Automated system for robot-assisted minimally invasive surgery

Abstract

The present invention relates to a precision automated system, particularly for robot-assisted minimally invasive surgery, comprising an instrument holder with five degrees of freedom adapted to support and actuate a tool, especially a surgical tool, for accessing difficult areas of the surgical field. The instrument holder comprises a shaft terminating in a controlled flexible portion and a tool holder including means for orientation and rotation, all of these movements being controllable independently of each other. The instrument holder's design features provide it with the rigidity necessary for manipulating tissues within the surgical field during the execution of a surgical procedure.The instrument holder is designed to be mounted on a robot with up to 6 degrees of freedom, also including a module with motors to drive the 5 degrees of freedom of the instrument holder, which itself does not contain sensitive electronic components and can be sterilized by various techniques. Figure 1.

Description

Title of the invention: Automated system for robot-assisted minimally invasive surgery technical field

[0001] The invention belongs to the field of robotics. More particularly, the invention belongs to the field of precision robotics for the remote control of a tool or instrument in a small and constrained volume.

[0002] The invention is particularly, but not exclusively, applicable to the field of minimally invasive surgery, or any other field in which it is necessary to access and perform a precise operation in a small area without affecting other areas, whether by performing the operation itself or by accessing the instrument to the small area.

[0003] This may involve, for example, complex remote troubleshooting operations in hostile environments such as the space domain. Previous technique

[0004] US patent 7824401 describes an instrument holder configured to be worn by a manipulator and the positioning of its end controlled in 3 degrees of freedom by means of a wrist located at the end of a rigid rod.

[0005] For many applications, limiting the mobility of the tool at the end of the instrument holder to 3 degrees of freedom may present shortcomings, particularly for accessing areas located under an obstacle and more generally when access to the reduced operating area cannot be obtained by a straight trajectory. Summary of the invention

[0006] These drawbacks of the prior art are resolved by a robotic intervention system comprising a manipulator and an instrument holder, the instrument holder being configured to be carried and moved by the manipulator and comprising a connection interface configured to cooperate with a receiving interface of the manipulator, the instrument holder comprising:

[0007] a rigid hollow rod comprising at a proximal end of the receiving interface a control module;

[0008] at a distal end of the control module, a flexible hollow portion extending from the rigid hollow rod along a central axis passing through centers of sections of the flexible hollow portion and the rigid hollow rod in a straight position, configured to be flexed and to move away from the central axis in a flexed position;

[0009] at one end of the flexible hollow portion a tool holder;

[0010] connected to the tool holder, a tool configured to perform at least one operational movement;

[0011] in which a plurality of cables each connected to a winding drum in the control module and extending inside the rigid hollow rod and the flexible hollow portion, and a rotating transmission member extending from the control module to the tool holder, configured to produce a rotation of the tool holder about an axis of rotation in which the axis of rotation coincides with the central axis in the straight position and is away from the central axis in the flexed position.

[0012] Thus the flexibility of the flexible portion allows access with the tool to areas far from an entry point in a mechanism while taking advantage of a possibility of rotation of the tool at the end of the instrument holder.

[0013] The system can be implemented according to the embodiments and variants set out below, which are to be considered individually or according to any technically operative combination.

[0014] The plurality of cables may include:

[0015] at least one bending cable configured to generate bending of the hollow portion flexible around a bending axis perpendicular to the central axis;

[0016] at least one orientation cable configured to generate a rotation of the tool holder around an orientation axis perpendicular to the central axis; and

[0017] at least one operating cable configured to control the operational movement of the tool.

[0018] In addition, the system may include at least one cable configured to control an orientation movement of the tool relative to the tool holder around an axis perpendicular to the orientation axis of the tool holder.

[0019] According to one embodiment, the rotary transmission member is hollow and at least one operating cable and at least one tool guidance cable extend inside the rotary transmission member.

[0020] According to one embodiment, the flexible hollow portion may comprise a chain of annular modules extending along the central axis in the upright position, each annular module being linked to a following annular element in the chain by a pivot joint around an articulation axis perpendicular and intersecting the central axis.

[0021] According to one embodiment, the rotating transmission element is a flexible shaft.

