Master control device, teleoperation system, and control method for surgical teleoperation and teleoperation simulation

Abstract

The robotic system (100) for medical or surgical teleoperation includes a master controller (110) that controls at least an opening and closing degree of freedom (GR) of a slave surgical instrument (170) using a first tracking sensor (31) and a second tracking sensor (32), and further includes at least one control unit (104) configured to detect a first change in a geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) of the master controller (110) along a first direction (X1), operate the slave surgical instrument (170) to open or close based on the detected first change in the geometric relationship, detect a second change in the geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) of the master controller (110) along a second direction (X2), and vary a closing / gripping / cutting force of the enslaved slave surgical instrument (170) based on the detected second change in the geometric relationship. [Reference diagram] Figure 4

Description

[Technical Field]

[0001] The present invention relates to a master control device.

[0002] The master controller of the present invention is particularly suited for robotic surgical systems.

[0003] The invention further relates to a medical or surgical teleoperation system comprising at least one master controller.

[0004] Furthermore, the present invention relates to a control method for controlling the degree of freedom of opening and closing by adjusting the clamping / cutting force of the slave surgical instrument. [Background technology]

[0005] Robotic surgical systems are commonly known in the art and typically include a central robotic tower or cart and one or more robotic arms extending from the tower / cart. Each arm includes a motorized positioning system (or manipulator) for moving a distally mounted surgical instrument to perform surgery on a patient. The patient typically lies on an operating table located in an operating room, where sterile conditions are maintained to prevent bacterial contamination from non-sterile parts of the robotic system.

[0006] To control the robotic manipulators, and therefore the slave surgical instruments, the surgeon operates one or more master controllers according to a master-slave teleoperation architecture.

[0007] In practice, it is desirable for the open / close commands of the master controller to control at least two functions of the slave surgical instrument: by controlling the degree of freedom between the tips (jaws) of the surgical instruments of the slave device, it is possible to perform a grasping or cutting function with the tips (jaws) closed, and also to increase the grasping or cutting force delivered by the tips of the slave surgical instrument.

[0008] Known robotic systems for surgical teleoperation are usually equipped with slave surgical instruments with different degrees of freedom of movement. Of particular interest is the opening and closing degree of freedom of the slave terminal clamp, in particular the gripping capacity with adjustable force, controlled by a dedicated master controller.

[0009] Several examples of user-controlled master controllers (usually surgeons) are known in which degrees of freedom of movement can be associated with kinematic chains formed by rigid links connected to movable joints that derive their position and orientation, and also provide degrees of freedom to control the opening and closing of tissue, needles, or sutures and adjust gripping force with additional strokes of the same movement.

[0010] For example, in a known arrangement disclosed in prior art document US-6,594,552, a master device is provided with different stiffnesses during the closing movement, and an elastic mechanism is shown that defines the change in stiffness associated with the initiation of the step of adjusting the gripping force of the slave surgical instrument.

[0011] Alternatively, a "flying" master device has been proposed, which is kinematically unconstrained (ungrounded) to any element of the master console, and the degrees of freedom for opening, closing, and grasping can be derived from dedicated internal sensors, or alternatively, from the pose, position, or orientation of optical sensors tracked within the workspace, for example using one or more cameras.

[0012] Further examples of both master and constrained devices are given in WO-2019-099584.

[0013] Some known examples disclose untethered wireless or wired flying masters in which degrees of freedom of movement, including opening, closing, and grasping, can be derived from detecting the attitude, position, or orientation of magnetometer-type sensors tracked within the workspace.

[0014] In particular, it is known to mount a pair of electromagnetic sensors, each with six degrees of freedom, on the same right and / or left master device body, with at least one degree of freedom of relative movement, in which a single relative movement along a defined trajectory controls both the degree of opening and closing and the adjustment of the gripping force, as shown, for example, in WO-2019-220408 by the same applicant.

