Medical attachment adapter for detachable attachment to a medical robot, medical attachment system and medical device

Abstract

Medical fastening adapter (2; 202; 302) for detachable fastening to a fastening section (4; 204; 304) of a medical robot (5), in particular a robot-guided surgical microscope, which is arranged in particular within a sterile cover, wherein the medical fastening adapter (2; 202; 302) has a support structure (3; 203; 303) with an instrument interface (14; 314), characterized in that the medical fastening adapter (2; 202; 302) further comprises: at least a first (6; 206; 306), a second (7; 207; 307) and a third geometric coupling structure (8; 208; 308), each designed for a positive connection to the fastening section (4; 204; 304), and an adjustment means (10; 210; 310) which is adapted to change the relative position of the at least first (6; 206; 306), second (7; 207; 307) and third geometric coupling structure (8; 208; 308) to one another in such a way that, in a first state of a first relative positioning, the fastening adapter (2; 202; 302) can be coupled to and uncoupled from the fastening section (4; 204; 304) and, in a second state of a second relative positioning, is non-releasably fixed to the fastening section (4; 204; 304), and by means of the first (6; 206; 306), second (7; 207; 307) and third coupling structure (8; 208; 308), a position of the fastening adapter (2; 202; 302) relative to the fastening section (4; 204; 304).

Description

Technical area

[0001] The present disclosure relates to a medical fastening adapter for detachable fastening to a fastening section of a medical robot, in particular a robot-guided surgical microscope, which is arranged in particular within a sterile cover. The medical fastening adapter has a support structure (as a base structure) with an instrument interface / coupling interface, which is adapted (by means of the predefined instrument interface) to connect or uncoupling a sterile medical product, such as an instrument or another medical device. In addition, the present disclosure relates to a medical fastening system and a medical device with a sterile cover for fastening sterile medical products to the medical device according to the preambles of the independent claims. Background of the Revelation

[0002] During surgical procedures, medical robots, especially medical surgical microscopes, are typically used in combination with other medical products such as surgical instruments or an additional endoscope or camera. Therefore, it is advantageous if the medical robots can be expanded to include the respective medical products, especially surgical instruments, via a coupling, depending on the desired requirements. To achieve this, it is necessary that the sterile instruments do not come into direct contact with the unsterile medical robots. In this case, a sterile barrier, e.g., in the form of a sterile cover, is usually placed between the instruments to be coupled and the medical robot.

[0003] The prior art includes approaches that enable the attachment of a sterile medical instrument to a medical robot, such as a surgical microscope. For example, the publications DE 10 2013 002 813 A1, DE 10 2018 107 357 A1, US 2017 / 0 086 930 A1, US 2022 / 0 257 324 A1, and US 2023 / 0 181 277 A1 disclose different solutions for a holding device or mounting adapter for surgical robot systems.

[0004] Traditionally, this attachment maneuver compromises or even destroys the intended sterile barriers, which is why, in most cases, only a single attachment, followed by a single use of the respective sterile barrier, is possible. This means that a medical instrument cannot be reattached to the robot without additional intermediate steps. Furthermore, approaches exist that allow for multiple changes or adjustments to the orientation of medical instruments attached to a medical robot, but the precision and repeatability of mounting medical instruments over a sterile barrier are severely limited with these conventional approaches.

[0005] It is of great importance that the sterile instruments can be easily and efficiently coupled to the medical robots and that the sterile barrier is not penetrated by coupling processes and, in particular, by repeated coupling maneuvers. Summary of the present disclosure

[0006] Therefore, the present disclosure is based on the object of avoiding or at least mitigating the disadvantages described above and, in particular, of providing a medical fastening adapter, a medical fastening system, and a medical device, in particular a medical robot, for releasably fastening a sterile medical instrument to a medical robot, with which a stable and precise connection can be established between the components (medical products) to be coupled. Furthermore, a partial object can be seen in designing the fastening adapter or the fastening system in such a way that a sterile barrier arranged between the medical robot and the sterile instrument to be coupled, in particular in the form of a sterile (plastic) cover, remains intact or is not damaged by repeated coupling processes.

[0007] The objects are achieved according to the invention by the features of claim 1 with regard to a generic medical fastening adapter, by the features of claim 8 with regard to a medical fastening system, and by the features of claim 13 with regard to a medical device.

[0008] The disclosure accordingly relates to a medical fastening adapter for detachable fastening to a fastening section of a medical robot, in particular a robot-guided surgical microscope, which (i.e. the medical robot) is arranged in particular within a sterile cover as a sterile barrier, wherein the medical fastening adapter has a rigid support structure (as a type of basic framework) with an instrument interface.The medical fastening adapter further comprises at least a first geometric coupling structure, a second geometric coupling structure and a third geometric coupling structure, each of which is adapted and designed for a positive connection to the fastening section, and an adjusting means / fixing means / closing means which is adapted to change the relative spatial position of the at least first, second and third geometric coupling structures to one another in such a way that in a first state of a first relative positioning the fastening adapter can be coupled to and uncoupled from the fastening section and in a second state of a second relative positioning is non-releasably fixed / fastened / fixed to the fastening section, and by means of the first, second and third coupling structure a defined / unambiguous position of the fastening adapter relative to the fastening section is determined.For example, the first, second and third coupling structures can point radially inwards in the direction of a fastening section and can be spaced further apart from one another in a first relative positioning than in the second relative positioning, wherein in the first relative positioning there is still a distance with a gap (i.e. still without rigid contact) between the coupling structures and the fastening section, so that the fastening adapter is freely movable and can be aligned or arranged, and in the second relative positioning the coupling structures are moved towards one another, subsequently shortening a distance, a geometric contact is established with corresponding fixation as a result.

