Instrument strainer for surgical instruments

Description

1. Technical area

[0001] The present invention relates to a system and method for at least partially automatic handling of an instrument tray for storing and providing surgical instruments. 2. Technical background

[0002] Surgical instruments (also known as surgical instruments or operating instruments), such as those typically used in hospital operating rooms, are primarily reused and therefore must be moved between the operating room and the sterilization department in a circular process. In this cycle, the instruments are often manually handled several times and transferred to different containers multiple times. These processes have so far been difficult to automate, as the instruments are typically placed in an unorganized manner in instrument trays or baskets after use in the operating room. Handling these instrument trays and the instruments they contain is therefore very labor-intensive and correspondingly expensive.

[0003] The process of a typical instrument cycle in a hospital is as follows. In the operating room, used surgical instruments are collected unsystematically in so-called instrument trays (such as wire baskets or other containers with openings to allow the instruments contained therein to be rinsed). Consumables and disposable materials are discarded. The used instruments are then transported to the sterilization department. In the sterilization department, the instrument trays are unpacked and a manual pre-inspection is carried out. Individual instruments are pre-cleaned, for example using ultrasound. The trays are then manually assembled for the washer-disinfector, and the instruments are then rinsed. The rinsed and thus cleaned instruments are placed in a warehouse where they are kept until shortly before the next use.The instruments required for an operation are requested individually. The requested instruments are picked up from the warehouse and transported to packing tables, where the instrument trays are manually packed or loaded for the respective operation. This process is very time-consuming and labor-intensive. After a visual inspection, the packed trays are wrapped in sterile cloth and transported, for example, to an autoclave. There they are sterilized and, after the sterilization process, unloaded and transported to the operating room. If necessary, so-called surgical case carts containing the prepared and sterilized instrument trays are prepared and brought to the operating room. There the case carts are unpacked and the sterilized instruments are spread out on the instrument tables next to the operating table so that the instruments are within easy reach.

[0004] US2014 / 0083886 A1 discloses a modular instrument tray in which instrument holders can be inserted and fastened into predetermined hole positions of the instrument tray and the instrument holders by means of separate spring pins.

[0005] US 2014 / 0069841 A1 also discloses a modular instrument tray with universal holders for attaching instruments in the instrument tray.

[0006] US 2011 / 0005342 A1 discloses a robotic system for the automated loading and unloading of an instrument holder with sterilizable instruments, wherein the instruments are gripped by the robot and captured by a camera.

[0007] The aim of the invention is to reduce the complexity of the surgical instrument cycle and thus reduce the costs and duration of an instrument cycle. In particular, the handling of the instrument trays is to be simplified and preferably at least partially automated. These and other objects are at least partially achieved by a system according to claim 1 and a method according to claim 9. 3. Content of the invention

[0008] The present invention relates to a system comprising an instrument tray and a manipulator which is configured to load this instrument tray with surgical instruments and / or to remove instruments from the instrument tray.

[0009] The instrument tray for storing and providing surgical instruments, comprising a container for holding surgical instruments, wherein the container is provided with unique visual markers for individual instruments. This allows instruments to be assigned unique instrument positions in the container. An instrument tray is understood herein to be any type of device suitable for holding surgical instruments and having corresponding drainage openings that allow the instrument tray with the instruments contained therein to be rinsed. For example, the instrument tray can comprise a metal wire basket into which the instruments are placed and which, together with the instruments, can be inserted into a suitable rinsing device.This allows the cleaning and disinfectant agents to drain away easily, allowing the instrument tray and the cleaned instruments to be removed from the rinsing device in one piece. The container for holding the instruments has a unique position for each individual instrument, which is defined by the marker. This means that the instruments are not placed loosely and in a disorganized manner in the container; instead, each instrument has its own, clearly assigned place in the container. This offers the advantage, among other things, that the instruments can be prepared in their entirety in the container in the operating room, for example, and no longer have to be manually removed from the container and placed on the operating table before the operation. All instruments are located in clearly defined and marked places, eliminating the need to manually arrange the instruments on the instrument tables next to the operating table.It is particularly advantageous if these instrument trays can be sterilized as a whole, i.e. with the fully loaded instruments. The loaded and sterilized instrument trays then remain in this state and do not need to be repackaged. Furthermore, it is generally advantageous if the instrument trays are approximately the size of the instrument tables. This allows the instruments to be prepared on the instrument tables in the operating room without the need to manually remove the instruments from the tray. Instead, the operating surgeon or an assistant can remove the instruments directly from the tray as needed during the operation. Furthermore, the markers are advantageously attached detachably so that the instrument positions, and if necessary the type of instrument, can be freely and individually adjusted.