[0022] According to one embodiment, the rotating transmission member is a transmission rod extending along the central axis inside a rigid hollow rod and a flexible hollow portion, a final portion of the transmission rod extending into the flexible hollow portion comprising a plurality of sections, each section being linked to the next according to the central axis by a cardan joint configured to allow a pivot of one section relative to the next along an axis coinciding with the articulation axis.

[0023] The tool may comprise two arms and be selected from a pinching forceps, a spreading forceps and scissors, the operative movement being a relative rotation of one of the two arms around an axis perpendicular to the central axis.

[0024] The system can be configured to perform a minimally invasive surgical operation. Brief description of the drawings

[0025] The system can be implemented according to the particular, non-limiting embodiments set out below with reference to [Fig. 1] to [Fig. 5], in which; Fig. 1

[0026] [Fig.1] represents, in a schematic top view, the system used for a minimally invasive surgical operation; Fig. 2

[0027] [Fig.2] shows, according to a life in perspective, an example of the realization of the door- instruments of the system in an upright position and in a flexed position; Fig.3

[0028] [Fig.3] shows, according to a perspective view and a partial exploded view, a example of how to make the flexible portion. Fig. 4

[0029] [Fig.4] shows, in perspective view, an example of the embodiment of an organ of rotary transmission and a partial section AA defined on the same view of this rotary transmission element; and Fig. 5

[0030] [Fig. 5] represents, in perspective views, examples of tools that can be carried by the instrument holder.

[0031] The views are intended to show the constructive principles of the different embodiments and do not represent all the parts involved in the construction of the system. Description of the implementation methods

[0032] [Fig. 1] According to one embodiment, the system comprises an instrument holder (100) carried by a manipulator (101), for example, a robot. The manipulator can be of any parallel or serial structure, anthropomorphic or gantry-like, without these examples being limiting, comprising 1 to 6 axes, for positioning and moving the instrument holder in space, and in particular for maintaining a fixed insertion point of the instrument holder in an operating field (191).

[0033] The manipulator includes a receiver interface (110) for gripping and controlling the functions of the instrument holder, comprising 5 motors.

[0034] A control bay (150) allows the axes of the manipulator and the functions of the instrument holder to be controlled so as to position and move in space a tool carried by the instrument holder according to defined positions and trajectories.

[0035] The control bay can be located remotely from the manipulator and, according to implementation examples, information can be exchanged between the control bay via a wired connection, a radio connection for example of the Wifi® type, via the internet or any other type of suitable connection allowing the system to be operated remotely.

[0036] [Fig.2] The instrument holder essentially comprises 3 parts. A connection interface (210) configured to cooperate with the manipulator's receiving interface, an active part (230) supporting a tool, and a hollow rod (220) connecting the connection interface (210) and the active part.

[0037] The hollow rod (220) comprises a rigid rod (221) and a flexible portion (222) extending from the rigid rod (221) along a central axis (250), the flexible portion (222) to which the active part (230) is connected at a distal end of the connection interface (210), which active part comprises a tool holder (231) configured to receive different types of tools (232).

[0038] The flexible portion (222) can be flexed to move the tool holder and the tool away from the central axis (250) into a flexed position whose amplitude of deflection can be controlled from a control module (219) of the connection interface.

[0039] When the instrument holder is in an upright position as shown in solid lines [Fig. 2], a rotation axis (251) of the tool holder (231) coincides with the central axis (250). When the instrument holder is in a flexed position, as shown in dashed lines [Fig. 2], a rotation (252) of the tool holder (231) around this rotation axis (251) can be controlled from the control module (259) regardless of the flexed position.

[0040] To this end, the control module (219) includes control elements configured to interface with the motors of the manipulator's receiver interface and thus be controllable from the control bay.

[0041] These control elements include a coupling shaft (211) to achieve the rotation (252) of the tool holder, and cable winding drums (212, 213, 214, 215) to achieve the bending of the flexible portion (222), and the orientation of the tool holder (231) along axes intersecting (253, 255) to the axis of rotation (251) of the tool holder.

