Surgical / medical instrument for a surgical robot, and support structure for supportingly receiving an end effector of a surgical / medical instrument

Abstract

The present invention relates to a medical instrument for a or of a medical robot (1), the medical instrument comprising: a support structure (116; 216; 316), for supportingly receiving at least one optionally exchangeable end effector (18) of the medical instrument and having a proximal coupling portion (30; 230) which is provided and designed for coupling to a distal end segment (10) of the robot (1); and comprising a distal coupling portion (32), which is provided and designed for coupling to the optionally exchangeable end effector (18); wherein the support structure (116; 216; 316) is or has a connecting component which extends in one piece at least between the proximal coupling portion (30) and the distal coupling portion (32), as a result of which, a coupling-free and / or tolerance-chain-free connection is created between the proximal and distal coupling portions (30, 32). The present invention also relates to a support structure (116; 216; 316) for a or of a surgical / medical instrument for a or of a surgical / medical robot, for supportingly receiving at least one optionally exchangeable end effector (18) of the instrument.

Description

[0001] Surgical / medical instrument for a surgical robot and

[0002] Support structure for storing an end effector of a surgical / medical instrument

[0003] Description

[0004] Technical area

[0005] The present disclosure relates to a surgical / medical instrument for a surgical robot, as well as a support structure for supporting an end effector of a surgical / medical instrument for a surgical robot.

[0006] Background of the Revelation

[0007] Robot-assisted handling of surgical / medical instruments is gaining increasing importance in surgery. The advantages are manifold, particularly the minimally invasive use of end effectors, such as tools, RF tips, lighting, optics, cameras, pedicle screws, and other tools, in the surgical field, which can be controlled with high precision and repeatability. At the same time, high precision and repeatability are fundamental prerequisites for performing the procedure with the aid of a robot, especially in cases of minimally invasive procedures without visual access to the surgical field.

[0008] Therefore, continuous knowledge of the position and location of the operating point in relation to the surgical field is crucial. For this purpose, the medical / surgical instrument guided by the robot is equipped with means for 3D tracking of the operating point – "rigid bodies" – which can be captured by a 3D camera and evaluated using triangulation, allowing the position and orientation of the operating point to be determined. Initial calibration is also performed on-site in the operating room using the rigid bodies. Starting from the calibrated initial state, the rigid bodies are tracked – both that of the instrument and, if applicable, that of the patient. If the surgical robot must be repeatedly moved out of the surgical field to change an end effector, time-consuming recalibration may be required following the change.An end effector is generally understood to mean any medical / surgical tool, product, or aid that can be inserted into the medical / surgical instrument, whether stationary or driven. Examples include a drill, milling cutter, scalpel, an RF coagulation tip, pedicle screw, overview camera, a microscope, endoscope, optics, light source, sensor, neurosensor, and the like.

[0009] State of the art

[0010] Surgical robots have an end effector that is coupled to the surgical instrument. In current systems, the distal end effector is located at the end of a chain of drive and housing components of the medical / surgical instrument. Each of the above components naturally has an "intrinsic tolerance" and also an assembly tolerance in interaction with the neighboring component, thus resulting in a tolerance chain. The more links (components) the tolerance chain has, the more difficult it becomes to maintain a maximum extension (deviation) of the operating point – the so-called target zone – within its specification characteristic of the procedure. Such tolerance chains, which result in particular from the number of consecutive assembly and coupling points of the medical instrument, are known, for example, from the "Mako" system from the manufacturer Stryker.

[0011] According to the present disclosure, the applicant has determined that in the known prior art, for example, a first housing part of a medical / surgical instrument is articulated to a mounting interface of a robot via a first coupling, the first housing part is serially connected to further housing parts of the end effector, and a receiving chuck for end effectors, movable relative thereto, is mounted on the last housing part, with an internal coupling for receiving an end effector. The applicant has further recognized that such a configuration fundamentally requires general calibration in the operating room. Added to this are the complex calibration of the surgical instrument with respect to the robot and the enlargement of the target zone with each additional link in the tolerance chain explained above by way of example.If the end effector is repeatedly moved out of the surgical area for replacement, this can lead to a decrease in the repeatability of the target zone, so that a time-consuming recalibration becomes necessary, which disrupts the operation.

[0012] Brief description of the revelation

[0013] In contrast, one object of the present disclosure is to avoid or at least mitigate the disadvantages of the prior art and, in particular, to provide a surgical / medical instrument for a surgical / medical robot, via which the position and extent (deviation) of an operating point of the end effector can be better reproduced. A further object is to create a support structure, in particular a housing, for supporting an end effector of a surgical / medical instrument for a surgical / medical robot.

[0014] The first problem is solved by a surgical / medical instrument having the features of claim 1. The second problem is solved by a supporting structure, in particular a housing, having the features of patent claim 15. Advantageous further developments are part of the subclaims, which may also be separately claimable.

[0015] A surgical / medical instrument for a surgical / medical robot has a support structure for supporting an optionally interchangeable stationary or drivable end effector, preferably for supporting the end effector and a drive of the end effector. The support structure has a proximal coupling section, which is provided and designed for coupling to a distal end segment of the robot. Furthermore, the support structure has a distal coupling section, which is provided and designed for coupling to the optionally interchangeable end effector. The support structure is or has a connecting component which extends in one piece, preferably made of one piece material, at least between the proximal coupling section and the distal coupling section. This creates a coupling- and / or tolerance-chain-free connection between the proximal and distal coupling sections.

