Surgical support robot system and control method for surgical support robot

Abstract

To provide a surgical support robot capable of reducing the burden on an operator when positioning the surgical support robot.SOLUTION: In a medical manipulator 1, a control unit 31 moves a medical cart 3 by a servo motor M5 so as to position an arm 60 with respect to a position corresponding to a port PT or trocar T for inserting a medical instrument 4 provided on a body surface S of a patient P placed on an operating table 5, based on an image captured by an imaging unit 51.SELECTED DRAWING: Figure 16

Description

[Technical Field]

[0001] The present invention relates to a surgical assistance robot system and a method for controlling a surgical assistance robot. [Background technology]

[0002] BACKGROUND ART Conventionally, a surgical support robot is known in which the surgical support robot is aligned with a patient (see, for example, Patent Document 1).

[0003] The above-mentioned Patent Document 1 discloses a remotely operated assembly (surgery support robot) having multiple arms to which medical instruments such as endoscopes are attached. The remotely operated assembly includes a base and a telescopic support column attached to the base. The telescopic support column is provided so as to extend vertically. A telescopic boom is provided so as to extend horizontally from the telescopic support column. The multiple arms are attached to an orientation platform provided at the tip of the telescopic boom via multiple support beams.

[0004] The remote control assembly of Patent Document 1 is configured to project a reference laser line from the remote control assembly onto a patient placed on an operating table. An operator, such as a nurse or technician, who moves the remote control assembly, moves the entire remote control assembly so that multiple arms are positioned along the reference laser line projected directly onto the patient, following guidance setup screen prompts displayed on the touchpad and voice prompts, thereby attempting to align the remote control assembly with the patient. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Special Publication No. 2017-515522 Summary of the Invention [Problem to be solved by the invention]

[0006] However, in the case of the remote control assembly described in Patent Document 1, the operator needs to align the remote control assembly with respect to the patient, which increases the burden on the operator.

[0007] The present invention has been made to solve the above-mentioned problems, and one object of the present invention is to provide a surgical support robot system and a control method for a surgical support robot that can reduce the burden on the operator when positioning the surgical support robot. [Means for solving the problem]

[0008] In order to achieve the above object, a surgical support robot system according to a first aspect of the present invention is a surgical support robot system comprising: a robot main body unit including an arm base supporting a plurality of arms, to which a plurality of medical instruments are respectively attached, and a positioner, which is a robot including a plurality of joints for moving the arm base; a movable medical cart that supports the robot main body unit; a medical cart drive unit for moving the medical cart; an imaging unit provided on the robot main body unit for photographing a patient placed on an operating table; and one or more control units; the patient has a plurality of trocars attached to their body surface for inserting a plurality of medical instruments, and the control unit plans a movement path of the medical cart and controls the medical cart drive unit based on the planned movement path to move the medical cart from a first position to a second position closer to the operating table than the first position; and with the medical cart positioned at the second position, causes the positioner to move the arm base so as to align the arrangement of the plurality of arms with the arrangement of the plurality of trocars based on the image captured by the imaging unit.

[0009] As described above, a surgical assistance robot system according to a first aspect of the present invention includes a control unit that performs at least one of control of the medical cart drive unit to move the medical cart and control of the robot main body unit to move the arm, so as to align the arm with a position corresponding to a port or trocar provided on the body surface of a patient placed on an operating table, based on an image captured by the imaging unit. As a result, the arm is automatically aligned with the position corresponding to the port or trocar by at least one of control of the medical cart drive unit to move the medical cart and control of the robot main body to move the arm, thereby reducing the burden on the operator when aligning the surgical assistance robot.

[0010] A control method for a surgery support robot according to a second aspect of the present invention is a control method for a surgery support robot comprising: a robot main body including an arm base supporting a plurality of arms, to which a plurality of medical instruments are respectively attached, and a positioner which is a robot including a plurality of joints for moving the arm base; a movable medical cart supporting the robot main body; and a medical cart drive unit for moving the medical cart, the method comprising the steps of: planning a movement path for the medical cart; photographing a patient who has a plurality of trocars installed on the body surface and who is placed on an operating table, using an imaging unit provided in the robot main body; and photographing the planned movement path for the medical cart. The method includes the steps of: controlling the medical cart drive unit based on the obtained movement path so that the medical cart moves from the first position to a second position closer to the operating table than the first position; moving the medical cart from the first position away from the patient by the medical cart drive unit to the second position where the surgery will be performed so that the endoscopic trocar is positioned at a predetermined position relative to the arm base based on the image taken by the imaging unit; and moving the arm base by the positioner while the medical cart is positioned at the second position so that the arrangement of the multiple arms is aligned with the arrangement of the multiple trocars based on the image taken by the imaging unit.

[0011] A method for controlling a surgical support robot according to a second aspect of the present invention includes, as described above, a step of controlling at least one of the medical cart drive unit to move the medical cart and the robot main body to move the arm, so as to align the arm with a position corresponding to a port or trocar provided on the body surface of a patient placed on an operating table, based on an image captured by the imaging unit. By performing at least one of the control of the medical cart drive unit to move the medical cart and the control of the robot main body to move the arm, the arm is automatically aligned with the position corresponding to the port or trocar, thereby providing a method for controlling a surgical support robot that can reduce the burden on the operator when aligning the surgical support robot. [Effects of the Invention]

[0012] According to the present invention, as described above, it is possible to reduce the burden on the operator when positioning the surgical support robot. [Brief explanation of the drawings]

[0013] [Figure 1] 1 is a diagram showing the configuration of a surgical operation system according to a first embodiment of the present invention. [Figure 2] 1 is a diagram showing the configuration of a medical manipulator according to a first embodiment of the present invention. [Figure 3] 1 is a perspective view showing the configuration of a medical cart according to a first embodiment of the present invention. [Figure 4] 1 is a diagram showing a medical manipulator according to a first embodiment of the present invention and a patient. [Figure 5] FIG. 10 is a diagram showing a mark displayed on a display unit. [Figure 6] FIG. 1 shows a trocar inserted into the surface of a patient's body. [Figure 7] FIG. 1 is a diagram showing an endoscope. [Figure 8] FIG. 10 is a diagram showing a pivot position teaching tool. [Figure 9] 1A and 1B are diagrams showing the configuration of an arm of a medical manipulator according to a first embodiment of the present invention. [Figure 10] FIG. 1 is a perspective view showing the configuration of an operation unit of a medical manipulator according to a first embodiment of the present invention. [Figure 11] FIG. 1 is a side view showing the configuration of an operation unit of a medical manipulator according to a first embodiment of the present invention. [Figure 12] 1 is a view showing a state in which an operator grips an operation unit of a medical manipulator according to a first embodiment of the present invention. FIG. [Figure 13] FIG. 10 is a diagram for explaining translational movement of an arm. [Figure 14] FIG. 10 is a diagram illustrating the rotational movement of the arm. [Figure 15] FIG. 2 is a block diagram showing the configuration of a control unit of the medical manipulator according to the first embodiment of the present invention. [Figure 16] FIG. 2 is a flow chart for explaining a method for aligning the arm of the surgery support robot according to the first embodiment of the present invention. [Figure 17] FIG. 1 is a diagram (1) showing a display unit of a medical cart according to a first embodiment of the present invention. [Figure 18] FIG. 2 is a diagram (2) showing the display unit of the medical cart according to the first embodiment of the present invention. [Figure 19] FIG. 10 is a diagram showing a state in which an imaging unit is imaging an operating table. [Figure 20] FIG. 2 is a diagram showing a state in which a patient is being photographed by an imaging unit. [Figure 21] FIG. 1 shows the alignment of the trocar and the markings displayed on the display unit. [Figure 22] FIG. 2 shows the alignment of the trocar and the markings displayed on the display unit. [Figure 23] FIG. 10 is a side view showing the configuration of a surgical operation system according to a second embodiment of the present invention. [Figure 24] FIG. 10 is a flowchart illustrating a method for planning the position of an arm of a surgery support robot according to a second embodiment of the present invention. [Figure 25]FIG. 10 is a top view showing the configuration of a surgical operation system according to a second embodiment of the present invention. [Figure 26] FIG. 10 is a flow chart for explaining a method for aligning the arm of a surgery support robot according to a second embodiment of the present invention. [Figure 27] FIG. 1 is a side view (1) of a modified surgical support robot. [Figure 28] FIG. 10 is a diagram showing an identification unit according to a modified example. [Figure 29] FIG. 2 is a side view (2) of a modified surgical support robot. DETAILED DESCRIPTION OF THE INVENTION

[0014] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will now be described with reference to the accompanying drawings.

