Robotic system for minimally invasive surgery

Abstract

Robotic system for minimally invasive surgery, with a robot arm (3.1) at the distal end of which a fastening device (4.11) for attaching an endoscope is mounted, a patient-side unit (3.6) which has a fixation device for fixing relative to a patient or an operating table, wherein the patient-side unit (3.6) has an opening for passing the endoscope (1) through and a drive element (7.2,7.3) for translational movement and / or rotation of the endoscope (1), characterized in that the patient-side unit (3.6) is connected to the robot arm (3.1) via a data connection, wherein a control of the robot arm (3.1) is designed for guiding the robot arm (3.1), to which the proximal end of the endoscope is attached, when the drive element (7.2, 7.3) performs a translational movement of the endoscope (1) into the patient body.

Description

[0001] The invention relates to a robotic system for minimally invasive surgery.

[0002] It is well known that endoscopes are used in minimally invasive surgery to perform diagnostic tasks or manipulations within hollow organs. During procedures, endoscopes are typically guided manually by the surgeon. This is particularly challenging with flexible endoscopes, as the surgeon holds the handle of the flexible endoscope in one hand and uses a lever on the handle to actuate the angulation of the endoscope tip. Simultaneously, rotating the handle rotates the endoscope around its longitudinal axis. With the other hand, the surgeon controls the advancement of the endoscope shaft into the patient.

[0003] Information on the state of the art can be found in the following publications: Deasai, Mihir M., et al. “Flexible robotic retrograde renoscopy: description of novel robotic device and preliminary laboratory experience.” US 2012 / 0065470 A1 WO2019139941 A1 US 10 219 867 B2 US 9 763 741 B2 US 2017 / 0119412 A1 US 2018 / 0092517 A1 US 2019 / 0 191 967 A1 DE 10 2019 134 352 A1

[0004] US Patent 8,870,815 B2 describes a robotic system for minimally invasive surgery that uses two opposing wheels to steer a tubular object located between them. This object is then inserted into the patient's body. The device with the two opposing wheels can be positioned close to the patient's body to guide the tubular instrument.

[0005] Further state of the art is known from US 2021 / 0023337 A1 and US 2004 / 0254566 A1.

[0006] The object of the invention is to provide a robotic system for performing minimally invasive surgical procedures that enables simplified handling.

[0007] The problem is solved according to the invention by the features of claim 1.

[0008] The robotic system according to the invention for minimally invasive surgery comprises a robotic arm at the distal end of which a mounting device for attaching an endoscope is mounted. This allows, for example, a connection with an unmodified endoscope for handheld use. It is preferred that the endoscope can be inserted into the mounting device without tools, for example by means of snap fasteners, magnetic closures, or latches attached to the mounting.

[0009] The robot system according to the invention further comprises a patient-side unit which has a fixation device for fixing relative to a patient or to an operating table.

[0010] According to the invention, the patient-side unit further comprises an opening for passing the endoscope through it, as well as at least one drive element for translational movement and / or rotation of the endoscope.

[0011] The robotic system according to the invention thus enables a particularly simple minimally invasive surgical procedure, for example in ureteroscopy. The surgeon does not have to hold the endoscope handle by hand, which can be tiring throughout the entire surgical procedure. This task is performed by the attachment device to which the endoscope, and in particular its proximal end, i.e., the endoscope handle, is attached. Furthermore, the patient-side unit allows for translational movement of the endoscope into and out of the patient's body and / or rotation of the endoscope about its longitudinal axis.This can be automated, whereby a suitable input device for the surgeon to issue commands to perform translational and / or rotational movements of the endoscope can be provided directly on the patient-side unit or the robotic arm, or at another suitable location. A minimally invasive surgical procedure can thus preferably be performed by a single surgeon, i.e., without an assistant. An assistant is otherwise mandatory as soon as an instrument is to be inserted through the working channel of the flexible endoscope and manipulated inside the patient (e.g., laser fiber, grasping forceps, or retrieval basket).