[0042] Thus the tool (232) carried by the instrument holder can be moved and positioned in space along 4 axes relative to the manipulator's receiving interface, a fifth axis being constituted by the operative movement (258) of the tool. This positioning of the active part is carried out from the distal end of the rigid rod (221) so that the instrument holder can be introduced into a device through an orifice with a diameter substantially equal to that of the rigid rod and then the tool moved into this device, possibly under an obstacle, to perform an operation in an area of ​​the device distant from the orifice while keeping the rigid rod inside this orifice.

[0043] In addition, the instrument holder does not include any motor or any electrical, hydraulic or pneumatic connection, which allows it to be introduced into hazardous environments and allows the instrument holder to be decontaminated or sterilized.

[0044] The principle of cable-driven movement control also makes it possible to create a small-diameter instrument holder capable of performing precise operations in a very confined space. As a non-limiting example, the diameter of the instrument holder is between 20 mm and 30 mm for a length, excluding the tool, of between 50 mm and 100 mm.

[0045] Thus the active part (230) of the instrument holder can be controlled from the manipulator's receiving interface and the control bay according to 5 independent movements: a flexion movement (260) of the flexible portion (260), an orientation movement of the tool holder (256) relative to the flexible portion, a rotation movement (252) of the tool holder, an orientation movement of the tool (254) relative to the tool holder and an operating movement (258) of the tool.

[0046] [Fig. 3] According to one embodiment, the flexible portion consists of a plurality of annular modules (321, 322, 323, 324, 325) linked in a chain by pivot joints whose axes (350), parallel to each other, are perpendicular to the central axis (251) when the instrument holder is in the upright position. It terminates with an end module (330) configured to be assembled with the tool holder.

[0047] According to this embodiment, the shape of the modules provides rigidity to the flexible portion against tensile and compressive stresses along the central axis when the instrument holder is in the upright position. This same shape, comprising a protruding ring (326) over approximately half its circumference, which can remain in contact with each other between the modules when the flexible portion is in the flexed position, also contributes to the rigidity of this assembly, including in the flexed position.

[0048] The internal faces of the modules may include cable guides (340) configured to guide at least a portion of the control cables connected to the control module.

[0049] According to one embodiment, a first bending cable (341) may comprise 2 strands (341 b 3412) connected at one end to the terminal module (330) and to their other end to the same winding drum each in an opposite winding direction thus forming a loop to control the bending of the flexible portion.

[0050] Similarly, a tool holder orientation control cable (342) may comprise two strands (342b 3422) passing through the terminal module (330) and connected to the tool holder, maintaining a constant length regardless of the curvature of the flexible portion, and controlling the orientation of the tool holder.

[0051] A person skilled in the art understands that the same result can be obtained by using a winding drum per strand.

[0052] [Fig.4] According to one embodiment, the rotation of the tool holder (252) is transmitted from the coupling shaft to the tool holder by a rotating transmission member (411) in the form of a hollow shaft extending along the central axis inside the rigid rod (221) and the annular modules of the flexible portion when the tool holder is in the upright position.

[0053] The portion of the transmission element (411) located within the flexible portion comprises a plurality of sections linked together in a chain by universal joints (412) whose relative pivot axes between each section coincide with the axes (350) of the pivot joints between each module of the flexible portion. Thus, the tool's orientation movement can be transmitted to the tool holder regardless of the deflection of the flexible portion, while avoiding unwanted orientation movements of the tool during deflection of the flexible portion.

[0054] The shaft of the transmission member is hollow and the cardan joints (412) include a central passage (440) allowing cables connected in the control module to winding drums to pass through in order to control the orientation movement of the tool (254) as well as the operational movement (258) of the tool.

[0055] As described previously, a tool orientation cable (441) may include 2 strands (441 b 4412) connected at one end to a winding drum and at the other end to a joint (454) of the tool relative to the tool holder, thus forming a loop, to control the orientation movement of the tool (254), and an operating cable (442) including two strands (442b 4422) connected at one end to another winding drum and at the other end to an operating joint (458) to control the operative movement (258) of the tool.