[0016] In the area between the end segment of the robot and the optionally replaceable / replaceable end effector, there are only two coupling points subject to tolerances due to the one-piece design of the connecting component: the one where the proximal coupling section is coupled to the end segment of the robot, and the one where the end effector is coupled to the distal coupling section. The tolerance chain and any resulting play are thus minimal across this area. The position and extent of a working point defined at the tip of the end effector, or the size of the target zone (TZ), thus depend solely on the tolerances of the connecting component—and, of course, the end segment and the end effector used. Unlike state-of-the-art solutions, internal tolerances of the instrument itself no longer influence the position and extent.Manufacturing efforts to achieve a highly precisely located operating point with minimal expansion can thus be focused on the production of the connecting component. Provided that the connecting component has been fixed to the end segment and initially calibrated, and that the dimensions and tolerances of the newly installed end effector are known, recalibration after the changeover is not necessary, since only the already known dimensions and tolerances of the new end effector are newly introduced into the system during the changeover.

[0017] Preferably, the target zone according to the present disclosure has a diameter of less than 2 mm to greater than 1 mm.

[0018] Particularly preferably, the target zone according to the present disclosure has a diameter of less than 1 mm. Such small diameters of the target zone can be achieved with reduced manufacturing effort compared to the prior art due to the short tolerance chain disclosed.

[0019] As mentioned above, the term "target zone" refers to the maximum extent or deviation of the operating point. In other words, the term "target zone" refers to the maximum envelope volume within which the tip of the end effector, i.e., the tool tip, is positioned due to tolerances.

[0020] The term "one-piece construction" within the meaning of the disclosure means at least that—particularly in a force flow—no further coupling section / no further coupling point is provided between the proximal and distal coupling sections. This is preferably implemented such that the proximal and distal coupling sections are manufactured from a single piece of the connecting component, preferably from a continuous material. Alternatively, for example, several pieces of the connecting component can be firmly joined, in particular welded or glued, with the coupling sections then being subsequently manufactured on the joined piece.

[0021] An end effector is generally understood to mean any medical / surgical tool, product, or aid that can be inserted into, coupled to, or driven by the medical / surgical instrument. Examples include: driven end effectors, such as drills or milling cutters; stationary or fixed end effectors, such as a scalpel, an RF tip for coagulation, an overview camera, a microscope, an endoscope, an optic, a light source, a sensor or sensor arrangement, a neurosensor; insertable products, such as a pedicle screw, or the like. According to the disclosure, the possible drive type is, of course, not limited to the rotating design mentioned above, but rather encompasses any drive type commonly used in surgery, such as an oscillating drive.Preferably, the surgical / medical instrument is equipped with the optionally interchangeable end effector by coupling it to the distal coupling section (32). Preferably, the surgical / medical instrument has a set of optionally interchangeable end effectors of different designs and / or nominal sizes, one of which is inserted and the others are stored.

[0022] The aforementioned advantages increase the tighter the tolerances of the connecting component, particularly its proximal and distal coupling sections, are manufactured. In a further development, the connecting component preferably has highly precise shape tolerances, alignment tolerances, and position tolerances, at least with respect to the coupling sections.

[0023] According to a further development, the coupling sections have a fixed orientation, angularity, or angle relative to one another. In this way, a main axis or working axis of the end effector is fixedly adjusted at a predetermined angle relative to the main axis or working axis of the end segment of the robot. Depending on the type of end effector and the requirements for its handling, the connecting component can have a fixed parallel or a fixed angular, in particular perpendicular, alignment of the coupling sections relative to one another. The alignment can be defined via the contact planes of the coupling sections or via their main axes.

[0024] In order to be able to align the end effector relative to the end segment without changing the connecting component, the connecting component is provided and designed in a variant for adjusting the contact planes or main axes of the coupling sections relative to one another.

[0025] In a preferred development, the connecting component is a housing or at least a housing section of the medical instrument, in particular a housing or a housing section of a drive of the medical instrument that can be coupled to the end effector. Thus, one and the same component can fulfill two functions: firstly, the tolerance-chain-free connection of the proximal and distal coupling sections, and secondly, the conventional protective function of a housing. In order to at least partially accommodate and support the end effector or a drive shaft of the drive and the end effector coupled to the drive shaft, the housing, in a development, has a shaft housing section on which the distal coupling section is formed. The shaft housing section preferably extends in the shape of a shaft or sleeve. It therefore has a slim design and requires little installation space.

[0026] For the insertion of the end effector or drive shaft and the end effector coupled to it, the shaft housing section preferably has a proximal inlet opening. Distally, it preferably has an outlet opening through which the end effector passes during normal operation, i.e., when the end effector is mounted.

[0027] As already explained above, to optimize the handling of the end effector, the orientation of the coupling sections of the connecting component can be predetermined in different ways (parallel, angular). In a possible further development, this orientation can be predetermined by the shape of the shaft housing section. In a particularly simple variant, the shaft housing section extends straight from its inlet opening to the distal coupling section, resulting in parallelism. Alternatively, it can be curved, at least in sections, in this area, resulting in angularity.

[0028] To ensure repeatable and gentle insertion of the end effector into the shaft housing section, the latter preferably has an insertion aid, preferably in a region of the inlet opening. The insertion aid is preferably designed as a continuous, preferably funnel-shaped, tapered interior or receiving space of the shaft housing section. The interior or receiving space preferably extends from the inlet opening to the outlet opening.

[0029] According to a further development, the shaft housing section has a radial constriction or an inner radial collar, which forms an axial stop of the distal coupling section. This axial stop is provided and designed to axially engage a correspondingly shaped axial stop of the end effector.

