Medical robot with different end effectors, robotic system and control method for a medical robot

Abstract

The disclosure relates to a medical collaborative robot (1), in particular a surgical collaborative robot, for actuating an end effector (2, 4) when examining or performing a procedure on a patient (P), having: a robotic base (6) as local connection point for the robot (1), a movable and actuatable robotic arm (8) connected to the robotic base (6) and having at least one robotic arm segment (10), at least two end effectors (2, 4) connected to the one robotic arm (8), a first end effector (2) being a visualization unit (12) with a visualization axis (14) and a second end effector (4) being a medical instrument unit (16) having an instrument (20) and an associated instrument axis (18), in particular having a surgical instrument, and a control unit (22) which is adapted to control the spatial pose of the visualization unit (12) or the spatial pose of the instrument (20) for a procedure by means of the actuatable robotic arm (8). Additionally, the disclosure relates to a robotic system (100), a control method and also a computer-readable storage medium and computer program according to the alternative independent claims.

Description

[0001] Medical robot with different end effectors, robot system and control method for a medical robot

[0002] Description

[0003] Technical area

[0004] The present disclosure relates to a medical, in particular surgical, collaborative robot for actuating an end effector. Furthermore, the disclosure relates to a medical robot system, a computer-implemented control method for a medical robot, a computer-readable storage medium, and a computer program according to the preambles of the independent claims.

[0005] Background of the present disclosure

[0006] Medical robots continue to advance in the field of medical technology and are becoming increasingly important in surgical procedures due to technological advances. However, commercial robots focus either on guiding surgical instruments ("robot hand") or on visualization ("robot eye"). Surgeons, however, require both better instrument guidance and better visualization during a procedure—improvements in both modalities. This need is growing in tandem with the trend toward smaller incisions, which limit the dexterity of a surgeon's hand and the surgeon's vision.

[0007] The use of both robot-based solutions requires two separate devices, usually on two different medical carts, which severely limits space in the operating room and significantly increases both the initial investment and maintenance costs. Furthermore, the robot visualization and robot instrumentation are not initially synchronized in the two modules, as they can be set up in different locations in the operating room and have a different (spatial) relationship to the patient. Establishing appropriate synchronization requires a certain amount of setup time both before and during the operation, which overall leads to a longer operating time and is detrimental to a good surgical outcome. This can also lead to surgeon fatigue. In addition, access and a clear field of vision for the surgeon are also complicated.

[0008] Summary of the present disclosure

[0009] It is therefore the object of the present disclosure to avoid or at least mitigate the disadvantages of the prior art and, in particular, to provide a medical robot, a robot system, a control method, a computer-readable storage medium, and a computer program that can be used in a compact, flexible, effective, yet precise, and safe manner. A sub-objective can be seen in the use of an end effector in a more space-saving, time-saving, yet precise manner. In particular, a sub-objective lies in the ability to flexibly use different end effectors for an examination or procedure intraoperatively, i.e., during the procedure, and to switch between them. Cost-effective production and maintenance should also be possible.

[0010] The object of the present disclosure is solved according to the invention with regard to a medical robot by the features of claim 1, with regard to a robot system by the features of claim 10, with regard to a computer-implemented control method for a robot by the features of claim 11, with regard to a computer-readable storage medium by the features of claim 12 and with regard to a computer program by the features of claim 13.

[0011] A basic idea of ​​the present disclosure therefore provides for two different modalities optimized in terms of installation space using only a single robot having a single robot base, and in which in particular a medical, mobile cart forms the robot base, which can be moved freely in the room (operating room), namely on the one hand a visualization modality by means of the visualization unit / visualization device (for visual detection by means of a recording) and on the other hand an instrument modality / intervention modality / manipulator modality by means of the instrument unit with the instrument.Similar to a tool turret with a tool holder for a variety of tools for different processing steps in the field of general mechanical engineering, in the field of medical technology, a single robot with its (single) local reference point at its robot base provides two modalities via its two different end effectors, which the surgeon can select and use as needed during the procedure. Due to the special design with a uniform robot base, no further initial synchronization of the visualization unit and the instrument unit is necessary. The robot base can be arranged at various locations in the operating room, with both the visualization and the instrumentation (already synchronized with each other) being provided equally.

[0012] The advantages of this combined medical robot according to the present disclosure can be seen in a reduced space requirement in an operating room as well as a reduction in required investment and maintenance costs. The combination can also shorten operating times and improve surgical outcomes. Likewise, production costs are lower, since multiple end effectors can be controlled via the single robot base with the single robot arm.