[0009] In other words, the fastening adapter has at least three geometric coupling structures / elements (for a one-to-one definition of a position, similar to mathematics where a plane can be defined by three points), which are provided and designed to couple / mount / fasten the fastening adapter to a fastening section formed or arranged on the medical robot. The coupling structures are preferably arranged within a common plane on the support structure. The fastening adapter has an adjustment means / adjustment element or fixing means (for fixing and releasing), by the actuation of which the relative position of the geometric coupling structures to one another can be changed / influenced, in particular manually.Actuating the adjustment means moves the fastening adapter from a first state of a first relative positioning of the geometric coupling structures to one another, in which the fastening adapter can be coupled to or uncoupled from the fastening section of the robot, to a second state of a second relative positioning of the geometric coupling structures to one another, in which the fastening adapter is permanently fixed to the fastening section. This means that in this second state, the coupling structures of the fastening adapter are aligned with one another such that the fastening adapter is (positively) fastened to the fastening section via these coupling structures, in particular encompassing or clasping it, so that it is fixed to the fastening section of the robot without the adjustment means necessarily being actuated again for release (i.e., the position of the fastening adapter on the fastening section is fixed).Thus, in this second state, a clear position of the fastening adapter relative to the fastening section of the robot is defined, and there are no degrees of freedom for relative movement of these two coupled components. Preferably, the medical fastening adapter has an (instrument) interface to which the medical product ultimately to be fastened, in particular a sterile one, such as an instrument, can be mounted / connected. Thus, the fastening adapter serves as a (serial) intermediate link for the medical product and the medical robot, wherein the fastening adapter is in particular designed to be sterilizable and / or sterilized in order to be connected in the sterile area.

[0010] Advantageously, such a fastening adapter enables a connection of a sterile instrument to a medical robot in such a way that a stable and defined, in particular re-detachable, coupling of the fastening adapter and thus of the medical instrument mounted thereon to the medical robot is provided via an actuation of an adjusting element and the resulting relative movement of specially designed coupling structures of the fastening adapter to one another.

[0011] Advantageous embodiments are claimed in the subclaims and are explained in particular below.

[0012] In a first advantageous embodiment, the first coupling structure, the second coupling structure, and the third coupling structure lie in one plane and each have a protruding / projecting convex surface, in particular in the form of a hemisphere, in order to engage positively, for example as a locking lug, into a complementary counter-coupling structure. At least the convex surface of the first coupling structure faces the convex surfaces of the second and / or the third coupling structure, and the convex surface of the first coupling structure is translationally / axially displaceable by means of the adjustment means in order to change a relative distance to the second and / or third coupling structure. The convex surface, in particular in the form of a hemisphere, thus creates a rounded coupling structure without sharp edges or points, which cannot damage a sterile drape if it is clamped between the fastening adapter and the fastening structure.In other words, the fastening adapter has three coupling structures, each of which is arranged in a common plane and each of which has a convex / curved / partially spherical geometry protruding from the support structure, in particular is designed in the form of a hemisphere. The coupling structures are arranged relative to one another such that a first of the coupling structures or its protruding geometry faces the second and / or the third coupling structure. The second and third coupling structures preferably point in the same direction and are in particular arranged parallel to one another. Furthermore, the first coupling structure is axially displaceable by manual actuation of the adjusting means to which the first coupling structure is connected, in an axial relative movement towards or away from the second and the third coupling structure.away, whereby the axial relative distance between the first coupling structure and the remaining coupling structures can be changed. This type of design with convex, in particular hemispherical, coupling structures allows alignment of the fastening adapter with high precision and, at the same time, blocks the degrees of freedom of the fastening adapter relative to the medical robot in a coupled state. Advantageously, such a curved design of the coupling structures as contact points does not have any pointed or angular geometries, which could potentially damage or break a sterile cover / barrier arranged between the contact points of the fastening adapter with the medical robot.

[0013] In a further preferred embodiment of the disclosure, the second coupling structure and the third coupling structure, in particular with their convex surfaces, are rigidly arranged on or relative to the support structure, in particular formed integrally in the support structure, and the adjustment means is designed in the form of a rotatable helical gear with a rotary handle for manual actuation, which, by rotation, adjusts a position of the first coupling structure, preferably with the convex surface, relative to the support structure and thus also relative to the second and third coupling structures. In other words, the relative position of the first coupling structure, in particular the convex surface, is adjustable by rotating a rotary handle arranged on the adjustment means.The first coupling structure engages with the adjustment means, in particular via a threaded connection, whereby the coupling structure can be or is displaced axially through the thread by a rotational movement of the rotary handle. Such a design with a screw gear and an actuatable rotary handle ensures the most precise fine adjustment possible. In particular, such a thread (compared to a spring or a clamping lever) compensates for tolerances that can arise from the sterile cover lying above it. The support structure of this fastening adapter in this embodiment is designed, for example, in the form of a fork with a second and third coupling structure, which are each arranged on the fork arms, or alternatively, in a further embodiment, has a closed (circumferential) contour, on whose inner circumferential contour, in particular on one side, the second and third coupling structures are arranged.The support structure of this alternative embodiment with a closed contour is designed in such a way that it encompasses the entire circumference of a fastening section.

[0014] According to a further embodiment, the screw gear has a torque limiter that is rigidly connected to the rotary handle and, when a limit torque is exceeded, only transmits the limit torque and also provides haptic and / or acoustic feedback to the operator. In other words, an (additional) torque limiter, which is preferably arranged inside the screw gear, limits the torque transmitted by the operator to the rotary handle. Preferably, when a limit torque is exceeded, a rotation of the screw gear is initiated, whereby no further screwing process and thus no further translational movement of the first coupling structure is possible. This prevents overtightening of the adjustment means, which could lead to damage to the sterile barrier or the components, the fastening adapter and / or the fastening section itself.Alternatively or additionally, the torque limiter enables the output of a haptic and / or acoustic signal to the operator, allowing them to detect when a torque limit is reached. For example, when the torque limit is exceeded, a click can be emitted as an acoustic signal as well as a haptic signal, similar to a torque wrench.

[0015] In particular, the fastening adapter can be packaged sterile in a sterile package so that after opening the sterile package it can be directly coupled to the fastening section (with an intermediate sterile cover) and fastened by means of the adjustment means.

[0016] According to a further embodiment, the support structure of the fastening adapter can have a guide stop (as a type of limiting edge) in the form of a projection, which is formed in the region of the first coupling structure and, in particular, protrudes in the same direction as the first coupling structure and lies parallel to the plane of the first, second, and third coupling structures in order to geometrically align the fastening adapter in the first state of the first relative positioning by means of the guide stop in alignment with a fastening section. Such a guide stop ensures that the fastening adapter, and in particular the first coupling structure, can be guided and arranged in a correct position or alignment with the fastening section during the coupling process. This prevents incorrect, in particular skewed, alignment of the fastening adapter.

