CHANGING DEVICE FOR AT LEAST TWO SURGICAL INSTRUMENTS, SURGICAL ROBOT SYSTEM AND METHOD FOR CHANGING SURGICAL INSTRUMENTS

Abstract

The present invention provides a changing device (10) for surgical interchangeable instruments (1). A linear guide (12) extends from an instrument magazine (14) for the interchangeable instruments (1) in the passive position in order to transfer one interchangeable instrument (1) on a carriage (13) from a change position to an active position. The interchangeable instrument (1) has a handle (2) and a shaft (3) which is parallel to the linear guide (12) in the change position and the active position. The instrument magazine (14) has a rail guide (15, 16) with a guide profile that defines a circular path. The carriage (13) has at least one rail section (17, 18, 19), the profile of which corresponds to the guide profile of the rail guide (15, 16) and which, in the change position, supplements the rail guide (15, 16) of the instrument magazine (14) along the circular path.Each interchangeable instrument (1) has at least one engagement element (22, 23) on the handle (2) with an engagement profile that is complementary to the guide profile of the rail guide (15, 16) and the rail section (17, 18, 19), so that each interchangeable instrument (1) can be moved along the circular path of the instrument magazine (14) in the passive position and positioned on the carriage (13) in the exchange position. Furthermore, a surgical robot system and a method for exchanging surgical interchangeable instruments (1) are disclosed.

Description

The invention relates to a changing device for at least two surgical changing instruments, a surgical robot system having such a changing device and a method for changing surgical changing instruments using the changing device.Master-slave robot systems for surgery are known from the prior art, which work directly on the patient and are controlled by an immortal operator at an input console. By means of the input console, tools can be operated on surgical instruments, which usually project through trocars into the patient's body. These instruments are guided and driven by articulated robot arms which convert the operator's movement inputs (on the console) into movements of the instrument tip in a complex interaction of all degrees of freedom (of robot arm and instrument). If different instruments are required for an operation on a robot arm, the instrument in the known systems must be changed manually by a sterile person in a direct patient environment. For this purpose, the interface of the instrument to be removed and ideally pulled back ready from the trocar to the robot must be released manually and the instrument must be removed. The new instrument is then introduced again in the reverse sequence and connected to the robot arm.It is thus not possible to carry out the operation completely from the console after the system has been set up. Either a pendulum of the operator between console and sterile patient environment or an assisting person in the vicinity of the patient is necessary.DE 10 2009 025 013 B4 discloses a system that enables an automated instrument change, wherein two medical instruments are present in an instrument storage unit having storage chambers, which can each be supplied to a working channel. The working channel can each receive the instrument to be used, for which purpose the instrument storage means is rotated like a turret until the storage chamber with the instrument to be used is aligned axially with the working channel. However, this instrument reservoir requires complex hydraulics to advance the instruments and do not allow shaft instruments to be used with this system.U.S. Pat. No. 10,617,561 B2 discloses an operating robot for minimally invasive interventions, which comprises an instrument manipulator with a manipulator front end, which is provided with an instrument receptacle for receiving one of a plurality of surgical instruments.U.S. Pat. No. 7,297,142 B2 shows a surgical instrument system which enables the replacement of any surgical instrument from a number of different surgical instruments at an operating site.DE 10 2012 025 101 A1 discloses an active positioning device of a surgical instrument and a surgical robot system or telemanipulator for minimally invasive surgery and in particular laparoscopic surgery.Proceeding from this prior art, it is an object of the present invention to provide an improved changeover device which makes it possible to change shaft instruments for use in a surgical robot system in a simple and automated manner.This object is achieved by a changing device having the features of claim 1.The further object of providing a surgical robot system, with the aid of which shaft instruments can be changed easily and automatically, is achieved by the robot system having the features of independent claim 13.The further object of changing shaft instruments for use in a surgical robot system in a simple and automatic manner is achieved by the method having the features of the independent claim 14.Developments or preferred embodiments of the changing device, the surgical robot system or the method are set out in the dependent claims.According to a first embodiment, the changing device is designed for at least two surgical changing instruments, which can be positioned in the changing device selectively in an active position, a changing position and a passive position. The changing device has an instrument magazine for receiving the at least two changing instruments in the passive position and a linear guide with a proximal end, on which the instrument magazine is arranged, and a distal end, on which the changing instrument is arranged in the active position. The changing device also has a drive unit which is designed to optionally arrange each of the changing instruments at the proximal end of the linear guide in a changing position, and a transfer device for transferring the changing instruments along the linear guide between the changing position at the proximal end into the active position at the distal end.According to the invention, each interchangeable instrument has a handle, a shaft and a tool which is arranged at a distal end of the shaft and is operatively coupled to the handle, which is arranged at a proximal end of the shaft, which defines an instrument axis A, which in the interchangeable position and the active position is parallel to a longitudinal axis L of the interchangeable device, wherein the longitudinal axis L is defined by the linear guide.Furthermore, the instrument magazine has a rail guide with a guide profile which defines at least one circular path which extends to the proximal end of the linear guide.The transfer device has a slide which can be moved along the linear guide and has at least one rail section, the profile of which corresponds to the guide