DEVICE FOR ASSISTING A SURGICAL ROBOT CARRIAGE TO A PATIENT'S HEAD AND THE ROBOT CARRIAGE CONTAINING IT

Abstract

TITLE OF THE INVENTION: DEVICE FOR ATTACHING A SURGICAL ROBOT CARRIAGE TO A PATIENT'S HEAD AND THE ROBOT CARRIAGE CONTAINING IT. The device for attaching a surgical robot carriage (11) (10) to the head (25) of a patient (24) comprises: - a pivot joint (15) on a wall of the carriage, - an arm (16, 18) mounted on this pivot joint, - a means for locking the angular position of the arm relative to the wall of the carriage, and - an attachment (17) for fixing the position and orientation of a headrest or stereotaxic frame (20) relative to the arm. Figure for the abstract: Figure 4

Description

Title of the invention: DEVICE FOR SOLIDARIZING A SURGICAL ROBOT CARRIAGE AND A PATIENT'S HEAD AND THE ROBOT CARRIAGE CONTAINING IT Technical field of the invention

[0001] The present invention relates to a device for securing a surgical robot cart to a patient's head and to a robot cart carrying it. It is particularly applicable to the field of computer-assisted cranial surgery. Prior art

[0002] The approaches described in this section are approaches that could be pursued, but not necessarily approaches that have been previously conceived or pursued. Therefore, unless otherwise indicated, it should not be assumed that any of the approaches described in this section constitutes prior art simply because of its inclusion in this section.

[0003] During robotic-assisted brain surgery, it is necessary to secure the patient's head to a trolley supporting a robotic arm. The aim is to create a rigid assembly that minimizes the patient's head movements relative to the robotic surgical assistance unit in order to maintain the accuracy of the alignment between the robot, the patient, and the medical imaging. For this purpose, a mechanical assembly is commonly used, forming a rigid link between the robotic unit and a headrest that restricts the patient's head movements. These mechanical systems can be complex to assemble. Errors in assembly and locking by users can lead to mechanical play, resulting in a loss of precision in the associated robotic system. Furthermore, these assemblies are bulky and difficult to move in the confined space of an operating room.

[0004] For example, there are robot trolleys that include a telescopic arm extended to be secured to a stereotaxic frame that is pre-attached to the patient's head. This type of arm has several drawbacks. Firstly, it occupies a significant amount of space inside the trolley, which reduces the available space for other internal components and / or imposes large dimensions on the trolley, hindering ease of use and movement. Secondly, it has limited axial rigidity, which reduces the positioning accuracy of the patient's head within the trolley's geometric reference frame, or it requires a large vertical cross-section, which also impairs its integration into the trolley.

[0005] A system for attaching the "Neuromate®" surgical assistance robot is also known, characterized by its immobilization in the operating room, notably via a pillar anchored to the floor. This system presents several drawbacks, primarily related to its floor immobilization: it takes up significant space in an operating room, alters the room's structure, and de facto restricts its use to neurosurgery. Furthermore, its rigid design (floor fixing) limits the possibilities for adapting to patient positioning. Summary of the invention

[0006] The present invention aims to overcome all or part of the aforementioned drawbacks by proposing a surgical assistance robot coupled to a mobile chassis integrating a rigid foldable arm whose distal end has a rigid attachment system to a headrest in order to facilitate its storage and minimize its bulk.

[0007] Thus, the arm remains outside the chassis of the trolley. It therefore does not impose any constraints on the internal components of this chassis or on the total volume of this chassis.

[0008] The arm is connected to the trolley frame via a pivot joint. The system implementing this pivot joint, for example a hinge, includes a locking mechanism and, preferably, a means for indicating the locked state. The rigid attachment system to the headrest may also include a means for indicating the locking state of the system. Preferably, at least a portion of the arm is radio-transparent. Preferably, the folding arm may be telescopic.

[0009] In some embodiments, the pivot joint is mounted on the wall of the carriage via a sliding joint.

[0010] Preferably, the pivot joint is provided with a marker or a pivot joint locking sensor. Brief description of the figures

[0011] Other advantages, purposes and particular features of the invention will become apparent from the following non-limiting description of at least one particular embodiment of the device and trolley that are the subject of the present invention, with reference to the accompanying drawings, in which: [Fig. 1] schematically represents, in side view, a first embodiment of a trolley with a support arm in a folded position, [Fig.2] schematically represents, in side view, the trolley illustrated in [Fig.1] whose support arm is in the unfolded position, [Fig.3] schematically represents, in side view, the trolley illustrated in [Fig.1] whose support arm is in the unfolded position with a telescopic extension deployed, [Fig.4] schematically represents, in side view, an implementation of the trolley illustrated in [Fig.1] during a surgical intervention with robotic assistance, [Fig.5] schematically represents, in side view, a second embodiment of the trolley that is the subject of the invention, [Fig. 6] schematically represents, in side view, a third embodiment of the trolley that is the subject of the invention, and [Fig.7] represents, in the form of a flowchart, the implementation steps of the device that is the subject of the invention. Description of the implementation methods

[0012] The present description is given by way of non-limiting grammar, each feature of an embodiment being able to be advantageously combined with any other feature of any other embodiment.