[0056] According to an alternative embodiment (not shown), the transmission element can be a flexible shaft, similar to a flexible shaft for a drill. Such a flexible shaft is hollow so that the tool guidance cable (441) and the operating cable (442) extend inside the flexible shaft. This embodiment is lighter, more compact, and more economical than one using segments. cardan joints but less rigid and does not ensure the absence of parasitic movement of the tool's orientation when the flexible part is bent.

[0057] [Fig. 5] Different types of tools can be mounted in the tool holder. As By way of non-limiting example, the tool comprising two arms configured to move away from and towards each other and to be selected from: pliers (510), a spreader (520) or scissors (530).

[0058] The operating cable (442) allows the approach or separation of the two branches of the tool to be controlled, this movement constituting the operational movement according to this embodiment.

[0059] Returning to [Fig. 1] the system can be used alone or as an assistance for carrying out a minimally invasive surgical operation on a patient (190) in a reduced operating field (191).

[0060] The system can be controlled remotely, allowing a remote practitioner to intervene during the operation.

[0061] The rigidity of the instrument holder (100) in all its orientation configurations allows for the manipulation of tissues in the surgical field (191) which may be required by the execution of the surgical procedure

Claims

Demands

1. A robotic intervention system comprising a manipulator (101) and an instrument holder (100), the instrument holder being configured to be carried and moved by the manipulator and comprising a connection interface (210) configured to cooperate with a receiver interface (110) of the manipulator, the instrument holder comprising: a rigid hollow rod (221) comprising at a proximal end of the receiver interface a control module (210); at a distal end of the control module, a flexible hollow portion (222) extending from the rigid hollow rod along a central axis (250) passing through the centers of sections of the flexible hollow portion and sections of the rigid hollow rod in a straight position, configured to be flexed and to move away from the central axis (250) in a flexed position; at one end of the flexible hollow portion a tool holder (231);connected to the tool holder, a tool (232, 510, 520, 530) configured to perform at least one operational movement (258); characterized in that it comprises a plurality of cables (341, 342, 441, 442) each connected to a winding drum (212, 213, 214, 215) in the control module (219) and extending inside the rigid hollow rod and the flexible hollow portion, and a rotary transmission member (411) extending from the control module (219) to the tool holder, configured to produce a rotation (252) of the tool holder (231) about an axis of rotation (251) in which the axis of rotation (251) coincides with the central axis (250) in the straight position and is offset from the central axis in the flexed position.;

2. A system according to claim 1, wherein the plurality of cables comprises: at least one bending cable (341), configured to generate a bending (240) of the flexible hollow portion (222) about a bending axis perpendicular to the central axis; at least one orientation cable (342), configured to generate a rotation (256) of the tool holder (231) about a orientation axis (255) perpendicular to the central axis; and at least one operating cable (442) configured to control the operating movement (258) of the tool.

3. System according to claim 2, comprising at least one cable (441) configured to control an orientation movement (254) of the tool relative to the tool holder around an orientation axis d of the tool (253) perpendicular to the orientation axis (255) of the tool holder.

4. System according to claim 3, wherein the rotary transmission member (411) is hollow and at least one operating cable (442) and at least one tool guidance cable extend inside the rotary transmission member (411).

5. System according to claim 1, wherein the flexible hollow portion (222) comprises a chain of annular modules (321, 322, 323, 324, 325) extending along the central axis (250) in the upright position, each annular module being linked to a next annular element in the chain by a pivot joint about a pivot axis (350) perpendicular and intersecting the central axis (250).

6. System according to claim 1, wherein the rotating transmission member is a flexible shaft.

7. System according to claim 5, wherein the rotating transmission member is a transmission rod (411) extending along the central axis (250) inside a rigid hollow rod (221) and the flexible hollow portion (222), a final portion of the transmission rod extending in the flexible hollow portion comprising a plurality of sections each section being linked to the next along the central axis by a universal joint (412) configured to permit pivoting of one section relative to the next along an axis perpendicular to the central axis (250) and coinciding with the articulation axis (350).

8. System according to claim 1 wherein an active part of the tool comprises two arms, the tool being selected from a pinching clamp, a spreading clamp and scissors, the operative movement being a relative rotation of one of the two arms around an axis perpendicular to the central axis.

9. System according to any one of the preceding claims configured to perform a minimally invasive surgical operation.

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