[0030] The axial support can be implemented directly or indirectly. In the latter case, for example, by means of at least one axial plain bearing or axial roller bearing located at the radial constriction or on the inner radial collar.

[0031] The axial stop inside the shaft housing section is easier to manufacture the closer it is formed to the distal end section of the shaft housing section. In a preferred embodiment, the radial constriction or inner radial collar is therefore formed by a distal end wall of the shaft housing section and penetrated by the outlet opening.

[0032] In order to minimize the extension of the end effector's operating point in the radial direction, according to a further development, the shaft housing section has an inner circumferential surface, which forms a radial stop of the distal coupling section. This is provided and designed to radially engage a correspondingly shaped radial stop of the end effector. The radial engagement can be direct or indirect. In the latter case, for example, by means of at least one radial plain bearing or radial roller bearing located on the inner circumferential surface.

[0033] Combinations of plain bearings and rolling bearings are possible.

[0034] According to a further development, a radial stop and / or axial stop coaxial with the inlet opening is provided and designed to support the end effector or to support a drive shaft of the drive of the end effector proximally on the shaft housing section.

[0035] Components of the drive include, for example, a motor, a coupled gearbox, and a drive shaft coupled to the gearbox, which in turn can be coupled to the end effector. Depending on its design, the use of a gearbox allows for an aligned or non-aligned arrangement of the motor relative to the end effector.

[0036] In a minimal design, the drive comprises the motor, which is designed and constructed for direct coupling to the end effector, preferably to a shaft of the end effector. Particularly in the case of a rotatable end effector, this provides the option of aligning the motor relative to the shaft housing section. This aligned arrangement has the advantage of making the drive narrow. However, it can result in a comparatively long drive.

[0037] To minimize the overall length of the drive and its housing, according to one variant, at least one component of the drive is arranged laterally to the shaft housing section. According to a preferred development, the housing has a motor housing section laterally to the inlet opening, which is provided and designed to accommodate at least the motor.

[0038] Preferably, the main axes of the shaft housing section and the motor housing section are parallel. In other words, a drive shaft of the motor is parallel to the drive shaft of the end effector accommodated in the shaft housing section or to the shaft of the end effector. This has the advantage that a simple spur gear can be provided for torque transmission.

[0039] Alternatively, the main axes of the shaft housing section and the motor housing section can be aligned relative to each other. This allows the installation space required by the drive to be optimized for use in the operating room.

[0040] Preferably, the motor housing section is substantially cylindrical.

[0041] According to a further development, the housing has a gear housing section that is provided and designed to accommodate, at least in part, a gear of the drive of the end effector. The gear housing section can be formed as a separate part or from a section of the motor housing section, the shaft housing section, or both.

[0042] According to a first variant of the housing, the motor housing section is connected in alignment with the shaft housing section. The connection is either direct, i.e., without the gearbox and the corresponding gearbox housing section, or it is indirect, with all three housing sections being connected in alignment. As already mentioned above, this enables a comparatively narrow but long design of the housing and thus of the medical instrument.

[0043] Alternatively, the motor housing section is connected laterally to the shaft housing section via the gear housing section. The lateral connection of the motor housing section to the shaft housing section has the advantage that disassembly of the motor is no longer necessary for changing the end effector, which requires pulling the end effector proximally out of the shaft housing section. Compared to the aligned arrangement, this variant thus enables a simplified end effector change.

[0044] According to a further development of the housing for a drive with a gear, at least one tapered portion is formed in the shaft housing section, which tapers in the insertion direction and is provided and designed for the rotatable mounting of an output element of a gear stage of the drive's transmission. The output element can be a friction wheel of a belt drive or a gear of a gear transmission. Its mounting can be implemented directly on the stage or indirectly via a plain bearing or roller bearing located there.

[0045] For a multi-stage transmission, according to a further development, a series of such stepped tapers is formed, over which the shaft housing section is increasingly narrowed in the insertion direction, wherein each taper is provided and configured to support an output element of a different one of several gear stages of the transmission. Alternatively, the series of such output elements can be arranged stacked in the precisely one radial, stepped taper of the shaft housing section.

[0046] According to the previous description, one advantage of the disclosed connecting component, which is designed with only two coupling points subject to tolerances, is that, under certain conditions, recalibration during the procedure in the operating room can be omitted after replacing the end effector. A necessary prerequisite is knowledge of the characteristic dimensions and tolerances of the newly introduced end effector. Based on the initially calibrated connecting component and the dimensions and tolerances of the new end effector, the new position and extension of the operating point can then be calculated. Recalibration in the operating room is no longer mandatory.

[0047] In a preferred embodiment, the instrument therefore has at least one end effector, preferably a set of optionally interchangeable end effectors, which is / are measured and documented with regard to its characteristic dimensions and tolerances. This measurement preferably takes place outside the operating room, preferably at the factory during the manufacture of the end effector, in particular during its production, so that the dimensions and tolerances can be adjusted upon insertion or coupling of the respective end effector into or to the instrument by a control unit designed to calculate the position and extent of the operating point. In this way, the new position and the new extent of the operating point can be calculated after the insertion / coupling of the end effector, and recalibration is not necessary.The effort of measuring or calibrating on site in the operating room is thus eliminated and - as already mentioned - is instead located at the factory, which represents a major advantage over the state of the art.