[0015] [First embodiment] The configuration of a surgical system 100 according to a first embodiment will be described with reference to FIGS. 1 to 22. The surgical system 100 includes a medical manipulator 1, which is a patient-side device, and a remote control device 2, which is an operator-side device for operating the medical manipulator 1. The medical manipulator 1 is configured to be movable and includes a medical cart 3 that moves a positioner 40, an arm base 50, and multiple arms 60, which will be described later. The remote control device 2 is located at a distance from the medical manipulator 1, and the medical manipulator 1 is configured to be remotely controlled by the remote control device 2. The surgeon inputs commands to the remote control device 2 to cause the medical manipulator 1 to perform a desired operation. The remote control device 2 transmits the input commands to the medical manipulator 1. The medical manipulator 1 operates based on the received commands. The medical manipulator 1 is also located in an operating room, which is a sterilized sterile field. The medical manipulator 1 is an example of a "surgery support robot" in the claims, and the arm base 50 is an example of a "robot body" in the claims.

[0016] The remote control device 2 is placed, for example, inside or outside an operating room. The remote control device 2 includes an operating manipulator arm 21, an operating pedal 22, a touch panel 23, a monitor 24, a support arm 25, and a support bar 26. The operating manipulator arm 21 constitutes an operating handle for the surgeon to input commands. The monitor 24 is a scope-type display device that displays images captured by the endoscope 6. The support arm 25 supports the monitor 24 so that its height is aligned with the surgeon's face. The touch panel 23 is attached to the support bar 26. The medical manipulator 1 can be operated by the remote control device 2 when a sensor (not shown) provided near the monitor 24 detects the surgeon's head. The surgeon operates the operating manipulator arm 21 and the operating pedal 22 while visually checking the affected area on the monitor 24. This inputs commands to the remote control device 2. The commands input to the remote control device 2 are transmitted to the medical manipulator 1.

[0017] The medical cart 3 is provided with a control unit 31 that controls the operation of the medical manipulator 1 and a storage unit 32 that stores programs and the like for controlling the operation of the medical manipulator 1. Based on commands input to the remote control device 2, the control unit 31 of the medical cart 3 controls the operation of the medical manipulator 1.

[0018] The medical cart 3 is also provided with an input device 33. The input device 33 is configured to receive operations for moving and changing the posture of the positioner 40, the arm base 50, and the multiple arms 60, mainly for preparing for surgery before the procedure.

[0019] As shown in FIGS. 1 and 2, a medical manipulator 1 is placed in an operating room. The medical manipulator 1 includes a medical cart 3, a positioner 40, an arm base 50, and a plurality of arms 60. The arm base 50 is attached to the tip of the positioner 40. The arm base 50 has a relatively long rod shape. The base of each of the plurality of arms 60 is attached to the arm base 50. The plurality of arms 60 are configured to be able to assume a storage position, which is a folded position. The arm base 50 and the plurality of arms 60 are used while covered with a sterile drape (not shown).

[0020] In the first embodiment, the arm base 50 is provided with an imaging unit 51. The imaging unit 51 images at least one of the operating table 5 and the patient P placed on the operating table 5.

[0021] The positioner 40 is configured, for example, by a seven-axis articulated robot. The positioner 40 is disposed on the casing 34 of the medical cart 3. The positioner 40 moves the arm base 50. Specifically, the positioner 40 is configured to move the position of the arm base 50 three-dimensionally.

[0022] The positioner 40 also includes a base portion 41 and a plurality of link portions 42 connected to the base portion 41. The plurality of link portions 42 are connected to each other by joint portions 43.

[0023] As shown in Fig. 1, a medical instrument 4 is attached to the tip of each of the multiple arms 60. The medical instrument 4 includes, for example, a replaceable instrument (see Fig. 2) and an endoscope 6 (see Fig. 7). When teaching a pivot position, which will be described later, a pivot position teaching instrument (see Fig. 8) is attached to the tip of the arm 60 to which the instrument is attached, instead of the instrument.

[0024] As shown in FIG. 2, the medical instrument 4 (instrument) includes a driven unit 4a driven by a servo motor M2 mounted on a holder 71 of an arm 60. The instrument also includes an end effector 4b at its tip. The end effector 4b includes, as articulated instruments, forceps, scissors, a glass burr, a needle holder, a microdissector, a stable applier, a tacker, a suction and irrigation tool, a snare wire, and a clip applier. The end effector 4b also includes, as non-articulated instruments, a cutting blade, a cauterizing probe, an irrigator, a catheter, and a suction orifice. The medical instrument 4 also includes a shaft 4c connecting the driven unit 4a and the end effector 4b. The driven unit 4a, the shaft 4c, and the end effector 4b are arranged along the Z direction.

[0025] 3 and 4, the input device 33 of the medical cart 3 is provided with a display unit 33a. The display unit 33a is configured to display in real time an image of the patient P photographed by the imaging unit 51. As shown in FIG. 5, the display unit 33a displays an image of the patient P photographed by the imaging unit 51 and a mark MK for aligning the arm base 50 with the patient P, superimposed on the image of the patient P photographed by the imaging unit 51. Specifically, the display unit 33a displays an image of a trocar T (see FIG. 6) for inserting the endoscope 6 from the body surface S of the patient P photographed by the imaging unit 51 and a mark MK for aligning the arm base 50 with the trocar T, superimposed on the image of the trocar T. The mark MK displayed on the display unit 33a is aligned with the trocar T displayed on the display unit 33a, thereby aligning the arm 60 with the surgical position of the patient P placed on the operating table 5. The positioning of the arm 60 is performed manually by an operator such as a nurse or technician, or automatically by the control unit 31 as described below.

[0026] The images of the patient P and trocar T displayed on the display unit 33a are images actually captured by the imaging unit 51, and the marking area MK is a GUI (Graphical User Interface) image generated by the control unit 31 and stored in the memory unit 32. The control unit 31 is equipped with an image processing circuit 31c that displays the images obtained from the imaging unit 51 on the display unit 33a. The image processing circuit 31c, which uses an FPGA (Field Programmable Gate Array) mounted on the control unit 31, combines the images of the patient P and trocar T actually captured by the imaging unit 51 and stored in the memory unit 32 with the marking area MK composed of the GUI image, and displays the combined images on the display unit 33a in real time with a delay imperceptible to the human eye. The image processing circuit 31c may be configured as an application-specific integrated circuit (ASIC), a system-on-chip (SOC), or the like, in addition to a field programmable gate array (FPGA).

[0027] Specifically, the trocar T includes a first trocar T1 through which the endoscope 6 is inserted and a second trocar T2 through which a medical instrument 4 other than the endoscope 6 is inserted. The markings MK displayed on the display unit 33a include a first marking MK1 aligned with the first trocar T1 and a second marking MK2 aligned with the second trocar T2 on the display unit 33a. Specifically, the first marking MK1 is displayed in approximately the center of the display unit 33a and has a substantially circular shape. The second marking MK2 has a crosshair shape centered on the substantially circular first marking MK1.

[0028] Furthermore, the size of the substantially circular first mark portion MK1 is larger than the size of the first trocar T1 displayed on the display unit 33a. Specifically, the diameter of the substantially circular first mark portion MK1 is larger than the diameter of the first trocar T1, which has a substantially circular cross section.

[0029] A plurality of second trocars T2 are provided on the body surface S of the patient P. The plurality of second trocars T2 are arranged in a substantially straight line. The trocars T are arranged in the following order to correspond to the four arms 60: second trocar T2, first trocar T1, second trocar T2, and second trocar T2.

[0030] The display unit 33a has a substantially rectangular shape. For example, the display unit 33a has a horizontally elongated rectangular shape when viewed from the operator. The crosshair-shaped second mark portion MK2 includes a substantially linear first line portion L1 extending along the vertical direction of the substantially rectangular display unit 33a and a substantially linear second line portion L2 extending along the horizontal direction of the substantially rectangular display unit 33a. The medical manipulator 1 is configured so that the multiple second trocars T2 are aligned on the display unit 33a along the first line portion L1 or the second line portion L2.