[0012] According to the invention, the patient-side unit is connected to the robot arm via a data connection. A control unit for the robot arm is designed to guide the robot arm, to which the proximal end of the endoscope is attached, when the drive element of the patient-side unit moves the endoscope translationally into the patient's body. This corresponds to the previous manual operation of an endoscope during a minimally invasive surgical procedure, in which the surgeon, for example, guides the endoscope handle towards the patient with their right hand while moving the endoscope shaft further into the patient with their left hand.It is preferred that the position of the mounting device relative to the patient-side unit is determined by suitable sensors, so that the robot arm's control system can determine in which direction the robot arm or the mounting device must be moved. It must be ensured that, on the one hand, the endoscope is not subjected to tensile stress if the mounting device is too far from the patient-side unit. On the other hand, the endoscope must not be kinked. This could occur, for example, if the mounting device is moved too close to the patient-side unit without the endoscope being inserted far enough into the patient's body.

[0013] It is preferred that the robot arm be manually positionable and lockable in a desired position, and in particular that it be gravity-compensated. Alternatively, instead of an actuated robot arm, a different type of non-actuated holding arm can be used, with the mounting device attached to its distal end. However, in this case, automatic tracking of the endoscope handle would not be possible.

[0014] It remains preferable for the robotic arm to automatically maintain its position as soon as the surgeon ceases applying force. This allows for particularly intuitive operation.

[0015] It is further preferred that the mounting device includes an actuator for actuating a control element for angling the tip of the endoscope. Furthermore, it additionally or alternatively includes an actuator for rotating the endoscope about its own axis. Alternatively, the longitudinal axis of the handle can coincide with that of the last axis of the robot, provided it offers sufficient freedom of movement.

[0016] These actuators enable the surgeon to generate input commands for angling the endoscope tip and / or rotating the endoscope using an input device that may be located distal to the robotic system, for example, in another room. This makes it possible to perform a procedure entirely via telemanipulation.

[0017] The mounting device is preferably designed such that the endoscope can be manually operated by a surgeon. For this purpose, all operating levers, etc., on the endoscope handle must be accessible to the surgeon, even when the endoscope is in the mounting device.

[0018] It is further preferred that an input device be provided for capturing input from the surgeon, which serves to angulate, rotate, and / or translate the endoscope. As already described, this device can be located distally, i.e., not directly on the robotic system. This could be, for example, a joystick, directional pad, space mouse, or similar input devices known from the prior art.

[0019] Furthermore, it is preferred that the patient-side unit can be connected to a sheath for inserting the endoscope into the patient's body by means of a force-fit and / or form-fit connection. It is preferred that the corresponding mechanism can be operated without tools. The sheath can, for example, have a tube with a funnel at its inlet (this is the usual design of commercially available sheaths in urology) and can be positioned from the end of the urethra to the surgical site to avoid injury to the urinary tract caused by repeated insertion and withdrawal of the ureteroscope. In order to be able to insert the endoscope into the patient automatically, the position of the sheath relative to the patient-side unit must be known. For this purpose, it must be connected to the patient-side unit in such a way that it is mechanically fixed relative to it, i.e., not movable.

[0020] It is further preferred that the patient-side unit has two spaced-apart parallel drive rollers for translational movement of the endoscope, wherein the endoscope is held between the two drive rollers in such a way that it is positively connected to one drive roller on each side. A counter-rotating rotation of the drive rollers results in translational movement of the endoscope.

[0021] Furthermore, it is preferred that the two drive rollers are translationally movable in opposite directions along their longitudinal axis, so that the endoscope rotates.

[0022] It is further preferred that the frictional connection between the two drive rollers and the endoscope can be released by moving at least one of the drive rollers away from the endoscope and / or by reducing the diameter of at least one of the drive rollers, wherein the frictional connection can be released in particular without tools and with one hand by the surgeon.

[0023] Furthermore, it is preferred that at least one drive roller can be folded away from the endoscope and / or moved translationally away.

[0024] It is further preferred that at least one drive roller be compressible to reduce its diameter.

[0025] It is still preferred that the released state, in which the frictional connection between the drive rollers and the endoscope is disengaged, is maintained automatically. This allows the surgeon to use both hands for the manual movement of the endoscope.