[0010] The visual markers are preferably silhouettes of the individual instruments. These are particularly preferably the same size as the instruments they represent. Each silhouette is located exactly where the respective instrument should be positioned. In this way, empty spaces are immediately visible and incorrectly loaded instruments can be identified immediately and easily. The use of clear visual markers, such as the aforementioned silhouettes, in particular enables automated handling of the instrument trays according to the invention. The markers make it possible to easily and reliably determine the loading status of an instrument tray, for example using computer-aided image processing. This is not possible with prior art instrument trays, since they involve a large number of instruments being arranged randomly and one on top of the other.Using silhouettes of individual instruments as markers simplifies reliable automated image capture and processing of instrument trays. The silhouettes are also a valuable tool, especially for manual visual inspection or manual refilling, which can increase the quality and efficiency of the instrument cycle.

[0011] Preferably, the container has retaining clamps designed to hold the instruments releasably and with some play. The instruments should not be held too tightly, as they may need to be easily and quickly removed during surgery. A retaining clamp with play is also advantageous so that the instruments can be fully wetted by the cleaning fluids during a cleaning procedure.

[0012] Particularly preferably, the retaining clips are provided with fastening pins, and the container has openings through which the pins can be guided. The pins are designed to be deformable in order to fix the retaining clips to the container. Such retaining clips allow the instrument trays to be individually loaded because they can be freely positioned and fixed to the container together with the visual markers. For this purpose, the pins are guided through corresponding openings in the container, such as openings in a wire basket if the container is designed as a wire basket, and then the pins on the underside of the container are bent, thereby fixing the retaining clips to the container. This can be done in the clinic itself if necessary, since the pins can be bent using simple pliers if necessary.

[0013] Preferably, the holding clamps each have two spring arms configured to releasably and loosely hold a portion of an instrument between them. The springs are arranged relative to one another in such a way that they form a snap connection with the instruments to be held. This allows for easy loading of the container with instruments while still ensuring simple and convenient removal of the instruments from the container, for example, during surgery.

[0014] The instrument tray is generally preferably autoclavable. All materials of the instrument tray are therefore preferably selected so that the instrument tray can be placed directly in an autoclave and sterilized there without further modification. The instrument tray is preferably made of metal.

[0015] The instrument tray features coupling devices designed to position the instrument tray in a surgical case cart. This ensures safe transport of the instrument trays.

[0016] Generally, the instrument positions in the container are preferably arranged on one level so that the instruments in the container do not overlap, or do not overlap significantly. This is in contrast to the prior art, where the instruments are tightly packed, bundled, or stacked in small baskets before an operation, or (e.g., after the operation) are randomly arranged in the baskets or are randomly thrown into the baskets. By arranging the instruments on one level, i.e. next to one another, it is now possible to handle the instruments automatically, for example using a suitable manipulator. In addition, the arrangement on one level allows the loaded instrument tray to be used directly in the operating room. It is no longer necessary to remove the instruments from the tray and place them on the table, as the instrument tray itself already provides suitable storage. This significantly shortens the surgical preparation time.

[0017] As explained above, the instrument tray according to the invention allows for the automation of the loading and handling process of the tray. Since each instrument has a unique position in the tray, the trays according to the invention make it possible to handle the instruments contained therein, for example, partially or fully automatically using a manipulator.

[0018] Manipulators, and especially robots, are programmable machines designed specifically for the automatic handling or processing of objects or workpieces. A typical example of such manipulators is so-called articulated-arm robots, which have a multitude of links that are connected to each other via corresponding joints. A tool holder is typically provided at one free end.