[0031] The first line L1 and the second line L2 displayed on the display unit 33a are fixed on the display unit 33a. The display unit 33a is fixed to the medical cart 3. As a result, the direction along the first line L1 corresponds to the front-to-rear direction, which is the movement direction of the medical cart 3. The image of the patient P displayed on the display unit 33a changes with the movement of the imaging unit 51 of the arm base 50 and the movement of the medical cart 3.

[0032] In addition, a magnification change button B is provided to enlarge or reduce the image of the first mark portion MK1 along with the image of the patient P displayed on the display unit 33a. The magnification change button B is displayed on the touch panel. When the magnification change button B is pressed, the magnification of the image is changed in a loop in the order of 100%, 200%, 400%, 100%, and 200%. Furthermore, when the image magnification is 100%, the edge of the operating table 5 and even nearby assistants and nurses are displayed on the display unit 33a.

[0033] Then, the first trocar T1 displayed on the display unit 33a is aligned with the first mark MK1, and the second trocar T2 displayed on the display unit 33a is aligned with the second mark MK2, either manually by the operator or automatically by the control unit 31, thereby aligning the arm 60 with the surgical position of the patient P placed on the operating table 5. Details of the alignment of the arm 60 with the surgical position of the patient P will be described later.

[0034] 3, a joystick 33b for controlling the movement of the positioner 40 is provided near the display unit 33a of the medical cart 3. By selecting an operation mode displayed on the display unit 33a and operating the joystick 33b, the positioner 40 can be operated three-dimensionally.

[0035] An enable switch 33c that permits or prohibits movement of the positioner 40 is provided near the joystick 33b of the medical cart 3. When the enable switch 33c is pressed down to permit movement of the positioner 40, the positioner 40 is moved by operating the joystick 33b.

[0036] A handle 35 for controlling the movement of the medical cart 3 is provided near the display unit 33a of the medical cart 3. The handle 35 has a throttle unit 35a that is gripped and turned by an operator such as a nurse or technician to control the movement of the medical cart 3. The handle 35 is configured to be rotatable left and right (R direction), and the direction of movement of the medical cart 3 is changed as the handle 35 is turned.

[0037] An enable switch 35b that permits or prohibits movement of the medical cart 3 is provided near the handle 35 of the medical cart 3. When the enable switch 35b is pressed down to permit movement of the medical cart 3, the throttle portion 35a of the handle 35 is operated to move the medical cart 3 forward or backward.

[0038] Furthermore, while the trocar T displayed on the display unit 33a is being aligned with the marking portion MK, the positioner 40 is controlled to move the arm base 50 so that the imaging unit 51 images a vertically downward direction. This control is performed by the control unit 31 that controls the operation of the medical manipulator 1.

[0039] Next, the configuration of the arm 60 will be described in detail.

[0040] 9, the arm 60 includes an arm section 61 having a base section 62, a link section 63, and a joint section 64, and a translational movement mechanism section 70 provided at the tip of the arm section 61. The arm 60 is configured so that the tip side thereof is movable three-dimensionally relative to an arm base 50 at the base side of the arm 60. The multiple arms 60 have the same configuration.

[0041] The translational movement mechanism 70 is provided on the distal end side of the arm 61, and has the medical instrument 4 attached thereto. The translational movement mechanism 70 translates the medical instrument 4 in the direction of insertion into the patient P. The translational movement mechanism 70 is configured to translate the medical instrument 4 relative to the arm 61. Specifically, the translational movement mechanism 70 is provided with a holder 71 that holds the medical instrument 4. The holder 71 houses a servo motor M2 (see FIG. 15). The servo motor M2 is configured to rotate a rotating body provided in the driven unit 4a of the medical instrument 4. The rotation of the rotating body of the driven unit 4a operates the end effector 4b.

[0042] The arm 60 is configured to be detachable from the arm base 50 .

[0043] The arm unit 61 is composed of a seven-axis articulated robot arm. The arm unit 61 also includes a base unit 62 for attaching the arm unit 61 to the arm base 50, and a plurality of link units 63 connected to the base unit 62. The plurality of link units 63 are connected to each other by joint units 64.

[0044] The translational movement mechanism 70 is configured to translate the holder 71 along the Z direction, thereby translating the medical instrument 4 attached to the holder 71 along the Z direction (the direction in which the shaft 4c extends). Specifically, the translational movement mechanism 70 includes a base-end link portion 72 connected to the tip of the arm portion 61, a tip-end link portion 73, and a connecting link portion 74 provided between the base-end link portion 72 and the tip-end link portion 73. The holder 71 is provided on the tip-end link portion 73.

[0045] The connecting link portion 74 of the translational movement mechanism 70 is configured as a speed-doubling mechanism that moves the distal link portion 73 along the Z direction relative to the proximal link portion 72. The distal link portion 73 is moved along the Z direction relative to the proximal link portion 72, thereby causing the medical instrument 4 provided in the holder 71 to translate along the Z direction. The distal end of the arm portion 61 is connected to the proximal link portion 72 so as to rotate the proximal link portion 72 about an axis in the Y direction perpendicular to the Z direction.

[0046] Also, as shown in FIG. 1, an endoscope 6 is attached to one arm 60 (for example, arm 60b) of the multiple arms 60, and medical instruments 4 other than the endoscope 6 are attached to the remaining arms 60 (for example, arms 60a, 60c, and 60d).

[0047] 10, the medical manipulator 1 is attached to the arm 60 and includes an operation unit 80 for operating the arm 60. The operation unit 80 includes an enable switch 81, a joystick 82, and a switch unit 83. The enable switch 81 permits or prohibits movement of the arm 60 by the joystick 82 and the switch unit 83. When an operator such as a nurse or an assistant holds the operation unit 80 and presses it, the enable switch 81 enters a state in which movement of the medical instrument 4 by the arm 60 is permitted. A pair of enable switches 81 are provided on both sides of an outer circumferential surface 80a of the operation unit 80 (see FIG. 11).

[0048] Specifically, the enable switch 81 is configured as a push button switch that is pressed by the operator's finger. Pressing the enable switch 81 enables control of energizing the servo motors M1 to M3. In other words, only while the enable switch 81 is pressed, control of moving the arm 60 becomes possible.

[0049] 12, the joystick 82 is configured to be operated by tilting it with the operator's finger. The arm 60 is controlled to move depending on the direction and angle at which the joystick 82 is tilted. The operator places their finger on the tip 82a of the joystick 82 and moves their finger to tilt the joystick 82. The input of a signal resulting from the operation of the joystick 82 is accepted only while the enable switch 81 is pressed. In other words, when the enable switch 81 is not pressed, the arm 60 is not moved even if the joystick 82 is operated.

[0050] 10 and 11, the joystick 82 is provided on an end surface 80c that intersects with the outer peripheral surface 80a of the operation unit 80. The joystick 82 can be operated by the operator's fingers when the operator grasps the outer peripheral surface 80a of the operation unit 80 and presses the enable switch 81 to permit movement of the arm 60. For example, as shown in FIG. 12, the operator presses a pair of enable switches 81 provided on the outer peripheral surface 80a of the operation unit 80 with the operator's thumb and middle finger, and then operates the joystick 82 provided on the end surface 80c of the operation unit 80 with the operator's index finger. This makes it easy to maintain a substantially constant distance between the operator's thumb and middle finger grasping the operation unit 80 and the index finger operating the joystick 82. The fingers that operate the enable switch 81 and the joystick 82 are not limited to the above example. Alternatively, movement of the arm 60 may be permitted when only one of the pair of enable switches 81 is pressed.

[0051] The joystick 82 is configured to control the movement of the medical instrument 4 by the arm 60 so that the tip 4d of the medical instrument 4 (see FIG. 9) moves on a predetermined plane. The operating unit 80 also includes a switch unit 83 for controlling the movement of the medical instrument 4 by the arm 60 so that the tip 4d of the medical instrument 4 moves along the longitudinal direction of the medical instrument 4, which is perpendicular to the predetermined plane. The predetermined plane along which the tip 4d of the medical instrument 4 moves is a plane parallel to the end face 80c of the operating unit 80 (the XY plane in FIG. 10). The longitudinal direction of the medical instrument 4, which is perpendicular to the predetermined plane, is the Z direction, which is perpendicular to the XY plane in FIG. 10. The coordinates represented by the X-, Y-, and Z-axes in FIG. 10 are called a tool coordinate system (or a base coordinate system). When the switch unit 83 is pressed while the enable switch 81 is pressed, the tip 4d of the medical instrument 4 moves along the longitudinal direction of the medical instrument 4.