[0048] In order to be able to determine these dimensions and tolerances for each insertable end effector, or to be able to tighten them as mentioned above, the surgical / medical instrument, preferably the connecting component, preferably the housing, in a preferred development has a detection unit designed to read out at least one ID and / or the characteristic properties and / or the dimensions and tolerances of the end effector guided past the detection unit, preferably a sensor, during insertion. A prerequisite for this is preferably that the insertable end effectors have a corresponding emitter or a corresponding tag on which the ID or the aforementioned data is or are stored.

[0049] The detection unit is preferably configured as a sensor, in particular as an NFC antenna for reading an RFID tag of the end effector. Data stored on the RFID tag preferably includes the article number, serial number, type, and nominal size of the end effector, as well as, in particular, its characteristic dimensions and tolerances, in particular the characteristic distance of the operating point from the axial stop of the end effector, the nominal size of the end effector, its concentricity, its coaxiality, and the like. The detection unit is preferably arranged in a region of the above-described inlet opening or the insertion aid.

[0050] Preferably, the detection unit has a receiving capacitance that covers at least a cross-section of the shaft housing section, preferably the inlet opening or the insertion aid. Preferably, the detection unit extends over the entire circumference of the shaft housing section or at least partially, preferably evenly distributed.

[0051] In a preferred embodiment, the proximal coupling section of the connecting component is either straight and bar-shaped, or it is designed in a pincer-like or clamp-like manner. Depending on the design, different advantageous coupling movements result for attaching the connecting component to the end segment of the robot.

[0052] In order to define the position and orientation of the proximal coupling section relative to the end segment as simply as possible, in a preferred embodiment, the proximal coupling section has three point-like, proximal coupling elements, which define a proximal coupling plane. The three coupling elements are particularly designed and configured to engage with three coupling elements on the end segment side that are adapted to them. The arrangement of the three coupling elements preferably forms the corners of an equilateral triangle.

[0053] According to a possible further development, at least one of the proximal coupling elements has a centner bore or trough and another has a centner dome or a centner sphere.

[0054] According to a possible further development, at least one of the proximal coupling elements has a stop acting transversely to the proximal coupling plane.

[0055] Due to the disclosed design, the connecting component extends in one piece up to the distal stop, i.e., close to the operating point of the end effector. This allows supply channels to be easily routed into this area. According to an advantageous development, the connecting component has at least one such channel that leads distally or opens distally, preferably at a distal end face and / or a distal outer surface of the connecting component, in particular the shaft housing section. The channel(s) preferably extend in and along a wall of the shaft housing section.The respective channel can be provided and designed to accommodate a light guide for illuminating a surgical area, an optic for viewing the surgical area, a coolant for cooling the end effector or its bearing, a data line for a distally attachable camera or a distally attachable sensor, in particular a force sensor for detecting forces and / or moments of the working end, or it is provided and designed to suction fluid in the surgical area.

[0056] Preferably, the connecting component has a fastening interface which is designed such that a drape can be fastened thereto.

[0057] In a preferred embodiment, the connecting component is a sterile item.

[0058] The drive can be manual or motorized, or the drive can be manual and servo-assisted. In a manual or servo-assisted configuration, the drive has a handpiece. In a manual configuration, the handpiece is preferably provided and configured to be directly coupled to the end effector. In a servo-assisted configuration, it is preferably provided and configured to be coupled to a specific gear stage of the transmission.

[0059] In a preferred embodiment, a drive transmission has multiple gear stages. The drive is particularly flexible in terms of speed and torque when it has multiple gear stages. Preferably, each gear stage is assigned an output element mounted axially and on the outer circumference of a stepped taper of the shaft housing section and rotatably mounted.

[0060] For easy coupling of one of the output elements to an end effector assigned to it, in particular to its shaft, the output elements have a preferably central through-recess with an inner circumferential coupling section.

[0061] A particularly simple assignment and coupling of the respective gear stage with an end effector assigned to it is made possible if the inner diameters of the through-holes decrease gradually in the insertion direction according to a further development.

[0062] The drive preferably has a set of interchangeable, optionally usable end effectors, each designed with a shaft of equal length. The end effectors each have an outer peripheral coupling section at the same height—measured from the coupling section of the end effector—which is designed and configured for coupling with one of the inner peripheral coupling sections.

[0063] The precise coupling of a specific end effector with its specifically assigned gear stage, i.e. with the specific output element, is achieved in a simple manner if the outer peripheral coupling sections each have a unique tuple of outer diameter and length according to a further development: The largest of the

[0064] The shortest outer diameter is assigned the shortest length, and the smallest outer diameter is assigned the longest length. Outside diameters in between decrease gradually in the insertion direction, while lengths increase gradually.

[0065] Short description of the characters

[0066] Fig. 1 shows a surgical robot with a surgical instrument coupled thereto according to the prior art, in perspective view,

[0067] Fig. 2 shows a connecting component designed as a housing of a surgical / medical instrument of a surgical robot according to a first embodiment, in a perspective view,

[0068] Fig. 3 shows the housing according to Figure 2, in a perspective partial section,

[0069] Fig. 4 shows a drive with the housing according to Figures 2 and 3 according to a first embodiment, in perspective view,

[0070] Fig. 5 shows the housing according to Figures 2 and 3 in a longitudinal section,

[0071] Fig. 6 shows a connecting component designed as a housing of a surgical / medical instrument of a surgical robot, according to a second embodiment, in a longitudinal section,

[0072] Fig. 7 shows the housing according to Figure 6 in a view from proximal,

[0073] Fig. 8 shows the housing according to Figure 5 with inserted end effector, in a partial section,

[0074] Fig. 9 shows a drive of a surgical / medical instrument according to a second embodiment, in a longitudinal section,