[0013] In other words, a medical robot with (automatic) positioning and alignment of a visualization unit / imaging unit (as the first end effector) and an instrumentation unit (as the second end effector) is disclosed. The medical robot therefore has two end effectors, one for visualization or imaging and one for instrumentation for a corresponding manipulation, for example of a patient's tissue. The end effectors can be mounted or (fixedly) stored or provided on a single robot arm or on two separate robot arms (one robot arm with visualization, one robot arm with instrument) but with a uniform robot base. The system preferably further comprises a tracking unit orSensor unit to locate the exact position and / or orientation, in particular the attitude, of the two end effectors with respect to the (registered) patient (in particular a position of an instrument tip) and to use various control mechanisms to move the robot for actuation of one or the other end effector.

[0014] In other words, according to the present disclosure, a medical, in particular surgical, collaborative robot is provided for actuating an end effector during an examination or intervention on a patient, comprising: a robot base as the local connection point of the robot, a movable and actuatable robot arm connected to the robot base and having at least one robot arm segment, at least two end effectors connected to the one robot arm, wherein a first end effector is an (analog or digital) visualization unit (Z-device) having a visualization axis, and a second end effector is a medical instrument unit having a medical instrument and an associated instrument axis, in particular having a surgical instrument, and a control unit adapted therefor,to control the spatial position of the visualization unit or the spatial position of the instrument for an examination or intervention using the actuatable robot arm. In particular, the position of an instrument tip of the instrument can be adjusted via the position of the instrument unit with the instrument. In particular, an instrument tip is not located in the field of view of the (optical) visualization unit, and the optical visualization axis and the instrument axis are separate from each other. A single robot arm is therefore used to carry and guide the visualization unit and the instrument unit, thus serving both the visualization and instrument guidance modalities. In other words, the robot has only one robot arm for the instrument, with the instrument unit for guiding the instrument being provided on the same robot arm as the visualization system.In particular, it is permanently mounted. In particular, the visualization unit and the instrument unit can be used separately (i.e., not simultaneously) during a surgical procedure. Two different modalities are provided with just one robotic arm.

[0015] The term "position" refers to a geometric position in three-dimensional space, which is specified in particular using coordinates of a Cartesian coordinate system. In particular, the position can be specified by the three coordinates X, Y, and Z.

[0016] The term "orientation," in turn, indicates an alignment (e.g., position) in space. One could also say that orientation indicates an orientation with a direction or rotation specification in three-dimensional space. In particular, orientation can be specified using three angles.

[0017] The term "attitude" encompasses both position and orientation. In particular, attitude can be specified using six coordinates: three position coordinates X, Y, and Z, and three angular coordinates for orientation.

[0018] Advantageous embodiments are claimed in the subclaims and are explained in particular below.

[0019] Preferably, an instrument unit adapter can be arranged on the robot arm and / or the visualization unit, to which the medical instrument unit can be coupled and decoupled / uncoupled by means of a predefined, complementary counter-adapter, in particular without tools, so that the instrument unit can be removed with the instrument and in particular replaced with another, different instrument. The instrument unit for instrument guidance can thus be mounted and dismounted intraoperatively, i.e. during the operation, relative to the visualization system, via the adapted and specially suitable adapter interface. Preferably, no tools need to be used (tool-free replacement), so that simple manual operation is sufficient for a change during the operation. This saves time and simplifies, for example, the exchange process.In particular, a further visualization unit, in particular with an endoscope, can be mounted to the instrument unit adapter with a corresponding counter-adapter. In this way, different "units" or "modules" can be interchanged via the "standardized" instrument unit adapter. For example, a surgical microscope can be used as the (first main) visualization unit, an instrument can be initially coupled and used using the instrument unit, and during the course of the procedure, the instrument unit can be decoupled and a further, second visualization unit in the form of an endoscope can be coupled instead, in order to be able to use both the modalities of the surgical microscope and the endoscope separately, in particular at different times, for example alternately.

[0020] Preferably, alternatively or in addition to the instrument unit adapter, a special visualization unit adapter can be arranged on the robot arm and / or the (first main) visualization unit and / or on the instrument unit, to which, in the case that the (first) visualization unit is designed to be adaptable, the first visualization unit can be coupled and uncoupled to the robot arm or to the instrument unit, or in the case that a further (second) medical visualization unit is used, by means of a predefined, complementary counter-adapter, in particular without tools, so that the visualization unit can be removed and in particular replaced with a different visualization unit.In particular, the (first) visualization unit can be a surgical microscope and the (second) visualization unit coupled via the visualization unit adapter can be an endoscope, so that in addition to the modality of a surgical microscope, the collaborative robot can also control an endoscope and use it during an intervention.

[0021] According to one embodiment, the visualization unit can have a rigid spatial relationship (rigid fixation) with respect to the medical instrument unit, and the control unit can be adapted to determine the position of the instrument unit using a predefined static transformation based on the position of the visualization unit, or to determine the position of the visualization unit based on the position of the instrument unit, in order to control the position of the other end effector, in particular based on the detected position of one end effector. In particular, the visualization unit and the instrument unit (for instrument guidance) have a fixed spatial position or relationship relative to one another. In particular, there is only a single (localization) sensor / tracker that spatially tracks / tracks either the visualization system or the instrument guidance system. The position of the other unit can then be determined via the rigid relationship.