[0026] Furthermore, it is preferred that the patient-side unit has at least one sensor for detecting the rotational and / or translational position of the endoscope. In particular, the translation and / or rotation of the endoscope shaft relative to the patient-side unit can be determined. For this purpose, for example, the endoscope camera image and a recognizable structure near the patient access point can be used. The actuator manipulates the shaft until this structure appears at a defined distance and orientation on the endoscope image. The measured values ​​for translation and rotation are then reset to zero. The position and orientation of the endoscope tip can then be incrementally calculated from the movements of the actuator mechanism. The sensor system can also prevent the endoscope from being retracted too far and losing contact with the drive rollers.This can be achieved, for example, via an external camera, the use of the endoscope camera image, or a limit value for the position of the endoscope tip and permanent monitoring of this value.

[0027] It is also possible to detect slippage between the two drive rollers and the endoscope shaft, enabling the correct calculation of the endoscope tip's pose. For this purpose, an optical sensor, such as those used in computer mice, can be employed. This sensor measures the movements of the shaft's outer surface. These measurements can be used to calculate a more accurate position estimate or to issue a warning to the surgeon if the deviation becomes too large. Alternatively, the camera's movement at the endoscope tip could be calculated from the camera image and compared with the endoscope's movement.

[0028] It is still preferable to provide a disposal point for material from inside the patient (e.g., stone fragments and biopsy material) in the immediate vicinity of the sluice. This is particularly advantageous for larger kidney stones that are fragmented by laser and then have to be removed piece by piece from the patient's tract using a retrieval basket. To ensure that the stone fragments or biopsy material do not become stuck to the forceps or the retrieval basket, a blower can also be provided at the disposal point to blow the objects towards the disposal point.

[0029] Preferred embodiments of the invention are explained below with reference to figures.

[0030] They show: Fig. 1: A handheld ureteroscope Fig. 2: A detailed view of the endoscope tip in its straight and curved states Fig. 3: The overall system for robotic manipulation Fig. 4: Attaching the endoscope handle unit to the robot arm Fig. 5 and Fig. 6: Alternative embodiments for actuating the endoscope shaft Fig. 7: An overall view of the patient-side unit Fig. 8: The basic structure of the patient-side unit Fig. 9a and Fig. 9b: Cross-section and side view of the patient-side unit Fig. 10 to 12: Various alternatives for opening the roller mechanism Fig. 13: The sensors for monitoring the endoscope movement Fig. 14: An input device for controlling the flexible endoscope Fig. 15: Exemplary visualization of the condition of the flexible endoscope

[0031] Fig. Figure 1 shows a handheld flexible ureteroscope. The handle 1.1 can be held by a surgeon while the flexible shaft 1.2 is partially inserted into the patient during the endoscopic procedure. By moving the actuating element 1.3 (along R2), the endoscope tip 1.4 can be bent in a plane. Various instruments, such as a fiber optic cable for a laser or a retrieval basket for removing bladder stones, can be inserted through the working channel 1.5. The plane in which the endoscope tip bends can be varied by rotating the entire endoscope around its longitudinal axis (R1). Depending on the endoscope model, the arrangement and design of the controls differ (see the two different endoscopes in Figure 1). Fig. 1 and Fig. 4. The type and number of endoscope degrees of freedom are typically identical for the various endoscopes used for a given application (such as urology).

[0032] As in Fig. As shown in Figure 2, the tip of flexible urological endoscopes, due to its small diameter (the endoscope must fit through the patient's urethra), can only be bent in one plane and within a specific range. The flexible section of the endoscope tip 2.1 is bent by actuating the adjustment wheel on the handle by means of cables / rods running inside the endoscope shaft. The endoscope tip 2.2 and the remaining shaft 2.3 remain rigid during this process.