[0017] In a further advantageous embodiment of the disclosure, the first, second and third coupling structures lie in one plane, the support structure has a first arm with a first coupling structure and a second arm with a second coupling structure, and the first coupling structure is opposite the second coupling structure, and the first and / or the second arm are designed such that they are elastically deflectable relative to one another in order to enable a relative positioning of the first coupling structure relative to the second coupling structure, and the adjusting means has a hinge-like lever pull / snap lever with a shape-adapting / tightenable (due to the small thickness of the steel strip, bendable but not stretchable in the longitudinal direction) steel strip, in particular further comprising two clamping jaws on the steel strip,which connects the two arms to each other and, together with the arms, forms a closed circumferential contour. A shortening of the steel band between two points is adjustable via the hinge-like lever pull, resulting in an elastic deformation of the first and second arms toward each other in order to reduce a relative distance between the first coupling structure and the second coupling structure and to fix the fastening adapter to the fastening section in the second state of the second relative positioning. In other words, the fastening adapter preferably has two (at least slightly) flexible / elastic arms, which can be moved toward each other within a predetermined range by applying force and each have a lateral coupling structure, in particular in the form of a curved projection. The arms are fastened with a flexible steel band / steel sheet.which is arranged on the outer contour of the mounting adapter and connects the two arms at the front end. It can be shortened via a hinge-like lever as an adjustment means. The shortening or contraction of the steel band also requires, in particular, a pressing of sliding jaw elements, which, upon actuation of the lever, further engage the mounting interface. This narrows the circumference of the mounting adapter, which causes the adapter to firmly grip the mounting section of the medical robot and places the mounting adapter in the second state of the second relative positioning of the coupling structures. The mounting adapter has a third coupling structure, which is arranged in particular on the inner contour side of the mounting adapter opposite the steel band, in particular with the clamping jaws.

[0018] According to a further embodiment, the fastening adapter has the instrument interface for the connection / assembly of a sterile medical product, in particular an instrument, as well as two alignment elements or projections which are arranged on the inner contour side which has the third coupling structure and are intended to prevent a lateral displacement of the fastening adapter during an assembly process.

[0019] In a further preferred aspect of the disclosure, the fastening adapter, in particular the support structure, comprises a (high-performance) plastic, preferably PA 66 GRP or PEEK GRP, as its material, in particular the support structure is made entirely of this material. This ensures that no electrical contact is or will be established between the fastening adapter and the medical robot. In particular, the support structure of the fastening adapter can be made of a mechanically resilient or stronger material, in particular metal, preferably stainless steel or a titanium alloy, and the electrical insulation can be realized via a (separate) insulating sleeve (preferably made of PEEK), in particular at the front instrument interface.

[0020] The present disclosure further relates to a medical fastening system for releasably fastening a fastening adapter to a fastening section of a medical robot, in particular a robot-guided surgical microscope, which is arranged in particular within a sterile cover as a sterile barrier. The fastening system comprises a separate fastening adapter according to the disclosure, and the fastening section has at least a first, second, and third counter-coupling structure, which are (respectively) designed and interact with the first coupling structure, the second coupling structure, and the third coupling structure of the fastening adapter in a form-fitting manner.In other words, the fastening section to which the fastening adapter can be coupled has corresponding (complementary) counter-coupling structures that are (geometrically) designed such that the respective coupling structures of the fastening adapter engage geometrically and positively with them during the coupling process. The coupling structures and counter-coupling structures of the fastening adapter and the fastening section are thus specifically coordinated with one another.

[0021] In particular, according to a possibly independently claimable aspect of the present disclosure, a set comprising a first fastening adapter according to the present disclosure and an associated first fastening section as well as a different second fastening adapter according to the present disclosure with an associated second fastening section can be provided, which are not interchangeable with one another, wherein the first and second fastening sections are mounted or mountable on the robot, so that only the first fastening adapter can be coupled to the first fastening section and only the second fastening adapter can be coupled to the second fastening section in order to prevent confusion by medical personnel.In this way, a set can be provided which enables a defined local assignment of the fastening adapter (to the corresponding complementary fastening section) without accidental replacement.

[0022] In a (particularly first) advantageous embodiment, the fastening section of the medical fastening system has a plate-shaped basic structure with a central opening perpendicular to the plane of the basic structure (for example, to enable a surgical microscope to be seen through this opening) and, on a front side (i.e., a side surface of the plate-shaped basic structure), a first counter-coupling structure with a concave notch that is oriented in the front direction and whose orientation lies in the plane of the basic structure, and, on a side region lateral to the central opening, a second and a third counter-coupling structure with a concave notch that are each oriented opposite to the front direction, so that in the fastening adapter with the first, second and third coupling structures that lie in one plane and each have a protruding / projecting convex surface,This convex surface interacts with the concave notch to determine the position of the mounting adapter relative to the mounting section by means of a positive fit of the at least three contact points. In other words, a central (through) opening is arranged on the plate-shaped base structure of the mounting section, in which the medical robot, in particular the surgical microscope, can be arranged. The mounting section has three concave counter-coupling structures, which are designed such that they complementarily accommodate the respective coupling structures of the mounting adapter during a coupling process.

[0023] In a further (particularly second) advantageous embodiment, the fastening section of the medical fastening system has a plate-shaped basic structure with a central opening perpendicular to the plane of the basic structure (or the longitudinal axis of the opening is perpendicular to the plate-shaped basic structure) and on a front side a first counter-coupling structure with a concave notch that is aligned in the front direction (longitudinal axis of the concave notch is aligned in the front direction) and lies in the plane of the basic structure, and on a rear side, which is arranged opposite the front side of the basic structure, a second and a third counter-coupling structure, each with a concave notch, which are each aligned opposite to the front direction, so that in the fastening adapter with the first, the second and the third coupling structure,which lie in one plane and each have a protruding / projecting convex surface, this convex surface interacts with the concave notch in order to determine a position of the fastening adapter relative to the fastening section by means of positive locking (via the relative movement by the adjusting means) of the at least three contact points.