[0022] According to a further embodiment, exactly one tracker or navigation sensor / localization sensor can be provided on the at least two end effectors. In particular, either a tracker, in particular a rigid body with optical markers, is attached to the visualization unit or a tracker is attached to the instrument unit. The control device is adapted to determine the position, in particular the orientation, of both the instrument (with instrument tip) and the visualization unit by tracking the single tacker and the predefined rigid spatial relationship of the visualization unit to the instrument unit. With only a single sensor / tracker, the position, in particular the orientation, of both the visualization unit and the instrument guide can be tracked.

[0023] Preferably, alternatively or in addition to a tracker (for example in the form of a rigid body with optical markers), the position and / or orientation of a selected end effector of the at least two end effectors can be determined via robot kinematics of the robot. The robot with its at least one robot arm therefore has an internal tracking system (without the need for an external camera for tracking) that is designed based on kinematics. For example, the robot can have sensors on the robot arm segments that detect the position of the robot arm segments relative to one another and (the control unit is adapted for this purpose) thereby determine the position and / or orientation of the first and second end effectors with respect to the robot base (for example via a static transformation of the end effectors relative to one another and to the robot head).In particular, the control unit can be adapted to determine the position and / or orientation via active control of the robot arm (e.g., with stepper motors) with a known transformation from the robot head to the selected end effector. In particular, the robot base has a tracker if it is not in a static spatial position relative to the patient, i.e., is not permanently connected to the patient, which can be detected by a tracking system, in particular an external navigation camera. Thus, in particular, by additional detection of the patient, the patient can be registered with the robot via the optically tracked robot base, and together with the robot kinematics, the position and / or orientation of the selected end effector relative to the patient can be controlled.

[0024] In particular, the instrument axis of the instrument can be aligned such that it does not intersect the visualization axis. In particular, the instrument axis and the visualization axis diverge from each other starting from the two end effectors, so that the instrument does not impair the visualization of the visualization unit, in particular, is not visible in the field of view of the visualization unit. In other words, the visualization axis of the visualization system and the instrument axis of the instrument guide preferably do not intersect, so that no instrument tip is visible in the field of view of the visualization system, and the visualization system (as a modality) can be used to its full extent without any disadvantages.

[0025] According to one embodiment, the visualization axis, starting from a front side of the visualization unit, can have a distance of at least 10 cm, preferably at least 30 cm, and particularly preferably at least 50 cm from the instrument axis at a distance along the visualization axis of (at least 10 cm and / or) a maximum of 60 cm. This eliminates any negative influence on the visualization even with longer instruments.

[0026] In particular, the visualization unit can be a surgical microscope, in particular an optical (surgical) microscope or a digital (surgical) microscope, or an endoscope or an ultrasound probe, which generates 2D images or 3D images, and / or the instrument unit can have a drilling or guide sleeve for trajectory guidance or a resection instrument, in particular a forceps or a suction tube or a scalpel, or a cutting block, in particular a knee cutting block. In particular, in addition to a first visualization unit, a second, different visualization unit can also be attached to the robot arm, for example a microscope and an ultrasound probe. The visualization unit can therefore preferably be a microscope, an endoscope, or an ultrasound probe. The visualization unit can generate two-dimensional 2D images or three-dimensional 3D images.The visualization unit can, in particular, be an optical microscope or a digital microscope. The instrument unit, in turn, can be equipped with trajectory guides, such as a drill or guide sleeve, or with a resection instrument, such as a forceps, a suction tube, or a scalpel, or with a cutting block, such as a knee cutting block. The term "3D" defines that the data is spatial, i.e., three-dimensional. The patient's body, or at least a spatially extended portion of the body, can be digitally represented as image data in a three-dimensional space, for example, with a Cartesian coordinate system (X, Y, Z).

[0027] According to a further embodiment, the medical robot can further comprise a navigation system with at least one display device, in particular a surgical monitor, and the control unit can control the robot with the end effectors based on the navigation system, in particular moving to waypoints for a selected end effector of the at least two end effectors and adjusting a position of the selected end effector accordingly, preferably based on a preoperatively defined surgical plan. The navigation system enables the robot to automatically move to waypoints and, for example, automatically provide a visualization of a tissue or to place the instrument in the correct position and, for example, perform an automated operation on a tissue. In this way, for example, an operation can be performed and the surgical result can be shown to the surgeon using the visualization unit.The surgeon can also authorize steps of the procedure, for example via a touch display, and allow the robot to proceed. In particular, the control unit can be specially adapted to: either navigate and control the instrument unit with the instrument and its instrument axis for navigation as the selected end effector for the procedure; or navigate and control the visualization unit with its visualization axis for navigation as the selected end effector for visualization. The medical robot therefore offers a user the option of selecting either the visualization unit or the instrument unit in order to determine the corresponding axis of interest (either the instrument axis or the visualization axis) that will be tracked and moved by the robot (via the control unit and a tracking system, in particular a navigation system).