[0015] For example, WO 2022-175800 of the same applicant discloses a solution for a master control device that is not mechanically / kinematically constrained to the operation console (groundless or unconstrained, according to the English terminology commonly used in the field), i.e., a "flying" type master device. This master device is equipped with a pair of sensors or tracking markers within a predetermined three-dimensional tracking volume that can be generated by electromagnetic emitters. In particular, this known solution describes a strategy for a system control unit to verify the existence of a predetermined geometric relationship between two sensors, i.e., two rigid rods of the master control device body that are hinged to each other and attached to the sensors. Summary of the Invention [Problem to be solved by the invention]

[0016] Although known master device solutions are partially advantageous in some respects, they are by no means without drawbacks.

[0017] For example, as shown in prior art document WO-2019-220407 by the same applicant, a resilient element can be provided on the unconstrained master device, and in a specific case a preloaded trigger can be provided at the cantilever position between the rods to provide force feedback to the surgeon when the opening / closing angle between the rods of the master device falls below a predetermined threshold.

[0018] Thus, in such known solutions, a first angular movement between the rods of the master device commands a dependent opening or closing of the slave device, and a second angular movement between the rods commands a dependent increase in the gripping (or cutting) force. This type of solution does not completely solve the problem of opening, because when the surgeon opens the rods, i.e., loosens his grip on the master device, the spring force between the rods causes them to open, but the first angular stroke commands a dependent loosening of the gripping (or cutting) degree of freedom of the slave device. Thus, the surgeon sees the master device open while the slave device is closed, and for these reasons, the surgeon experiences a kind of undesirable delay between the given open command and the subsequent action of the slave surgical instrument.

[0019] In addition to the position, orientation, and opening / closing of a teleoperated robotic surgical gripper, it is thought that it will be necessary to control the adjustment of the gripping force.

[0020] This should be felt by the user operating the master and clearly understand which movements or parts of movements are associated with opening and closing the gripper, and which movements or parts of movements are associated with adjusting the gripping force.

[0021] Furthermore, while the virtual control point identifying the slave device typically follows a point in the master workspace calculated as the midpoint between the master device's rod-mounted sensors, some inconsistencies inevitably arise if the master device is not closed symmetrically. In other words, for example, if only one of the master device's rods is moved relative to the master reference system, the midpoint between the rods also moves, resulting in a dependent movement of the control point in the slave space. As a result, when faced with a closure command by the surgeon, the closure may be observed along with a rotation of the tip (jaw) of the slave surgical instrument, causing the control point of the slave device to move to the position dictated by the master command.

[0022] Therefore, in such a situation, there is a risk that unwanted commands to the surgical instrument, specifically translating the midpoint between the rods of the master device, i.e., between the sensors, relative to the origin of the master reference system, will involuntarily activate the tip joint rotation, i.e., the yaw joint at the articulated end of the surgical instrument.

[0023] Therefore, there is a strong need to improve the open / close degree of freedom control of a slave surgical instrument controlled by an unconstrained master device to make it more intuitive and accurate, so that it can distinguish between the open / close action and the action of increasing or decreasing the closing, gripping, and / or cutting force between the tips (jaws) of the slave device's surgical instruments.

[0024] Users operating the master have felt the need to associate opening and closing their fingers with opening and closing the gripper, and increasing finger pressure with adjusting the gripping force.

[0025] On the other hand, there is a strong need to avoid, or at least minimize, the risk of sending unnecessary commands from the master device to the slave device when manipulating the opening and closing degrees of freedom of the slave surgical instrument.

[0026] There is also a strong need to measure the opening and closing movements separately from the opening, closing, gripping and cutting force adjustment movements in a medical or surgical teleoperated master device.

[0027] We felt the need to adequately measure opening and closing movements and force adjustment movements while providing sufficient resolution, sufficient robustness, a simple and economical design, and minimizing the number of sensors and electronic components installed. [Means for solving the problem]

[0028] It is an object of the present invention to overcome the shortcomings noted in the prior art and to provide a solution to the need for improved control over the opening and closing of articulating gripping and / or cutting ends of surgical instruments for remote medical or surgical manipulation.

[0029] This and other objects are achieved by a system according to claim 1, an apparatus according to claim 16, a method according to claim 18, a program according to claim 19, and a system according to claim 20.

[0030] Some advantageous embodiments are the subject of the dependent claims.

