Laser-guided robot, projection method, and laser-guided robot system for visually projecting a surgical plan guide

Abstract

The present invention relates to a laser-guided robot (1) for visually projecting a surgical guide onto the surgical area of a patient (100). The laser-guided robot comprises a guiding robot (1) having a robot arm (2) and a robot head (4), a tracking system (6) configured to detect the position and / or orientation of the robot head (4) and the patient (100), a projection laser (8) arranged on the robot head (4) such that the position and orientation of the projection laser (8) can be adjusted via the robot head (4), and a control unit (14) adapted to determine a target position and a target orientation of the projection laser (8) relative to the surgical area of the patient (100) and to control the robot arm (2) such that, while the projection laser (8) moves to the target position and the target orientation, at least one guide axis (16) is visually displayed by the projection laser projecting a laser irradiation (12) in the target orientation. The present invention also relates to a laser-guided robot system and a projection method.

Description

Technical Field

[0001] The present disclosure relates to a laser-guided robot for visually projecting a surgical plan guide onto a patient's intervention area. The present disclosure also relates to a projection method for visually projecting the guide, and a laser-guided robot system comprising the laser-guided robot and a medical device or medical product according to the preamble of the independent patent claims.

Background Art

[0002] In computer-assisted surgery, a navigation system and / or a surgical robot is used. When using a navigation system, surgical instruments are detected and tracked / followed. In particular, the position and orientation of the surgical instruments in space are detected. The detected information is synthesized in correlation with preoperative images detected preoperatively. These preoperative images are, in particular, models of the patient or the patient's body. This digital model is created, for example, by computed tomography images (CT images) and / or magnetic resonance images (MRI images). When using a surgical robot, the surgical instruments are moved to the target position by one or more robot arms, where this target position is determined based on the preoperative images.

[0003] The use of both navigation systems and surgical robots has certain drawbacks. The use of a navigation system causes restrictions on the freedom of movement because a navigation tracker needs to be attached to the surgical instrument. On the other hand, the use of a surgical robot requires an end effector, which makes the working space and working area narrower and the system more complex.

[0004] Therefore, surgeons perform surgery as usual, and solutions have been developed to support surgeons by projecting the surgically planned preoperatively.

[0005] German Published Patent Gazette No. 102017127791 discloses a medical control system. For example, a projector configured in the form of a laser projects surgical instructions onto a patient. The surgical instructions may represent the intervention position relative to the patient, as well as the position of the patient's vulnerable tissues or organs. Since the projection can be used for orientation, the projected surgical instructions will support the operating surgeon. The surgical instructions are determined by scanning the patient preoperatively.

[0006] European Patent Publication No. 3733111 describes a laser-based system for providing instructions during surgery. This system has a semi-circular arm (C-arm X-ray device) equipped with a laser projector. This (X-ray) arm scans the patient's body and displays the scan results on a screen. The user can directly edit the surgical information on the screen. For example, the user can input surgical information using a touch panel. The control unit converts the surgical information, and the laser projector projects this surgical information onto the patient's body. However, since the system has a large and bulky C-arm, this will have an adverse effect on handling during surgery. Furthermore, the C-arm cannot be freely moved during surgery, and strategic repositioning is required.

[0007] Also, a (robot) system that uses a high-energy laser to cut bone is known. The surgical plan is created based on preoperative data. The effector is controlled by an optical navigation system and cuts the bone with a laser based on the surgical plan. This has the advantage that the robot creates a very clean cut and no chips are generated in laser cutting. However, laser cutting cannot be used for other surgical interventions such as biopsies and the placement of screws and similar tools.

[0008] Furthermore, a system using several fixed lasers is known as "Liao, et.al - Precision-guided surgical navigation systems using laser guidance and 3D autostereoscopic image overlay (written by Liao et al., 'Precision-guided surgical navigation system using laser guidance and 3D autostereoscopic image overlay')". At least two lasers are placed at a distance from each other. Both lasers project laser beams onto the surgical surface. The intersection line of these two lasers represents the surgical line. For example, an intervention line can be displayed during surgery. However, the stationary system lacks the flexibility to accommodate many surgeries.

[0009] In summary, the systems known from the prior art can show the surgeon where an intervention must be made and can also mark relevant anatomical orientation points such as organs that the surgeon must not damage during the operation. Note that this information is only projected onto the patient from above. As a result, only a two-dimensional image is displayed without providing spatial information.

Summary of the Invention

Problems to be Solved by the Invention

[0010] Therefore, an object of the present disclosure is to overcome or at least reduce the drawbacks of the prior art, and in particular, to provide additional spatial information for guidance and navigation to the user, especially the operating surgeon, and in particular, to enable the function of displaying where and especially at what angle an intervention can be made, and to provide an effective and flexible laser guidance robot, projection method, and laser guidance robot system. A further partial object is to provide a mobile laser guidance robot and guidance robot system that can be used especially in a mobile manner and that minimizes the impact on the operating room from the perspective of the required volume and that is low-cost. In particular, the intervention area needs to be freely accessible to the surgeon.