[0028] In particular, the robot arm and thus the end effector can be controlled manually using a force sensor, which is in particular attached to an end effector, preferably integrated into a handle attached to the corresponding end effector. In particular, in the case where a first force sensor is attached to the visualization unit and a further, second force sensor is attached to the instrument unit, the surgeon can select and control the corresponding end effector by operating the respective associated force sensor. Alternatively or additionally (e.g., by switching between a manual and automatic mode via user input or in a time-controlled or step-controlled manner), the robot arm with the selected end effector can also perform an automatic movement derived from a preoperative (image-based) plan (e.g., based on CT scans).Alternatively or additionally, the robot arm with the end effector can also be controlled by remote control device(s) such as voice control and / or an external joystick and / or gesture control and / or head control and / or eye control. The preoperative image-based plan can be a predefined trajectory for moving the instrument unit or a predefined waypoint for moving the visualization unit into it. Furthermore, the robot arm for visualization can preferably be controlled by the control unit via the visualization unit such that it follows the surgical tool, while the surgical tool is tracked either by machine vision by the visualization unit itself or by an external tracking system such as a navigation system.

[0029] In particular, the medical robot has only one robot arm with two end effectors, one for visualization and one for instrumentation. The two end effectors are firmly connected to each other, so that only one localization system (especially a navigation tracker) is required. Alternatively, the two end effectors can be coupled, preferably with a manual joint, so that two separate localization systems (especially a navigation tracker) are required. The joint can have between one and six degrees of freedom. The joint can be used, for example, for the coarse alignment of the instrument guide, which means that the robot arm needs to be moved less and is required less for movements over long distances. After coarse alignment, the joint can be locked or fixed (a spatial relationship between the instrument unit and the visualization unit becomes statically fixed).Since the instrument guide (i.e., the instrument unit) is located separately, the robot arm can be used for fine-tuning the instrument guide to enable precise alignment of the instrument. In particular, the medical robot can also have a robot arm with interchangeable end effectors for the visualization unit and / or the instrument unit.

[0030] In particular, the medical robot system can comprise a robot according to one of the preceding claims, wherein an instrument unit adapter is arranged on the robot arm and / or the visualization unit, and the robot system further comprises at least two different instrument units with different instruments (but) a similarly designed counter-adapter in order to equip the robot with different instruments as needed via a uniform interface. In this way, a set of instrument units can be provided that can even be changed intraoperatively. If the surgeon requires a scalpel as the first instrument in a first step and a surgical drilling tool or resection tool later in the procedure, the instrument unit with the scalpel can be removed, and the new instrument unit with the drilling tool or resection tool can be (removably) attached to the robot arm.In particular, a tool-free attachment is provided, allowing for quick, safe, and efficient changes. Another advantage is that only the instrument unit adapter needs to be sterile, while the rest of the robot can be covered with a sterile covering. Therefore, only the interface with the instrument unit adapter is crucial.

[0031] In particular, the medical robot system can also comprise an additional visualization unit with a similarly designed mating adapter, which can be coupled to and detached from the instrument unit adapter to provide an additional visualization modality. In particular, the additional connectable visualization unit can comprise an endoscope to provide an endoscope function during a procedure. In this way, the robot system provides a set of instrument units with both instruments and visualization units.

[0032] With regard to a computer-implemented control method for a medical robot for actuating a medical end effector during an examination or intervention on a patient, in particular a robot according to the present disclosure, the object is achieved in that it comprises the steps: preferably registering the patient by means of a navigation system; selecting either a visualization unit with a visualization axis or an instrument unit with an instrument and an associated instrument axis as the selected end effector (target end effector), both of which are connected as end effectors to a robot arm with at least one robot arm segment of the robot,wherein the robot arm is in turn connected to a robot base as a local connection point; tracking a position (position and orientation) of the selected end effector by the navigation system; controlling the selected end effector by means of the robot arm by a control unit such that the selected end effector is moved into a position according to a specification, preferably into a position relative to the registered patient. This control method can provide the surgeon with at least two different modalities: visualization and instrumentation. Preferably, in a (first) step, a preoperative plan, which includes, for example, CT-based trajectories for an instrument or for waypoints of a visualization,be read in. After this, in a further step, the patient can be registered against the preoperative images by a navigation camera of a navigation system. The end effector is selected as the selected end effector (target end effector), in particular an automatic selection based on a currently performed step in the surgical plan or through manual input. If the visualization unit is selected as the target end effector, the position, in particular the orientation, of the visualization unit is recorded and in the "mode" of visualization, the robot moves the visualization unit to the predetermined waypoints, in particular according to the surgical plan (the position of the end effector is adjusted accordingly). If, alternatively, the instrument unit is selected as the selected end effector (target end effector), the position,In particular, the position of the instrument unit and thus also of the instrument is spatially recorded and tracked (in particular, the instrument tip is known through a known transformation of the instrument or instrument unit). Then, in the instrumentation "mode," the robot moves the instrument unit according to a predetermined trajectory. Both alternatives lead to an optional subsequent step of performing the intervention. The surgeon can therefore select the mode in which they currently want to operate, whether they require visualization and move the visualization unit accordingly in the visualization mode (or have it move automatically based on the preoperatively defined surgical plan), or whether they require an instrument and the instrument unit is the selected end effector and moves accordingly.