[0013] It should be noted from the outset that the figures are not to scale.

[0014] As will be understood from the present description, various inventive concepts can be implemented by one or more of the methods or devices described below, several examples of which are provided herein. The actions or steps carried out in the implementation of the method or device can be ordered in any appropriate manner. Consequently, it is possible to construct embodiments in which the actions or steps are performed in a different order than that illustrated, which may include the simultaneous execution of certain acts, even if they are presented as sequential acts in the illustrated embodiments.

[0015] The indefinite articles "un" and "une", as used in the description, should be understood as meaning "at least one", unless clearly stated otherwise.

[0016] The expression "and / or", as used in this document, shall be understood as meaning "either or both" of the elements thus joined, that is, elements that are present conjunctively in some cases and disjunctively in others. Multiple elements listed with "and / or" shall be interpreted in the same way, that is, "one or more" of the elements thus joined. Other elements may possibly be present, other than the elements specifically identified by the "and / or" clause, whether or not they are related to those specifically identified elements. Thus, by way of non-limiting example, a reference to "A and / or B", when used in conjunction with an open language such as "comprising", may refer, in one embodiment, to A only (possibly including elements other than B); in another embodiment, to B only (possibly including elements other than A); in yet another embodiment, to A and B (possibly including other elements); etc.

[0017] As used herein in the description, "or" is to be understood inclusively.

[0018] As used in this description, the expression "at least one," with reference to a list of one or more elements, is to be understood as meaning at least one element chosen from one or more elements in the list of elements, but not necessarily including at least one of each element specifically enumerated in the list of elements and not excluding any combination of elements in the list of elements. This definition also allows for the optional presence of elements other than the elements specifically identified in the list of elements to which the expression "at least one" refers, whether or not they are related to those specifically identified elements.Thus, by way of non-limiting example, "at least one of A and B" (or, equivalently, "at least one of A or B", or, equivalently, "at least one of A and / or B") may refer, in one embodiment, to at least one, possibly including more than one, A, without B present (and possibly including elements other than B); in another embodiment, to at least one, possibly including more than one, B, without A present (and possibly including elements other than A); in yet another embodiment, to at least one, possibly including more than one, A, and at least one, possibly including more than one, B (and possibly including other elements); etc.

[0019] In the description below, all transitive expressions such as "comprising", "including", "carrying", "having", "containing", "implying", "holding", "composed of", and others, should be understood as open, that is, as meaning including but not limited to. Only the transitive expressions "consisting of" and "consisting essentially of" should be understood as closed or semi-closed transitive expressions, respectively.

[0020] Throughout this description, the terms "upper" and "top" refer to what is at the top when the device of the present invention is in its operational configuration. The terms "lower" and "bottom" refer to what is at the bottom when the device of the present invention is in its operational configuration. The term "inside" refers to what is inside the device. The term "outside" refers to what is outside the device.

[0021] The first embodiment is shown in Figures 1 to 4. A robot 10 comprises a carriage 11 mounted on casters 14 and a robotic arm 12 having joints 13. On one of the sides of the carriage 11, there is a pivot joint 15, for example a hinge, on which a support arm 16 is mounted. The support arm 16 can thus perform a rotation (illustrated by an arrow in [Fig. 2]) around the pivot link 15, so that its distal end 17 moves away from the chassis of the trolley 11 and extends towards the head of a patient to be operated on.

[0022] The robotic arm 12 is an anthropomorphic industrial robotic arm. The carriage 11 is equipped with cylinders (not shown) actuating support feet on the ground, which fix the carriage in position and stabilize it during the movements of the robotic arm 12. The support arm 16 has a base (not shown) perpendicular to its main axis. This base is connected to the pivot joint 15 so as to pivot about the horizontal axis of rotation of this pivot joint 15.

[0023] The pivot joint 15 is equipped with locking means (not shown) configured so that once the base of the support arm 16 reaches the end of its upward rotation, these locking means secure the base in position. These locking means may be similar to the locking means for tilting or hinged doors or windows. They may also include hinged flaps or handles rotating about an axis perpendicular to the support plane of the base in the locked position, bolts, magnets, or electromagnets, for example.