Means for Solving the Problems

[0011] The object of the present disclosure is achieved by the features of claim 1 with respect to the general-purpose laser-guided robot according to the present invention, by the features of claim 12 with respect to the general-purpose laser-guided robot system according to the present invention, by the features of claim 13 with respect to the general-purpose projection method according to the present invention, by the features of claim 14 with respect to the computer-readable storage medium, and by the features of claim 15 with respect to the computer program.

[0012] Therefore, the core idea of the present disclosure is to not only make it possible to display the position by combining a robot as a positioning system and a laser as a display system by laser irradiation having a longitudinal axis, but also to visually display the axis in the space with respect to this position for the surgeon so that the surgeon can appropriately align medical products or medical instruments using the axis information. The decisive factor here is that the robot can be manipulated and the laser can be moved to a predetermined position and orientation with respect to the patient and thus the intervention position, and the laser aims at the target point in the intervention area in this posture, aligns the laser irradiation with the longitudinal axis and thus the guide axis to this aimed target point, and visually displays it. Thereby, the surgeon can not only position medical products such as biopsy needles and medical instruments such as screwdrivers at the instructed positions, but also align the longitudinal axis according to the instructed guide axis.

[0013] In other words, the present disclosure relates to a (surgical) guide, in particular a laser-guided robot for visually projecting a preoperatively calculated surgical plan onto a patient's intervention area. This laser-guided robot comprises a (guidance) robot having a robot arm movably articulated or connected to a robot base and a terminal / distal robot head / end connected to the robot arm, and further comprises a tracking system, in particular an optical navigation system or a tracking system based on robot kinematics (wherein the kinematics of the (guidance) robot are used to determine, preferably, in particular, the position and orientation of the laser with respect to the patient), this tracking system being adapted to detect the position and / or orientation of the robot head and / or to detect the position and / or orientation of the patient and thus the intervention area. This laser-guided robot further comprises a projection laser whose emitted laser irradiation is preferably in the visible range for the human eye, the position and orientation of the projection laser being arranged such that both indirect detection and adjustment are possible via the robot head, in particular a projection laser attached to the robot head. Also, this laser-guided robot is adapted to determine the target position and target orientation of the projection laser with respect to the patient's intervention area, and to control the robot arm having the robot head and the projection laser such that, while the projection laser moves / travels to the target position and target orientation, at least one guide axis is visually displayed in the intervention area via the (visual) projection of the laser irradiation in the target orientation.

[0014] In particular, the control unit calculates a surgical plan and thus at least one predetermined intervention position for the intervention using the relevant target position and target orientation of the projection laser from the preoperative image. Furthermore, the control unit can in particular be adapted to calculate an intervention axis located at the intervention position at the calculated intervention angle. The robotic arm is mobile and has a large number of degrees of freedom. The projection laser is arranged / attached to the distal end of the robotic arm or robotic head and is thus movable together with the robotic arm and controllable by the robot. The tracking system detects the position and orientation of the robotic head and thus the position and orientation of the projection laser in space (in particular via a statically known or pre-determinable transformation from the coordinate system of the robotic head to the projection laser). In this way, it is drivable to reach the target position and target orientation of the projection laser and can also detect this. The projection laser is arranged / positioned and aligned using the degrees of freedom of the robotic arm such that the laser irradiation emitted by the projection laser (i.e., the longitudinal axis of the laser irradiation) corresponds to the calculated intervention axis having the calculated intervention angle. The laser irradiation emitted by the projection laser forms a guide axis for the surgery or intervention by emitting a wavelength in the visible light range and thus being directly visible or being in the non-visible light range but emitting fluorescence within the instrument.

[0015] The target position and target orientation of the projection laser are the position and orientation of the projection laser such that the guide axis projected by the laser irradiation corresponds to the calculated intervention axis while being aligned in particular with the target point targeted in the intervention area.

[0016] The preoperative image is acquired preoperatively, preferably by computed tomography (CT image) and / or magnetic resonance imaging (MRI image).

[0017] The term "tracking system" represents a technical system that enables spatial positioning and enables the detection of the position and / or orientation of an object.

[0018] The term "position" refers to a geometric position in three-dimensional space and is specified in particular using the coordinates of a Cartesian coordinate system. In particular, a position can be specified by three coordinates X, Y, and Z.

[0019] And also the term "orientation" indicates an alignment (such as a position) in space. Also, it can be said that the orientation indicates an alignment regarding a direction or rotation in three-dimensional space. In particular, an orientation can be specified using three angles.

[0020] The term "posture" covers both position and orientation. In particular, a posture can be specified using six coordinates consisting of three position coordinates X, Y, and Z and three angular coordinates for indicating the orientation.

[0021] In summary, in other words, the core of the present disclosure is that the projection laser is positioned and aligned by a robotic arm so that the laser irradiation emitted by the projection laser approaches the intervention axis, in particular, the intervention axis calculated preoperatively for surgery. The surgeon is given the option of not only visually displaying the position within the intervention area but also the axis (having the corresponding intervention angle).