[0075] Fig. 10 shows a drive of a surgical / medical instrument according to a third embodiment, in a longitudinal section,

[0076] Fig. 11 shows a drive of a surgical / medical instrument according to a fourth embodiment, in a longitudinal section,

[0077] Fig. 12 shows a similar end effector with different coupling sections for coupling with different gear stages of a drive of the surgical / medical instrument,

[0078] Fig. 13 shows a detail of the drive according to Figure 11, in perspective view, Fig. 14 shows the drive according to Figure 13 with inserted end effector, in perspective view,

[0079] Fig. 15 shows a drive with the housing according to Figure 5, according to a fifth embodiment, in a longitudinal section,

[0080] Fig. 16 shows the drive according to Figure 15 with an end effector to be inserted, Fig. 17 shows a drive of a surgical / medical instrument according to a seventh embodiment and with the housing according to Figures 6 and 7, in a longitudinal section, and

[0081] Fig. 18 shows the drive according to Figures 15 and 16 with channels running in the housing.

[0082] Figure 1 shows a robot arm of a surgical robot 1 with a drive of an end effector 18 with a housing 16 according to the prior art. The robot arm has articulated segments 2, 4, 6, 8, 10 and an end segment 10. A surgical instrument 14 is coupled to the end segment 10 via a coupling arm 12. The instrument 14 is fixed in a receptacle of the coupling arm 12 with its housing 16. A working end or end effector 18 of the instrument 14 emerges from the distal end of the housing 16. At the tip of the working end or end effector 18 is the working point 20 of the instrument 14, which is effective in the surgical field. Starting from the end segment 10 to the end effector 18, the instrument 14 has a chain of coupling points 22, 24, 26, 28. In the system shown in Figure 1, components of the drive of the end effector 18 and the housing 16 are connected between the end segment 10 and the end effector 18 via a multitude of coupling points 22, 24, 26, 28.This creates a tolerance chain and thus a clearance, which causes a spherical extension of the operating point, the target zone, to increase. This effect must be minimized or eliminated.

[0083] For this purpose, a preferably high-precision connecting component for the medical / surgical instrument is proposed, the exemplary embodiments of which are described in succession in Figures 2 to 18. In the exemplary embodiments, the connecting component is designed as a housing-like component and is referred to below as the "housing" for the sake of simplicity. It is characterized in particular by the absence of multiple coupling points, which minimizes the tolerance chain. The target zone of the end effector 18 can thus be significantly narrowed and optimized.

[0084] Figure 2 shows a perspective view of a connecting component configured as a housing 116 for a medical / surgical instrument having the end effector 18, according to a first exemplary embodiment. The housing 116 has a proximal coupling section 30, which can be coupled to the end segment 10 (see Figure 1), and a distal coupling section 32, to which the end effector 18 is coupled. Between the coupling sections 30 and 32, the housing 116 extends in one piece, i.e., without additional coupling points in the frictional connection between the end segment 10 and the end effector 18. The number of coupling points is thus reduced to a minimum of two. Compared to the prior art solutions, internal coupling points of a drive of the end effector 18 or other coupling points of the housing 116 have no influence on the position of the operating point 20. Only the tolerances of the coupling sections 30 and 32 determine the target zone.In order to minimize the expansion of the target zone, the coupling sections 30, 32 are manufactured with high precision with regard to shape, alignment and position tolerances.

[0085] According to Figure 2, the housing 116 has a tubular or sleeve-shaped shaft housing section 34, through which a proximal coupling 36 of the end effector 18 extends. The coupling arm 12 is attached at an obtuse angle laterally to the shaft housing section 34. The coupling arm 12 is weight-optimized by means of a recess 38. The coupling section 30 branches into two coupling legs 40, on each of which a spherical coupling element 42 (one concealed) of the coupling section 30 is formed radially on the inside. At the apex of the branch, the coupling section 30 has a further coupling element 44, which is designed as a through-bore and opens in the direction of the recess 38. The disclosed advantage lies in the precision of the relative position of the coupling plane defined by the coupling elements 42, 44 to the coupling plane defined by the coupling section 32. According to Figure 2, the housing 116 also has a gear housing section 46, which is described further below.

[0086] Figure 3 shows the housing 116 according to Figure 2 in a perspective longitudinal section without the end effector 18. The gear housing section 46 is shown uncut. The distal coupling section 32 arranged on the inside is visible and the sleeve-shaped extension of the shaft housing section 34 is evident. The distal coupling section 32 has an axial stop in the extension direction of the end effector 18, which in the illustrated embodiment is formed by a front-side, radial constriction of the shaft housing section 34. This constriction borders an outlet opening 48 of the shaft housing section 34, through which the end effector 18 (see Figure 1) exits.

[0087] Figure 4 shows a manual, servo-motor-assisted drive 50 with the housing 116 according to Figures 2 and 3. The drive 50 has a handpiece 52, via which rotation of the end effector 18 can be initiated. The handpiece 50 is designed to be attachable and, within the gear housing section 46, is operatively connected to a gear insert (not shown) of the drive 50. The rotation of the handpiece 52 thus effects the servo-motor assistance. In this way, for example, the screwing in of a pedicle screw can be motor-assisted, while the surgeon still retains a feel for the applied torque.