profile of the rail guide and which, in the change position, supplements the rail guide of the instrument magazine along the at least one circular path.Each interchangeable instrument on the handle has at least one engagement element with an engagement profile which is formed complementary to the guide profile of the rail guide and of the rail section, so that each interchangeable instrument can be moved on the circular path of the instrument magazine in the passive position and can be positioned on the slide in the interchangeable position."Changing instrument" herein means a surgical instrument having a shaft that can be inserted into the changing device and changed by means of the changing device.The "handle" of the interchangeable instrument comprises all components for controlling and moving the tool at the distal end of the shaft of the instrument. It corresponds in principle to a gear unit of a surgical instrument.The "at least one circular path" refers to individual structures described in more detail below, which can be profiles, profile structures or the like and which can lie parallel to one another in different radii in order to thus form a rail guide."Passive position", "changeover position" and "active position" denote the different positions which one of the at least two changeover instruments can assume in the changeover device. In the instrument magazine, the at least two interchangeable instruments are initially present in a passive position. Resting on the carriage located at the proximal end of the linear guide, the exchangeable instrument located there assumes an exchangeable position. Advanced to the distal end of the linear guide, introduced into the trocar or a trocar device, the interchangeable instrument resting on the carriage is in the active position. Since the change position and active position of the change instrument refer to the position of the slide in the linear guide, the terms change position and active position are also used in a corresponding manner with respect to the slide in order to denote its positioning at the proximal or distal end of the linear guide.The changing device according to the invention is advantageously suitable for offering a possibility for automatic and simple instrument changing of shaft instruments on a robot arm of a surgical robot system. The changing device is capable of accommodating a plurality of shaft instruments, of engaging these via the rail guide as a suitable interface with an insertion and control mechanism for the changing instruments and of subsequently moving the instruments into and out of the trocar again without a person having to change the instruments manually. The principle can be applied to shaft instruments with different gears.According to a further embodiment of the changing device according to the invention, the at least one engagement element with the engagement profile is provided on the handle of each changing instrument by at least one movement transducer which can be moved parallel to the instrument axis A for the purpose of controlling the tool and extends through an opening in a base plate of the handle, such that the engagement profile projects beyond the base plate. The movement sensor can serve for transmitting a movement and thus for controlling a pivoting or opening and closing movement of the tool at the distal end of the shaft of the interchangeable instrument. Furthermore, at least one motion transmitter is arranged on the carriage, which motion transmitter can be moved parallel to the longitudinal axis L with respect to the carriage and provides a counter profile for positive engagement with the engagement profile of the motion receiver. The counter profile projects beyond the slide. In this case, in the changeover position, the guide profile of the at least one rail section is provided or supplemented on the carriage along the at least one circular path by the counter-profile of the movement transmitter. This means that either the motion transmitter with the counter profile serves as a rail section of the carriage with the guide profile in the changing position and thus in the changing position completes the rail guidance of the instrument magazine along the at least one circular path in sections. Or, preferably, adjacent to the longitudinally movable motion transmitter, rail sections are formed on the carriage with a profile corresponding to the guide profile, which is supplemented by the counter-profile of the motion transmitter in the change position, so that the at least one circular path of the rail guide of the instrument magazine runs uninterruptedly on the carriage in the change position. Here, "changeover position" also refers to the position of the longitudinally movable movement transmitter with respect to the carriage.For interchangeable instruments with several motion receivers on the handle, which can be moved parallel to the instrument axis A and whose engagement profiles project beyond the base plate, the rail guide of the instrument magazine and of the slide can be formed with correspondingly adapted guide profiles. Since the carriage has a plurality of motion encoders that can be moved parallel to the longitudinal axis L for engagement with the plurality of motion receivers, their counter profiles can provide or supplement the guide profiles of the rail sections on the carriage along the at least one circular path as described above in the change position.Between or next to the motion transmitters, which provide rail sections of the carriage in the change position, the carriage can have one or more additional rail sections, which supplement or complete the guide profile of the instrument magazine. This is especially the case in which the proximal end of the linear guide divides the instrument magazine and its rail guide into two sections, preferably halves. These are connected by the carriage located in the changeover position in order to provide a continuous rail guide with the guide profile, if the motion transmitters are also aligned in the changeover position in which the counter-profile of the motion transmitters supplements the guide profile of the rail guide. Thus, the change instruments can be moved along the continuous rail guide between passive and change positions, wherein the movement pick-ups provide the engagement profiles which are configured on the one hand for sliding the change instruments along the rail guide and the rail sections of the carriage and on the other hand for engaging with the counter-profile of the movement pick-ups on the carriage. In other words, in a preferred embodiment of the changing device, the movement transmitter / sensors on the slide can / can serve on the one hand as a rail section, the profile of which in the changing position supplements the guide profile of the rail guide, and on the other hand, by engagement with the