[0022] The laser-guided robot according to the present disclosure enables a user or a medical professional, in particular a surgeon, to track the calculated intervention axis as accurately as possible. Therefore, the advantages of the surgical robot, namely, the accurate tracking of the preoperatively calculated surgical trajectory, can be combined with the high flexibility and easy handling of (conventional) manual surgery. In particular, the angle at which intervention should be made is shown to the surgeon performing the procedure. For example, how to insert a biopsy needle into a patient's body or at what angle to screw a pedicle screw into a patient's spine can be shown by the projected guide axis. By supporting the surgeon with the display / projection of the guide axis, the surgery can be performed accurately and the safety of the patient is enhanced. Trauma related to the surgery is reduced.

[0023] The object of the present disclosure is further achieved by a projection method according to the present disclosure for projecting a guide (having a guide axis), in particular a surgical plan (calculated preoperatively), using a projection laser attached to a robot head. The projection method has the following steps. A tracking system detects the position and / or orientation of the robot head and thus the orientation of the projection laser in space (via a determinable transformation between the robot head and the projection laser). A control unit calculates the guide axis, in particular based on preoperative images. The control unit further calculates the target position and target orientation of the projection laser, in particular based on an intervention axis calculated from the preoperative images. Then, the robot arm moves the robot head having the projection laser to the calculated predetermined target position and target orientation. The projection laser projects the laser irradiation in the target orientation such that at least one guide axis is visually displayed on the intervention area. In particular, the projected guide axis corresponds to the calculated intervention axis.

[0024] The surgical plan is preferably calculated by a control unit based on images detected preoperatively. The calculated surgical plan has at least one intervention position (target point), as well as an intervention axis and / or an intervention angle. In particular, the surgical plan has a linear trajectory.

[0025] Using the projection method according to the present disclosure, the calculated intervention axis of the planned surgery can be displayed as the projected guide axis. Thereby, the surgeon can perform the surgery with high precision by following the guide axis and thus the intervention axis.

[0026] Advantageous further embodiments of the present disclosure are the subject matter of the dependent claims and are explained in particular below.

[0027] Preferably, the control unit calculates at least a first target position and a target orientation of the projection laser based on the surgical plan stored in the memory unit. The control unit can control the robotic arm such that the projection laser projects its laser irradiation onto the intervention position calculated at the target position and target orientation, and visually displays a guide axis having the calculated target orientation. In this way, the laser irradiation, and thus the guide axis, indicates the intervention position calculated by the control unit.

[0028] The memory unit can be configured as part of the control unit or as part of an external control unit.

[0029] It may be advantageous for the control unit to drive, i.e., position and orient, the projection laser with respect to a predetermined intervention position via the robotic arm such that the guide axis forms a predetermined angle with respect to the predetermined intervention position (or the target point of the intervention position). As a result, the laser irradiation emitted by the projection laser will indicate the intervention angle. In particular, the intervention angle is an angle calculated as optimal for the surgical intervention. The intervention angle can be calculated based on the preoperative data set.

[0030] According to a further optional aspect of the present disclosure, the surgical plan is preferably composed of a (surgical) trajectory, which is preferably linear, (intermediate) target points (in particular, target points on a linear surgical trajectory, such as, for example, target points for indicating the axis of an instrument and a target position), and / or the outer shape of a (surgical) target object. The surgical plan also preferably includes at least one intervention position, an intervention axis, and / or an intervention angle. The control unit can set the target orientation (accompanied by the relevant target position) of the projection laser such that the guide axis corresponds to the intervention axis. As a result, the calculated intervention axis is displayed to the user by the projected guide axis. Therefore, since the projection laser can be moved to almost any position and orientation by a (movable) robotic arm, the guide axis can correspond to any intervention axis. During the surgery, the surgeon only needs to follow the projected guide axis in order to position his / her (medical) instrument or medical product at the correct intervention angle. This increases the probability that the surgeon meets the calculated intervention axis.

[0031] Preferably, the laser irradiation emitted by the projection laser is adapted to visually indicate or point to the focal position at a predetermined intervention depth. The intervention depth can be the subject of the calculated surgical plan and can be calculated by the control unit based on the preoperative image. If the projection laser displays the calculated intervention depth during the surgery, the possibility that the surgeon inadvertently intervenes at the wrong depth is minimized. For this reason, complications and traumas can be avoided. The surgery is patient-friendly and the postoperative recovery time is also shortened.

[0032] Laser irradiation projected by a projection laser can be advantageous for forming a conical structure having a focus, which indicates the depth of intervention. The depth of intervention is visually represented by the focus at the tip of the conical structure away from the projection laser, and a ring or elliptical shape is formed in the intervention area above the depth of intervention (i.e., facing the projection laser) and converges at the focus at the depth of intervention. This means that the emitted laser irradiation is configured with a circular cross-section (with a varying diameter) and is not point-like. The laser irradiations intersect each other at the intersection points that form the tip of the cone. The intersection points indicate the optimal (calculated) depth of intervention. If the surgeon has not yet reached the desired depth of intervention, the laser irradiation is displayed as a ring on the projection plane. The size of the ring can indicate how far the surgeon is from the depth of intervention. The larger the projected ring, the farther the distance from the desired depth of intervention. When the surgeon is following the intervention axis, the laser irradiation can be configured as concentric rings. Also, when the surgeon deviates from the intervention axis during the intervention, i.e., when the intervention direction is angled with respect to the laser irradiation and the projection plane on the patient is not orthogonal to the longitudinal axis, the laser irradiation may be displayed as an ellipse. This indicates to the surgeon that the intervention direction does not coincide with the calculated intervention axis.