[0024] The second and third counter-coupling structures are arranged, in particular, adjacent to one another on the rear side of the base structure, which is opposite the front side with the first counter-coupling structure. This means that in this embodiment, all three counter-coupling structures are arranged on the base structure in such a way that the coupling structures of the fastening adapter of this embodiment, which are arranged along the closed inner contour of the fastening adapter, engage or can engage complementarily with them.

[0025] In the further (particularly third) advantageous embodiment, the fastening section has a plate-shaped basic structure with a central opening perpendicular to the plane of the basic structure and a first counter-coupling structure and a second counter-coupling structure arranged on two opposite side walls and a third counter-coupling structure on a front side, so that in the fastening adapter with the first arm with the first coupling structure and the second arm with the second coupling structure, which are designed in such a way that they can be elastically deflected relative to one another, this first, the second and the third coupling structure interact with the respective counter-coupling structure, in particular in interaction with the two clamping jaws on the steel strip which connects the two arms to one another, in order to fix a position of the fastening adapter relative to the fastening section by means of positive locking of the at least three contact points.

[0026] In a further advantageous aspect of the disclosure, the medical fastening system comprises a separate sterile cover that is arranged or can be arranged between the fastening adapter and the fastening section and is in contact with at least the first, second, and third counter-coupling structure of the fastening section as well as the first, second, and third coupling structure of the fastening adapter. In other words, a sterile cover / sterile barrier, in particular in the form of a sterile plastic film / cover, is arranged between the sterile fastening adapter and the (non-sterile) fastening section of the medical robot, whereby the sterility of the medical instrument to be coupled is not impaired / influenced by the mounting / coupling to the medical robot via the fastening adapter.In particular, the medical fastening system is designed such that the sterile drape can be easily arranged or clamped between the coupling structures of the fastening adapter and the complementary counter-coupling structures of the fastening section without risk of damage or breaching the sterile barrier. In particular, the fastening adapter has only rounded surfaces and (rounded) "edges" on the coupling structures, which engage indirectly via the sterile drape with the counter-coupling structures, to prevent damage to the sterile drape.

[0027] The present disclosure further relates to a medical device, in particular a medical robot, for example in the form of a robot-guided surgical microscope, with a sterile cover for attaching / coupling sterile medical products to the medical device. The medical device, in particular the robot, comprises at least one attachment section and at least one attachment adapter according to the disclosure, in particular a plurality of attachment sections and attachment adapters, for example as a attachment adapter set, or the medical device, in particular the robot, comprises a attachment system according to the disclosure (with attachment section and attachment adapter according to the present disclosure).The sterile cover is arranged between the fastening section and the fastening adapter attached thereto in such a way that the robot with the fastening section(s) is arranged in a non-sterile area, and the fastening adapter with, for example, a medical instrument is arranged in a sterile area and is thus separated from each other.

[0028] Any disclosure relating to the mounting adapter of the present disclosure also applies to the mounting system of the present disclosure and vice versa. Short description of the characters

[0029] The disclosure is explained in more detail below using advantageous embodiments and with reference to the accompanying figures. They show: Fig. 1 a perspective (top) view of a partial section of a medical fastening system according to a first advantageous embodiment of the disclosure; Fig. 2 shows a plan view of a sectional view through a plane of the medical fastening system according to the first advantageous embodiment of the disclosure, which is spanned by the three coupling structures of the fastening adapter; Fig. 3 a perspective view of the medical fastening system according to the first advantageous embodiment in a state coupled to a surgical microscope and thus also a medical device in the form of a robot according to a preferred embodiment; Fig. 4 a perspective view of a fastening adapter according to a first advantageous embodiment; Fig. 5 is a perspective front view of a mounting portion according to a first advantageous embodiment of the disclosure for a medical robot; Fig. 6 shows a further perspective rear view of the fastening section according to the first advantageous embodiment of the disclosure; Fig. 7 is a longitudinal sectional side view through a partial section of the fastening adapter according to the first embodiment in the coupled state with the fastening section according to the first embodiment of the disclosure; Fig. 8 is a longitudinal sectional side view through the adjustment means of the fastening adapter according to the first advantageous embodiment of the disclosure, in a decoupled state of the fastening adapter; Fig. 9 shows a further longitudinal sectional side view through the adjustment means of the fastening adapter according to the first advantageous embodiment of the disclosure, in a coupled state of the fastening adapter; Fig. 10 is a perspective (side) view of a medical fastening system according to a second advantageous embodiment of the disclosure; Fig. 11 is a perspective view of the medical fastening adapter according to a second advantageous embodiment of the disclosure; Fig. 12 is a perspective longitudinal sectional view through the adjustment means of the fastening adapter according to the second advantageous embodiment of the disclosure, in a coupled state of the fastening adapter; Fig. 13 is a perspective longitudinal sectional side view through one of the second or third coupling structures of the fastening adapter according to the second embodiment of the disclosure, in a coupled state of the fastening adapter; Fig. 14 is a perspective side view of the medical fastening system according to the second advantageous embodiment in a state coupled to a surgical microscope; Fig. 15 is a longitudinal sectional side view through the adjustment means / fastening means for the first or second embodiment of the medical fastening adapter in an alternative embodiment; Fig. 16 is a perspective top view of a medical fastening system according to a third advantageous embodiment of the disclosure; Fig. 17 is a perspective view of the medical fastening adapter according to a third advantageous embodiment of the disclosure; Fig. 18 is a further perspective view of the medical fastening adapter according to the third advantageous embodiment of the disclosure; Fig. 19 is a perspective (front) view of the fastening portion according to a third advantageous embodiment of the disclosure; Fig. 20 a perspective (side) view of the fastening portion according to a third advantageous embodiment of the disclosure; Fig. 21 is a perspective side view of the medical fastening system according to the third embodiment during a coupling process; Fig. 22 a longitudinal sectional side view through an alignment element of the fastening adapter according to the third embodiment during a coupling process.