[0052] The switch unit 83 also includes a switch unit 83a that moves the tip 4d of the medical instrument 4 in the direction along the longitudinal direction of the medical instrument 4, in which the medical instrument 4 is inserted into the patient P, and a switch unit 83b that moves the tip 4d of the medical instrument 4 in the direction opposite to the direction in which the medical instrument 4 is inserted into the patient P. The switch units 83a and 83b are both configured as push button switches. The switch units 83 are provided on both sides of the outer circumferential surface 80a of the operating unit 80 (see FIG. 11). Specifically, the switch units 83 (switch units 83a and 83b) are provided in pairs on both side surfaces of the operating unit 80.

[0053] 10, the operating unit 80 also includes a pivot button 85 that indicates a pivot position PP, which is a position (see FIG. 14) that serves as a fulcrum when moving the medical instrument 4 attached to the arm 60. The pivot button 85 is provided on a surface 80b of the operating unit 80 adjacent to the enable switch 81. The pivot position PP is indicated by pressing the pivot button 85. A pair of pivot buttons 85 are provided on both sides of the outer circumferential surface 80a of the operating unit 80 (see FIG. 11).

[0054] 10 and 11, an adjustment button 86 for optimizing the position of the arm 60 is provided on the surface 80b of the operation unit 80. After teaching the pivot position PP for the arm 60 to which the endoscope 6 is attached, pressing the adjustment button 86 optimizes the position of the other arm 60 (arm base 50). A pair of adjustment buttons 86 is provided on both sides of the outer circumferential surface 80a of the operation unit 80.

[0055] As shown in FIG. 10, the operation unit 80 also includes a mode switching button 84 that switches between a mode for translating (see FIG. 13) and a mode for rotational (see FIG. 14) movement of the medical instrument 4 attached to the arm 60. In the operation unit 80, the mode switching button 84 is disposed near the joystick 82. Specifically, the mode switching button 84 is provided adjacent to the joystick 82 on the end surface 80c of the operation unit 80. The mode switching button 84 is also formed by a push button switch. A mode indicator 84a is also provided near the mode switching button 84. The mode indicator 84a indicates the switched mode. Specifically, the current mode (translational movement mode or rotational movement mode) is displayed by the mode indicator 84a being lit (rotational movement mode) or extinguished (translational movement mode).

[0056] As shown in Fig. 13, in the mode in which the arm 60 is translated, the arm 60 is moved so that the tip 4d of the medical instrument 4 moves on the XY plane. Also, as shown in Fig. 14, in the mode in which the arm 60 is rotationally moved, when the pivot position PP has not been taught, the arm 60 is moved so that the medical instrument 4 rotates around the end effector 4b, and when the pivot position PP has been taught, the arm 60 is moved so that the medical instrument 4 rotates around the pivot position PP as a fulcrum. Note that the medical instrument 4 is rotationally moved with the shaft 4c of the medical instrument 4 inserted into the trocar T.

[0057] 9, the operating unit 80 is provided on the translational movement mechanism 70. The operating unit 80 is attached to the translational movement mechanism 70 so as to be adjacent to the medical instrument 4 attached to the translational movement mechanism 70. Specifically, the operating unit 80 is attached to the distal link portion 73 of the translational movement mechanism 70. The operating unit 80 is disposed so as to be adjacent to the driven unit 4a of the medical instrument 4.

[0058] 15, the arm 60 is provided with a plurality of servo motors M1, an encoder E1, and a reducer (not shown) so as to correspond to the plurality of joints 64 of the arm section 61. The encoder E1 is configured to detect the rotation angle of the servo motor M1. The reducer is configured to reduce the rotation speed of the servo motor M1 to increase the torque.

[0059] 15, the translational movement mechanism 70 is provided with a servo motor M2 for rotating a rotor provided in the driven unit 4a of the medical instrument 4, a servo motor M3 for translationally moving the medical instrument 4, encoders E2 and E3, and a reducer (not shown). The encoders E2 and E3 are configured to detect the rotation angles of the servo motors M2 and M3, respectively. The reducers are configured to decelerate the rotation of the servo motors M2 and M3 to increase the torque.

[0060] The positioner 40 is also provided with a plurality of servo motors M4, an encoder E4, and a reducer (not shown) so as to correspond to the plurality of joints 43 of the positioner 40. The encoder E4 is configured to detect the rotation angle of the servo motor M4. The reducer is configured to reduce the rotation speed of the servo motor M4 to increase the torque.

[0061] The medical cart 3 is also provided with a servomotor M5, an encoder E5, a reducer, and a brake (not shown) that drive each of the multiple front wheels of the medical cart 3. The reducer is configured to reduce the rotation speed of the servomotor M5 and increase torque. A potentiometer P1 is provided on the throttle unit 35a of the medical cart 3, and the servomotor M5 of the front wheels is driven based on the rotation angle detected by the potentiometer P1 in response to the twist of the throttle unit 35a. The rear wheels of the medical cart 3 are dual-wheeled, and are steered based on the left-right (R direction) rotation of the handle 35. A potentiometer P2 is provided on the handle 35 of the medical cart 3, and the rear wheels of the medical cart 3 are provided with a servomotor M6, an encoder E6, and a reducer (not shown). The reducer is configured to reduce the rotation speed of the servomotor M6 and increase torque. The servo motor M6 is driven based on the rotation angle detected by the potentiometer P2 in response to the left and right rotation (R direction) of the handle 35. In other words, the steering of the rear wheels caused by the left and right rotation (R direction) of the handle 35 is power-assisted by the servo motor M6. The servo motors M5 and M6 are examples of the "medical cart driving unit" in the claims.

[0062] The front wheels of the medical cart 3 are driven to move forward and backward, and the rear wheels are steered by turning the handle 35 of the medical cart 3, causing the medical cart 3 to turn left and right.

[0063] The control unit 31 of the medical cart 3 includes an arm control unit 31a that controls the movement of the multiple arms 60 based on commands, and a positioner control unit 31b that controls the movement of the positioner 40 based on commands and the drive of the front wheels (not shown) and the steering drive of the rear wheels (not shown) of the medical cart 3. A servo control unit C1 that controls a servo motor M1 that drives the arm 60 is electrically connected to the arm control unit 31a. An encoder E1 that detects the rotation angle of the servo motor M1 is also electrically connected to the servo control unit C1.

[0064] The arm control unit 31a is also electrically connected to a servo control unit C2 for controlling a servo motor M2 for driving the medical instrument 4. The servo control unit C2 is also electrically connected to an encoder E2 for detecting the rotation angle of the servo motor M2. The arm control unit 31a is also electrically connected to a servo control unit C3 for controlling a servo motor M3 for translationally moving the translational movement mechanism 70. The servo control unit C3 is also electrically connected to an encoder E3 for detecting the rotation angle of the servo motor M3.

[0065] Then, the operation command input to the remote operation device 2 is input to the arm control unit 31a. The arm control unit 31a generates a position command based on the input operation command and the rotation angle detected by the encoder E1 (E2, E3), and outputs the position command to the servo control unit C1 (C2, C2). The servo control unit C1 (C2, C3) generates a torque command based on the position command input from the arm control unit 31a and the rotation angle detected by the encoder E1 (E2, E3), and outputs the torque command to the servo motor M1 (M2, M3). As a result, the arm 60 is moved in accordance with the operation command input to the remote operation device 2.

[0066] Furthermore, the control unit 31 (arm control unit 31a) is configured to operate the arm 60 based on an input signal from a joystick 82 of the operation unit 80. Specifically, the arm control unit 31a generates a position command based on the input signal (operation command) input from the joystick 82 and the rotation angle detected by the encoder E1, and outputs the position command to the servo control unit C1. The servo control unit C1 generates a torque command based on the position command input from the arm control unit 31a and the rotation angle detected by the encoder E1, and outputs the torque command to the servo motor M1. As a result, the arm 60 is moved in accordance with the operation command input to the joystick 82.

[0067] The control unit 31 (arm control unit 31a) is configured to operate the arm 60 based on an input signal from a switch unit 83 of the operation unit 80. Specifically, the arm control unit 31a generates a position command based on the input signal (operation command) input from the switch unit 83 and the rotation angle detected by the encoder E1 or E3, and outputs the position command to the servo control unit C1 or C3. The servo control unit C1 or C3 generates a torque command based on the position command input from the arm control unit 31a and the rotation angle detected by the encoder E1 or E3, and outputs the torque command to the servo motor M1 or M3. As a result, the arm 60 is moved in accordance with the operation command input to the switch unit 83.