movement receiver / s of a changing instrument, serve as a drive element(s), with which the tool of the changing instrument is / are controlled in the active position.All profiled component components which are correspondingly configured to engage with one another are curved in a manner corresponding to the circular paths, so that a smooth engagement can be established and released again. The continuous rail guide is composed on the carriage of the rail sections on the carriage surface and the correspondingly shaped motion transmitters. The engagement is preferably a form-fit engagement which locks in the longitudinal direction of the exchangeable instrument or the linear guide, so that the instruments can be guided in a held manner and thus a quick exchange is possible. Alternatively, other embodiments of the engagement profiles are possible, such as a gap between the motion pick-ups, which then have a certain width, or other solutions that appear suitable to the person skilled in the art.According to yet another embodiment of the changing device according to the invention, the carriage has an automatic positioning system which is designed to position the at least one motion transmitter in the changing position when the carriage is arranged at the proximal end, such that the counter profile provides or supplements the guide profile of the at least one rail section along the at least one circular path. The automatic positioning system comprises an electronic and actuator unit, for example at least one motor with encoder, which detects the current position of the slide and / or of the movement transmitter and outputs it as an electrical signal to a control unit of the motor in order to bring the slide and the movement transmitter into the changeover position in which the counter profile of the movement transmitter supplements the guide profile along the at least one circular path.According to yet another embodiment of the changing device according to the invention, the at least one engagement element of the changing instrument, which has the engagement profile, is provided by two movement transducers, which are arranged parallel to the instrument axis A, for orienting a swashplate and are connected to a pivot mechanism of the tool via steering wires. Additionally or alternatively, the at least one engagement element can be provided by a movement transducer arranged in the instrument axis A for axial movement of an actuating rod, wherein the actuating rod can be connected to an opening and closing mechanism of the tool. Motion transmitters and motion receivers can have a corresponding profile, for example rectangular grooves and tongue or alternating groove-and-tongue constructions. Advantageously, the gear of the change instrument can be controlled via the engagement elements.According to yet another embodiment of the changing device according to the invention, each exchangeable instrument has at least one rotation sensor on the handle, which can be rotated about an axis parallel to the instrument axis A for controlling the shaft and extends through an opening in a base plate of the handle, so that the rotation sensor protrudes beyond the base plate. At least one rotation transmitter is additionally arranged on the carriage, which can be rotated about the longitudinal axis L or about an axis parallel to the longitudinal axis L and is designed for engagement with the rotation transmitter. The engagement is preferably frictional, so that the rotation receiver can be set in rotation by friction on the rotation transmitter and a simple movement transmission can take place. The rotary encoder does not belong to the rail guide, but can supplement it.According to yet another embodiment of the changing device according to the invention, the rotation sensor is designed as a friction wheel and comprises an elastomer material. The elastomer material is formed at least in the portion in which the friction wheel can be in contact with the rotary encoder. In this case, an elastic deformability of the elastomer material and a protrusion of the friction wheel over the base plate are coordinated with one another in such a way that the friction wheel can be compressed apart from the base plate for changing the changing instrument between the passive position and the changing position. The friction wheel can transmit rotary movements as an intermediate wheel to the shaft axis arranged above the base plate. Additionally or alternatively, the instrument magazine can have, parallel to the rail guide, a track for rolling the friction wheel or a cut-out groove along the pivot region defined by the instrument magazine. Alternatively, the rotation receiver can be arranged on the handle such that it can be extended and retracted or pivoted, so that the rotation receiver is inserted or pivoted into the handle in the passive position, i.e. does not protrude beyond the base plate, and is extended or pivoted out of the handle when transferred into the change position, in order to protrude beyond the base plate for engagement with the rotation transmitter.The interchangeable instruments can form different arrangements in the passive position, which are determined by the shape of the instrument magazine or the course of the rail guide. Equivalent alternative arrangements of instruments are a fan arrangement, a turret arrangement, a conical arrangement and a mixture of a conical and turret arrangement.According to a preferred embodiment of the changing device according to the invention, the changing instruments are arranged in the passive position in a fan-shaped manner, wherein the at least one circular path extends in a plane with the longitudinal axis L and the instrument axes of the changing instruments in the passive position and the changing position intersect at a center point R of the circular path. This is a particularly space-saving variant, above all in the case of a limited small number of interchangeable instruments.According to a first alternative embodiment, the interchangeable instruments can also be arranged in the passive position in the manner of a turret, wherein the at least one circular path runs in at least one plane orthogonally to the longitudinal axis L and the instrument axes of the interchangeable instruments are present in the passive position parallel to the longitudinal axis L and correspond to the longitudinal axis L in the interchangeable position. In yet another alternative embodiment, the interchangeable instruments can be arranged conically in a combination of the fan-shaped and turret-like arrangement, wherein the at least one circular path runs in at least one plane which intersects the longitudinal axis L at an angle deviating from 90°, and the instrument axes of the interchangeable instruments lie on a lateral surface of an imaginary cone in the passive position and the interchangeable