[0030] The figures are merely schematic in nature and serve solely to facilitate understanding of the present disclosure. It should be noted that the features of the individual embodiments may be interchanged and may occur in a specific combination. Detailed description of preferred embodiments

[0031] In the following, the present disclosure will be explained on the basis of the advantageous embodiments with reference to the Fig. 1 to 22. Fig. 1 to 9 show views of a fastening system according to a first preferred embodiment with a fastening adapter of a first preferred embodiment and a (corresponding) fastening section of a first preferred embodiment for a medical robot according to a preferred embodiment. Fig. 10 to 15 further show a fastening system according to a further, second preferred embodiment with a fastening adapter and a fastening section each according to a second preferred embodiment. Fig. 16 to 22 finally show a fastening system according to a further, third preferred embodiment with a fastening adapter and a fastening section each according to a third preferred embodiment.

[0032] Fig. 1 shows a perspective view of a partial section of a fastening system 1 and Fig. 2 shows a sectional view through a plane spanned by three coupling structures 6, 7, 8 of a fastening adapter 2, according to the first advantageous embodiment of the medical fastening system 1. The fastening adapter 2 according to the first advantageous embodiment has a support structure 3, in particular a fork-shaped one. The fastening adapter 2 is shown in a coupled state with a (separate) fastening section 4, which is designed as part of a medical robot 5 or can be connected thereto. The coupling or contact between the components of the fastening adapter 2 and the fastening section 4 takes place via a first coupling structure 6, a second coupling structure 7, and a third coupling structure 8 of the fastening adapter 2, which in this first embodiment are designed as convex / curved surfaces in the form of spherical hemispheres.These three coupling structures 6, 7, 8 are arranged in a plane and engage in three complementary counterstructures 20, 22, 24 of the fastening section 4, which in this first embodiment are designed as (complementary) concave indentations (for example, with recessed hemispherical surfaces). The first coupling structure 6 is arranged on a central axis of the fastening adapter 2 and is directed opposite the second coupling structure 7 and the third coupling structure 8. One can also say that the first coupling structure 6 lies opposite the second and third coupling structures with its convex surface, and in this embodiment, a longitudinal axis of the first coupling structure 6 is parallel to the longitudinal axes of the second and third coupling structures 7, 8, with the directions of the convex surfaces being opposite.

[0033] The second and third coupling structures 7, 8 are arranged at the end sections of the fork-like arms of the support structure 3 of the fastening adapter 2, in particular along an imaginary common axis, and are simultaneously laterally spaced from the first coupling structure 6. Furthermore, the fastening adapter 2 has an adjustment means 10 in the form of a screw gear, which can be manually actuated via a rotary handle 12. This adjustment means 10 is connected to the first coupling structure, whereby, upon manual rotation of the rotary handle 12, the first coupling structure 6 can be displaced translationally / axially along the central axis of the fastening adapter, toward the second and third coupling structures 7, 8 or away from them.In this way, the fastening adapter can be transferred by means of the adjustment means 10 from a first state of a first relative positioning of the coupling structures 6, 7, 8 to one another into a second state of a second geometric relative positioning, as will be explained in detail below.

[0034] Fig. Figure 3 shows a perspective side view of the medical fastening system 1 according to the first advantageous embodiment in a state coupled to a robot-guided surgical microscope 5. Thus, the Fig. 3 also shows the medical robot according to a preferred embodiment. The fastening section 4 can be designed as an integral part of the surgical microscope 5 or, alternatively, as in the present case, can be mounted as a separate component of a fastening section 4 in an additional step on this robot-guided surgical microscope 5. Furthermore, Fig. 3 shows a cylindrical or conical instrument interface 14 for a sterile medical instrument. When the fastening adapter 2 is coupled, the instrument interface 14 is perpendicular to a plane of the fastening system 1 or a plane of the fastening adapter (i.e., parallel to an axis of a central opening) and is arranged at the end portion of the support structure 3 facing away from the fork-shaped arms of the support structure 3. The support structure 3 can also be described as Y-shaped with two opposing arms, with the instrument interface 14 being arranged at the portion facing away from the arms (the lower part of the Y, so to speak).In a side view, the support structure 3 does not lie entirely in one plane, but the arms with the second and third coupling structures 7, 8 as well as the adjustment means 10 with the first coupling structure 6 lie essentially in one plane, which is adjoined by a sloping section with a distal front section with the instrument interface 14, wherein the front section is again aligned offset parallel to the plane of the arms (in the manner of a step in order to ensure accessibility to the adjustment means 10).

[0035] Fig. 4 shows a perspective view of the fastening adapter 2 according to the first advantageous embodiment. As described above, the support structure 3 of the fastening adapter of this first embodiment has a fork-like shape with two arms. At the end section of each of these arms, one of the second and third coupling structures 7, 8 is arranged. The first coupling structure 6, which is connected to the adjustment means 10, is arranged centrally of the support structure 3. The adjustment means 10 has a rotary handle 12, via which the first coupling structure 6 is (operating technically) axially displaceable (rotation is converted into translation). One end section of the support structure 3 has a conical (instrument) interface 14 for the coupling (connection) of a medical instrument as a medical product.In addition, the support structure 3 has a projecting guide stop 16 below the first coupling structure 6, which is formed integrally with the support structure 3 and is intended to geometrically align the fastening adapter 2 with respect to the fastening section 4. The guide stop 16 protrudes in the same direction as the first coupling structure 6.

[0036] Fig. 5 shows a perspective front view of a fastening section 4 and Fig. 6 shows a perspective rear view of the attachment portion 4 according to a first advantageous embodiment of the disclosure for a medical robot.

[0037] The fastening section 4 according to this first embodiment has a plate-shaped base structure with a central opening 18 perpendicular to the plane of the base structure. The opening 18 is intended, in particular, to accommodate (centrally) an objective lens of a medical surgical microscope 5. The base structure has, on its front side, a first counter-coupling structure 20 with a concave notch oriented in the front direction and lying in the plane of the base structure. The two opposite side walls of the base structure each have a projection in the lateral direction, on which the second and third counter-coupling structures 22, 24, respectively, are integrated, each of which has a concave notch oriented in the opposite direction to the first counter-coupling structure 20 (their virtual longitudinal axes, starting from the notch, point away from the first counter-coupling structure).The first, second and third counter-coupling structures 20, 22, 24 lie in the same plane and are designed and coordinated in such a way as to complementarily receive the coupling structures 6, 7, 8 of the fastening adapter 2 in order to cooperate with them and to determine a position of the fastening adapter 2 relative to the fastening section 4 by means of positive locking of the at least three contact points in the second state of the second relative positioning.