[0024] A pivot joint locking marker or sensor 19 provides a signal indicating that the pivot joint 15 is locked. With a marker, this signal can be visual, for example, by displaying a colored surface when the locking is complete, or audible, with the locking producing a recognizable sound. With a sensor, the signal can also be electrical, for example, via a dry contact in an electronic circuit that is closed when the locking is complete. In this latter case, the signal can be processed by an electronic and / or computer circuit so that an indicator light on a user interface displays an appearance that signifies to the operator that the support arm 16 is locked in the operating position. The signal can also be processed by the robot's central processing unit to disable all or part of the robot's functions until the support arm 16 is locked in the operating position.

[0025] When the support arm 16 is locked in the operating position, it adopts the configuration shown in [Fig.2].

[0026] At least part, and preferably all, of the support arm 16 is radio-transparent to allow medical imaging by scanning in the operating room, for example if a movement of the patient has caused a shift of his head in the geometric frame of the robot or of the medical imaging or to carry out a control imaging of the positioning of the implants (electrodes).

[0027] The telescopic support arm 16 is then extended as illustrated in [Fig. 3] to move the distal end 17 of the support arm 16 away from the chassis of the trolley 11. By this movement, a fastener positioned at this distal end 17 is brought into alignment of a lower arm of a headrest or stereotaxic frame 20, as illustrated in [Fig. 4]. Preferably, the support arm 16 includes a locking mechanism for its telescopic extension. Preferably, a marker or sensor (not shown) provides a visual, audible, or electrical signal that represents the locking of this extension, similar to the sensor 19 described above.

[0028] This headrest or frame is fixed to the head 25 of a patient 24 lying on an operating table 26. Once the lower arm of the headrest or frame 20 is positioned on this distal attachment, this attachment is locked to block the position and orientation of the stereotaxic headrest or frame 20.

[0029] Preferably, a marker or sensor (not shown) provides a signal, visual, audible or electrical, representative of the locking of this attachment of the headrest or stereotaxic frame on the support arm, in a manner similar to sensor 19 described above.

[0030] The second embodiment of the device of the invention, illustrated in [Fig. 5], contains the same elements as the first embodiment, except that the pivot joint 21 is mounted on a sliding joint 22 that extends vertically along a wall of the carriage 11. The pivot joint, and consequently the arm 16 and the distal attachment 17, can thus be moved vertically, in particular to facilitate the joining of the distal attachment 17 to the headrest or stereotaxic frame 20 and to adapt to the size and positioning (seated or standing) of the surgeon and the patient (the table height being adjustable). This increases the ergonomic comfort for the surgeon, as this type of surgery can last several hours. Of course, the sliding joint 22 can be locked in position.Preferably, a marker or sensor (not shown) provides a visual, audible, or electrical signal representative of the locking of this slide link 22, in a manner similar to the sensor 19 described above.

[0031] In the third embodiment of the device of the invention illustrated in [Fig.6], we find the same elements as in the first embodiment, except that the pivot joint 15 is supplemented by a movable lateral reinforcement 23.

[0032] Consequently, the arm 16 and the distal attachment 17 can be moved vertically by rotation around the axis of the pivot joint 15, in particular to facilitate the joining of the distal attachment 17 and the headrest or stereotaxic frame 20. Of course, the configuration of the lateral reinforcement 23 can be locked. Preferably, a marker or sensor (not shown) provides a visual, audible, or electrical signal that indicates the locking of the lateral reinforcement 23 configuration, similarly to the sensor 19 described above.

[0033] The present invention relates to the device extending from the chassis wall of the trolley 11 to the arm of the headrest or stereotaxic frame 20. The present invention aims also the surgical robot trolley 11, which includes this device which is the subject of the present invention.

[0034] Fig. 7 represents, in the form of a logic diagram 30, implementation steps of a trolley that is the subject of the invention.

[0035] During a step 31, an operator positions the trolley 11 and it is immobilized by deploying its cylinders.

[0036] During a step 32, the operator rotates the support arm.

[0037] During a step 33, the operator locks the pivot joint which is at the base of the support arm.

[0038] During a step 34, the operator or the circuits of the trolley 11 check the locking of the pivot link.

[0039] During a step 35, the operator causes the extension and locking of the extension of the support arm.

[0040] During a step 36, the operator positions the arm of the headrest or stereotaxic frame on the distal attachment of the support arm.

[0041] During a step 37, the operator locks the position and orientation of the stereotaxic headrest or frame onto the distal attachment of the support arm.

[0042] During a step 38, the operator performs the re-regulation of the position and orientation of the headrest or stereotaxic frame, the medical imaging, and the robot's geometric reference frame. This re-regulation involves, for example, a robot probe or a navigation camera and a pointer equipped with a handheld navigation reference, attached to the patient's head, or attached to the headrest or stereotaxic frame. A navigation reference 27, illustrated in [Fig. 4], is a set of at least four markers pre-mounted on a rigid support, in non-coplanar and asymmetrical positions. An image of this navigation reference thus makes it possible to determine the position (three coordinates in an orthonormal coordinate system) and the orientation (three angular coordinates in this coordinate system) of this navigation reference.