[0019] The system further comprises an image recognition unit with a camera for image capture and an image processing device. The image recognition unit transmits information about the loading status of the instrument tray to the control device of the manipulator. The control device is configured to control the manipulator using the information to load and / or remove instruments from the instrument tray. The system thus allows automated detection of the loading status and automated control of the manipulator, for example, to detect incorrectly positioned instruments and automatically arrange them correctly, to replace missing instruments, or to specifically remove certain instruments from the instrument tray.

[0020] The system also includes a surgical case cart, which is suitable for holding instrument trays, and an automated guided vehicle (AGV) for moving the case cart. Automated guided vehicles are floor-mounted conveyors with their own drive, which are automatically controlled and guided without contact. The use of such conveyors can further simplify the automation of instrument tray handling.

[0021] The system further comprises a sterilization device, wherein the control device of the manipulator is configured to grasp the instrument tray upon detection of a full or substantially full loading state and move it into the sterilization device, and to remove it again after completion of the sterilization process. Detection of the loading state is simplified by the special features of the instrument tray according to the invention, allowing reliable detection and handling of the tray by a manipulator.

[0022] In general, it is advantageous if the instrument tray is provided with unique, machine-readable codes. This allows different trays to be clearly identified, simplifying automated handling.

[0023] The invention also relates to a method for at least partially automated handling of an instrument tray of the system as described herein, comprising the following steps: providing an instrument tray according to the invention; providing a manipulator with an associated image recognition unit, comprising a camera for image acquisition and a device for image processing; capturing an image of the instrument tray and recognizing the loading state by means of the image recognition unit; controlling the manipulator, taking into account the loading state, for loading and / or removing instruments from the instrument tray.

[0024] Due to the predefined instrument positions in the instrument tray according to the invention, automation with manipulators and the aid of image processing is possible. For example, instrument trays containing missing parts can now be automatically detected by image processing and, if necessary, completed or corrected. Robotic loading of the instrument trays is advantageously possible due to the precisely predefined instrument positions. The integration of robots supports the reliability of sterilization, as robots can be operated germ-free. The image processing device can, for example, be a specially configured computer, or it can be integrated into the manipulator control system, or it can share hardware components with it.

[0025] In the present method, the manipulator is preferably controlled in such a way that the manipulator equips empty instrument positions. This does not necessarily require all empty positions to be equipped; it is also conceivable for the manipulator to only equip certain, predefined positions.

[0026] Further preferably, the manipulator is controlled in such a way that the manipulator removes selected instruments upon instruction from a user. This can occur, for example, during a surgery when a robot hands the instruments to the surgeon.

[0027] When a full or essentially full loading state is detected, the following steps are performed: The manipulator grasps the instrument tray; moves the instrument tray into a sterilization device using the manipulator; performs a sterilization process in the sterilization device; and then removes the sterilized instrument tray from the sterilization device using the manipulator. Image processing enables the system in the present method to automatically detect whether, for example, an instrument tray is fully loaded or has a loading according to specific specifications. In this case, the manipulator can automatically feed the tray to a sterilization device. Since the sterilized tray does not have to be handled manually by a person but can be removed by the manipulator, the tray remains sterile.

[0028] After removing the sterilized instrument tray using the manipulator, the following steps are carried out: arranging the instrument tray using the manipulator in a surgical case cart; and moving the case cart to an operating room using an automated guided vehicle. The instrument tray is designed so that it can be arranged in a surgical case cart. For automated handling, a machine-readable code (such as a barcode, QR code, slotted grid, etc.) is preferably provided on each instrument tray at suitable positions. The code also advantageously allows for unique identification of the tray, for which purpose, for example, corresponding information can be stored in a database. The case cart advantageously has a corresponding drawbar for connecting to the transport vehicle so that the automated guided vehicle can couple to the case cart and move it.For this purpose, the case cart can, for example, have machine-readable markings so that a transport vehicle equipped with image recognition can automatically identify which case cart is to be moved. 4. Description of preferred embodiments

[0029] Preferred embodiments of the invention are explained in detail below with reference to the drawings. Figure 1a schematic plan view of an instrument tray; Figure 2aa schematic, sectional side view of the instrument tray of Figure 1 ; Figure 2b shows a schematic detailed representation of a holding clamp; and Figure 3 shows a schematic representation of a system for the automated handling of instrument trays.