[0033] Preferably, the medical device or medical product may have a predetermined projection area or projection device where the user can view the projection of the projection laser.

[0034] In particular, the laser irradiation projected by the projection laser forms a hyperbolic / double conical structure (like an hourglass), and the focus for visually indicating the depth of intervention is located at the common apex of the double cone, whereby a ring or elliptical shape is formed in the intervention area above the depth of intervention and converges at the focus at the depth of intervention and diverges again in a ring or elliptical shape below the depth of intervention. When the surgeon penetrates too deeply during the intervention, the laser irradiation may appear as a ring that grows larger as the distance to the desired depth of intervention increases.

[0035] Preferably, the projection laser emits at least two linear laser beams that intersect at an angle to each other, and the intersection point of the at least two laser beams indicates the calculated intervention depth. As described above, the laser irradiation of the projection laser cannot be emitted parallel or converging. As a result, the plurality of emitted laser beams (which are not linear and fan-shaped) intersect and form an intersection point. The calculated intervention depth is indicated by the intersection point. Two points can in particular be projected through two linear laser beams, and the distance between these laser beams decreases towards the focus and converges to one overlapping point.

[0036] According to a further optional aspect of the present disclosure, the laser-guided robot comprises an input / output unit, in particular a (touch) display, for inputting control commands and / or outputting information to a medical professional, in particular a surgeon. For example, the user can select, via the input / output unit, the desired end position and end orientation of the robot head and / or the target position and target orientation of the projection laser, and the robot moves the projection laser accordingly. Also, the user, in particular a medical practitioner or surgeon, can input the surgical trajectory via the input / output unit.

[0037] Preferably, the tracking system comprises an optical navigation system having a navigation camera and at least one or a plurality of optical trackers. These trackers are provided and configured to be attached to the distal end of the robotic arm or the robotic head and / or to the patient, whereby their positions and orientations in space are detected by the navigation camera of the navigation system in order to move the projection laser to the detected position and / or orientation of the patient and thus to the calculated target position and target orientation with respect to the intervention area. In particular, the robotic head includes a rigid body having reflective markers as robotic trackers. For example, one tracker is placed on the patient and another tracker is placed on the robotic head. The navigation camera is preferably a stereo camera capable of detecting the position and orientation of the tracker. In this way, the position and orientation of the patient, and thus the position and orientation of the intervention area, as well as the position and orientation of the robotic head, and thus the position and orientation of the projection laser, can be detected. In particular, the registration of the patient may be performed based on the patient tracker, or the control unit may be adapted to perform the registration of the patient via the tracking system. In particular, the initial position of the robotic head may be detected by the optical navigation system, and the robotic head may be moved to the target position and aligned in the target direction with respect to the intervention area of the patient. The optical navigation system recognizes when the target position and target orientation have been reached.

[0038] Preferably, the position and orientation of the robotic head can be detected via the servo motors of the guiding robot (via the corresponding robotic kinematics). This means that an optical tracking system or a navigation system with a camera and trackers is not required to detect the position and orientation of the robotic head. Exactly controllable servo motors are already provided in the guiding robot.

[0039] Furthermore, the projection laser can preferably be moved relative to the robot head by a servo motor in order to actively adjust the orientation of the projection laser relative to the robot head. This means that the projection laser has at least one degree of freedom relative to the robot head. This allows for more flexible alignment of the projection of the laser irradiation by the projection laser.

[0040] According to any other optional aspect of the present disclosure, the preoperative images of the patient are stored in the memory unit / data providing unit, particularly in the form of computed tomography and / or magnetic resonance images (CT images and / or MRI images). Based on the registered patient, the control unit calculates the intervention axis included in the preoperative images and the target position and target orientation that are most relevant as much as possible, and the projection laser is appropriately moved / displaced so that the guide axis is displayed in the best possible way and particularly corresponds to the intervention axis, i.e., is aligned coaxially therewith.

[0041] Preferably, the guiding robot has at least one projection laser, preferably two projection lasers, and one or more projection lasers are adapted to emit lasers of at least two different wavelengths in order to display two different colors, particularly to color-code different targets within the intervention area. The different colors of the lasers can be used to indicate different relevant orientation points such as organs, or different targets such as biopsies and / or tumors or medical products.

[0042] According to yet another optional aspect of the present disclosure, the projection laser can also be brought to the calculated end position by manually moving the robot arm, while the (optical) navigation system detects the current position and / or orientation of the projection laser during the manual movement and indicates that the calculated target position and / or target orientation has been reached. This means that the surgeon can also manually position the robot arm and can grasp how far it is from the target position and target orientation via the display device.