[0043] During step 39, the surgical procedure is performed. After the end of the surgical operation, the steps for folding the support arm are the reverse of steps 37 to 32 described above.

[0044] The implementation of the present invention has the following advantages: - it prevents locking errors thanks to markers and / or sensors, - it ensures rigid support between the trolley and the headrest or stereotaxic frame, - it provides flexibility in positioning within the operating room, - it minimizes imaging artifacts thanks to the radiolucency of the support arm. Presentation of the invention

[0045] The present invention aims to remedy all or part of the drawbacks of the prior art.

[0046] To this end, according to a first aspect, the present invention relates to a device for securing a surgical robot carriage and the head of a patient, which comprises a pivot joint on a wall of the carriage, an arm mounted on this pivot joint, a means for locking the angular position of the arm relative to the wall of the carriage, and a locking attachment for the position and orientation of a headrest or stereotaxic frame relative to the arm.

[0047] Thanks to these arrangements, the patient head support arm does not clutter the inside of the surgical robot trolley.

[0048] According to particular characteristics, the device of the invention further comprises a marker or a locking sensor for the pivot link.

[0049] Thus, visually, audibly or electrically, an operator and / or an electronic and computer circuit of the trolley can verify the locking of the pivot link.

[0050] According to particular characteristics, the arm is telescopic.

[0051] Thanks to these arrangements, the position of the fixation attachment can be adapted to the respective position of the trolley and the head of the patient lying on the operating table, by simply deploying the telescopic arm.

[0052] In embodiments, the device of the invention further comprises a marker or a locking sensor for the deployment of the telescopic arm.

[0053] Thus, visually, audibly or electrically, an operator and / or an electronic and computer circuit of the trolley can verify the locking of the extension of the telescopic arm.

[0054] According to particular characteristics, the device of the invention further comprises a sliding connection of the pivot connection on the wall of the carriage.

[0055] The vertical position of the support arm can thus be easily modified by sliding the pivot joint on the sliding joint.

[0056] In embodiments, the device of the invention further comprises a marker or a locking sensor for the sliding link.

[0057] Thus, visually, audibly or electrically, an operator and / or an electronic and computer circuit of the trolley can check the locking of the sliding link and therefore the height of the headrest attachment or stereotaxic frame.

[0058] According to particular features, the device of the invention further comprises a movable reinforcement connecting the wall of the carriage to the arm and configured to support the arm in a position away from the wall of the carriage on which the pivot joint is mounted.

[0059] The rigidity of the support arm is thus reinforced.

[0060] According to particular characteristics, the device which is the subject of the invention further comprises a marker or a locking sensor for the mobile reinforcement.

[0061] Thus, visually, audibly or electrically, an operator and / or an electronic and computer circuit of the trolley can verify the locking of the mobile reinforcement.

[0062] According to particular characteristics, at least a part of the arm is radio transparent.

[0063] It is thus possible to produce, in the operating room, a medical image with a scanner without artifact caused by the support arm.

[0064] According to a second aspect, the present invention relates to a surgical robot trolley, which includes a device that is the subject of the present invention. Since the advantages, purposes, and specific characteristics of this trolley are similar to those of the device that is the subject of the invention, they are not described here.

Claims

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10. Demands Device for securing a surgical robot carriage (11) (10) and the head (25) of a patient (24), characterized in that it comprises: - a pivot joint (15, 21) on a wall of the carriage, - an arm (16, 18) mounted on this pivot joint, - a means for locking the angular position of the arm relative to the wall of the carriage, and - a fastener (17) for fixing the position and orientation of a headrest or stereotaxic frame (20) in relation to the arm. A device according to claim 1, further comprising a marker or sensor (19) for locking the pivot joint (15). A device according to claim 1 or 2, wherein the arm (16, 18) is telescopic. Device according to claim 3, which further comprises a marker or a locking sensor for the deployment of the telescopic arm (16, 18). Device according to any one of claims 1 to 4, which further comprises a sliding connection (22) of the pivot connection (21) on the wall of the carriage. A device according to claim 5, further comprising a marker or a locking sensor for the sliding joint (22). A device according to any one of claims 1 to 6, further comprising a movable reinforcement (23) connecting the carriage wall to the arm (16, 18) and configured to support the arm in a position away from the carriage wall on which the pivot joint (15) is mounted. Device according to claim 7, which further comprises a marker or a locking sensor for the mobile reinforcement (23). Device according to any one of claims 1 to 8, wherein at least a part of the arm (16, 18) is radio transparent. Surgical robot trolley (10), which includes a device according to any one of claims 1 to 9.

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