[0031] According to one aspect of the present invention, a method for controlling remote medical or surgical manipulation includes the steps of: (i) providing at least one master control device for controlling at least one degree of freedom of opening and closing a slave surgical instrument, the master control device having a first tracking sensor and a second tracking sensor; (ii) detecting a first change in a geometric relationship between the first tracking sensor and the second tracking sensor of the master control device along a first direction, and moving the slave surgical instrument to open or close based on the detected first change in the geometric relationship; and (iii) detecting a second change in the geometric relationship between the first tracking sensor and the second tracking sensor of the master control device along a second direction, and varying a clamping / cutting force of the slave surgical instrument based on the detected second change in the geometric relationship.

[0032] This control method can also be applied to a computer simulation of a slave surgical instrument.

[0033] According to one aspect of the invention, there is provided a computer program configured to carry out at least some (preferably all) of the steps of the control method.

[0034] According to one aspect of the present invention, a teleoperated medical or surgical robotic system includes at least one slave surgical instrument having at least one degree of freedom to open and close, and at least one master controller that controls at least the degree of freedom to open and close the slave surgical instrument, the master controller including a first tracking sensor and a second tracking sensor.

[0035] According to one aspect of the present invention, the system includes at least one control unit configured to detect a first change in a geometric relationship between a first tracking sensor and a second tracking sensor of the master control device along a first direction, operate a slave surgical instrument to open or close based on the detected first change in the geometric relationship, detect a second change in the geometric relationship between the first tracking sensor and the second tracking sensor of the master control device along a different second direction, and vary a clamping / cutting force of the slave surgical instrument based on the detected second change in the geometric relationship.

[0036] In one embodiment, the change in the geometric relationship between the first tracking sensor and the second tracking sensor is amplified, i.e., multiplied, relative to the change in the geometric relationship between the operating interface portions of the master control device configured to receive the operator's finger.

[0037] According to one aspect of the present invention, the master control device is configured to control the opening and closing degrees of freedom of the slave surgical instruments and comprises a body having a first surgical operating section and a second surgical operating section that are movable relative to one another by manual action of a surgeon, the first surgical operating section and the second surgical operating section having at least one open configuration configured to control at least one slave open configuration of the slave surgical instruments and at least one closed configuration configured to control at least one slave closed configuration of the slave surgical instruments.

[0038] According to one aspect of the present invention, the at least one closed configuration of the master device includes a first closed configuration and a second closed configuration, and a transition between the first closed configuration and the second closed configuration is configured to control a change in clamping / cutting force of the slave surgical instrument.

[0039] The master controller is of a type that is kinematically unconstrained relative to the operator console and can be tracked by a dedicated tracking system.

[0040] According to one aspect of the present invention, the master control device further comprises a first tracking sensor operatively connected to a first surgical operation unit of the master device body and a second tracking sensor (32) operatively connected to a second surgical operation unit of the master device body, wherein (i) a transition between at least one open configuration and a first closed configuration results in a first change in a geometric relationship between the first tracking sensor and the second tracking sensor, (ii) a transition between the first closed configuration and the second closed configuration results in a second change in the geometric relationship between the first tracking sensor and the second tracking sensor, and (iii) the first change in the geometric relationship and the second change in the geometric relationship occur along two different directions.

[0041] The master control device may further include a first operating unit and a second operating unit for operation by a surgeon's hand, where the first operating unit is operatively connected to a first surgical operating unit of the master device body, the second operating unit is operatively connected to a second surgical operating unit of the master device body, and the first operating unit and the second operating unit are movable relative to each other along a single third direction, e.g., relative approach / separation.

[0042] According to one aspect of the present invention, a robotic system for medical or surgical teleoperation and / or simulation of teleoperation includes at least one slave surgical instrument having at least one degree of freedom to open and close, and at least one master controller that controls at least the degree of freedom to open and close the slave surgical instrument, the master controller including a first tracking sensor and a second tracking sensor.

[0043] The system may include at least one control unit configured to detect the pose or movement of the tracking sensor and transfer the movement to at least one slave surgical instrument. The "pose" of the sensor is preferably intended to indicate its position (e.g., x-y-z coordinates) and orientation (e.g., roll, pitch, yaw) relative to three global reference sets (which may be located in the console).