position and run through the tip thereof. The fan or cone shape is formed by the partially circular magazine shape, the center of the circle or pivot center of which lies in the distal direction adjacent to a trocar which is provided for connection to the patient. Such arrangements are space-saving and allow a structurally simple changeover mechanism for shaft instruments. In order to prevent an instrument arranged on the carriage, the motion pick-ups of which are in engagement with the motion pick-ups on the carriage, from being actuated as long as it is not in an active position in the changing device and is not advanced in the trocar, contact of the motion pick-ups on the carriage with the required drive means can be interrupted, whereby the distal movement of the instrument tip is also blocked or a movement of the tool is not made possible.In the case of a fan-shaped arrangement of the change instruments in the passive position, according to a further embodiment of the change device according to the invention, the center point R of the at least one circular path can lie on the longitudinal axis L distal to the distal end of the linear guide. In the turret-like arrangement of the interchangeable instruments in the passive position according to the first alternative, a center point of the at least one circular path can lie on a center axis parallel to the longitudinal axis L. In the case of a conical arrangement of the interchangeable instruments in the passive position, according to the further alternative, a center point of the at least one circular path can lie on a center axis of the imaginary cone, the tip of which lies on the longitudinal axis L distal to the distal end of the linear guide.According to a further embodiment of the changing device according to the invention, the guide profile of the rail guide of the instrument magazine defines a plurality of circular paths which run parallel about a common center point R or a common center axis and are supplemented by the guide profile of the at least one rail section of the slide in the changing position, wherein the guide profile has a rectangular, triangular or wavy contour. These contours as height profiles enable a positive fit to the drive side for the force transmission. The heights and depths of the contour likewise form the aforementioned circular path, so that the guide profile of the rail guide can overall form the circular path.The change instruments are ideally situated close and space-saving next to one another in a fan shape or cone shape in the change device, but do not touch one another in this case and are spaced apart from one another such that they do not interfere with one another in the movement when the position changes from the passive position to the change position and the active position. According to yet another embodiment of the changing device according to the invention, the changing device has the trocar device distal to the distal end of the linear guide or a simple trocar for guiding the shaft of the changing instrument when transferred into the active position. The trocar device can be equipped with or without a proximal-side insertion funnel for inserting the shaft of the exchangeable instrument into the trocar device. Additionally or alternatively, in a further embodiment of the changing device according to the invention, it can be provided that the changing device has a guide device distal to the distal end of the linear guide, which guide device is designed to hold the distal end of the shaft of the changing instrument in the passive position, to support it when changing to the changing position and to guide it when transferring to the active position. For this purpose, the guide device provides a guide of the distal shaft end of the interchangeable instrument on a circular path, which is concentric to the instrument magazine, with a correspondingly smaller radius. For example, the guide device can have a distal rail guide similar to the rail guide of the instrument magazine, wherein each interchangeable instrument has a guide element with a corresponding engagement profile at the distal shaft end (or also at the proximal end of the tool).In the case of the fan-shaped arrangement of the changing instruments in the passive position, according to yet another embodiment of the changing device, the center point R of the at least one circular path can lie on the longitudinal axis L between the distal end of the linear guide and the trocar or else of the trocar device. In the conical arrangement of the change instruments in the passive position according to the further alternative embodiment of the change device according to the invention, the tip of the imaginary cone can lie on the longitudinal axis L between the distal end of the linear guide and the trocar device.According to yet another embodiment of the changing device according to the invention, the linear guide is provided by a guide rail or by a guide channel which is bounded between the proximal end and the distal end by side walls. In this case, a sliding or rolling rail guide is formed between the linear guide and the carriage. In the case of slide rail guidance, dimensionally stable and low-abrasion materials with low coefficients of sliding friction are selected for slides and channel or coatings thereof, which materials provide a low-sliding friction material pairing. In the case of rolling rail guidance, the carriage or the channel can have corresponding wheels, rollers, rolling bodies.Further embodiments of the change device according to the invention relate to the fact that the material or a coating of the rail guide of the instrument magazine and of the rail section of the slide on the one hand and the material or a coating of the engagement elements on the handle of the change instruments on the other hand also provide a low-friction material pairing. A drive unit, with which the interchangeable instruments are moved in the instrument magazine along the rail guide, can comprise, for example, a toothed rim concentric to the rail guide, which is formed (as an internal toothed rim) about the pivot axis of the interchangeable instruments on a proximal housing wall of the instrument magazine or a frame element or (as a crown wheel) next to the rail guide. Each change instrument can be in engagement with the toothed rim via a corresponding pinion on the handle. For transferring the slide along the linear guide between the change position at the proximal end and the active position at the distal end, the transfer device can likewise have a drive unit, such as a linear spindle. The control and energy supply of the motion / rotation generators on the carriage can be wired or via a contact rail, but optionally also wirelessly and with a battery.A surgical robot system according to the invention has at least one robot arm and a control