[0088] Figure 5 shows the housing 116 in a longitudinal section. The gear housing section 46 is not shown here. In addition to the illustrations in Figures 2 to 4, a proximal inlet opening 54 of the shaft housing section 34 can be seen, through which the end effector 18 can be inserted into the housing 116. The inlet opening 54 is comparatively wide. In the insertion direction, the shaft housing section has a comparatively steep, stepped taper 56 in the vicinity of the inlet opening 54. This taper forms a cylindrical receiving space 58 for a set of output elements of the gear unit (not shown). Adjacent to the stepped taper 56 is a funnel-shaped taper 60, which acts as an insertion aid when inserting the end effector 18. At the distal end of the shaft housing section 34, an axial stop 62 and a radial stop 64 of the distal coupling section 32 are shown in section.The first is a highly precisely machined, inwardly facing annular end face that surrounds the outlet opening 48; the radial stop 64 is a section of an inner circumferential surface of the shaft housing section 34 that adjoins the annular end face.

[0089] Figures 6 and 7 show a second embodiment of a housing 216 of an end effector of a surgical instrument of a surgical robot, whereby only the differences from the first embodiment will be discussed in order not to overload the description. In contrast to the housing 116 according to Figures 2 to 5, the shaft housing section 34 extends from its inlet opening 54 to the outlet opening 48 with only one radial taper 56. The insertion aid (compare 60, Figure 5) has been omitted here. The stepped, radial taper 56 of the housing 216 is kept comparatively flat. The taper 56 is therefore suitable for accommodating only one output element of a gear stage. Alternatively, it serves as a proximal bearing point for a shaft of the end effector or a drive motor to which this shaft can be coupled, which is explained further below in Figure 17.In the exemplary embodiment shown, the proximal coupling section 230 of the housing 216 has an axial coupling surface 66 for frontal contact with a corresponding coupling surface of the end segment 10 and a lateral coupling surface 68 for lateral contact with a corresponding coupling surface of the end segment 10. According to Figures 6 and 7, the dimension H, which defines the distance of the axial coupling surface 66 of the proximal coupling section 230 to the axial stop 62, the dimension L, which defines the distance of the lateral coupling surface 68 of the proximal coupling section 230 to the center of the radial stop 64 and the dimension d, which defines the diameter of a radial stop in the region of the inlet opening 54, are manufactured with high precision with regard to shape, alignment and position tolerance.

[0090] Figure 8 shows the distal coupling section 32 of the respective shaft housing section 34 of Figures 2 to 7 in detail, with a coupled end effector 18. This has a shaft 70 extending within the shaft housing section 34, a radial collar 72 distally adjoining it, and a working end 74 emerging from the outlet opening 48 with the working point 20 at the tip. It can be clearly seen that a distally oriented annular end face 76 of the radial collar 72 is in sliding contact with the axial stop 62 of the distal coupling section 32. The end effector 18 can be centered either via a circumferential surface of the radial collar 72, which is supported on the inner surface forming the radial stop 64, or via a partially conical centering collar 78, which is immersed in the outlet opening 48.

[0091] As already mentioned above, according to the present disclosure, the target zone with a diameter of less than 2 mm, particularly preferably less than 1 mm, can be achieved with low manufacturing effort. This is due to the fact that fewer surfaces need to be machined due to the shortened tolerance chain than with solutions according to the prior art. Regardless of the respective embodiment according to the disclosure, the term target zone, with reference to Figure 8, means an envelope volume / extending tolerance space extending around the tip of the end effector 18, in which the tip of the end effector 18 is arranged according to tolerances after assembly of the end effector 18.

[0092] Figure 9 shows a drive 150 of an end effector of a surgical robot according to a second exemplary embodiment, in a longitudinal section. In contrast to the previous description, the housing 316 has a motor housing section 80 laterally connected to the shaft housing section 34, in which a drive motor 82 with a drive shaft 84 parallel to the shaft 70 is accommodated. The housing sections 34 and 80 are connected via a gear housing section 46, in which a gear 88 designed as a spur gear is accommodated in sections. The gear 88 has a drive spur gear 90 coupled to the drive shaft 84 and an output spur gear 94 connected to the drive shaft 84 in a rotationally fixed manner via a gear 92 and coupled to the shaft 70. The gears 90, 92, and 94 form a gear stage 91 with a fixed gear ratio of the drive 150.For coupling, the shaft 70 of the end effector 18 has an outer peripheral coupling section 96 in a rotationally fixed connection with an inner peripheral coupling section 98 of a through-hole of the output spur gear 94. In contrast to the previous embodiments, the end effector 18 is not supported via a radial collar, but via an annular end face 76 of the shaft 70 and two ball bearings on the axial stop 62 of the distal coupling section 32.

[0093] Fig. 10 shows a drive 250 of an end effector 18 of a surgical robot according to a third embodiment, in a longitudinal section. Unlike the embodiment shown in Fig. 9, the shaft housing section 34 does not extend linearly, but rather in a curved manner. The shaft housing section 34 is rigid and, by means of the curvature, is adapted to a specific requirement in the surgical field. This requires that the shaft 70 be flexible.

[0094] Fig. 11 shows a drive 350 of an end effector 18 of a surgical robot according to a fourth exemplary embodiment, in a longitudinal section. In contrast to the exemplary embodiment according to Figures 9 or 10, a second gear stage 93 is provided in addition to the first gear stage 91. Its drive spur gear 95, like the drive spur gear 90 of the first gear stage 91, is firmly coupled to the drive shaft 84. Both spur gears 90 and 95 therefore always rotate with the drive shaft 84 and drive their respective output spur gears 94 (first gear stage 91) and 99 (second gear stage 93). Different speeds are set at the output spur gears 94, 99. An end effector 18 that can be coupled to the respective inner circumferential coupling section 98, 100 can thus be driven at different speeds depending on which coupling section 98, 100 it engages.