[0038] Fig. Figure 7 shows a longitudinal section through a partial section of the fastening adapter 2 according to the first embodiment in the coupled state with the fastening section 4 according to the first embodiment of the disclosure. The hemispherical first coupling structure 6 of the fastening adapter 2, which is firmly connected to the adjustment means 10 (not shown here), preferably via a screw connection, engages in this view with the counter-coupling structure 20 of the fastening section 4 provided for this purpose. Fig. 7 a coupled state of the fastening adapter 2 and the fastening section 4.

[0039] Fig. Fig. 8 shows a longitudinal section side view through the adjustment means 10 of the fastening adapter 2 according to the first advantageous embodiment of the disclosure, in a first decoupled state of the fastening adapter 2 and Fig. 9 shows the same longitudinal section side view in a second coupled state of the fastening adapter 2. In this embodiment, the adjustment means 10 is designed in the form of a helical gear with a rotary handle 12. By manually turning the rotary handle 12, the first hemispherical coupling structure 6 is moved axially in the direction of the first counter-coupling structure 20 provided on the fastening section 4 and ultimately brought into positive (operative) engagement. The adjustment means 10 in this first embodiment of the fastening adapter 2 has a torque limiter 26, which is firmly or rigidly connected to the rotary handle 12, in particular via a screw connection. The torque limiter 26 ensures that when a limit torque is exceeded, only the limit torque is transmitted and also provides an operator with haptic and / or acoustic feedback / signal.Furthermore, a fixing ball 28 is arranged in an eccentric axial groove within a sleeve 27 of the screw thread, and the fixing ball 28 simultaneously engages in a spherical notch / milled recess on the outer circumference of the first coupling structure 6.

[0040] This prevents rotation of the first coupling structure 6 together with the rotary handle 12. Thus, the fixation ball 28 moves together with the first coupling structure 6 in the direction of the counter-coupling structure 20 when the rotary handle 12 is actuated for a coupling process of the fastening adapter 2. A purely axial displacement of the first coupling structure 6 ensures that an existing sterile drape, which is clamped between the first coupling structure 6 and the first counter-coupling structure 20, is wound up or destroyed.

[0041] Fig. 10 shows a perspective view of the medical fastening system 201 according to a second advantageous embodiment of the disclosure. The fastening adapter 202 in this second embodiment has a support structure 203 with a closed contour (in contrast to the two arms as in the first embodiment). This support structure 203 completely encompasses the outer contour of the fastening section 204 of this second embodiment. The fastening adapter 202 of this second embodiment also has a fastening means 210 with a rotary handle 212, similar to the fastening means 10 of the first embodiment of the fastening adapter 2.

[0042] Fig. 11 shows a perspective view of the medical fastening adapter 210 according to the second advantageous embodiment of the disclosure. The support structure 203 of the fastening adapter 202 has a closed contour for enclosing the outer contour of a fastening section 204. The first coupling structure 206 is connected to the adjustment means 210, which can be actuated via the rotary handle 212, and points into the interior of the closed contour of the support structure. The second coupling structure 207 and the third coupling structure 208 are arranged on the inner side, which is opposite the side with the first coupling structure 206. An imaginary axis of the first coupling structure 206 extends through the central axis of the fastening adapter 202, and the second and third coupling structures 207, 208 are arranged on imaginary axes, each of which is spaced at an equal distance, parallel, from the imaginary axis of the first coupling structure 206.The first coupling structure 206 also points in the opposite direction to that in which the second and third coupling structures 207, 208 point, and thus towards each other.

[0043] Fig. 12 shows a perspective longitudinal section side view through the adjustment means 210 of the fastening adapter 202 according to the second advantageous embodiment in a coupled state of the fastening adapter 210 and Fig. 13 shows a perspective longitudinal section side view through one of the second or third coupling structures 207, 208 of the fastening adapter 202 according to this second embodiment in a coupled state of the fastening adapter 202. The adjustment means / fastening means 210 of this second embodiment is designed in particular identically to the fastening means 10 of the first embodiment. In Fig. 12 shows the engagement of the first coupling structure 206, which is rigidly connected to the fastening means 210, into the complementary counter-coupling structure 220 of the fastening section 204. Fig. 13 shows the positive engagement of the second coupling structure 207 into the complementary counter-coupling structure 222 of the fastening section 204.

[0044] Fig. 14 shows a perspective side view of the medical fastening system 201 according to the second advantageous embodiment in a state coupled to a robot-guided surgical microscope 5 (as a medical robot according to the present disclosure). The support structure 203 of the fastening adapter 202 completely encompasses a fastening section 204, which is arranged in a section of the surgical microscope 5. The sterile cover, which is preferably arranged between the surgical microscope 5, in particular the fastening section 204, and the fastening adapter 202, is in Fig. 14 not shown.

[0045] Fig. 15 shows a longitudinal sectional side view through an alternative embodiment of the fastening means 10 for the first (or second) embodiment of the medical fastening adapter 2. This alternative embodiment of the fastening means 10 does not have a torque limiter 26. The sleeves of the fastening means 10 are connected here via a snap ring 13. Furthermore, this embodiment also has the fixing ball 28, which prevents rotation of the first coupling structure 6.

[0046] Fig. 16 shows a perspective top view of the medical fastening system 301 according to a third advantageous embodiment of the disclosure. The fastening adapter 302 in this third embodiment has a first arm 330 and a second arm 332 arranged opposite the first arm, which are designed to be elastic. In this illustration, the fastening adapter 302 is already arranged in alignment with the fastening section 304, but is not yet coupled. The coupling is sometimes achieved via an engagement of the first coupling structure 306 and the second coupling structure 307 in the respective counter-coupling structures 322, 324 (not shown here) of the fastening section 304. Furthermore, the fastening adapter 302 is additionally held by two clamping jaws 336, which are connected to a flexible / shortenable steel band 334. These clamping jaws 336 are adapted to the outer contour of the fastening section 304.In this embodiment, the fastening means comprises a hinge-like lever mechanism 310 (in . Fig. 16 (still in a first detachable and connectable state). Actuation of the lever mechanism 310 causes the first and second elastic arms 330, 332, and thus also the first coupling structure 306 and the second coupling structure 307, to deflect relative to one another, as well as a shortening of the steel band 334, thereby determining a position of the fastening adapter 302 relative to the fastening section 304 or coupling both components. The lever mechanism 310 attached to one arm thus causes the steel band attached to the other, opposite arm to contract, with a concomitant contraction and elastic deflection of the arms toward one another, thereby shortening a relative distance between the first and second coupling structures (i.e., from a first relative positioning to a second relative positioning).