[0068] 15, the positioner control unit 31b is electrically connected to a servo control unit C4 for controlling a servo motor M4 that moves the positioner 40. The servo control unit C4 is also electrically connected to an encoder E4 for detecting the rotation angle of the servo motor M4. The positioner control unit 31b is also electrically connected to a servo control unit C5 for controlling a servo motor M5 that drives front wheels (not shown) of the medical cart 3. The servo control unit C5 is also electrically connected to an encoder E5 for detecting the rotation angle of the servo motor M5.

[0069] Furthermore, an operation command related to setting a standby position or the like is input from the input device 33 to the positioner control unit 31b. The positioner control unit 31b generates a position command based on the operation command input from the input device 33 and the rotation angle detected by the encoder E4, and outputs the position command to the servo control unit C4. The servo control unit C4 generates a torque command based on the position command input from the positioner control unit 31b and the rotation angle detected by the encoder E4, and outputs the torque command to the servo motor M4. This causes the positioner 40 to move in accordance with the operation command input to the input device 33. Similarly, the positioner control unit 31b moves the medical cart 3 based on the operation command from the input device 33.

[0070] Next, a description will be given of a method for controlling the medical manipulator 1. In the first embodiment, a port PT or a trocar T is provided in advance on a body surface S of a patient P placed on an operating table 5.

[0071] First, as shown in Fig. 16, in step S1, preparations are made for positioning the medical manipulator 1. Specifically, as shown in Fig. 17, the area to be operated on (anatomy: "abdomen", etc.) and the insertion direction of the medical manipulator 1 into the patient P ("from the right side", etc.) are selected on the touch panel of the display unit 33a.

[0072] Next, in step S2, the "roll-in" button displayed on the display unit 33a is pressed, as shown in Fig. 17. This sets the roll-in mode, and the movement of the arm base 50 and the arm 60 is controlled so that the medical manipulator 1 assumes the roll-in posture. The roll-in posture is a posture in which each arm 60 is folded so as not to interfere with the patient P when the arm 60 is positioned above the patient P by the movement of the medical manipulator 1, a posture in which the arm base 50 is positioned by the positioner 40 so that the imaging unit 51 provided on the arm base 50 can image vertically downward, and a posture in which the arm base 50 is positioned by the positioner 40 so that the arrangement direction of each arm 60 corresponds to the information on the surgical site and the information on the insertion direction selected in step S1. That is, after the "Roll-in" button displayed on the display unit 33a is pressed to switch to roll-in mode, the enable switch 33c is pressed to allow movement of the positioner 40, and the joystick 33b is operated, and the control unit 31 automatically moves the positioner 40 and each arm 60 so that the medical manipulator 1 assumes a roll-in posture.

[0073] Next, in step S3, as shown in FIG. 18, after the arm 60 has moved, the screen of the display unit 33a switches to an image captured by the imaging unit 51. Then, the imaging unit 51 provided on the arm base 50 captures an image of at least one of the operating table 5 and the patient P placed on the operating table 5. Specifically, when the distance between the imaging unit 51 of the medical manipulator 1 and the patient P is relatively large, the imaging unit 51 captures an image of the operating table 5 (see FIG. 19). Furthermore, imaging by the imaging unit 51 is performed continuously.

[0074] Next, in step S4, in the first embodiment, as shown in FIGS. 19 and 20 , the control unit 31 moves the medical cart 3 to the vicinity of the patient P placed on the operating table 5 based on an image of the operating table 5 captured by the imaging unit 51. Specifically, the control unit 31 recognizes the operating table 5 using image recognition technology in the image captured by the imaging unit 51, and drives the servo motors M5 and M6 to move the medical cart 3 so that the medical cart 3 approaches the operating table 5. As a result, the imaging unit 51 captures an image of the port PT or trocar T provided on the body surface S of the patient P placed on the operating table 5. Then, the control unit 31 recognizes the port PT or trocar T using image recognition technology in the image captured by the imaging unit 51, and moves the medical cart 3 so that the port PT for the endoscope 6 or the trocar T for the endoscope 6 is positioned directly below the imaging unit 51. As a result, the port PT or trocar T is positioned directly below the imaging unit 51. Then, on the display part 33a, the first trocar T1 is placed inside the substantially circular first mark part MK1 (see FIG. 21).

[0075] 22, in the first embodiment, the control unit 31 moves the arm 60 by moving the arm base 50 with the positioner 40 so as to align the arm 60 with the port PT or trocar T based on an image of the port PT or trocar T provided on the body surface S of the patient P captured by the imaging unit 51. As a result, on the display unit 33a, with the first trocar T1 positioned inside the substantially circular first mark portion MK1, the multiple second trocars T2 are positioned approximately along the first line portion L1 or the second line portion L2 of the second mark portion MK2.

[0076] Next, in step S6, the control unit 31 transitions the multiple arms 60 to a setup position. Note that the setup position is different from the roll-in position (a position in which each arm 60 is folded) and refers to a position in which the distance between the arms 60 is increased so that it is easy to attach a pivot position teaching tool 7 (see FIG. 8) or an endoscope 6 (see FIG. 7) to each of the multiple arms 60. Then, an operator such as a nurse or technician attaches the pivot position teaching tool 7 or the endoscope 6 to each of the multiple arms 60.

[0077] Next, in step S7, the control unit 31 acquires a tentative position of the pivot position PP based on the arrangement position of the port PT. The tentative position of the pivot position PP is input in advance by the operator. In the first embodiment, the control unit 31 acquires the coordinates of the port PT or trocar T provided on the body surface S of the patient P, which are captured by the imaging unit 51. Specifically, the control unit 31 acquires the coordinates of the port PT or trocar T by calculating the distance to the port PT or trocar T and the distance between the ports PT or between the trocars T, based on multiple images captured by the imaging unit 51 at different distances between the imaging unit 51 and the patient P. Note that the distance to the port PT or trocar T refers to the distance between the imaging unit 51 and the body surface S of the patient P.

[0078] Then, based on the calculated distance, the control unit 31 associates the positional relationship between the tip of each of the pivot position teaching instruments 7 or endoscope 6 attached to each arm 60 and the temporary position of the pivot position PP. Then, the control unit 31 recalculates the distance between the tip of each of the pivot position teaching instruments 7 or endoscope 6 and the port PT or trocar T. As a result, the three-dimensional coordinates of the port PT or trocar T are acquired.

[0079] Next, in step S8, in the first embodiment, the control unit 31 moves the arm 60 based on the acquired coordinates of the port PT or trocar T. Specifically, the control unit 31 moves the medical instrument 4 or the pivot position teaching instrument 7, which teaches the pivot position PP, to the vicinity of the pivot position PP, which is a position that serves as a fulcrum when moving the medical instrument 4 attached to the arm 60, based on the acquired coordinates of the port PT or trocar T. More specifically, the control unit 31 moves the arm 60 until the medical instrument 4 or the pivot position teaching instrument 7 comes into contact with the body surface S of the patient P. Whether the medical instrument 4 or the pivot position teaching instrument 7 has come into contact with the body surface S of the patient P is determined by the control unit 31 based on the force applied to the arm 60 (servo motor M1), a torque sensor (not shown), current feedback from the servo motor M1, etc.

[0080] Next, in step S9, the control unit 31 receives instruction of the pivot position PP from the operator while the medical instrument 4 is in contact with the body surface S of the patient P.

[0081] [Effects of the first embodiment] In the first embodiment, the following effects can be obtained.

[0082] (Effects of medical manipulators) In the first embodiment, as described above, the control unit 31 performs at least one of control to move the medical cart 3 by the servo motor M5 and control to move the arm 60 by the arm base 50, so as to align the arm 60 with a position corresponding to a port PT or a trocar T for inserting a medical instrument 4 provided on the body surface S of the patient P placed on the operating table 5, based on the image captured by the imaging unit 51. As a result, the arm 60 is automatically aligned with a position corresponding to the port PT or the trocar T by at least one of control to move the medical cart 3 by the servo motor M5 and control to move the arm 60 by the arm base 50, thereby reducing the burden on the operator when aligning the medical manipulator 1.