[0095] Fig. 12 illustrates this possibility of providing the end effector 18 with different outer peripheral coupling sections 96, 101, engaging them, and thus driving them at different speeds. Depending on the outer peripheral coupling section 96, 101 used according to Figure 12, the end effector 18 is driven by the first gear stage 91 at its own speed n1 or by the second gear stage 93 at its own speed n2.

[0096] Fig. 13 shows the drive 350 according to Fig. 11 in the area of ​​the output spur gears 94 and 99 in a perspective view from above. Figure 14 shows the drive according to Fig. 13, wherein the left end effector 18 in Fig. 12, which has the outer peripheral coupling section 96, is inserted. Due to its smaller diameter and greater height, the coupling section 96 couples only with the lower, inner peripheral coupling section 98 of the output spur gear 94 of the first gear stage 91. The second gear stage 93 thus remains disengaged and merely runs along, i.e., without transmitting torque to the end effector 18.

[0097] Figure 15 shows a drive 450 that differs from the one shown in Figures 11, 13, and 14 only in its higher number of gear stages—three instead of just two. This is evident from the three-layer set of output spur gears 94, 99, and 103, with the output spur gears 94, 99 representing the previously described first and second gear stages 91 and 93, and the output spur gear 103 representing the additional third gear stage.

[0098] Fig. 16 highlights a further detail of the drive 450, which enables the inserted end effector 18 to be uniquely identified and its ID or other characteristic data sets to be transmitted to a control unit of the surgical robot. This is an RFID antenna or an NFC antenna 104, which extends in an axially limited section in the area of ​​the insertion aid 60, completely circumferentially and within the wall of the shaft housing section 34. The inserted end effector 18 has an RFID chip 106, which is read by the antenna 104 as it passes. The end effector 18 can have any type of surgical working end.According to the disclosure, its characteristic, calibrated dimensions are recorded during production and, according to the disclosure, these are dimensions that influence the spatial position of the operating point, such as the distance of the annular end face / axial stop 76 to the operating point 20, as well as its tolerance, as well as a concentricity of the operating point 20 (see Figure 8) or other information, such as a diameter, a surface roughness, a degree of sharpness, and the like. The RFID chip 106 can, for example, carry the article number and serial number of the end effector 18 as a minimum data set. When passed by the antenna 104, this information is read and transmitted to the aforementioned control unit. The type of end effector 18 is uniquely assigned to the article and serial number in an attachable database.By mapping the article number, all other dimensions and tolerances of the inserted end effector 18 can then be applied and used to clearly calculate the position of the new operating point – without recalibration. Alternatively, the aforementioned data can, of course, already be stored on the RFID chip 106 itself and read directly and transmitted to the control unit.

[0099] Fig. 17 shows a drive 550 with the housing 216 according to Figures 6 and 7, as well as with a motor 582 that is not lateral to the shaft housing section 34, but rather flush with it. Accordingly, to replace the end effector 18, the motor 582 must first be lifted from the housing 216. Subsequently, the shaft 70 is separated from the motor 582, and the new end effector 18 is inserted into the shaft housing section 34 until the radial collar 72 of the end effector 18 axially abuts the axial stop of the distal coupling section 32 (see center of Figure 17). Finally, the motor 582 is connected to the coupling 36.

[0100] Figure 18 shows the drive 450 with the housing 316 according to Figures 15 and 16. The housing is configured with channels 108, 110, 112, 114 that extend from the proximal coupling section 30 to the distal coupling section 30 within the solid material of the housing 316 (see Figure 18, left) and open distally (see Figure 18, right) or are configured as a blind channel. Due to the disclosed, one-piece design of the housing 316, light, data, image data, coolant, or the like can be arranged, transmitted, or conveyed smoothly and safely in the channels across this area. In the illustrated embodiment, for example, four fiber optic channels 108 for illuminating the surgical area, a sensor channel 110 of a sensor, via which bearing forces of the end effector 18 can be detected, as well as a cooling channel 112 and a heating channel 114 lead out. List of reference symbols for surgical robots