[0043] In particular, the target position may be set on the longitudinal axis of the laser irradiation and may be particularly displayed. In other words, the guide axis can be aligned in space, but in the case of parallel laser irradiation, it can move along the longitudinal axis while continuously displaying the guide axis.

[0044] In particular, the projection laser can adapt the laser irradiation in the form of an intersecting laser beam so as to change the distance between the projection laser and the intersecting laser beam for setting the focal position. In particular, the control unit can adapt to maintain the focal position while translating the robot head together with the projection laser along the longitudinal axis of the laser irradiation by appropriately changing the distance between the projection laser and the intersecting laser beam.

[0045] The object of the present disclosure is further achieved by a laser-guided robot system comprising a laser-guided robot according to the present disclosure, in particular according to one of the aspects described above. This laser-guided robot system comprises a medical instrument, in particular a surgical instrument, in particular a screwdriver, and / or a medical product, in particular a biopsy needle or a pedicle screw. This laser-guided robot projects a guide axis onto the intervention area via a projection laser. The medical instrument or medical product can be aligned with its longitudinal axis along the guide axis, and preferably the proximal part (along the longitudinal axis) of the medical instrument or medical product has a projection surface on which the projection laser emits laser irradiation when the medical instrument or medical product is aligned with its longitudinal axis substantially parallel, in particular coaxial, with the guide axis.

[0046] Preferably, the medical device has an optical marking at the proximal end indicating whether the surgical device is aligned with the intervention axis. The proximal marking may be, for example, concentric circles. When a dot-like protrusion is located at the center of the marker or a ring-like protrusion is concentric with the circle of the marker when laser irradiation is cast on the proximal marker, the surgical product is aligned with the guide axis or the intervention axis. Other rings may indicate an angle, which helps the surgeon determine whether the selected intervention axis of the medical instrument or medical product is still within the tolerance range with respect to the optimal intervention axis. In particular, a target or a ring like the target may be applied to the projection surface, so that when the laser dot lights up at the center of the target, it may indicate whether the surgeon is coaxial with the guide axis.

[0047] The laser-guided robot according to the present disclosure can be modified, in particular, according to at least one of the following embodiments. The robot head may include a surgical microscope. The laser-guided robot may be combined with a known navigation system. The laser-guided robot may be combined with a robotic surgery system. The projection laser may be incorporated into the optical system of the surgical microscope. The projection laser may be attached to the robot head or may be configured to be attachable to the robot head. The laser-guided robot may be used as a robot laser pointer controlled by an external user. The navigation system may be based on an infrared system equipped with an infrared camera and / or may be based on electromagnetic tracking (EM tracking) and / or may be based on a computer vision system.

[0048] The laser-guided robot and the projection method can be used as follows. The following applications are examples. The list is not exhaustive. The planned intervention position / incision site may be projected onto the patient's skin. The path or trajectory (especially a straight line) from the intervention position to the tumor may be projected. Important structures such as blood vessels may be marked to avoid unintentional damage. The outer boundary / periphery of the tumor may be marked. The biopsy trajectory may be marked and displayed via a guide axis. The trajectory of a (planned) bone screw may be marked via a guide axis. The laser can be used as a remotely operated laser pointer, and this laser pointer may guide the surgeon performing the procedure or surgery by indicating the anatomical orientation points to the assisting surgeon.

[0049] This object is achieved with respect to a computer-readable storage medium and with respect to a computer program, respectively, the latter including instructions which, when executed by a computer, cause the computer to execute the steps of the projection method according to the present disclosure.

Brief Description of the Drawings

[0050] Hereinafter, the present disclosure will be described in more detail with reference to the following drawings with reference to preferred embodiments.

[0051]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6a

Figure 6b

Figure 6c

Figure 7

[0052] The figures are in fact merely schematic and are intended only to assist in the understanding of the present disclosure. The same reference numerals are assigned to the same elements. The features of the various embodiments can be interchanged.

Mode for Carrying Out the Invention

[0053] FIG. 1 shows a laser guidance robot 1 positioned adjacent to a patient 100. The laser guidance robot 1 comprises a guidance robot having a robot arm 2 that is movably articulated or attached (movable) to a robot base 3. The robot arm 2 has a distal robot head 4 connected to the robot arm 2. The laser guidance robot 1 further has a tracking system 6, a projection laser 8, and an input / output unit 10 in this embodiment. The tracking system 6 detects the position and orientation of the robot head 4, and further the position and orientation of the patient 100, and thus the position and orientation of the intervention area. The projection laser 8 is attached to the robot head 4 so that the position and orientation of the projection laser 8 can be indirectly adjusted via the robot head 4. The projection laser 8 emits a laser irradiation 12 in the visible range for the human eye between 380 nm and 750 nm in this embodiment.

[0054] The laser-guided robot 1 further has a control unit 14 (shown in FIG. 2), which is adapted to determine the target position and target orientation of the projection laser 8 with respect to the intervention area of the patient 100. The control unit 14 controls the robot arm 2 having the robot head 4 and the projection laser 8 such that the projection laser 8 moves / displaces to the target position and target orientation. At least one guide axis 16 and the intervention position (target point) are visually displayed on the intervention area via the (visual) projection of the laser irradiation 12 of the projection laser 8 in the target orientation. In this way, in contrast to the known prior art, the surgeon is provided not only with the projection of the intervention point on the patient, but also with the guide axis visually displayed.