[0033] With regard to a computer-readable storage medium and a computer program, the objects of the present disclosure are achieved in that the latter comprises instructions which, when executed by a computer, cause the computer to carry out the method steps of the control method according to the present disclosure. According to an independent aspect of the present disclosure, which can also be claimed completely independently in a further application, the medical robot can have two robot arms, wherein a first robot arm is equipped with a visualization unit as an end effector for visualizing the surgical field and a further, second robot arm is equipped with an instrument unit as an end effector for guiding a medical, in particular a surgical, instrument, which are connected to a single robot base.In this medical robot according to the independent aspect, the two robot arms are mounted (i.e., connected) to a single (integral) robot base, in particular on or connected to a medical cart. In particular, both arms can each have a (localization) sensor with which the exact position, in particular the orientation of the respective end effector, can be localized (for example, using a navigation camera and a tracked tracker as a (localization / orientation) sensor). The sensors can preferably be integrated into the robot arms or attached externally to the end effectors with trackers (such as optical markers). Preferably, the visualization unit on one robot arm can also be used as a visual sensor to localize the end effector of the visualization unit.Depending on the surgical indication, the two robot arms can be used sequentially (e.g., visualize first, then instrument), in parallel (e.g., visualize and instrument simultaneously), or independently of each other (in particular, only for visualization or only for instrumentation), and controlled accordingly by the control unit. In a synchronized mode, the control unit can preferably be adapted so that the two robot arms work together. The visualization unit can, for example, detect critical areas in space and localize the corresponding position in space, and the control unit can be adapted to control the instrument unit on the basis of these detected spatial critical areas (e.g., define them as a "no-go zone" for guidance) so that the instrument robot cannot collide with or collide with these areas.The disclosure in connection with the medical robot according to the present disclosure also applies to the medical robot according to the above independent aspect. The features can therefore be interchanged between these two variants. The visualization unit can preferably also be used to define surgical targets and locate their position in space, so that the instrument unit is guided to the surgical target.

[0034] Any disclosure related to the medical robot according to the present disclosure also applies to the control method according to the present disclosure and vice versa.

[0035] Short description of the characters

[0036] The invention is explained in more detail below using preferred embodiments with the aid of figures. They show:

[0037] Fig. 1 is a perspective view of a robot system comprising a robot with a robot arm and two end effectors according to a preferred embodiment, in which the two end effectors are in a rigid spatial relationship to each other;

[0038] Fig. 2 is a perspective view of another embodiment of the robot system comprising the robot and a robot arm with the two end effectors, in which a joint is provided between the instrument unit and the visualization unit, which can be manually adjusted to increase the range and speed of target detection and to exchange instrument units without tools;

[0039] Fig. 3 shows a system with two robot arms, one robot arm for visualization and one robot arm for instrumentation, in which a navigation camera is used as a tracking system to locate the position of the end effectors (according to an independently claimable aspect); and

[0040] Fig. 4 shows a flowchart of a control method according to an embodiment of the present disclosure. The figures are schematic in nature and are intended only to assist in understanding the invention. Like elements are provided with the same reference numerals. The features of the various embodiments can be interchanged.

[0041] Detailed description of preferred embodiments

[0042] Fig. 1 shows a schematic perspective view of a robot system 100 with a surgical collaborative robot 1 according to a first preferred embodiment for actuating two end effectors 2, 4, which is used during an examination or an intervention on a patient P.

[0043] The robot 1 has a robot base 6 as a local connection point, in this case a medical rolling cart, which is only indicated schematically. A robot arm 8 with at least one robot arm segment 10 is movably and actuatably mounted on the robot base 6. Two different end effectors 2, 4 are provided on the terminal free side of the robot arm 8. A first end effector 2 is a visualization unit 12 with a visualization axis 14 for visual (optical) recording, and a second end effector 4 is a medical instrument unit 16 with a surgical instrument 20 and an associated instrument axis 18. A control unit 22 of the robot 1 is adapted to control the spatial position of the visualization unit 12 or the spatial position of the instrument 20 for an intervention using the actuatable robot arm 8.Thus, the robot 1 has two end effectors 2, 4: one end effector 2 for visualization and one end effector for the instrument 20. Both end effectors 2, 4 are in a fixed spatial relationship to each other.