[0030] Figure 1shows an instrument tray 10 for storing and arranging surgical instruments. The system comprises a container 12 for holding the instruments, which is in the form of a wire basket. The container 12 does not necessarily have to have a basket or mesh; rather, it is essential that the bottom of the container is perforated so that cleaning or sterilization fluid can drain away if necessary. The bottom of the container 12 is provided with a series of unique visual markers 14. In the illustrated embodiment, the markers 14 are silhouettes of the individual instruments that are to be attached at the specified position. The markers or silhouettes 14 have the same shape and size as the instruments they represent. Figure 1The schematically illustrated surgical instruments are therefore not intended to represent the instruments themselves, but only silhouettes of the instruments. Each silhouette or marker 14 is additionally assigned an individual machine-readable code 15, with which the associated instrument can also be uniquely identified. The instrument tray 10 also has a machine-readable code 17 with which the tray can be uniquely identified. An alphanumeric designation 18 for the tray is arranged next to the code 17. The reference numerals 11 denote coupling devices with which the tray can be arranged, for example, in a surgical case cart. The coupling devices 11 can also serve as handles for a manipulator or a human user. Advantageously, all instrument positions in the container 12 are arranged in one plane so that the instruments in the container do not overlap.Each instrument position, which is defined by a marker or a silhouette 14, is assigned one or more holding clamps 20, with which the respective instruments can be held releasably and with play.

[0031] In Figure 2a the sieve is made of Figure 1 shown in a schematic, sectional side view. The reference numerals 16 designate various surgical instruments (of which only schematic cross-sections are shown in the figure) which are held by the holding clamps 20. In the embodiment shown (see also Figure 2b ) Each retaining clamp comprises two spring arms 22, 23, which are elastically mounted on a base 25 by means of springs 24. The base 25 is provided with one or more fastening pins 21, which can be inserted through openings in the bottom of the container 12, so that the fastening pins 21 extend from the bottom of the container 12. This is shown in Fig. 2bshown for the left mounting clamp. The mounting pins 21 are deformable and can be bent to fix the retaining clamps to the bottom of the container 12. This is shown in Fig. 2b shown for the remaining mounting clamps. This allows the retaining clamps to be individually configured and secured in container 12 as required.

[0032] Figure 3is a schematic view of a system for the partially or fully automated handling of instrument trays 10. The system comprises a manipulator 30, which is provided in the form of an articulated-arm robot. The manipulator 30 carries a gripper 31 with which surgical instruments can be gripped. An instrument tray 10 is provided on a table 36. An image recognition unit 40 with a camera 41 for image acquisition and an image processing device 42 is arranged such that it can capture images of the interior of the instrument tray 10. The image recognition unit 40 is configured to transmit information about, for example, the loading status of the instrument tray 10 to a control device 34 of the manipulator 30.The control device 34 of the manipulator 30 can then, in turn, control the manipulator 30 accordingly, for example, to remove or add instruments from the tray 10, taking into account the information about the loading status. The system shown also includes a surgical case cart 60 in which additional instrument trays 10 are arranged. The case cart 60 is coupled to an automated guided vehicle 70 by means of drawbars 61 and 71. The automated guided vehicle 70 can thus move the case cart 60 autonomously, for example, from a warehouse to an operating room. Furthermore, a sterilization device 50 is provided, such as an autoclave, and the control device 34 of the manipulator 30 is configured, for example, to move instrument trays 10 into the sterilization device 50 and to remove them from it again.The image recognition unit 40 can, for example, use the silhouettes 14 to identify which instruments need to be arranged in which positions. Alternatively or additionally, the image recognition unit 40 can also capture the various machine-readable codes 15 and 17 and process them accordingly.

[0033] Preferably, the case cart 60 also has machine-readable codes so that, for example, transport vehicles 70 equipped with appropriate image recognition devices can identify the case cart 60. For example, the central sterilization department of a clinic may have a warehouse of fully stocked and sterile instrument trays that can be added as needed. The warehouse may be operated by a storage robot, and the transport vehicles 70 can automatically pick up the required case carts for specific operations.