unit and comprises a changing device according to the invention having at least two surgical changing instruments.Advantageously, a robot system is provided which can be based on the master-slave principle and which is capable of automatically and easily changing surgical instruments during the operation, i.e. in particular to pick them up, engaging the insertion and control mechanism via the above-described interface on the slide and then inserting or removing the instruments again into the trocar. This allows necessary personnel to perform an operation to be reduced or used for other tasks. The instrument change can be initiated directly by the control unit or by a further, external control unit, such as a console.A method according to the invention for changing surgical changing instruments using a changing device according to the invention comprises the stepsselecting one of the surgical changing instruments which are accommodated in the instrument magazine in the passive position, wherein the surgical changing instruments are in engagement with the at least one engagement element on the handle, preferably in sliding engagement, with the rail guide of the instrument magazine, the guide profile of which defines the at least one circular path which extends to the proximal end of the linear guide,arranging the carriage with the at least one rail section at the proximal end of the linear guide in the changeover position, thereby complementing the rail guide of the instrument magazine along the at least one circular path with the at least one rail section,activating the drive unit for moving the selected changing instrument from the passive position along the at least one circular path and positioning the selected changing instrument in the changing position on the carriage, andtransferring the carriage with the selected changing instrument along the linear guide from the changing position at the proximal end of the linear guide into the active position at the distal end of the linear guide.In a further step of the method according to the invention, in the change position, the motion sensors on the slide advantageously engage with the motion sensors on the change instrument and thus also establish the drive connection between drive means for the handle and handle of the change instrument. A manual mechanical or electronic connection is not necessary, but rather takes place automatically therewith. The motion sensors transmit the motion of the motion sensors to the mechanics of the handle for controlling the tool. The tool can be actuated from this point or only after the change instrument has been transferred into the active position.In a further step of the method according to the invention, reversing the method steps causes the interchangeable instrument in use to be guided from its active position at the distal end of the linear guide along the linear guide back into the interchangeable position at the proximal end of the linear guide until the carriage has arrived in its initial position and the rail sections or their profiles coincide with those of the instrument magazine or come into congruence. With renewed activation of the drive unit for moving the selected changing instrument, the latter can be moved along the at least one circular path from the changing position into the passive position by the carriage into the instrument magazine. The motion transducers lose engagement with the motion transducers on the carriage and come into contact with the rail guide of the instrument magazine.In order to select the suitable interchangeable instrument, it can be provided in a further step of the method according to the invention that a first interchangeable instrument can be positioned from one side of the instrument magazine onto the carriage and, in addition, onto the respective other side of the instrument magazine, in order to be able to select the desired interchangeable instrument precisely in the case of a fan-shaped instrument magazine. In the case of a conical or revolver-shaped instrument magazine, it can alternatively be provided that the interchangeable instruments are guided in a "circle" direction until the desired interchangeable instrument comes to rest on the carriage.Other embodiments of the switching device and the surgical robotic system, as well as some of the advantages associated with these and other embodiments, will be apparent and better understood from the following detailed description with reference to the accompanying figures. Items or parts thereof that are substantially the same or similar may be provided with the same reference numerals. The figures are merely a schematic representation of an embodiment of the invention.The following are shown: FIG. 1 is a perspective view of the surgical robot system according to the invention, FIG. 2 shows a perspective view of the changing device according to the invention with two changing instruments in the passive position, FIG. 3 shows a perspective view of the changing device according to the invention with two changing instruments in the passive position and one changing instrument in a changing position, FIG. 4 shows a perspective view of the changing device according to the invention with two changing instruments in the passive position and one changing instrument in an active position, FIG. 5 shows a detailed view of an instrument magazine of the changing device according to the invention, FIG. 6 shows a first detailed view of a base plate of a changing instrument for the changing device according to the invention, and FIG. 7 shows a further detailed view of a base plate of a changing instrument for the changing device according to the invention.In FIG. 1, a surgical robot system 100 has a robot arm 110, a control unit 104 and a changing device 10 for changing changing tools 1, the latter being shaft instruments with a shaft 3 and a handle 2, the distal ends of which are equipped with tools 4. The changing instrument 1 can be inserted into the patient 103 in the context of a minimally invasive surgical treatment via a trocar 105 which is connected to a patient 103 lying on a table 102. The trocar 105 has an insertion funnel 106 which has for guiding the shaft 3 of the changing instrument 1 into the trocar 105.FIGS. 2 to 4 show the changing device 10 including changing instruments 1 in their different possible positions. A changing instrument 1 of the changing device 10 can be selectively positioned in a passive position (FIG. 2 ), a changing position (FIG. 3 ) and an active position (FIG. 4 ). The changing device 10 has an elongate base 11 as a basic component, to which an instrument magazine 14 (hereinafter abbreviated to magazine 14), in which two changing instruments 1 are accommodated in their passive position, adjoins in a T-shaped manner at a proximal end 12 aof the base 11. "passive position" means here