[0055] The robot base 3 of the laser-guided robot 1 is preferably arranged on a rollable or movable cart in order to provide a movable laser-guided robot 1 that can be moved to different positions in the operating room. The cart houses the control unit 14 (not shown in FIG. 1 but shown in FIG. 2), a power supply (not shown), and optionally a battery (not shown) for an emergency power supply. The cart further houses a memory unit 17 (not shown).

[0056] The robot arm 2 has several robot arm segments and joints such that the robot arm 2 can move with various translational degrees of freedom and at least one rotational degree of freedom. The robot head 4 is hinged to the distal end of the robot arm 2 so as to be rotatable about an axis. In this way, the robot head 4 and thus the projection laser 8 can be translated at least in space and is rotatable about the longitudinal axis of the distal end of the robot arm 2 to set a target position in space and a target orientation with a corresponding guide axis (with respect to the patient).

[0057] Figure 2 is a schematic diagram showing a laser-guided robot 1 including a robot arm 2 with a robot head 4, a tracking system 6, a projection laser 8, and a control unit 14. The tracking system 6 has an optical navigation system 18 including a navigation camera 19 having at least two spaced-apart camera lenses 20 and a number of (optical) trackers 22 (markers). Each tracker 22 has three or four arms 24 protruding in different directions from a common point. These arms 24 are each preferably arranged perpendicular to each other or at an angle of 120°. At the outer end of each arm, a tracker ball 26 is arranged. The tracker ball 26 is easily detected by the navigation camera 19 and is also configured to emit an optical signal. The tracker balls 26 of the trackers 22 are each on a common plane. By aligning this plane in space, the navigation system 8 can calculate how each tracker 22 is arranged on an object. Such trackers 22 are known.

[0058] A laser tracker 28 is attached to the robot head 4 at the distal end of the robot arm 2. Thereby, the position and orientation of the robot head 4 in space can be detected. A patient tracker 30 is arranged on a patient 100 to detect the position and orientation of the patient 100 in space and use this information to register the patient.

[0059] The input / output unit 10 is a touch-panel display through which information can be output to the user or the user can input information to the laser-guided robot 1.

[0060] The control unit 14 of the laser-guided robot 1 can determine the target position and target orientation of the projection laser 8 with respect to the patient's intervention area and control the robot arm 2. In particular, the control unit 14 can control the robot arm 2 so that the projection laser 8 moves / displaces to the target position and target orientation. The control unit 14 calculates the target position, target orientation, and intervention axis 32 from the patient's preoperative images. The preoperative images are acquired by the patient's computed tomography and / or magnetic resonance images and provided to the control unit 14 by the data providing unit. The control unit 14 appropriately displaces the projection laser 8 so that the guide axis 16 corresponds to the intervention axis 32.

[0061] For example, the robot head 4 has an (intervention) camera 34 through which the user can inspect the intervention site or the surgical site. The projection laser 8 that emits the laser irradiation 12 is arranged on the robot head 4. The guide axis 16 in the intervention area or the surgical plan is displayed by the laser irradiation 12 emitted from the projection laser 8. The surgical plan may be, for example, the intervention position where the surgeon makes an incision. The surgical plan may also be a trajectory from the incision site to a target such as a biopsy area, a tumor, or a (surgical) screw, and the trajectory may be visualized at least in cross-section via the corresponding guide axis.

[0062] Figure 3 shows the distal end of the robot arm 2 having the robot head 4, the tracker 22, and the projection laser 8. In particular, the tracker 22, which is a laser tracker, enables the (optical) navigation system 18 to detect the position and orientation of the robot head 4 in space in real time. Thereby, the control unit 14 can recognize when the robot head 4 reaches the target position and target orientation.

[0063] FIG. 4 shows the calculated intervention axis 32 in the preoperative image of patient 100. The body or tissue 102 of patient 100 is detected or scanned preoperatively. The control unit 14 or an external computing unit (not shown) uses these preoperative images to calculate a surgical plan having at least one surgical trajectory 50. Also, the intervention axis 32 is calculated, and in this embodiment, the target points on the intervention axis of the surgical trajectory are also calculated along with the corresponding distances. The purpose of this surgery is to ensure that the medical device or product 36 follows the calculated intervention axis 32 as accurately as possible and stops appropriately at the target depth for performing the corresponding operations. For this purpose, it is necessary to visualize the calculated intervention axis 32 so that the surgeon can follow the intervention axis 32 with the medical device 36. This is achieved by the present disclosure. In particular, the target point can be visualized at the target depth via intersecting laser beams.