[0033] During manually performed urological procedures using flexible endoscopes (e.g., endoscopic kidney stone removal), the surgeon and assistant are positioned between the patient's spread legs to manipulate the flexible endoscope and the instruments guided through its working channel. The use of a robot for manipulating the flexible endoscope should enable such procedures to be performed without an assistant in the future. Fig. Figure 3 shows a possible overall setup for the robotic manipulation of flexible endoscopes for urology, with (left) and without (right) the patient: The robot arm 3.1 can be mounted on a mobile and height-adjustable cart 3.2 as shown, but can also be attached to the side rails of the operating table 3.3 or a ceiling-mounted stand (not shown). It is also conceivable that the base of the robot arm is oriented horizontally rather than vertically as shown. A mounting for the endoscope handle unit 3.4 is attached to the tool flange of the robot arm. The patient-side unit 3.6 is located in close proximity to the opening of the patient's urethra 3.5.Not shown are the additional computers required to control the robot (which can be flexibly positioned in the operating room), the surgeon's input device for controlling the flexible endoscope, and the screen for displaying the endoscope image (which must be accessible and visible from the surgeon's position between the patient's legs).

[0034] In the overall setup shown, the robotic arm acts as an intelligent stand for the endoscope handle unit. The surgeon can move and position the handle unit freely in space, as is customary with manual procedures, with the robotic arm following the movements while compensating for gravity. If the surgeon releases the handle unit or locks a position via a user input (button press, foot pedal activation, voice control, etc.), the robot switches to a position-controlled or rigid impedance-controlled mode, ensuring that the pose (position and orientation) of the endoscope handle unit is maintained even after the surgeon releases it. If the endoscope tip is moved inside the patient during the procedure via telemanipulation by the surgeon, the robotic arm can also vary the pose of the endoscope handle unit as needed to allow for the advancement of the endoscope tip and prevent torsion of the endoscope shaft.Collisions with patients or surgeons can be avoided either by predefined workspace boundaries or by suitable monitoring of the operating room setup (e.g., using external tracking systems).

[0035] Fig. Figure 4 shows the attachment of the endoscope handle unit to the robot arm: For robotic movement of the endoscope 4.1, its handle unit 4.2 must be connected to the tool flange 4.3 of the robot arm 4.4. In the simplest case shown, this is achieved via several aluminum profiles 4.5-4.7 and a positive-locking holder for the handle unit 4.8. In this example, the holder consists of two halves screwed together, but other variations are also possible (one-sided hinge plus latch, click fasteners between the halves, hook-and-loop fasteners for fixing the halves, etc.). The aluminum profiles and the holder must neither obstruct the working channel of the endoscope 4.9 nor hinder the surgeon when grasping and moving the handle unit 4.2 or when actuating the lever 4.10. If the lever 4.10. To enable complete telemanipulation of the endoscope movement, a motor and a suitable detachable and low-backlash transmission mechanism between the motor and the lever must be provided.

[0036] Because the flexibility of the endoscope shaft makes precise movement of the endoscope tip impossible solely through movement of the endoscope handle unit, the endoscope shaft must be manipulated in two degrees of freedom (translation along the longitudinal axis and rotation around the longitudinal axis) in close proximity to the patient access point. Various actuation concepts are conceivable for this purpose.

[0037] Fig. Figure 5 illustrates the principle of actuating the endoscope shaft via two rotating rollers in a rotating assembly. The translation of the endoscope shaft is actuated by the two rollers. The counter-rotation of the two rollers around their longitudinal axis results in a translation of the endoscope shaft along its longitudinal axis (in this illustration, into or out of the plane of the image) (left and center). The rotation of the endoscope shaft around its longitudinal axis is achieved by rotating the two rollers, along with their bearings, around the longitudinal axis of the endoscope shaft (right). The structural component for the roller bearings can be designed as a circle or circular segment, and its drive can be, for example, via belts or toothed belts, a spur gear, a bevel gear, or a worm gear.

[0038] Fig. Figure 6 shows the principle of actuating the endoscope shaft via two rotating and translating rollers.

[0039] In this preferred embodiment, the endoscope shaft is actuated by two rollers. The counter-rotation of the two rollers around their longitudinal axis results in a translation of the endoscope shaft along its longitudinal axis (in this illustration, into or out of the image plane) (left and center). A counter-translation of the two rollers along their longitudinal axis results in a rotation of the endoscope shaft around its longitudinal axis (right). This arrangement allows for a very compact design and simplifies the cable routing for the two roller drives. It was therefore adopted as the basis for further design.