[0101] 2, 4, 6, 8 segments

[0102] 10 End segment

[0103] 12 coupling arm

[0104] 14 surgical instrument

[0105] 16; 116; 216; 316 housing

[0106] 18 End effector

[0107] 20 operating points

[0108] 22, 24, 26, 28 coupling point

[0109] 30; 230 proximal coupling section

[0110] 32 distal coupling section

[0111] 34 Shaft housing section

[0112] 36 Clutch

[0113] 38 recess

[0114] 40 coupling legs

[0115] 42, 44 coupling element

[0116] 46 Gearbox housing section

[0117] 48 Exit opening

[0118] 50; 150; 250; 350; 450; 550 drive

[0119] 52 Handpiece

[0120] 54 Entrance opening

[0121] 56 radial taper

[0122] 58 Recording Room

[0123] 60 insertion aid

[0124] 62 Axial stop

[0125] 64 Radial stop

[0126] 66 axial coupling surface

[0127] 68 lateral coupling surface

[0128] 70 shaft

[0129] 72 Radial collar

[0130] 74 Working end 76 Axial stop

[0131] 78 Centering collar

[0132] 80 Engine housing section

[0133] 82 drive motor

[0134] 84 Drive shaft

[0135] 88 gearboxes

[0136] 90 Drive spur gear

[0137] 91 first gear stage

[0138] 92 gear

[0139] 93 second gear stage

[0140] 94 Output spur gear

[0141] 95 Drive spur gear

[0142] 96 coupling section

[0143] 98 coupling section

[0144] 99 Output spur gear

[0145] 100 coupling sections

[0146] 101 coupling section

[0147] 103 Output spur gear

[0148] 104 NFC antenna

[0149] 106 RFID chips

[0150] 108 Fiber optic channel

[0151] 110 sensor channels

[0152] 112 Coolant channel

[0153] 114 Heating medium duct

[0154] H Distance axial stops

[0155] L Distance from rotation axis to lateral stop d Diameter of radial stop

Claims

Claims 1 . Medical instrument for a or a medical robot (1 ) with a support structure (116; 216; 316) for the storage of at least one optionally exchangeable end effector (18) of the medical instrument, preferably for the storage of the end effector (18) and a drive (50; 150; 250; 350; 450; 550) of the end effector (18), with a proximal coupling section (30; 230) which is provided and designed for coupling to a distal end segment (10) of the robot (1 ), and with a distal coupling section (32) which is provided and designed for coupling to the optionally exchangeable end effector (18), wherein the support structure (116; 216;316) is or has a connecting component which extends at least between the proximal coupling section (30) and the distal coupling section (32) in one piece, preferably in one piece, whereby a coupling and / or tolerance chain-free connection is established between the proximal and distal coupling sections (30, 32); 2. Medical instrument according to claim 1, wherein the connecting component forms a housing (116; 216; 316) or a housing section of the medical instrument, or wherein the connecting component forms a frame structure which is arranged parallel to a housing of the medical instrument and thus determines the relative position of the distal coupling section to the proximal coupling section.

3. Medical instrument according to claim 1 or 2, wherein the connecting component (116; 216; 316) has highly precise shape tolerances, alignment tolerances and / or position tolerances at least with respect to the coupling sections (30, 32).

4. Medical instrument according to one of the preceding claims with a fixed parallel, angular or perpendicular alignment of contact planes or main axes of the coupling sections (30, 32) to one another.

5. Medical instrument according to one of the preceding claims, with a shaft housing section (34) on which the distal coupling section (32) is formed, with an inlet opening (54) through which the end effector (18) can be inserted, and with a distal outlet opening (48) through which the end effector (18) passes during normal operation.

6. Medical instrument according to claim 5, wherein the shaft housing section (34) has a radial constriction or an inner radial collar distally, from which or from which an axial stop (62) of the distal coupling section (32) is formed for axial coupling with an axial stop (76) of the end effector (18).

7. Medical instrument according to claim 5 or 6, wherein the shaft housing portion (34) has an inner circumferential surface from which a radial stop (64) of the distal coupling portion (32) is formed for radial coupling with a radial stop of the end effector (18).

8. Medical instrument according to one of claims 5 to 7, wherein a radial stop coaxial with the inlet opening (54) and / or an axial stop (56) is provided for the drive or a drive train of the drive.

9. Medical instrument according to one of claims 5 to 8 with a motor housing section (80) arranged laterally to the inlet opening (54), which is provided and designed to at least partially accommodate a motor (82) of the drive.

10. Medical instrument according to one of the preceding claims, comprising a gear housing section (46) which is provided and designed to at least partially accommodate a gear (88) of the drive.

11. Medical instrument at least according to claim 10, wherein a motor housing section (80) is connected via the gear housing section in alignment (116) with the shaft housing section (34) or is connected laterally (316) to the shaft housing section (34).

12. Medical instrument at least according to claim 5, wherein in the shaft housing section (34) at least one stepped taper (56) in the insertion direction is formed for the rotatable mounting of at least one output element (94; 94, 99; 94, 99, 103) of at least one gear stage (91; 91, 93) of a gear of the drive.

13. Medical instrument according to one of the preceding claims, comprising a sensor (104) via which at least one ID, characteristic properties and / or dimensions and tolerances of the end effector (18) can be read out.

14. Medical instrument at least according to claim 12, wherein in the region of the stepped taper (56) output elements (94, 99; 94, 99, 103) of several gear stages of a gear of the drive (350; 450) are rotatably mounted, wherein the respective output element (94, 99; 94, 99, 103) has a, preferably central, through-recess with an inner circumferential coupling section (98, 100;98, 100, 105), wherein the inner diameters of the through-holes decrease in steps in the insertion direction, and with a set of selectively exchangeable end effectors, each having a shaft with an outer circumferential, preferably cylindrical, coupling section (96, 101) ending at the same height in the insertion direction, wherein the outer circumferential coupling sections (96, 101) each have a unique value pair of outer diameter and length such that the largest of the outer diameters is assigned the shortest length (101) and the smallest of the outer diameters is assigned the greatest length (96), wherein outer diameters located therebetween decrease in steps in the insertion direction and lengths located therebetween increase in steps in the insertion direction.; 15. Support structure (116; 216; 316), preferably a housing, for a surgical / medical instrument or a surgical / medical robot, for supporting at least one optionally exchangeable end effector (18) of the instrument, preferably for supporting the end effector (18) and a drive (50; 150; 250; 350; 450; 550) of the end effector (18), with a proximal coupling section (30; 230) which is provided and designed for coupling to a distal end segment (10) of the robot (1), and with a distal coupling section (32) which is provided and designed for coupling to the optionally exchangeable end effector (18) of the surgical / medical instrument, wherein the support structure (116; 216; 316) is or has a connecting component which extends in one piece, preferably in one piece, at least between the proximal coupling section (30) and the distal coupling section (32), whereby a coupling- and / or tolerance-chain-free connection is established between the proximal and distal coupling sections (30, 32).

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