[0044] According to one aspect of the present invention, the relative movement between the two sensors of the master control device is determined according to a first relative movement direction detected and transmitted by the control unit to open and close the slave surgical instrument by operating a control operation imposed by a user on the master control device according to a single opening and closing operation trajectory.

[0045] According to one aspect of the invention, in adjusting the gripping force of the slave surgical instrument only, the relative movement between the same two sensors of the master control device is determined according to a second direction of relative movement detected and transmitted by the control unit.

[0046] According to a first direction of relative movement related to opening and closing, the relative movement between the two sensors can be a change in relative distance, and according to a second direction of relative movement related only to adjusting the force, the relative movement between the same two sensors can be a change in orientation.

[0047] The relative movement between two sensors according to a first direction of relative movement associated with opening and closing can be a first defined curved trajectory and / or circumferential arc, and the relative movement between the same two sensors according to a second direction of relative movement associated only with force modulation can be a second, different defined curved trajectory and / or circumferential arc.

[0048] The second, differently defined curved trajectory in the first direction of relative movement may have an opposite concavity to the first defined curved trajectory in the second direction of relative movement.

[0049] The control unit can be configured to inhibit any translational movement induced in the slave surgical instrument 170 or the control point 177 during the step of varying the clamping / cutting force, which translational movement results from a change in the geometric relationship between the sensors along the first direction X1 that commands the opening or closing of the slave device. In other words, during the adjustment of the clamping / cutting force F and / or during the second relative movement between the two sensors 31, 32 according to the second relative movement direction X2, the control unit 104 is configured to inhibit any translational movement of the slave surgical instrument 170 or the control point 177 caused by further relative movement between the two sensors 31, 32 according to the first relative movement direction X1.

[0050] In one embodiment, by applying a single movement trajectory control movement of the master control device during opening and closing, the translational movement of the slave surgical instrument or control point is not mechanically transmitted, and / or the calculated midpoint of the distance or relative angle between the sensors is kept constant and not mechanically changed.

[0051] According to one embodiment, by applying a control movement of the single movement track in the closing direction, once the contact point is reached and passed, further relative movement in the first relative movement direction is mechanically inhibited and only movement in the second relative movement direction is mechanically possible.

[0052] In one embodiment, when the contact point is reached and passed, the control action of the single movement track is applied in the opening direction, so that relative movement in the second relative movement direction is mechanically prevented and only relative movement in the first relative movement direction is mechanically possible.

[0053] In one embodiment, the control action of the single movement track is applied in a closing direction, such that a greater closing force is applied when the contact point is reached and passed, and during movement along the second relative movement direction, than is required to move along the first relative movement direction.

[0054] The single movement trajectory may be a curve and / or an arc, or may be a straight line.

[0055] In one embodiment, a first portion of the control action of a single movement trajectory imposed by the user on the master control device is associated with actuation of a first relative movement direction, and thus opening and closing of the slave surgical instrument, and a second portion of the control action of a single movement trajectory imposed by the user on the master control device is associated with actuation of a second relative movement direction, and thus changing the clamping / cutting force of the slave surgical instrument.

[0056] In one embodiment, the second change in the geometric relationship is determined by elastic deformation of the master device body.

[0057] The proposed solution makes it possible to distinguish between a first command aimed at opening or closing a slave surgical instrument and a second command aimed at changing the closure force of the same slave surgical instrument, even if the first and second commands are determined by identical or similar actions by the surgeon on the master device, such as the relative approaching or separating of two fingers of the surgeon's hand.

[0058] The proposed solution allows for the management of the opening and closing of the slave robotic surgical gripper and the adjustment of the gripping force (compression). The management of the slave surgical gripper's position and orientation can also be done by the same master controller.

[0059] Therefore, a user operating the master device can clearly understand which operations or parts of operations are related to opening and closing the slave gripper, and which operations or parts of operations are related to adjusting the gripping force of the slave gripper itself.

[0060] Thus, the user can associate closing / opening the fingers with closing / opening the gripper, and pressing the fingers with adjusting the gripping force.