[0044] The configuration according to the present disclosure allows two end effectors 2, 4 to be operated independently of one another using just a single robot arm 8. This configuration is space-saving, safe, efficient, and also easy to set up and maintain, allowing intuitive operation by a surgeon. The surgeon only needs to keep an eye on one robot arm when it is operating in the surgical area and can perform the desired surgical steps, for example, first setting up a visual representation of a tissue that needs to be treated, then moving the instrument 20 into the desired position for an (automated procedure), and after the procedure, switching back to the visual representation to assess the surgical outcome.

[0045] An instrument unit adapter 24 is arranged on the robot arm 8 and / or the visualization unit 12, to which the instrument unit 16 can be coupled and decoupled by means of a predefined, complementary counter-adapter 26, so that the instrument unit 16 with the instrument 20 can be removed and replaced with another, different instrument 20'. The further instrument unit 16' with the second instrument 20' in the form of a scalpel can be exchanged for the first instrument 20. Thus, a medical professional can select the appropriate instruments 20, 20' intraoperatively, depending on the progress of the operation and as needed, and couple them accordingly to the robot 1 (removably and without tools).

[0046] In the embodiment shown in Fig. 1, the visualization unit 12 has a rigid spatial relationship with the instrument unit 16. The control unit 22 is adapted to switch between the position of the visualization unit 12 and the position of the instrument unit 16 using a static transformation stored in a memory and to calculate the other position. Thus, the position of the other end effector 2 can be controlled based on the detected position of one end effector 4. Since a static spatial relationship exists, only a single tracker 28, designed in the form of a rigid body with optical markers, is required. This tracker 28 is rigidly attached to the instrument unit 16.The control device 22 is adapted to determine the position of both the instrument 20 and the visualization unit 12 by tracking the single tacker 28 and the predefined rigid spatial relationship of the visualization unit 12 to the instrument unit 16, and to control the robot 1 accordingly via the robot arm 8. Thus, the robot 1 can perform either a visualization modality (visualization unit 12 is controlled as the end effector) or an instrumentation modality via the tracker 28, depending on the selection. Since only one tracker 28 is used, a potential collision or obstruction is less likely than if multiple trackers 28 must be used.

[0047] In this case, the visualization unit 12 is a digital surgical microscope 30, and the instrument unit 16 is a guide sleeve 32 into which a minimally invasive tool can be inserted. The instrument axis 18 of the instrument 20 is aligned such that it is parallel to the visualization axis 14 and thus does not intersect it. The instrument axis 18 serves to align and position the insertable tool, which the surgeon can operate manually, for example. This provides collaborative robotic support to the surgeon during the procedure.

[0048] The medical robot 1 further comprises a navigation system 34 with at least one display device in the form of a surgical monitor 36, and the control unit 22 controls the robot 1 with the two end effectors 2, 4 on the basis of the navigation system 34. In a visualization mode, waypoints are approached for the visualization unit 12 as the selected end effector 2 and the position of the visualization unit 12 is adjusted accordingly in relation to a patient P. In the further instrumentation mode, on the basis of a preoperatively defined surgical plan, the instrument unit 16 is defined as the selected end effector 4 and a position of the instrument unit 16 as the selected end effector 4 and thus the position of the instrument 20 is adjusted accordingly with the specification of the instrument tip.

[0049] This provides the surgeon with the option of selecting a mode. Through appropriate user input, for example via the surgical monitor, which is designed as a touch display, and requesting an end effector mode, the control unit then either controls the instrument unit 16 as the selected end effector 4 with the instrument 20 and its instrument axis 18 and is navigated and controlled accordingly for the procedure, or if the visualization unit 12 with its visualization axis 14 is selected for navigation, this is navigated and controlled accordingly as the selected end effector 2 for visualization. Fig. 2 shows a further embodiment of the robot system 100 and the robot 1 according to the present disclosure. The robot system 100 and the robot 1 as shown in Fig. 2 differ from that of Fig.1 in that a joint 38 is provided between the visualization unit 12 and the instrument unit 16 (as a serial connection). The joint 38, in the form of a ball joint, can be manually adjusted, in particular to increase the range and speed of target acquisition. The joint 38 is initially used by the surgeon for rough alignment, and the surgeon can use the joint to manually adjust the spatial relationship between the visualization unit 12 and the instrument unit 16. When the joint 38 is locked, i.e., the ball is frictionally fixed in the socket, the robot arm 8 subsequently performs a fine alignment of the instrument 20, controlled by the control unit 22. In this embodiment of Fig. 2, the visualization and instrumentation units have separate (navigation) racks 28.

[0050] Furthermore, the two axes 14, 18 are arranged such that the instrument axis 18 and the visualization axis 14 move away from each other starting from the two end effectors 2, 4, so that the instrument 20 does not impair the visualization of the visualization unit 12 and is not visible in the field of view of the visualization unit 12.