[0083] Furthermore, in the first embodiment, as described above, the control unit 31 moves the medical cart 3 to the vicinity of the patient P placed on the operating table 5, and moves the arm 60 using the arm base 50 so as to align the arm 60 with a position corresponding to the port PT or the trocar T based on the image captured by the imaging unit 51. As a result, both the movement of the medical cart 3 to the vicinity of the patient P placed on the operating table 5 and the alignment of the arm 60 with a position corresponding to the port PT or the trocar T are automatically performed, so that the burden on the operator when aligning the medical manipulator 1 can be further reduced.

[0084] Furthermore, in the first embodiment, as described above, the control unit 31 moves the medical cart 3 to the vicinity of the patient P placed on the operating table 5 based on the image of the operating table 5 captured by the imaging unit 51. As a result, even if the port PT or trocar T is not visible in the image captured by the imaging unit 51, the medical cart 3 can be easily moved to the vicinity of the patient P placed on the operating table 5 based on the image of the operating table 5 captured by the imaging unit 51.

[0085] Furthermore, in the first embodiment, as described above, the control unit 31 performs at least one of control to move the medical cart 3 and control to move the arm 60 using the arm base 50 so as to align the arm 60 with the port PT or trocar T, based on an image of at least one of the operating table 5 and the port PT or the trocar T provided on the body surface S of the patient P captured by the imaging unit 51. As a result, by recognizing at least one of the operating table 5 and the port PT or the trocar T provided on the body surface S of the patient P shown in the image, the control unit 31 can easily perform at least one of control to move the medical cart 3 and control to move the arm 60 using the arm base 50 so as to align the arm 60 with the port PT or the trocar T.

[0086] Furthermore, in the first embodiment, as described above, a plurality of arms 60 are provided, and the plurality of arms 60 are attached to the arm base 50, and the control unit 31 moves the arm base 50 based on the image captured by the imaging unit 51, thereby aligning the arm 60 with a position corresponding to the port PT or trocar T for inserting the medical instrument 4 provided on the body surface S of the patient P placed on the operating table 5. As a result, even if the arm 60 is not appropriately positioned at a position corresponding to the port PT or trocar T by simply moving the medical cart 3, the arm 60 can be appropriately positioned at a position corresponding to the port PT or trocar T by moving the arm base 50.

[0087] Furthermore, in the first embodiment, as described above, the imaging unit 51 is provided on the arm base 50. This prevents the relative position of the imaging unit 51 with respect to the arm base 50 from changing, and therefore, unlike when the relative positions of the imaging unit 51 and the arm base 50 change, it is possible to easily control the movement of the medical cart 3 based on the image captured by the imaging unit 51.

[0088] Furthermore, in the first embodiment, as described above, the control unit 31 acquires the coordinates of the port PT or trocar T provided on the body surface S of the patient P imaged by the imaging unit 51, and, based on the acquired coordinates of the port PT or trocar T, moves the medical instrument 4 or the pivot position teaching instrument 7 for teaching the pivot position PP to the vicinity of the pivot position PP, which is a position that serves as a fulcrum when moving the medical instrument 4 attached to the arm 60. This eliminates the need for the operator to move the medical instrument 4 or the pivot position teaching instrument 7 to the vicinity of the pivot position PP when teaching the pivot position PP, thereby saving the operator time and effort.

[0089] Furthermore, in the first embodiment, as described above, the control unit 31 acquires the coordinates of the port PT or trocar T by calculating the distance to the port PT or trocar T and the distance between the ports PT or between the trocars T based on a plurality of images captured by the imaging unit 51 with different distances between the imaging unit 51 and the patient P. This makes it possible to prevent the configuration of the medical manipulator 1 from becoming complicated, unlike when a separate sensor or the like is provided to calculate the distance to the port PT or the trocar T.

[0090] (Effects of control methods for medical manipulators) In the first embodiment, as described above, the control method for the medical manipulator 1 includes a step of performing at least one of controlling the servo motor M5 to move the medical cart 3 and controlling the arm base 50 to move the arm 60 so as to align the arm 60 with a position corresponding to a port PT or a trocar T for inserting a medical instrument 4 provided on the body surface S of a patient P placed on the operating table 5, based on an image captured by the imaging unit 51. Thus, by performing at least one of controlling the medical cart 3 to move with the servo motor M5 and controlling the arm 60 with the arm base 50, the arm 60 is automatically aligned with a position corresponding to the port PT or the trocar T, thereby providing a control method for the medical manipulator 1 that can reduce the burden on the operator when aligning the medical manipulator 1.

[0091] [Second embodiment] The configuration of a surgical operation system 200 according to the second embodiment will be described with reference to FIGS.

[0092] 23, a surgical operation system 200 includes a medical manipulator 1 and a processing unit 210. The configuration of the medical manipulator 1 is similar to the configuration of the medical manipulator 1 of the first embodiment.

[0093] The processing unit 210 is configured to plan the position of the arm 60 with respect to a position corresponding to a port PT for inserting the medical instrument 4, which is provided on the body surface S of the patient P placed on the operating table 5. Specifically, the processing unit 210 is configured to create a three-dimensional model of the patient P from an image of the patient P taken in advance, determine the position of the port PT for inserting the medical instrument 4 based on the three-dimensional model, and plan the position of the arm 60 based on the determined position of the port PT. A method for planning the position of the arm 60 will be described below.

[0094] (How to plan the arm position) As shown in FIG. 24, in step S11, the processing unit 210 acquires a three-dimensional model (volume data) generated from an image of the patient P taken by the CT device 220, for example.

[0095] Next, in step S12, the processing unit 210 acquires kinematic information of the medical manipulator 1 from the medical manipulator 1. The kinematic information includes, for example, shape information relating to the shapes of the arm 60 and the medical instrument 4 and motion information relating to the motion. This shape information includes the length and weight of each part of the arm 60 and the medical instrument 4, the angle of the arm 60 relative to a reference direction (for example, a horizontal plane), the attachment angle of the medical instrument 4 relative to the arm 60, etc.

[0096] Next, in step S13, the processing unit 210 virtually performs an insufflation simulation on the patient P. Specifically, the processing unit 210 performs an insufflation simulation based on the pre-insufflation volume data acquired from the CT device 220, and generates three-dimensional data that is the post-insufflation volume data.

[0097] Next, in step S14, the processing unit 210 acquires information on the surgical procedure. The surgical procedure determines the treatment to be performed by the medical manipulator 1. Furthermore, the medical instrument 4 required for the treatment is determined according to the treatment.

[0098] Next, in step S15, the processing unit 210 acquires the initial positions of the multiple ports PT according to the acquired surgical procedure. In this case, the processing unit 210 acquires the three-dimensional coordinates of the initial positions of the ports PT. The information on the ports PT includes identification information of the port PT, information on the position on the body surface S of the patient P where the port PT is to be pierced, information on the size of the port PT, etc. The information on the multiple ports PT is stored as a template in the memory 211 in the processing unit 210 or in an external server. The information on the multiple ports PT is determined, for example, by the surgical procedure.

[0099] Next, in step S16, the processing unit 210 acquires information about the target region from the medical manipulator 1. The target region is an object to be treated by the medical manipulator 1, and is a region including tissues such as blood vessels, bronchi, organs, bones, the brain, the heart, the feet, and the neck.

[0100] Next, in step S17, the processing unit 210 determines whether the medical instrument 4 inserted from each port PT can access the target area based on the initial position of the port PT and the position of the target area. In other words, it determines whether the medical instrument 4 can perform treatment with the medical manipulator 1 according to the acquired surgical procedure.

[0101] Next, if the determination in step S17 is no, in step S18, the processing unit 210 moves at least one of the positions of the multiple ports PT along the body surface S of the patient P. Note that the position of the port PT may be moved by input from the operator. Then, the process returns to step S17.

[0102] Next, in step S17, if yes, the processing unit 210 ends the process of calculating the plan for the position of the arm 60 (port position simulation).

[0103] (Planning your travel route) Next, a description will be given of the planning of the movement path MP along which the medical manipulator 1 moves. As shown in Fig. 25, the movement path MP means the path along which the medical manipulator 1 moves within the operating room 300.

[0104] First, the processing unit 210 acquires an operating room map showing the planar shape of the operating room 300. The processing unit 210 also acquires an equipment range area showing the range of the equipment 301 placed in the operating room 300. The processing unit 210 also acquires a location area showing the range where doctors, nurses, technicians, etc. are located within the operating room 300. The operating room map, equipment range area, and location area may be stored in advance in the memory 211 of the processing unit 210, or may be acquired by the processing unit 210 from an external server or the like.