that the changing instruments 1 are stored in the magazine 14 and are not advanced into the trocar 105; this would correspond to the "active position". In the distal direction, the base 11 extends along a longitudinal axis L. A linear guide 12 is formed in the base along the longitudinal axis L. The linear guide 12 is a simple guide channel which is bounded between the proximal end 12 aand the distal end 12 bby side walls. A carriage 13 is inserted in the linear guide 12 and can be moved along the linear guide 12. For this purpose, the linear guide 12 and the carriage 13 form a sliding or rolling rail guide. For advancing the slide 13 and for moving the change instruments 1 within the magazine 14, a motor drive (not shown in the drawings) is provided.The linear guide 12 forms together with the carriage 13 and the drive a transfer device for transferring one of the change instruments 1 between the change position at the proximal end 12 ato the active position at the distal end 12 bof the linear guide 12 (see FIGS. 3 and 4 ).The magazine 14 is partially circular in the changing device 10 shown in FIGS. 2 to 5 and has a rail guide 15, 16 made of two rails with a guide profile which defines a plurality of circular path sections in two partial profiles, which run parallel about a common center R. The carriage 13 has two supplementary rail sections 18, 19 to the two rails 15, 16 which extend over the entire extent of the magazine 14. With the slide 13 in the changeover position for a changeover instrument 1 in FIGS. 2, 3 and 5, rails extending over the entire extent of the magazine 14 in the transverse direction to the longitudinal axis L are thus formed. The rail guide 15, 16 and the supplementary rail sections 18, 19 have an identically designed guide profile and thus supplement one another. The guide profile shown in FIGS. 2 to 5 has a rectangular contour.The circular paths of the rail guide 15, 16 and of the two supplementary rail sections 18, 19 of the slide 13 in the changeover position run in a plane with the longitudinal axis L about a center point R, in which the instrument axes A of the changeover instruments 1 also intersect in the passive position and the changeover position. The center point R lies on the longitudinal axis L distal to the distal end 12 bof the linear guide 12 and in front of the trocar 105. The radius of the circular paths and thus also the length of the base 11 and the arrangement of the magazine 14 along the longitudinal axis L are oriented here to the dimensions of the interchangeable instrument 1 or the length of the shaft 3 of the interchangeable instrument 1. The point of intersection R, or the radius of the circular paths, is selected such that the change instruments 1 or their distally arranged tools 4 do not touch each other or impede each other in which position or position. In the instrument magazine 14, the two or three interchangeable instruments 1 are initially present in a passive position. Resting on the carriage 13, the exchangeable instrument lying there assumes an exchangeable position. When advanced into the trocar 105, the changing instrument 1 resting on the carriage is then in the active position.Each interchangeable instrument 1 inserted into the magazine 14 has a handle 2, a shaft 3 and the already named tool 4. The tool 4 is arranged at a distal end 3 bof the shaft 3 and is coupled to the handle 2, which is arranged at a proximal end 3 aof the shaft 3. The shaft defines an instrument axis A, which is parallel to a longitudinal axis L of the changing device 10 in the changing position and the active position. Connecting piece 31 can optionally be used for an RF connection of the changing instrument 1.The instrument magazine 14 shows in FIGS. 3 and 5 the slide 13 in an initial position at the proximal end 12 aof the rail 12 / the changing device 10 corresponding to the changing position. The first rail sections 18, 19 are each in turn arranged in elongate through-openings 18' and a square through-opening 19' and are provided by motion generators 18, 19 which, as will be explained in greater detail below, serve for controlling the interchangeable instrument 1 in the active position. The second rail sections 17 are formed fixedly in a surface of the carriage 13 and are located next to or between the first rail sections 18, 19 in order to supplement the rail guide 15, 16 of the magazine 14 in the change position. In this case, the rail section 18 is arranged in the proximal opening 18', which complements the rail guide 15 of the magazine 14. The rail sections 19 are inserted into the two openings 19' which are parallel to one another in order to align with the rail guide 16 in the change position. In addition, the "rail gaps" on the surface of the carriage 13 which are present in relation to the magazine 14 are filled by second rail sections 17 next to the rail sections 18, 19, of which only two are designated in FIG. 5 for the sake of clarity. The rail sections 18, 19 provided by the motion transmitters 18, 19 can be moved with respect to the carriage 13 in the through openings 18', 19' parallel to the longitudinal axis L of the changing device 10 or the carriage 13, respectively. In the proximal opening 18', a wheel-shaped rotation transmitter 32 is arranged on the distal side adjacent to the rail section or motion transmitter 18, which rotation transmitter can be set in rotation by a suitable drive means. The rotation transmitter 32 does not belong to the guide profiles, but rather serves as a drive means for controlling a rotational movement of the shaft 3 of the interchangeable instrument 1.FIGS. 6 and 7 show a proximal end section of the change instrument 1, which connects to the proximal end 3 aof the shaft 3 in the proximal direction. This proximal end section corresponds to the handle 2, wherein the underside of the handle 2 is shown in FIGS. 6 and 7. The handle 2 of each instrument 1 has a base plate 20 into which two axially parallel elongated openings 21 and a central proximal opening 21' are worked. In each of the two openings 21, which are on the left and right to the instrument axis A, an engagement element 22 is inserted, and an engagement element 23 with an engagement profile, which projects beyond the base plate 20, is inserted into the proximal opening 21'. The engagement profile is formed complementary to the guide profile of the rail guide 15, 16 and the rail sections 17, 18, 19, wherein in the present case the partial profile of the engagement elements 22 is formed complementary to the partial profile of the rail guide 16 and the rail sections 17, 19, and the partial profile of the engagement element 23 is formed complementary to the partial profile of the rail guide 15 and the rail sections 17, 18. The engagement elements 22, 23 are movably mounted in the openings 21, 21', namely parallel to the instrument axis A (see