[0061] This allows the opening and closing operations and the grip force adjustment operations to be properly measured with sufficient resolution, robustness, and a simple and economical design, and minimizes the number of sensors installed in the master device.

[0062] The proposed solution allows an unconstrained master controller to derive its degrees of freedom of movement, including opening and closing movements and grip / squeeze adjustments, from only the poses of two sensors tracked in the workspace.

[0063] The proposed solution makes it possible to associate a first relative movement between two sensors with closing / opening and a second, different relative movement between the same two sensors with adjusting the clamping / cutting force.

[0064] The relative motion between the two sensors for adjusting the clamping / cutting force of the surgical instrument can be induced to be amplified relative to the movement of the part of the control interface that the surgeon's fingers act on directly, facilitating accurate and reliable detection.

[0065] According to the proposed solution, the relative movement between two sensors according to a first relative movement direction is associated with opening and closing, while the relative movement between the same two sensors according to a second relative movement direction is associated only with adjusting the clamping / cutting force.

[0066] The relative movement between the two sensors according to a first direction of relative movement associated with opening and closing can be a first defined curved trajectory, and the relative movement between the same two sensors according to a second direction of relative movement associated only with adjusting the force can be a second, different defined curved trajectory, for example, the second, different defined curved trajectory having an opposite concavity to the first defined curved trajectory and / or the first and second curved trajectories have different instantaneous centers of rotation.

[0067] Relative movement between two sensors according to a first relative movement direction associated with an opening or closing operation can result in a change in relative distance, while relative movement between the same two sensors according to a second relative movement direction associated only with force adjustment can result in a change in orientation.

[0068] The second relative movement direction associated with the force adjustment can be activated only when the stroke end of the first relative movement trajectory associated with the opening / closing operation is reached. Reaching the stroke end of the first trajectory can be associated with the master gripper being fully closed. Therefore, reaching the stroke end is clearly recognized by the user during the forced control operation. The stroke end is indicated by contact between two free ends associated with two sensor portions of the master device, respectively, making it intuitive for the operator. The possibility of further relative movement along the first movement direction can be inhibited upon reaching the stroke end, and only movement along the second movement direction can be permitted. The master device can include a second, further stroke end position associated with the second relative movement direction and the transmission of maximum clamping force / cutting force / torque.

[0069] Both the first and second relative movement directions can be obtained by actuating a manipulation action imposed by a user according to a single movement direction, for example, a relative approaching movement of the two interface parts for the user. The manipulation action can be located on a defined curve and / or line and can be determined by counting the fingers of the surgeon on the respective manipulation parts of the master device.

[0070] A first part of the operating action can be associated with actuation of a first direction of relative movement, thus closing / opening, and a second part of the operating action can be associated with actuation of a second direction of relative movement, thus adjusting the clamping / cutting force / torque.

[0071] A manipulation movement along the manipulation direction can be associated with the application of a first force inducing a first direction of relative movement related to opening or closing, and a second force inducing a second direction of relative movement related solely to adjusting the gripping / cutting force of the slave surgical instrument. The first force can be constant. The second force can increase with the control movement until a second further stroke end position is reached.

[0072] The master device may be comprised of two parts (e.g., two rods) connected / hinged with a rotational and / or translational connection joint. The connection joint between the two parts may be elastically preloaded to keep the master device in a maximum open state. It may have an open stroke end. Each part may be comprised of two rigid sections (one proximal and one distal) connected by an elastic means. The two parts may be separated and connected by the elastic means as an additional component, or the two parts may be part of the same part, with the elastic means being an elastic hinge made of a reduced-thickness portion of the same part, which may have, for example, a folded and / or curved sheet body.

[0073] The proximal portion can include a portion or surface area where a finger rests (e.g., a control portion), and the distal portion can include a portion into which a tracking sensor can be inserted (e.g., a surgical control portion).