[0034] In a preferred embodiment, the instrument trays are provided in various configurations containing various surgical instruments. For example, instrument trays can be provided with a basic configuration that is required for virtually every operation, while other specialized instrument trays contain only specific instruments that are used depending on the operation. List of reference symbols:

[0035] 10Instrument tray 11Coupling device 12Container 14Marker (silhouette) 15Machine-readable code 16Surgical instrument 17Machine-readable code 18Alphanumeric code 20Retaining clamps 21Fastening pin 22, 23Spring arms 30Manipulator 32Gripper 34Manipulator control device 36Table 40Image recognition unit 41Camera 42Image processing device 50Sterilization device 60Surgical case cart 61Case cart drawbar 70Automated guided vehicle 71Automatic guided vehicle drawbar

Claims

1. System comprising an instrument tray comprising a container (12) for receiving surgical instruments (16), wherein the container (12) is provided with dedicated visual markers (14) for individual instruments in order to assign instruments to dedicated instrument positions in the container, and a manipulator (30) configured to furnish the instrument tray (10) with surgical instruments (16) and / or remove instruments (16) from the instrument tray, and further comprising a sterilization device (50) and a control device (34) of the manipulator (30), having an image recognition unit (40) with a camera (41) for image capture and with an image processing device (42), wherein the image recognition unit (40) of the control device (34) of the manipulator (30) transmits information concerning the furnished state of the instrument tray (10), characterized in that the system comprises a surgical case cart (60) configured to receive the instrument tray (10), and a driverless transport vehicle (70) for moving the case cart (60), and in that the instrument tray (10) has coupling devices (11) configured for arranging the instrument tray (10) in the surgical case cart (60), and in that the manipulator control device (34) is configured to actuate the manipulator (30), using the information, to furnish and / or remove instruments from the instrument tray (10) and, when a fully or substantially fully furnished state is recognized, to grip the instrument tray (10) and move it into the sterilization device (50) and, after completion of a sterilization process, to remove it again and arrange it in the surgical case cart (60).

2. System according to Claim 1, characterized in that the markers (14) are silhouettes of the individual instruments, wherein the silhouettes are preferably the same size as the instruments that they represent.

3. System according to Claim 1 or 2, characterized in that the container (12) has holding clamps (20) which are configured to hold the instruments releasably and with play.

4. System according to the preceding claim, characterized in that the holding clamps (20) have fastening pins (21), and the container (12) has openings through which the pins (21) can be guided, wherein the pins (21) are configured deformably for fixing the holding clamps (20) on the container (12) .

5. System according to either of Claims 3 and 4, characterized in that the holding clamps (20) each have two spring arms (22, 23), which are configured to receive between them a part of an instrument (16) releasably and with play.

6. System according to one of the preceding claims, characterized in that the instrument tray (10) can be autoclaved.

7. System according to one of the preceding claims, characterized in that the instrument positions in the container (12) are arranged in one plane, such that the instruments (16) in the container (12) do not overlap.

8. Method for at least partially automated handling of an instrument tray in a system according to one of Claims 1 to 7, comprising the following steps: making available such an instrument tray (10); making available a manipulator (30) having an associated image recognition unit (40) comprising a camera (41) for image capture and an image processing device (42); capturing an image of the instrument tray (10) and recognizing the furnished state by means of the image recognition unit (40); actuating the manipulator (30), in consideration of the furnished state, so as to furnish and / or remove instruments from the instrument tray (10), wherein, when a fully or substantially fully furnished state is recognized, the following steps are carried out: gripping of the instrument tray (10) by the manipulator (30); movement of the instrument tray (10) into a sterilization device (50) by means of the manipulator (30); performance of a sterilization procedure in the sterilization device (50); and then removal of the sterilized instrument tray (10) from the sterilization device (50) by means of the manipulator (30), and wherein, after removal of the sterilized instrument tray by means of the manipulator, the following steps are carried out: placement of the instrument tray into a surgical case cart (60) by means of the manipulator; movement of the case cart to an operating theatre by means of a driverless transport vehicle (70).

9. Method according to the preceding claim, characterized in that the actuation of the manipulator (30) takes place in such a way that the manipulator (30) furnishes empty instrument positions.

10. Method according to one of the preceding method claims, characterized in that the actuation of the manipulator (30) takes place in such a way that the manipulator (30) removes selected instruments (16) on the instructions of a user.