[0105] Then, the processing unit 210 calculates a movement path MP based on the operating room map, the device range area, and the location area. For example, the movement path MP is calculated so that the medical manipulator 1 moves from a location where the medical manipulator 1 is previously placed in the operating room 300 to the vicinity of the operating table 5 while avoiding the device range area and the location area.

[0106] Next, a control method for the medical manipulator 1 will be described with reference to Fig. 26. In the second embodiment, a port PT or a trocar T may or may not be provided in advance on the body surface S of a patient P placed on an operating table 5.

[0107] The operations in steps S1 and S2 are the same as those in the first embodiment.

[0108] In step S21, the control unit 231 moves the medical cart 3 according to a pre-planned movement path MP. The pre-planned movement path MP is acquired from the processing unit 210. Specifically, in this embodiment, the control unit 231 moves the medical cart 3 by the servo motor M5 to the vicinity of the patient P placed on the operating table 5 so that the arm 60 is positioned at the planned position based on the image captured by the imaging unit 51. In more detail, the control unit 231 moves the medical cart 3 while checking the current position of the medical manipulator 1 and any obstacles based on the image captured by the imaging unit 51. As a result, the port PT or the trocar T is positioned directly below the imaging unit 51.

[0109] Next, in step S22, in the second embodiment, the arm 60 is moved by the arm base 50 so that the arm 60 is placed at a planned position based on the image captured by the imaging unit 51. Specifically, the arm 60 is moved by the arm base 50 so that the contour of the patient P in the image captured by the imaging unit 51 matches the contour of the patient P based on the volume data of the patient P used in the port position simulation. This aligns the arm 60 with the position of the port PT determined by the port position simulation.

[0110] Next, in step S23, the control unit 231 automatically determines the pivot position PP based on the position of the arm 60 that has been planned in advance.

[0111] Next, in step S24, the control unit 231 moves the multiple arms 60 to preplanned positions. That is, the control unit 231 shifts the multiple arms 60 to the setup posture.

[0112] Next, in step S25, an operator such as a nurse or technician attaches the medical instrument 4 and the endoscope 6 to each of the multiple arms 60.

[0113] [Effects of the second embodiment] In the second embodiment, the following effects can be obtained.

[0114] In the second embodiment, the control unit 231 acquires an image captured by the imaging unit 51, and based on the image, performs at least one of control to move the medical cart 3 using the servo motor M5 so that the arm 60 is positioned at a planned position, and control to move the arm 60 using the arm base 50. This allows the arm 60 to be automatically positioned at a planned position with respect to the position corresponding to the port PT, thereby reducing the burden on the operator when aligning the medical manipulator 1.

[0115] Furthermore, in the second embodiment, as described above, the control unit 231 moves the medical cart 3 to the vicinity of the patient P placed on the operating table 5 based on the pre-planned movement path MP. As a result, even if the port PT or trocar T is not visible in the image captured by the imaging unit 51, the medical cart 3 can be easily moved to the vicinity of the patient P placed on the operating table 5 based on the pre-planned movement path MP.

[0116] Furthermore, in the second embodiment, as described above, the control unit 231 performs at least one of control to move the medical cart 3 and control to move the arm 60 using the arm base 50 so as to align the arm 60 with the position of the port PT, based on the position of the arm 60 planned with respect to the position corresponding to the port PT for inserting the medical instrument 4 provided on the body surface S of the patient P placed on the operating table 5 and the image captured by the imaging unit 51. This makes it possible to automatically align the arm 60 with the position corresponding to the port PT or the trocar T without actually forming the port PT or placing the trocar T in the patient P.

[0117] Furthermore, in the second embodiment, as described above, a processing unit 210 is provided that creates a three-dimensional model of the patient P from an image of the patient P taken in advance and plans the position of the port PT based on the three-dimensional model, and the control unit 231 performs at least one of control to move the medical cart 3 and control to move the arm 60 using the arm base 50 so as to align the arm 60 with the port PT based on the position of the port PT determined by the processing unit 210 and the image taken by the imaging unit 51. In this way, the position of the port PT is determined based on a three-dimensional model according to the individual body shape of the patient P, so that the arm 60 can be appropriately positioned according to the individual body shapes of the patients P.

[0118] Furthermore, in the second embodiment, as described above, the processing unit 210 is configured to create a three-dimensional model of the patient P from an image of the patient P taken in advance, and plan the position of the arm 60 based on the three-dimensional model. As a result, the position of the arm 60 is planned based on a three-dimensional model according to the individual body shape of the patient P, and therefore the arm 60 can be appropriately positioned according to the individual patients P who have different body shapes.

[0119] [Variations] The embodiments disclosed herein should be considered to be illustrative and not restrictive in all respects. The scope of the present invention is defined by the claims rather than the above description of the embodiments, and further includes all modifications (variations) within the meaning and scope of the claims.

[0120] For example, in the above first and second embodiments, an example is shown in which three second trocars T2 are inserted into the patient P, but the present invention is not limited to this. The number of second trocars T2 may be, for example, two.

[0121] Furthermore, in the first and second embodiments, an example in which four arms 60 are provided is shown, but the present invention is not limited to this. The number of arms 60 provided may be at least one.

[0122] In the first and second embodiments, the arm unit 61 and the positioner 40 are configured as a seven-axis articulated robot, but the present invention is not limited to this. For example, the arm 60 and the positioner 40 may be configured as an articulated robot with an axis configuration other than a seven-axis articulated robot (for example, a six-axis or eight-axis robot).

[0123] In the first and second embodiments, the medical cart 3 is moved to the vicinity of the patient P placed on the operating table 5 based on the image of the operating table 5 captured by the imaging unit 51 and the port PT or the trocar T. However, the present invention is not limited to this. For example, as in the medical cart 403 shown in FIG. 27 , the medical cart 3 may be moved to the vicinity of the patient P based on the distance measured by a distance measuring unit 403a provided on the medical cart 403 that measures the distance between the operating table 5 and the medical cart 403. Furthermore, the medical cart 3 may be moved while checking the current position of the medical manipulator 1 and obstacles based on images captured by an imaging unit 410 provided in the positioner 40 or an imaging unit 420 installed in advance in the operating room 300.

[0124] In the first embodiment, the control unit 31 (231) moves the medical cart 3 so as to align the arm 60 with the port PT or the trocar T based on an image of the operating table 5 and the port PT or the trocar T provided on the body surface S of the patient P, captured by the imaging unit 51. However, the present invention is not limited to this. For example, as shown in FIG. 28 , the control unit 31 (231) may move the medical cart 3 so as to align the arm 60 with the port PT or the trocar T, based on an image of an identifier ID attached to at least one of the operating table 5 and the port PT or the trocar T provided on the body surface S of the patient P, captured by the imaging unit 51. The identifier ID is, for example, a mark (sticker). Alternatively, an indicator (not shown), an IC tag, an RFID (radio frequency identifier), or the like may be used as the identifier ID. This makes it easier to recognize the common identification part ID than to recognize at least one of the operating table 5 and the port PT or trocar T, which may have different shapes and sizes, and therefore makes it easier to control at least one of moving the medical cart 3 and moving the arm 60 using the arm base 50.

[0125] In the first and second embodiments, the control unit 31 moves the medical cart 3 so that the port PT for the endoscope 6 or the trocar T for the endoscope 6 is located directly below the imaging unit 51, but the present invention is not limited to this. For example, the control unit 31 may move the medical cart 3 so that the port PT or the trocar T for the endoscope 6 is located at a position slightly away from directly below the imaging unit 51.

[0126] Furthermore, in the above first embodiment, an example has been shown in which the control unit 31 moves the arm base 50 so as to align the arm 60 with the port PT or trocar T based on an image of the port PT or trocar T photographed by the photographing unit 51, but the present invention is not limited to this. For example, the arm base 50 may be moved (rotated) based on data such as the position of the port PT or the surgical site and the insertion direction of the medical instrument 4 that have been input into the control unit 31 in advance, without using an image of the port PT or trocar T photographed by the photographing unit 51.

[0127] In the first embodiment, the distance to the port PT or the trocar T and the distance between the ports PT or between the trocars T are calculated in step S8, but the present invention is not limited to this. For example, these distances may be calculated in step S6, in which the position of the arm 60 is adjusted by moving the arm base 50.