arrows in FIGS. 6 and 7 ). They thus serve as motion pick-ups 22, 23 of the motion that initiate the motion pick-ups 18, 19 of the carriage 13, i.e. the rail sections 18, 19. The motion sensors 22, 23 transmit the motion of the motion sensors 18, 19 to the mechanics of the handle 2 for controlling the tool 4.For this purpose, the two motion sensors 22 arranged parallel to the instrument axis A are provided for aligning a swashplate 25. This is connected via steering wires 26 to a swivel mechanism of the tool 4. By means of the movement sensor 23 arranged in the instrument axis A, an axial movement of an actuating rod 27 is made possible, which is connected to an opening and closing mechanism of the tool 4. Furthermore, a rotation sensor 24 is arranged adjacent to the movement sensor 23, which controls a rotational movement of the shaft 3. The rotation sensor 24 which can be rotated about an axis parallel to the instrument axis A extends out of the opening 21' in the base plate 20 of the handle 2 in such a way that the rotation sensor 24 projects beyond the base plate 20. The carriage 13 correspondingly has the rotation transmitter 32, which can be rotated about the longitudinal axis L or an axis parallel to the longitudinal axis L and can be brought into engagement with the rotation receiver 24. The rotation sensor 24 is a friction wheel and has an elastomer material, so that it can be compressed as far as the base plate 20 when the interchangeable instrument 1 is transferred in the magazine 14.LIST OF REFERENCE CHARACTERS1 Interchangeable instrument 2 handle 3 shaft 3 a, 3 b Proximales shaft end, distal shaft end 4 tool 10 interchange device 11 base 12 linear guide 13 slide 14 instrument magazine 15 rail guide 16 rail guide 17 rail section 18 rail section / motion transmitter 18' opening 19 rail section / motion transmitter 19' opening 20 base plate 21 opening 21' opening 22 engagement element / motion receiver 23 engagement element / motion receiver 24 rotation receiver 25 swashplate 26 steering wires 27 actuation rod 31 HF connection 32 rotation transmitter 100 surgical robot system 102 table 103 patient 104 control unit 105 trocar 106 insertion funnel 110 robot arm

Claims

Changing device (10) for at least two surgical changing instruments (1) which can be positioned in the changing device (10) selectively in an active position, a changing position and a passive position, wherein the changing device (10) - an instrument magazine (14) for receiving the at least two changing instruments (1) in the passive position and - a linear guide (12) having a proximal end (12a) at which the instrument magazine (14) is arranged and a distal end (12b) at which the changing instrument (1) is arranged in the active position, and - a drive unit which is designed to selectively arrange each of the changing instruments (1) at the proximal end (12a) of the linear guide (12) in the changing position, and - a transfer device for transferring the interchangeable instrument (1) along the linear guide (12) between the changeover position at the proximal end (12a) and the active position at the distal end (12b), characterized in that - each interchangeable instrument (1) has a handle (2), a shaft (3) and a tool (4) which is arranged at a distal end (3b) of the shaft (3) and is operatively coupled to the handle (2) which is arranged at a proximal end (3a) of the shaft (3) which defines an instrument axis (A) which, in the changeover position and the active position, is parallel to a longitudinal axis (L) of the interchangeable device (10), wherein the longitudinal axis (L) is defined by the linear guide (12), and - the instrument magazine (14) a rail guide (15, 16 ) with a guide profile which defines at least one circular path which extends to the proximal end (12a) of the linear guide (12), and - the transfer device has a carriage (13) which can be moved along the linear guide (12) and has at least one rail section (17, 18, 19), the profile of which corresponds to the guide profile of the rail guide (15, 16) and which, in the changing position, complements the rail guide (15, 16) of the instrument magazine (14) along the at least one circular path, wherein each changing instrument (1) has, on the handle (2), at least one engagement element (22, 23) with an engagement profile which is formed in a complementary manner to the guide profile of the rail guide (15, 16) and of the rail section (17, 18, 19), such that each changing instrument (1) can be moved in the passive position on the circular path of the instrument magazine (14) and, in the changing position, can be positioned on the carriage (13).The changing device (10) according to claim 1, characterized in that the at least one engagement element (22, 23) of the changing instrument (1) with the engagement profile on the handle (2) of each changing instrument (1) serves as at least one movement transducer (22, 23), which is movable parallel to the instrument axis (A) for controlling the tool (4) and extends through an opening (21) in a base plate (20) of the handle (2), so that the engagement profile protrudes beyond the base plate (20), and at least one movement transducer (18, 19) is arranged on the carriage (13), which is movable parallel to the longitudinal axis (L) with respect to the carriage (13) and serves as a counter profile for engaging with the engagement profile of the movement transducer (22, 23), wherein the counter profile protrudes beyond the carriage (13) and provides or supplements the guide profile of the at least one rail section (17, 18, 19) along the at least one circular path in the change position.The changing device (10) according to claim 2, characterized in that the carriage (13) has an automatic positioning system which is designed to position the at least one motion transmitter (18, 19) in the changing position when the carriage (13) is arranged at the proximal end (12a), so that the counter profile provides or supplements the guide profile of the at least one rail section (17, 18, 19) along the at least one circular path.The changing device (10) according to claim 2 or 3, characterized in that the at least one engagement element (22, 23) of the changing instrument (1) providing the engagement profile is provided - by two motion transducers (22) arranged parallel to the instrument axis (A) for aligning a swashplate (25), which is connected via steering wires (26) to a pivot mechanism of the tool (4), and / or - by a motion transducer (23) arranged in the instrument axis (A) for axial movement of an actuating rod, which is connected to an opening and closing mechanism of the tool (4).The changing device (10) according to at least one of claims 1 to 4, characterized in that each changing instrument (1) has at least one rotation sensor (24) on the handle (2), which can be moved about an axis of rotation parallel to the instrument