[0051] Fig. 3 shows an example of an independently claimable aspect that can be claimed in a further application. Here, two robot arms are connected to a single robot base, with a first robot arm supporting the first end effector 2 (in the form of a visualization unit, here a surgical microscope) and capable of adjusting its position in space accordingly, and a further robot arm guiding the second end effector 4 (in the form of an instrument unit with an instrument, here a guide bushing) and capable of adjusting the position of the instrument indirectly via the position of the instrument unit as the second end effector.

[0052] Fig. 4 shows a flowchart of a computer-implemented control method for a medical robot 1 for actuating a medical end effector 2, 4 during an examination or procedure on a patient according to a preferred embodiment of the present disclosure. This control method can be used in particular with the robot 1 of Figs. 1 or 2.

[0053] In a first (optional) step SO, a preoperative plan is read in, which provides predefined waypoints and steps.

[0054] Likewise, in a further optional step, registration S1 of the patient P is carried out using a navigation system 34.

[0055] In step S2, either a visualization unit 12 with visualization axis 14 or an instrument unit 16 with an instrument 20 and an associated instrument axis 18 is selected as the selected end effector, both of which are connected as end effectors 2, 4 to a robot arm 8 with at least one robot arm segment 10 of the robot 1, wherein the robot arm 8 is in turn connected to a robot base 6 as a local connection point.

[0056] Now the control procedure splits up depending on the selection (i.e. depending on the selected end effector).

[0057] If the visualization unit 12 is selected as end effector 2, in a step S3a a tracking of a position of the visualization unit 12 is carried out by the navigation system 34, in particular by a navigation camera of the navigation system 34 which tracks a tracker.

[0058] Subsequently, in a step S4a, the selected end effector 2 is controlled by the control unit 22 using the robot arm 8 such that the selected end effector 2, i.e., the visualization unit 12, is moved according to a specification into a predetermined position relative to the registered patient P, i.e., moves to a waypoint. A visual examination can then be performed at this waypoint. In an optional step S5, a robot-assisted visualization is then performed in this set position of the end effector 2.

[0059] If, however, the instrument unit 16 is selected as end effector 4 (as target end effector), the instrument unit 16 is tracked with the instrument 20 in a step S3b, and in a step S4b the control unit 22 again controls the position of the instrument 20. Thereafter, a robot-assisted intervention can be carried out in step S5, for example a robot-guided incision.

[0060] The control method thus allows for the optional selection of one of the two end effectors 2, 4, which can then be used (in isolation). Interaction between the two end effectors 2, 4 is also possible, for example, with the visualization unit continuously scanning a room and, if an obstacle is detected in the room, controlling the robot arm with the instrument in such a way that the instrument does not collide with the detected obstacle.

[0061] List of reference symbols

[0062] 1 robot

[0063] 2 first end effector

[0064] 4 second end effector

[0065] 6 Robot base

[0066] 8 Robot arm

[0067] 10 Robot arm segment

[0068] 12 Visualization unit

[0069] 14 Visualization axis

[0070] 16, 16' instrument unit

[0071] 18 Instrument axis

[0072] 20, 20' instrument

[0073] 22 Control unit

[0074] 24 instrument unit adapters

[0075] 26 counter adapters

[0076] 28 T racker

[0077] 30 surgical microscope

[0078] 32 guide sleeve

[0079] 34 Navigation system

[0080] 36 operating room monitor

[0081] 38 joint

[0082] 100 Medical Robot System

[0083] P Patient

[0084] 50-step preoperative plan read-in

[0085] 51 Step Registration Patient to Navigation System

[0086] 52 Step Selection of the End Effector

[0087] S3a Step Tracking the Visualization Unit

[0088] S3b Step Tracking Instrument Unit S4a Step Controlling the Position of the Visualisation Unit

[0089] S4b Step Controlling the Position of the Visualization Unit

[0090] S5 Step performing a robot-assisted surgical step

Claims

Claims 1. A medical, in particular surgical, collaborative robot (1) for actuating an end effector (2, 4) during an examination or an intervention on a patient (P), comprising: a robot base (6) as a local connection point of the robot (1), a movable and actuatable robot arm (8) connected to the robot base (6) and having at least one robot arm segment (10), at least two end effectors (2, 4) connected to the one robot arm (8), wherein a first end effector (2) is a visualization unit (12) having a visualization axis (14) and a second end effector (4) is a medical instrument unit (16) having an instrument (20) and an associated instrument axis (18), in particular having a surgical instrument, and a control unit (22) adapted therefor,to control the spatial position of the visualization unit (12) or the spatial position of the instrument (20) for an examination or an intervention by means of the actuatable robot arm (8).