[0040] The Fig. Figure 7 shows the entire patient-side unit: During the operation, the shaft of the flexible endoscope is inserted into the patient via the sheath 7.1, which is pushed into the urethra, to prevent injury to the urethra during repeated insertion and withdrawal of the endoscope shaft. For automated movement of the shaft, the position of the sheath relative to the rollers for actuating the shaft 7.2 and 7.3 must be known; this is achieved here by a sheath attachment 7.4. To achieve a defined position of the shaft, it is guided by the sheath after actuation and by the two shaft guide elements 7.5 and 7.6 before actuation. The two sides of the actuation mechanism (consisting of the rails plus the attached motors with the rollers) can be opened (see Figure 7). Fig. 12) to allow the endoscope shaft to be inserted into the patient-side unit or, if necessary, to be moved manually by the surgeon (e.g., when haptic feedback is required for particularly sensitive movement). In the folded position, the two sides of the activation mechanism are releasably fixed against each other by a suitable locking mechanism (e.g., the locking bolt 7.7).

[0041] In Fig. Figure 8 shows the basic structure of the patient-side unit with the sheath mounting: The gear 8.1 and the motor 8.2 for actuating the roller translation are rigidly connected to the lower part of the sheath mounting 8.3. The upper part of the sheath mounting 8.4 is movable relative to the lower part by means of a hinge 8.5 and can be connected to it via a positive-locking snap 8.6. The position and orientation of the sheath (not shown) are determined by the recesses in both parts of the sheath mounting and by the two dowel pins 8.7; that is, the sheath mounting is positively locked to the sheath used in this area.

[0042] Fig. Figure 9 shows the actuation of the drive rollers in a cross-section through the center of the rails (left) and a side view (right): The drive rollers 9.1 and 9.2 are driven synchronously by motors 9.3 and 9.4. These are mounted on carriages 9.5 and 9.6, which are guided vertically on rails 9.7 and 9.8. The mounting of the motors is adjustable horizontally perpendicular to the rail (arrows in the left image) by means of elongated holes to allow the feeding of endoscopes with different diameters. The carriages are held in position by two antagonistic forces: The compression springs 9.9 and 9.10, guided on two cylindrical metal rods, exert a force in the direction of the rollers, while the toothed belt 9.11 holds the carriages back (and is thus pre-tensioned by the two compression springs). The toothed belt engages a drive roller 9.12, whose rotation moves the carriages in opposite directions in a translational manner. The rails 9.7 and 9.8 are rotatably mounted about two axes 9.13 and 9.14 to fold the rollers to the side for manual operation. The lock holder 9.15 is located above the drive motor 9.17, which actuates the drive roller 9.12 of the toothed belt 9.11.

[0043] Several constructive solutions exist to create a detachable, force-fit connection between the drive rollers and the endoscope shaft.

[0044] Fig. Figure 10 describes a method for releasing the frictional connection by deflecting spring-loaded roller mountings. For this purpose, adapted commercially available side pressure pieces can be used, for example: The rollers 10.1 are connected by a thread 10.2 to a side pressure piece 10.3, which is pressed into the driven shaft 10.4 belonging to the roller. Thus, the spring 10.3.1 of the side pressure piece pushes the attached roller into a vertical position and ensures a frictional connection to the endoscope shaft. To release this frictional connection (and thus make the endoscope shaft freely movable), an external force F, pointing away from the shaft, must be exerted on the upper part of the roller, which is large enough to overcome the spring force of the spring-loaded pressure piece. The roller then moves away from the endoscope shaft (dashed line).The opening mechanism shown can also be implemented with one spring-loaded and one rigid roller mounting instead of two spring-loaded roller mountings as shown.

[0045] Similarly, as in Fig. Figure 11 shows how a change in diameter of elastic rollers is used to establish or release the frictional connection: An elastic roller 11.1 is guided on a sleeve 11.2, which in turn is centered on the axis of rotation 11.3. A screw 11.4 presses against the top of the elastic roller via a washer 11.5 (and optionally a larger pressure washer 11.6). This pressure force compresses the elastic roller in length, resulting in an increase in diameter. The sleeve 11.2 acts as an end stop for the compression. If the screws are unscrewed (see right-hand arrangement), the elasticity of the rollers leads to an increase in length while simultaneously reducing the diameter. This increases the gap between the two rollers, and the previously frictionally guided endoscope shaft can be easily removed.Instead of screws, tool-free clamping elements such as eccentric clamps can also be used.