[0064] FIG. 5 shows the laser-guided robot system of the present disclosure having the laser-guided robot 1 and the medical product or medical device 36. The projection laser 8 emits a laser irradiation 12 representing the guide axis 16. The longitudinal axis of the medical product 36 is aligned along the projected guide axis 16. When the longitudinal axis of the medical product 36 corresponds to the guide axis 16, the medical product 36 is also aligned along the calculated intervention axis 32. Due to the degrees of freedom of the robot arm 2, the projection laser 8 can be aligned and positioned such that the emitted laser beam 12 corresponds to the guide axis 16. The tracker 22 detects the position and / or orientation of the robot head 4 by the projection laser 8 so that the target position and target orientation can be accurately controlled. A concentric ring-shaped mark is made on the proximal portion 40 of the medical product 36 to indicate whether the medical product 36 is aligned with the longitudinal axis 42 of the guide axis 16. If the linear laser beam of the projection laser is displayed at the center of the concentric ring, it can be assumed that the intervening axis 32 and the guide axis 16 are coaxially aligned.

[0065] Figures 6A to 6C show different embodiments of the projection laser 8 having different configurations of laser irradiation, and each embodiment can be used in the laser-guided robot 1 or the laser-guided robot system of the present disclosure.

[0066] Figure 6a shows the projection laser 8 according to the first embodiment. Here, the laser beam 12 is emitted in a double conical shape by the projection laser 8. Since the ring-shaped laser beams 12 are angled with respect to each other, they overlap at the intersection point 38. The intersection point 38 of the laser beams 12 forming the double conical contour can be used to display the calculated intervention depth. More precisely, the laser beam 12 converges in a conical shape. The tip of the cone marks the calculated / desired intervention depth. This projection shows the shape of the ring or ellipse in the intervention as long as the intervention depth is not reached. When the intervention depth is reached, only the points are visualized. If the incision penetrates deeper than the calculated intervention depth, the ring grows larger again as the distance to the intervention depth increases.

[0067] Figure 6b shows the projection laser 8 according to the second embodiment. The projection laser 8 is configured as a point laser or a line laser. When the projection laser 8 is configured as a line laser, the projection laser 8 has a special lens (not shown) that fans out a point laser into a line laser (i.e., a constant cross-sectional contour along the longitudinal axis of the laser irradiation as a line). In this embodiment, the laser irradiation 12 cannot display the calculated or desired cut depth. However, the laser irradiation 12 can display the guide axis 16 very precisely.

[0068] Figure 6c shows the projection laser 8 according to the third embodiment. Here, a predetermined area is marked with a hollow cylindrical laser beam 12 using a circle. The marked area can be used, for example, to identify a tumor to be resected.

[0069] Figure 7 is a flowchart showing a projection method according to the present disclosure for visually projecting a guide for a surgical plan onto an intervention area of a patient 100 using the projection laser 8 attached to the robot head 4 of the robot arm 2.

[0070] In the first step S1, the tracking system 6 detects the position and orientation of the robot head 4 and the projection laser 8 in the space.

[0071] In step S2, the control unit 14 plans / calculates the intervention axis 32 based on the preoperative image.

[0072] In step S3, the control unit 14 calculates the target position and target orientation of the projection laser 8.

[0073] In step S4, the robot arm 2 moves the robot head 4 having the projection laser 8 to a predetermined target position and target orientation.

[0074] In step S5, the projection laser 8 projects the laser irradiation 12 in its target orientation so that the guide axis 16 projected by the projection laser 8 corresponds to the intervention axis 32.

[0075] In this way, the projection method can display the axis to the surgeon.

Explanation of Reference Numerals

[0076] 1: Projection device 2: Robot arm 3: Robot base 4: Robot head 6: Tracking system 8: Projection laser 10: Input / output unit 12: Laser irradiation 14: Control unit 16: Guide axis 18: Navigation system 19: Navigation camera 20: Camera lens 22: Tracker 24: Arm 26: Tracker sphere 28: Laser tracker 30: Patient tracker 32: Intervention shaft 34: Intervention camera 36: Medical product 38: Intersection point 40: Proximal part 42: Longitudinal axis 50: Surgical trajectory 100: Patient 102: Tissue

Claims

1. A laser-guided robot (1) for a guide axis, in particular for visually projecting a preoperatively calculated surgical plan onto the intervention area of a patient (100), comprising: A guiding robot (1) having a robot arm (2) movably articulated to a robot base (3) and a terminal robot head (4) connected to the robot arm (2); A tracking system (6), in particular an optical navigation system, adapted to detect the position and / or orientation of the robot head (4), and more preferably the position and / or orientation of the patient (100) and thus the intervention area; A projection laser (8) whose emitted laser irradiation (12) is preferably in the visible range of the human eye, and which is arranged such that the position and orientation of the projection laser (8) can be adjusted indirectly via the robot head (4), in particular a projection laser (8) statically attached to the robot head (4); In particular, based on the preoperatively calculated surgical plan or a predetermined intervention axis (32), a control unit (14) is adapted to determine the target position and target orientation of the projection laser (8) relative to the intervention area of the patient (100), and to control the robot arm (2) having the robot head (4) and the projection laser (8) such that the projection laser (8) moves to the target position and target orientation and visually displays at least one guide axis (16) on the intervention area via the projection of the laser irradiation (12) in the target orientation while moving; A laser-guided robot (1) comprising the above.