axis (A) for controlling the shaft (3) and extends through an opening (21') in a base plate (20) of the handle (2), so that the rotation sensor (24) protrudes beyond the base plate (20), and at least one rotation sensor (32) is arranged on the carriage (13), which can be rotated about the longitudinal axis (L) or about an axis parallel to the longitudinal axis (L) and is designed for engagement with the rotation sensor (24).The changing device (10) according to claim 5, characterized in that the rotation receiver (24) is designed as a friction wheel and comprises an elastomer material, wherein - an elastic deformability of the elastomer material and a protrusion of the friction wheel over the base plate (20) are coordinated with one another in such a way that the friction wheel is compressible apart from the base plate (20) for changing the changing instrument (1) between the passive position and the changing position, and / or - the instrument magazine (14) comprises a track for rolling the friction wheel parallel to the rail guide (15, 16).The changing device (10) according to at least one of claims 1 to 6, characterized in that the changing instruments (1) in the passive position are - arranged in a fan-shaped manner, wherein the at least one circular path extends in a plane with the longitudinal axis (L) and the instrument axes (A) of the changing instruments (1) in the passive position and the changing position intersect in a center point (R) of the circular path, or - arranged in a turret-like manner, wherein the at least one circular path extends in at least one plane orthogonally to the longitudinal axis (L) and the instrument axes (A) of the changing instruments (1) in the passive position are parallel to the longitudinal axis (L) and in the changing position correspond to the longitudinal axis (L), or - arranged conically in a combination of the fan-shaped and turret-like arrangement, wherein the at least one circular path extends in at least one plane, which intersects the longitudinal axis (L) at an angle deviating from 90°, and the instrument axes (A) of the interchangeable instruments (1) in the passive position and the interchangeable position lie on a lateral surface of an imaginary cone and run through the tip thereof.The changing device (10) according to claim 7, characterized in that - in the case of a fan-shaped arrangement of the changing instruments (1) in the passive position, the center point (R) of the at least one circular path lies on the longitudinal axis (L) distal to the distal end (12b) of the linear guide (12); - in the case of a turret-like arrangement of the changing instruments (1) in the passive position, a center point of the at least one circular path lies on a central axis parallel to the longitudinal axis (L); - in the case of a conical arrangement of the changing instruments (1) in the passive position, a center point of the at least one circular path lies on a central axis of the imaginary cone, the tip of which lies on the longitudinal axis (L) distal to the distal end (12b) of the linear guide (12).The changing device (10) according to at least one of claims 1 to 8, characterized in that the guide profile of the rail guide (15, 16) of the instrument magazine (14) defines a plurality of circular paths which run parallel around a common center point (R) or a common center axis and are supplemented by the guide profile of the at least one rail section (18, 19) of the carriage (13) in the changing position, wherein the guide profile has a rectangular, triangular or wavy contour.The changing device (10) according to at least one of claims 1 to 9, characterized in that the changing device (10) comprises, distal to the distal end (12b) of the linear guide (12), - a trocar (105) for guiding the shaft (3) of the changing instrument (1) in the active position with or without a proximally-side insertion funnel (106) for inserting the shaft (3) of the changing instrument (1) into the trocar device (105) when transferred into the active position; and / or - a guide device which is designed to hold the distal end (3b) of the shaft (3) of the changing instrument (1) in the passive position, to support it when changing into the changing position and to guide it when transferring into the active position.The changing device (10) according to claim 10, characterized in that in the fan-shaped arrangement of the changing instruments (1) in the passive position, the center point (R) of the at least one circular path on the longitudinal axis (L) lies between the distal end (12b) of the linear guide (12) and the trocar device (105); in the conical arrangement of the changing instruments (1) in the passive position, the tip of the imaginary cone lies on the longitudinal axis (L) between the distal end (12b) of the linear guide (12) and the trocar device (105).The changing device (10) according to at least one of claims 1 to 11, characterized in that the linear guide (12) is provided by a guide rail or by a guide channel which is bounded by side walls between the proximal end (12a) and the distal end (12b), wherein the linear guide (12) and the carriage (13) form a sliding or rolling rail guide.Surgical robot system (100) having a robot arm (110), a control unit (104) and a changing device (10) according to at least one of Claims 1 to 12 having at least two surgical changing instruments (1).Method for changing surgical changing instruments (1) using a changing device (10) according to at least one of claims 1 to 13, comprising the steps of - selecting one of the surgical changing instruments (1) which are accommodated in the instrument magazine (14) in the passive position, wherein the surgical changing instruments (1) with the at least one engagement element (22, 23) on the handle (2) are in engagement with the rail guide (15, 16) of the instrument magazine (14), the guide profile of which defines the at least one circular path which extends to the proximal end (12a) of the linear guide (12), - arranging the slide (13) with the at least one rail section (18, 19) at the proximal end (12a) of the linear guide (12) in the changing position, thereby complementing the rail guide (15, 16) of the instrument magazine (14) along the at least one circular path with the at least one rail section (18, 19), - activating the drive unit for moving the selected interchangeable instrument (1) from the passive position along the at least one circular path and positioning the selected interchangeable instrument (1) in the exchangeable position on the carriage (13), and - transferring the carriage (13) with the selected interchangeable instrument (1) along the linear guide (12) from the exchangeable position at the proximal end (12a) of the linear guide (12) into the active position at the distal end (12b) of the linear guide (12).

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