[0047] Fig. 17 and Fig. 18 each show a perspective side view of the medical fastening adapter 302 according to the third advantageous embodiment of the disclosure. The support structure 303 of the fastening adapter 302 has a conical / cylindrical instrument location 314 at one end portion for connecting a medical instrument (in Fig. 18 not shown). Furthermore, the support structure 303 of the fastening adapter 302 has a third coupling structure 308 (not shown here) on an inner side, which is arranged opposite the clamping jaws 336. The first, second and third coupling structures 306, 307, 308 are preferably formed as elongated, in particular stadium-shaped, bulges. Furthermore, the support structure 303 has two projection-like alignment elements 342, which are arranged on the inner contour side and lie opposite the clamping jaws 336 in the longitudinal direction. These alignment elements 342 are provided to prevent a lateral displacement of the fastening adapter 302 during an assembly process / coupling process to the fastening section 304.

[0048] Fig. 19 shows a perspective front view and Fig. 20 shows a perspective side view of the fastening section 304 according to a third advantageous embodiment of the disclosure. The third counter-coupling structure 320 is arranged on the front side of the fastening section 304 and has an elongated, in particular stadium-shaped, notch as a geometry into which the third coupling structure 308 of the fastening adapter 302 can complementarily engage. The first and second counter-coupling structures 322, 324 are arranged on the side walls of the fastening section 304, preferably forming a rectangular recess on the side walls. Furthermore, recesses 340 are provided at the respective corners of the fastening section 304, which are arranged between the side walls and the front side. These recesses each complementarily receive an alignment element 342 of the fastening adapter 302 during a coupling process.

[0049] Fig. 21 shows a perspective side view of the medical fastening system 301 and Fig. 22 shows a longitudinal section side view through an alignment element 342 of the fastening adapter 302 according to the third embodiment during a coupling process. Fig.21 shows that a coupling or assembly process of the fastening adapter 302 to the fastening section 304 first begins with an alignment of the third coupling structure 308 with the associated counter-coupling structure 320 and the two alignment elements 342 with the associated indentations 340 on the fastening section 304. The opposite end section of the fastening adapter 302, on which the clamping jaws 336 are arranged, is angled relative to the fastening section 304 and is, so to speak, pulled obliquely over it. This is possible because the steel band 334 with the clamping jaws 336 is in the loosened or extended state, whereby in this state the inner circumference of the fastening adapter 302 is larger than the outer circumference of the fastening section 304.Only after the lever pull 310 is actuated does the steel band 334 shorten with the clamping jaws 336 and, at the same time, the first arm 330 and the second arm 332 are deflected towards each other, whereby the fastening adapter 302 is coupled to the fastening section 304. List of reference symbols 1, 201, 301 medical fastening system 2, 202, 302 medical mounting adapter 3, 203, 303 support structure 4, 204, 304 fastening section 5 medical robots, surgical microscope 6, 206, 306 first coupling structure 7, 207, 307 second coupling structure 8, 208, 308 third coupling structure 10, 210 helical gears 12, 212 rotary handle 13 Snap ring 14, 314 Instrument interface 16 Guide stop 18 Opening 20, 220, 320 first negative feedback structure 22, 222, 322 second negative feedback structure 24, 224, 324 third negative feedback structure 26 torque limiters 27 Cover 28 Fixing ball 310 lever pull 330 first arm 332 second arm 334 steel band 336 clamping jaw 340 notch 342 Alignment element