[0128] In the first embodiment, the control unit 31 calculates the distance to the port PT or trocar T and the distance between the ports PT or between the trocars T based on multiple images captured by the imaging unit 51, but the present invention is not limited to this. For example, a 3D camera or a distance measuring sensor may be used instead of multiple images. Furthermore, the sizes of the operating table 5 and the patient P and the distances between the ports PT may be input in advance, and these distances may be calculated by simulation.

[0129] Furthermore, in the first embodiment described above, an example was shown in which the instruction for the pivot position PP was received while the endoscope 6 or the pivot position teaching instrument 7 attached to the arm 60 was in contact with the body surface S of the patient P, but the present invention is not limited to this. For example, the control unit 31 may acquire the coordinates of the port PT or trocar T provided on the body surface S of the patient P photographed by the imaging unit 51, and, based on the acquired coordinates of the port PT or trocar T, move the endoscope 6 or the pivot position teaching instrument 7 to a position near the port PT or trocar T but not in contact with the port PT or trocar T.

[0130] Furthermore, in the above first and second embodiments, an example has been shown in which the medical cart 3 is moved to the vicinity of the patient P placed on the operating table 5, and then the arm base 50 is moved to align the arm 60 with a position corresponding to the port PT or the trocar T, but the present invention is not limited to this. For example, a configuration may be adopted in which the arm base 50 is moved in advance before the medical cart 3 is moved to the vicinity of the patient P, and the arm 60 is aligned with a position corresponding to the port PT or the trocar T simply by moving the medical cart 3 to the vicinity of the patient P.

[0131] In the second embodiment, the control unit 231 is provided in the medical manipulator 1, but the present invention is not limited to this. In the present invention, the control unit 231 may be provided in a unit other than the medical manipulator 1, such as the processing unit 210.

[0132] In the first and second embodiments, the servo motor M5 is used to control the movement of the medical cart 3, and then the arm base 50 is used to control the movement of the arm 60. However, the present invention is not limited to this. For example, the positioning of the arm 60 may be performed only by controlling the movement of the arm 60 by the arm base 50.

[0133] 29, an obstacle detection sensor 3a may be provided on the medical cart 3, and when the medical cart 3 is moved to the vicinity of the patient P placed on the operating table 5 in step S4 (step S21 in the second embodiment), if the obstacle detection sensor 3a detects an obstacle, the control unit 31 may move the medical cart 3 backward and resume moving the medical cart 3 to the vicinity of the patient P. If the obstacle detection sensor 3a continues to detect an obstacle even after the medical cart 3 is moved again, the medical cart 3 may be stopped and left as it is so that an operator (manual) such as a nurse or technician can move the medical cart 3 using an indicator 52 or the like provided on the arm base 50.

[0134] As a result, the obstacle detection sensor 3a detects an obstacle, thereby preventing the medical cart 3 from colliding with the obstacle. Furthermore, by configuring the medical cart 3 to move backward and resume moving to the vicinity of the patient P when the obstacle detection sensor 3a detects an obstacle, even if an obstacle is present, the medical cart 3 can be moved to the vicinity of the patient P placed on the operating table 5 while preventing the medical cart 3 from colliding with the obstacle.

[0135] The obstacle detection sensors 3a are composed of contact sensors, non-contact optical sensors, etc. If the obstacle detection sensors 3a are contact sensors, the obstacle detection sensors 3a are provided so as to surround the periphery of the medical cart 3. If the obstacle detection sensors 3a are optical sensors, etc., the obstacle detection sensors 3a are provided on the front, side, and rear of the medical cart 3, etc.

[0136] Furthermore, in step S24 of the second embodiment, when the multiple arms 60 are moved to preplanned positions, the imaging unit 51 or a contact sensor provided on the arm 60 may be used to predict (or detect) contact between the arm 60 and the patient P or the medical instrument 4. If contact between the arm 60 and the patient P or the medical instrument 4 is predicted (or detected), the movement of the arm 60 is stopped. Then, the control unit 231 performs control (such as issuing a notification to the indicator 52 in FIG. 29) to prompt the operator to manually move the arm 60. [Explanation of symbols]

[0137] 1. Medical manipulators (surgical support robots) 3 Medical trolleys 3a Obstacle detection sensor 4 Medical equipment 5 Operating table 7 Pivot position teaching tool 31, 231 Control section 50 Arm base (robot body) 51 Photography Department 60 Arm 210 Processing section ID Identification Section MP movement route M5, M6 servo motor (medical trolley drive unit) P patient PP pivot position PT Port S body surface T trocar

Claims

1. A surgical assistance robot system, a robot body including an arm base supporting a plurality of arms to which a plurality of medical instruments are respectively attached, and a positioner which is a robot including a plurality of joints for moving the arm base; a movable medical cart that supports the robot main body; a medical cart driving unit for moving the medical cart; an imaging unit provided in the robot body for imaging a patient placed on an operating table; one or more control units; a plurality of trocars for inserting the plurality of medical instruments respectively are installed on the body surface of the patient; The control unit a movement path of the medical cart is planned, and based on the planned movement path, the medical cart driving unit is controlled so that the medical cart moves from a first position to a second position that is closer to the operating table than the first position; A surgical support robot system in which, while the medical cart is positioned at the second position, the positioner moves the arm base so as to align the arrangement of the multiple arms with the arrangement of the multiple trocars based on an image taken by the imaging unit.

2. The surgery support robot system according to claim 1 , wherein the control unit moves the medical cart based on the image captured by the imaging unit and the movement path.

3. a distance measuring unit for measuring the distance between the operating table and the medical cart; The surgery support robot system according to claim 1 , wherein the control unit moves the medical cart based on the distance measured by the distance measurement unit and the movement path.

4. The surgery support robot system according to claim 1 , wherein the control unit moves the medical cart based on an image captured by a second imaging unit that captures an image of the inside of the operating room and the movement path.

5. 5. The surgical support robot system according to claim 1, further comprising an obstacle detection sensor provided on the medical cart that detects an obstacle that impedes movement of the medical cart.

6. 6. The surgical support robot system according to claim 1, wherein the control unit moves the arm base using the positioner so that the arrangement of the plurality of arms matches the arrangement of the plurality of trocars based on an image captured by the imaging unit.

7. one of the plurality of medical instruments is an endoscope; 7. The surgical support robot system according to claim 1, wherein the control unit moves the arm base using the positioner so as to align the arrangement of the plurality of arms with the arrangement of the plurality of trocars based on an image captured by the imaging unit, using an image of a trocar into which the endoscope is inserted as a reference.

8. 8. The surgical support robot system according to claim 1, wherein the imaging unit is provided on the arm base.

9. 9. The surgical support robot system according to claim 1, wherein the imaging unit includes a three-dimensional camera.

10. The plurality of trocars are respectively placed on the body surface via a plurality of ports, 10. The surgical support robot system according to claim 1, wherein the control unit acquires coordinates of each of the plurality of ports based on an image captured by the imaging unit, and aligns the arrangement of the plurality of arms with the arrangement of the plurality of ports based on the acquired coordinates of each of the plurality of ports.

11. a plurality of identification portions are attached to the body surface to indicate positions of a plurality of ports at which the plurality of trocars are to be installed on the body surface; 10. The surgical support robot system according to claim 1, wherein the control unit acquires images of the plurality of identification parts photographed by the photographing unit, and aligns the arrangement of the plurality of arms with the arrangement of the plurality of ports based on the acquired images.

12. A method for controlling a surgical support robot, the robot comprising: a robot main body including an arm base supporting a plurality of arms, each of which has a plurality of medical instruments attached thereto, and a positioner that is a robot including a plurality of joints for moving the arm base; a movable medical cart that supports the robot main body; and a medical cart drive unit that moves the medical cart, planning a movement path of the medical cart; a step of photographing a patient on a body surface having a plurality of trocars for inserting the plurality of medical instruments, respectively, and the patient placed on an operating table, by an imaging unit provided in the robot main body; controlling the medical cart drive unit based on the planned movement path so that the medical cart moves from a first position to a second position that is closer to the operating table than the first position; a step of moving the arm base by the positioner while the medical cart is positioned at the second position so as to align the arrangement of the multiple arms with the arrangement of the multiple trocars based on an image captured by the imaging unit.

Images