[0046] While the in Fig. 10 and Fig. The 11 concepts shown for releasing the frictional connection can only achieve a relatively small distance between the endoscope shaft and the roller; opening the roller mechanism by folding it open, as in Fig. The figure shows a clear spatial separation between the rollers and the endoscope shaft. The roller mechanism is opened by tilting the two side sections with their linear rails relative to the central section 12.1 about the axes 12.2 and 12.3. Preferably, the tilting of the two halves occurs synchronously, e.g., by using two gears 12.4 and 12.5. Appropriate stops and / or locking mechanisms are provided to maintain the open and closed configurations. For example, magnetic stops can be used. The V-shaped recesses of the two shaft guide elements 12.6 and 12.7 capture the shaft when the roller mechanism is closed and position it coaxially with the sheath 12.8.

[0047] Additional technical components can be provided between the sluice and the drive rollers, in particular the defined discharge point for stone fragments and biopsy material described above, as well as the [missing information]. Fig. Figure 13 shows sensors for monitoring endoscope movement. To detect slippage between the drive rollers 13.1 and the endoscope shaft 13.2, additional sensors can be provided near the shaft (preferably between the drive rollers and the sheath, where the shaft position is well defined) to measure the shaft movement. If the measurement result deviates from the movement imparted by the drive rollers, this indicates slippage between the drive rollers and the endoscope shaft. The sensors can operate optically, as shown on the left, whereby, similar to an optical mouse sensor, an LED / laser 13.3 illuminates the shaft and the reflected light is captured by a micro camera 13.4. If the natural structure of the shaft surface is insufficient for reliable operation, additional markings 13.5 can be applied to it, as shown in the figure.Alternatively, the shaft movement can also be detected mechanically. In this case, a roller 13.6, lightly pressed against the shaft, is set into rotation during the shaft movement. This rotational movement can be measured via a suitable sensor 13.7 (optical, magnetic, inductive, potentiometer, etc.) which is connected to the roller and the stationary structure.

[0048] When working with handheld flexible endoscopes, the mapping between the movements of the handle and its lever and the movements of the endoscope tip is unintuitive and difficult to predict, especially for less experienced surgeons. Robotic manipulation of the flexible endoscope offers the possibility of creating a more intuitive mapping between the surgeon's input and the endoscope movement. This requires an ergonomic input device, such as the one described in [reference to relevant article / document]. Fig. As shown, the input device offers at least three degrees of freedom for actuating the three endoscope degrees of freedom (feed, rotation, angulation). The user acts these degrees of freedom via a cylindrical pin 14.1, which is connected to a sensor module 14.2 for detecting the forces applied by the user. Preferably, the inclination of the entire arrangement can be adjusted (dashed arrow), for example, via a hinge 14.3. As an additional input option, buttons 14.4 or comparable control elements can be attached to the sensor module or the pin. A preferred mapping between the input device and the flexible endoscope is as follows: The translation of the cylindrical pin along its longitudinal axis 14.5 controls the translation of the endoscope along its longitudinal axis, the rotation of the pin about its longitudinal axis 14.6 controls the rotation of the endoscope about its longitudinal axis, and the rotation of the pin about the sensor module 14.7 controls the angulation of the endoscope tip. The illustration shows a prototypical implementation of the input device based on a Spacemouse. An input device specifically optimized for endoscope control should additionally take into account the boundary conditions of working in sterile environments (waterproofness, disinfectability, sterile packaging using sterile drape) and offer options for implementing haptic feedback.

[0049] Due to the robotic actuation of the endoscope's degrees of freedom, the surgeon lacks information about the endoscope's condition that he would obtain through self-perception with a handheld endoscope, namely the position and rotation of the endoscope handle and the position of the lever for angling the endoscope tip. This information must therefore be provided to the surgeon by other means, for example, via the [missing information - likely a specific device or system]. Fig.In the visualization shown in Figure 15, the user is informed about the endoscope's three degrees of freedom in three easily understandable displays: The endoscope's advance can be represented by the numerical display of the distance from the sheath inlet (top left). Optionally, potentially critical states (leaving the sheath inlet or reaching the maximum shaft length) can be highlighted by color. The angulation of the endoscope tip can be displayed as a continuous scale value (green pointer) between a straight endoscope tip and maximum angulation (top right). The rotation of the endoscope shaft around its longitudinal axis can also be displayed as a continuous scale value (green pointer) between the two maximum rotations.