Claims

[1] Medical fastening adapter (2; 202; 302) for detachable fastening to a fastening section (4; 204; 304) of a medical robot (5), in particular a robot-guided surgical microscope, which is arranged in particular within a sterile cover, wherein the medical fastening adapter (2; 202; 302) has a support structure (3; 203; 303) with an instrument interface (14; 314), characterized by that the medical fastening adapter (2; 202; 302) further comprises: at least a first (6; 206; 306), a second (7; 207; 307) and a third geometric coupling structure (8; 208; 308), each designed for a positive connection to the fastening section (4; 204; 304), and an adjustment means (10; 210; 310) which is adapted to change the relative position of the at least first (6; 206; 306), second (7; 207; 307) and third geometric coupling structure (8; 208; 308) to one another in such a way that, in a first state of a first relative positioning, the fastening adapter (2; 202; 302) can be coupled to and uncoupled from the fastening section (4; 204; 304) and, in a second state of a second relative positioning, is non-releasably fixed to the fastening section (4; 204; 304), and by means of the first (6; 206; 306), second (7; 207; 307) and third coupling structure (8; 208; 308), a position of the fastening adapter (2; 202; 302) relative to the fastening section (4; 204; 304). [2] Medical fastening adapter (2; 202) according to claim 1, characterized byin that the first (6; 206), the second (7; 207) and the third coupling structure (8; 208) lie in a plane and each have a convex surface, in particular as a hemisphere, in particular pointing in a direction in the plane, wherein at least the convex surface of the first coupling structure (6; 206) faces the convex surface of the second (7; 207) and / or the third coupling structure (8; 208) and the convex surface of the first coupling structure (6; 206) is translationally displaceable by means of the adjusting means (10; 210) in order to change a relative distance. [3] Medical fastening adapter (2; 202) according to claim 2, characterized byin that the second coupling structure (7; 207) and the third coupling structure (8; 208) are arranged rigidly on the support structure (3; 203), in particular are formed integrally in the support structure (3; 203), and the adjusting means (10; 210) is designed in the form of a rotatable screw gear (10; 210) with a rotary handle (12; 212) for manual actuation, which, by rotation, adjusts a position of the convex surface of the first coupling structure (6; 206) relative to the support structure (3; 203) and thus also relative to the second (7; 207) and the third coupling structure (8; 208). [4] Medical fastening adapter (2; 202) according to claim 3, characterized by in that the screw gear (10; 210) has a torque limiter (26) which is rigidly connected to the rotary handle (12; 212) and which, when a limit torque is exceeded, only transmits the limit torque and also provides an operator with haptic and / or acoustic feedback. [5] Medical fastening adapter (2; 202) according to one of claims 2 to 4, characterized by in that the support structure (3; 203) of the fastening adapter (2; 202) has a guide stop (16) in the form of a projection which is formed in the region of the first coupling structure (6; 206) and projects in the same direction as the first coupling structure (6; 206) and lies parallel to the plane of the first, second (7; 207) and third coupling structure (8; 208) in order to align the fastening adapter (2; 202) in the first state of the first relative positioning by means of the guide stop (16) in a geometrically aligned manner with respect to the fastening section (4; 204). [6] Medical fastening adapter (302) according to claim 1, characterized bythat the first (306), second (307) and third coupling structure (308) lie in one plane, the support structure (303) has a first arm (330) with the first coupling structure (306) and a second arm (332) with the second coupling structure (307), wherein the first coupling structure (306) lies opposite the second coupling structure (307) and the first (330) and / or the second arm (332) are designed such that they can be elastically deflected relative to one another, and the adjusting means has a hinge-like lever (310) with a shape-adapting steel band (334), in particular further with two clamping jaws (336) on the steel band (334), which connects the two arms (330, 332) to one another and via the hinge-like lever (310) a shortening of the steel band (334) between two points can be adjusted, which results in an elastic Deformation of the first (330) and second arm (332) towards each other results,to reduce a relative distance between the first coupling structure (306) and the second coupling structure (307) and to fix the fastening adapter (302) to the fastening section (304) in the second state of the second relative positioning. [7] Medical fastening adapter (2; 202; 302) according to one of the preceding claims, characterized by that the fastening adapter (2; 202; 302), in particular the support structure (3; 203; 303), has a plastic, preferably PA 66 GFK or PEEK GFK, as material, in particular the support structure (3; 203; 303) is made entirely of this material. [8] Medical fastening system (1; 201; 301) for the detachable fastening of a fastening adapter (2; 202; 302) to a fastening section (4; 204; 304) of a medical robot (5), in particular a robot-guided surgical microscope, which is arranged in particular within a sterile cover, characterized by , that the fastening system (1; 201; 301) comprises a fastening adapter (2; 202; 302) according to one of the preceding claims, and the fastening section (4; 204; 304) has at least a first (20; 220; 320), second (22; 222; 322) and third counter-coupling structure (24; 224; 324) which interact in a form-fitting and complementary manner with the first (6; 206; 306), the second (7; 207; 307) and the third coupling structure (8; 208; 308). [9] Medical fastening system (1) according to claim 8, characterized byin that the fastening section (4) has a plate-shaped basic structure with a central opening (18) perpendicular to the plane of the basic structure and has, on a front side, a first counter-coupling structure (20) with a concave notch which is oriented in the front direction and, on a side region lateral to the central opening (18), has a second (22) and a third counter-coupling structure (24), each with a concave notch, which are each oriented opposite to the front direction, so that in the fastening adapter (2) with the first (6), the second (7) and the third coupling structure (8), which lie in one plane and each have a convex surface, this convex surface each cooperates with the concave notch in order to determine a position of the fastening adapter (2) relative to the fastening section (4) by means of a positive fit of the at least three contact points. [10] Medical fastening system (201) according to claim 8, characterized byin that the fastening section (204) has a plate-shaped basic structure with a central opening (18) perpendicular to the plane of the basic structure and has, on a front side, a first counter-coupling structure (220) with a concave notch that is oriented in the front direction and, on a rear side, which is arranged opposite the front side of the basic structure, a second (222) and a third counter-coupling structure (224), each with a concave notch, which are each oriented opposite to the front direction, so that in the fastening adapter (202) with the first (206), the second (207) and the third coupling structure (208), which lie in one plane and each have a convex surface, this convex surface each cooperates with the concave notch in order to fix a position of the fastening adapter (202) relative to the fastening section (204) by means of a positive fit of the at least three contact points. [11] Medical fastening system (301) according to claim 8, characterized bythat the fastening section (304) has a plate-shaped basic structure with a central opening (18) perpendicular to the plane of the basic structure and a first counter-coupling structure (320) and a second counter-coupling structure (322) are arranged on two opposite side walls and a front side has a third counter-coupling structure (324), so that in the fastening adapter (302) with the first arm (330) with the first coupling structure (306) and the second arm (332) with the second coupling structure (307), which are designed such that they can be elastically deflected relative to one another, the first (306), the second (307) and the third coupling structure (308) cooperate with the respective counter-coupling structure (320, 322, 324), in particular in cooperation with the two clamping jaws (336) on the steel strip (334) which connects the two arms (330, 332) to one another,to determine a position of the fastening adapter (302) relative to the fastening section (304) by means of positive locking of the at least three contact points. [12] Medical fastening system (1; 201; 301) according to claim 8, characterized by a separate sterile cover which is arranged between the fastening adapter (2; 202; 302) and the fastening section (4; 204; 304) and which is in contact with at least the first (20; 220; 320), the second (22; 222; 322) and the third counter-coupling structure (24; 224; 324) of the fastening section (2; 202; 302) as well as the first (6; 206; 306), the second (7; 207; 307) and the third coupling structure (8; 208; 308) of the fastening adapter (2; 202; 302). [13] Medical device (5), in particular a medical robot (5), preferably in the form of a robot-guided surgical microscope, with a sterile cover for attaching sterile medical products to the medical device, characterized by , that the medical device, in particular the robot (5), has at least one fastening section (4; 204; 304) and at least one fastening adapter (2; 202; 302) according to one of claims 1 to 7, in particular a plurality of fastening sections (4; 204; 304) and fastening adapters (2; 202; 302), or the medical device, in particular the robot (5), has a fastening system (1; 201; 301) according to one of claims 8 to 12, wherein the sterile cover is arranged between the fastening section (4; 204; 304) and the fastening adapter (2; 202; 302) fastened thereto, so that the robot (5) with the fastening section (4; 204; 304) is arranged in a non-sterile area, and the fastening adapter (2; 202; 302) with, for example, a medical instrument is arranged in a sterile area.

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