2. The control unit (14) is adapted to calculate at least a first target position and target orientation of the projection laser (8) based on a surgical plan stored in a memory unit (17), and to appropriately control the robot arm (2), whereby the projection laser (8) moves to the target position and target orientation and its laser irradiation (12) projects onto the intervention position calculated for visually displaying the guide axis (16). The laser-guided robot (1) according to claim 1, characterized in that.

3. The control unit (14) positions and orients the projection laser (8) with respect to a predetermined intervention position via the robotic arm (2) such that the longitudinal axis of the laser irradiation (12), and thus the guide axis (16), forms a predetermined angle with respect to the predetermined intervention position. The laser-guided robot (1) according to claim 1 or 2.

4. The surgical plan includes a surgical trajectory, intermediate target points, and / or the outer shape of the surgical object, and / or includes at least one intervention position, an intervention axis (32), and / or an intervention angle, The laser-guided robot (1) includes the control unit (14) that sets the target orientation of the projection laser (8) such that the guide axis (16) projected via the laser irradiation corresponds to the surgical trajectory or the guide axis (16) corresponds to the intervention axis (32). The laser-guided robot (1) according to any one of claims 1 to 3.

5. The laser irradiation (12) emitted by the projection laser (8) visually indicates a focus at a predetermined intervention depth and is particularly adapted to indicate this focus in a direction-dependent manner. The laser-guided robot (1) according to any one of claims 1 to 4.

6. The laser irradiation (12) projected by the projection laser (8) forms a double cone, and the focus for visually indicating the intervention depth is located at the common vertex of the double cone, whereby a ring or elliptical shape is formed in the intervention area above the intervention depth, converges at the focus at the intervention depth, and diverges again in a ring or elliptical shape below the intervention depth. The laser-guided robot (1) according to any one of claims 1 to 5.

7. The projection laser (8) emits at least two laser beams (12) that intersect at an angle to each other, and the intersection point of the at least two laser beams indicates the calculated intervention depth. The laser-guided robot (1) according to any one of claims 1 to 6.

8. The tracking system (6) comprises an optical navigation system (18) having a navigation camera (19) and at least one optical tracker (22) arranged at least on the robot head (4) and in particular attachable to the patient, whereby the position and orientation in space are accurately detected by the navigation camera (19) in order to move the projection laser (8) to the calculated target position and target orientation with respect to the intervention area. The laser-guided robot (1) according to any one of claims 1 to 7, characterized in that.

9. The position and orientation of the robot head (4), and thus the attitude of the projection laser (8), are detected via the servo motors of the guiding robot (1). The laser-guided robot (1) according to any one of claims 1 to 8, characterized in that.

10. The projection laser (8) is adjustable in its orientation with respect to the robot head (4) via at least one bearing, and in particular is actively adjustable to a predetermined orientation with respect to the robot head (4) via a servo motor. The laser-guided robot (1) according to any one of claims 1 to 9, characterized in that.

11. The pre-operative images of the patient (100), in particular CT images and / or MRI images, are stored in the memory unit (17), the control unit (14) calculates the intervention axis (32) included in the pre-operative images based on the registered patient (100), and the projection laser (8) is moved to the target position and target orientation such that the guide axis (16) corresponds to the intervention axis (32). The laser-guided robot (1) according to any one of claims 1 to 10, characterized in that.

12. A laser-guided robot system comprising the laser-guided robot (1) according to any one of claims 1 to 11, and further comprising a medical instrument, in particular a surgical instrument, or a medical product (36), wherein the laser-guided robot (1) projects the guide axis (16) onto the intervention area via the projection laser, enabling the medical instrument or medical product (36) to be aligned with the longitudinal axis (42) along the guide axis (16), and preferably, a part (40), in particular the proximal part, of the medical instrument or medical product (36) has a projection surface on which the projection laser (8) projects the laser irradiation (12) when the medical product (36) is aligned with its longitudinal axis (42) substantially coaxially with the guide axis (16).

13. A projection method for visually projecting a guide axis, in particular a pre-operative surgical plan, onto an intervention area of a patient (100) using a projection laser (8) arranged on a robot head (4) of a robot arm (2), comprising: detecting (S1) the position and / or orientation of the projection laser (8) in space by a tracking system (6), in particular indirectly via the posture of the robot head (4); calculating (S2) an intervention axis (32) by a control unit (12), in particular based on pre-operative images; calculating (S3) the target position and target orientation of the projection laser (8) by a control unit (12) in the vicinity, in particular on the intervention axis (32); moving (S4) the robot head (4) having the projection laser (8) to the predetermined target position and target orientation by the robot arm (2); projecting the laser irradiation (12) by the projection laser (8) in the target orientation such that the guide axis (16) projected by the projection laser (8) indicates the calculated intervention axis (32). A projection method comprising the above steps.

14. A computer-readable storage medium comprising instructions for causing a computer to execute the steps of the projection method according to claim 13 when executed by the computer.

15. A computer program comprising instructions for causing a computer to execute the steps of the projection method according to claim 13 when executed by the computer.

Images