[0050] Additionally, the force required for the translation of the endoscope should be monitored: This allows the movement of the endoscope to be stopped before it is mechanically overloaded and possibly damaged (for example, if a grasped stone fragment is too large for the sheath, or the surgeon wants to withdraw the endoscope through the sheath even though its tip is still angled).

[0051] To prevent the latter, the system can also automatically issue a warning if the surgeon pulls the distal end of the endoscope into the sheath while the endoscope tip is angled.

Claims

[1] Robotic system for minimally invasive surgery, with a robot arm (3.1) at the distal end of which a fastening device (4.11) for attaching an endoscope is mounted, a patient-side unit (3.6) which has a fixation device for fixing relative to a patient or an operating table, wherein the patient-side unit (3.6) has an opening for passing the endoscope (1) through and a drive element (7.2,7.3) for translational movement and / or rotation of the endoscope (1), characterized by , that the patient-side unit (3.6) is connected to the robot arm (3.1) via a data connection, wherein a control of the robot arm (3.1) is designed to guide the robot arm (3.1), to which the proximal end of the endoscope is attached, when the drive element (7.2, 7.3) performs a translational movement of the endoscope (1) into the patient body. [2] Robot system according to claim 1 , characterized by , that the robot arm (3.1) can be manually positioned and locked in a desired position, and in particular is gravity compensated. [3] Robot system according to claim 2, characterized by , that the robot arm (3.1) automatically holds its position as soon as no force is exerted on it by the user. [4] Robot system according to claims 1-3, characterized by , that the fastening device (4.11) has an actuator for actuating an actuating element for angling the tip of the endoscope (1) and / or has an actuator for rotating the endoscope (1) about its own axis. [5] Robot system according to claims 1-4, characterized by , that the fastening device (4.11) is designed such that the endoscope (1) can be operated manually by a surgeon. [6] Robot system according to claims 1-5, characterized byan input device (14) for receiving input from the surgeon, which serves to angulate, rotate and / or translate the endoscope (1). [7] Robot system according to claims 1-6, characterized by , that the patient-side unit (3.6) can be connected to a sheath for inserting the endoscope into the patient's body by means of force-locking and / or form-locking. [8] Robot system according to claims 1-7, characterized by , that the patient-side unit (3.6) has two spaced-apart parallel drive rollers (7.2, 7.3) for translational movement of the endoscope (1), wherein the endoscope (1) can be received between the two drive rollers (7.2, 7.3) in such a way that it is positively connected to a drive roller on each side, wherein a translational movement of the endoscope (1) takes place when the drive rollers (7.2, 7.3) rotate in opposite directions. [9] Robot system according to claim 8, characterized by, that the two drive rollers (7.2, 7.3) are each translationally movable in opposite directions along their longitudinal axis, so that this causes the endoscope (1) to rotate. [10] Robot system according to claim 8 or 9, characterized by , that the frictional connection between the two drive rollers (7.2, 7.3) and the endoscope (1) can be released by moving at least one of the drive rollers away from the endoscope and / or by reducing the diameter of at least one of the drive rollers, wherein the frictional connection can be released in particular without tools and with one hand by a user. [11] Robot system according to claim 10, characterized by , that at least one drive roller (7.2, 7.3) is foldable and / or translationally movable. [12] Robot system according to claim 10, characterized by , that at least one drive roller (7.2, 7.3) is compressible to reduce its diameter. [13] Robot system according to claims 10 to 12, characterized by , that the released state in which the force-locking connection between the drive rollers (7.2, 7.3) and the endoscope (1) is released is maintained automatically. [14] Robot system according to claims 10 to 13, characterized by , that the patient-side unit (3.6) has at least one sensor for detecting the rotational and / or translational position of the endoscope (1).

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