 44) comprises at least one socket. Robot (2) according to one of the preceding claims, characterized in that at least one further interface (47) is provided for the transmission of an additional quantity, in particular a force, a torque, an electrical quantity, a physical quantity and / or data. Robot (2) according to one of the preceding claims, characterized in that the robot (2) comprises an RF generator (4, 4b) which is wholly or partially integrated into one or more of its arm elements (21, 22) and / or joints (5) and / or its base (6) and / or into an operating table (3). Robot (2) according to one of the preceding claims, characterized in that at least one arm element (21, 22) and / or joint (5) of the robot (2) comprises at least two interfaces (29B, 30A, 30B) for electrical contacting with adjacent components of the robot (2). Robot (2) according to claim 7, characterized in that an interface (29B, 30A, 30B) comprises a first connection (31B, 34A, 34B) for transmitting a control signal for controlling the RF generator (4, 4b) integrated in the robot (2), at least one actuator of the robot (2) and / or the surgical instrument (27), and a second connection (33B, 36A, 36B) for transmitting an RF current. Robot (2) according to one of the preceding claims, characterized in that a single control line (23) is provided for controlling both an RF generator (4, 4b) integrated in the robot (2) and an actuator of the robot (2). Robot (2) according to one of the preceding claims, characterized in that the robot (2) has a connection (45) to which a neutral electrode (17, 17b) can be connected. Robot (2) according to one of the preceding claims, characterized in that a control unit (13) is provided which determines whether a monopolar or bipolar surgical instrument (27) is attached to the robot (2) and whether a neutral electrode (17, 17b) is connected to the robot (2), and which generates a warning or error signal when a bipolar surgical instrument (27) and a neutral electrode (17, 17b) and / or when a monopolar surgical instrument (27) and no neutral electrode (17, 17b) are connected.

Images