2. Medical robot (1) according to claim 1, characterized in that an instrument unit adapter (24) is arranged on the robot arm (8) and / or the visualization unit (12), to which instrument unit adapter the medical instrument unit (16) or a further visualization unit can be coupled and uncoupled without tools by means of a predefined, complementary counter-adapter (26), so that the instrument unit (16) with the instrument (20) or the further visualization unit can be removed without tools and in particular can be replaced with a further, different instrument (20') or a further visualization unit.

3. Medical robot (1) according to one of the preceding claims, characterized in that the visualization unit (12) has a rigid spatial relationship with respect to the instrument unit (16), and the control unit (22) is adapted to determine the position of the instrument unit (16) via a predefined static transformation based on the position of the visualization unit (12). determine or, based on the position of the instrument unit (16), determine the position of the visualization unit (12) in order to control the position of the other end effector (4; 2) in particular on the basis of the detected position of one end effector (2; 4).

4. Medical robot (1) according to claim 3, characterized in that exactly one tracker (28) is provided on the at least two end effectors (2, 4), in particular either a tracker (28), in particular a rigid body with optical markers, is fixed to the visualization unit (12) or a tracker (28) is fixed to the instrument unit (16), and the control device (22) is adapted to determine the position of both the instrument (20) and the visualization unit (12) by tracking the single tacker (28) and the predefined rigid spatial relationship of the visualization unit (12) to the instrument unit (16).

5. Medical robot (1) according to one of the preceding claims, characterized in that the instrument axis (18) of the instrument (20) is aligned such that it does not intersect the visualization axis (14), in particular the instrument axis (18) and the visualization axis (14) move away from each other starting from the two end effectors (2, 4), so that the instrument (20) does not impair the visualization of the visualization unit (12), in particular is not visible in the field of view of the visualization unit (12).

6. Medical robot (1) according to one of the preceding claims, characterized in that the visualization axis (14), starting from a front side of the visualization unit (12), at a distance along the visualization axis (14) of a maximum of 60 cm, has a distance to the instrument axis (18) of at least 10 cm, preferably of at least 30 cm, particularly preferably of at least 50 cm.

7. Medical robot (1) according to one of the preceding claims, characterized in that the visualization unit (12) is a surgical microscope (30), in particular an optical surgical microscope or a digital surgical microscope, or a Endoscope or an ultrasound probe which generates 2D images or 3D images, and / or the instrument unit (16) has a drilling or guide sleeve (32) for trajectory guidance or a resection instrument, in particular a forceps or a suction tube or a scalpel, or a cutting block, in particular a knee cutting block.

8. Medical robot (1) according to one of the preceding claims, characterized in that the medical robot (1) further comprises a navigation system (34) with at least one display device, in particular an operating room monitor (36), and the control unit (22) controls the robot (1) with the end effectors (2, 4) on the basis of the navigation system (34), in particular waypoints for a selected end effector which moves to at least two end effectors (2, 4) and adjusts a position of the selected end effector accordingly, preferably on the basis of a preoperatively defined operation plan.

9. Medical robot (1) according to claim 8, characterized in that the control unit (22) is adapted to: either navigate and control the instrument unit (16) with the instrument (20) and its instrument axis (18) for navigation as a selected end effector (4) for the intervention accordingly, or navigate and control the visualization unit (12) with its visualization axis (14) for navigation as a selected end effector (2) for visualization accordingly.

10. Medical robot system (100) for an examination or intervention on a patient (P), characterized in that the medical robot system (100) comprises a robot (1) according to one of the preceding claims, wherein an instrument unit adapter (24) is arranged on the robot arm (8) and / or the visualization unit (12), and the robot system (100) further comprises at least two different instrument units (16, 16') with different instruments (20, 20') with an identically designed counter adapter (26) in order to to equip a medical robot (1) with different instruments (20, 20') via a uniform interface (24, 26).

11. Computer-implemented control method for a medical robot for actuating a medical end effector during an examination or an intervention on a patient, in particular a robot (1) according to one of claims 1 to 9, characterized by the steps: - Preferably registering (S1) the patient (P) by means of a navigation system (34); - Selection (S2) of either a visualization unit (12) with a visualization axis (14) or an instrument unit (16) with an instrument (20) and an associated instrument axis (18) as the selected end effector, both of which are connected as end effectors (2, 4) to a robot arm (8) with at least one robot arm segment (10) of the robot (1), wherein the robot arm (8) is in turn connected to a robot base (6) as a local connection point; - tracking (S3a; S3b) a position of the selected end effector by the navigation system (34); - controlling (S4a; S4b) the selected end effector by means of the robot arm (8) by a control unit (22) such that the selected end effector is moved according to a specification into a position, preferably into a position relative to the registered patient (P), in order to carry out an examination or an intervention.

12. A computer-readable storage medium comprising instructions which, when executed by a computer, cause the computer to carry out the method steps of the control method according to claim 11.

13. A computer program comprising instructions which, when executed by a computer, cause the computer to carry out the method steps of the control method according to claim 11.

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