[0074] Further features and advantages of the present invention will become apparent from the following description of preferred embodiments, given by way of non-limiting example, with reference to the accompanying drawings, which are briefly described below. It should be noted that references to "an" embodiment in this disclosure should be understood to refer to at least one embodiment, and not necessarily to the same embodiment. Furthermore, for the sake of brevity and reducing the total number of figures, certain figures may be used to show features of more than one embodiment, and not all elements of a figure are essential to a particular embodiment. [Brief explanation of the drawings]

[0075] [Figure 1A] FIG. 1 is a perspective view of a medical or surgical teleoperated robotic system, according to one embodiment. [Figure 1B] FIG. 1 is a perspective view of a system for simulating medical or surgical teleoperation, according to one embodiment. [Figure 2] FIG. 2 is a diagram of a system control unit, according to one embodiment. [Figure 3]FIG. 1 is a perspective view that schematically illustrates a robotic system for medical or surgical teleoperation, according to one embodiment. [Figure 4] FIG. 2 is a perspective view of a master controller according to one embodiment. [Figure 5A] FIG. 5 is a plan view of the master control device of FIG. 4, showing an open configuration. [Figure 5B] FIG. 5 is a plan view of the master control device of FIG. 4, showing the first closed configuration. [Figure 5C] FIG. 5 is a plan view of the master controller of FIG. 4, showing the second closed configuration. [Figure 5D] 5B illustrates the transition between the first and second closed configurations, the transition being caused by the overlap of the details of FIGS. 5A and 5B. FIG. [Figure 5E] 5B illustrates the transition between the first and second closed configurations, the transition being caused by the overlap of the details of FIGS. 5A and 5B. FIG. [Figure 6A] FIG. 2 is a plan view of a master control device according to one embodiment, showing an open configuration. [Figure 6B] FIG. 2 is a plan view of a master control device according to one embodiment, showing a first closed configuration. [Figure 6C] FIG. 2 is a plan view of a master control device according to one embodiment, showing a second closed configuration. [Figure 7A] FIG. 2 is a plan view of a master control device according to one embodiment, showing an open configuration. [Figure 7B] FIG. 2 is a plan view of a master control device according to one embodiment, showing a first closed configuration. [Figure 7C] FIG. 2 is a plan view of a master control device according to one embodiment, showing a second closed configuration. [Figure 8A] FIG. 2 is a plan view of a master control device according to one embodiment, showing an open configuration. [Figure 8B] FIG. 2 is a plan view of a master control device according to one embodiment, showing a first closed configuration. [Figure 8C] FIG. 2 is a plan view of a master control device according to one embodiment, showing a second closed configuration. [Figure 8D] FIG. 2 is a plan view of a master control device according to one embodiment, showing a second closed configuration. [Figure 9A] FIG. 2 is a plan view schematically illustrating a master control device according to an embodiment. [Figure 9B] 9B is a plan view showing the master control device of FIG. 9A, with an enlarged view of the area inside the box. [Figure 9C] 9B is a schematic diagram of the master control device of FIG. 9A in a closed position, showing an enlarged view of the area within the box. [Figure 10A] FIG. 2 is a plan view schematically illustrating a master control device according to an embodiment in an open state. [Figure 10B] FIG. 10B is an enlarged view of a detail of FIG. 10A. [Figure 10C] FIG. 10B is a diagram schematically illustrating the master device of FIG. 10A in a closed state. [Figure 10D] FIG. 10D is an enlarged view of a detail of FIG. 10C. [Figure 11A] 1 is a perspective view of a tracking sensor according to some embodiments. FIG. [Figure 11B] 1 is a perspective view of a tracking sensor according to some embodiments. FIG. [Figure 11C] 1 is a perspective view of a tracking sensor according to some embodiments. FIG. [Figure 11D] FIG. 2 is a schematic diagram illustrating a pair of tracking sensors according to one embodiment. [Figure 12A] FIG. 2 is a plan view of a master control device according to one embodiment, showing an open configuration. [Figure 12B] FIG. 2 is a plan view of a master control device according to one embodiment, showing a first closed configuration. [Figure 12C] FIG. 2 is a plan view of a master control device according to one embodiment, showing a second closed configuration. [Figure 13A] FIG. 2 is a perspective view showing a master control device according to an embodiment. [Figure 13B] FIG. 13B is a plan view schematically illustrating the master device of FIG. 13A in an open configuration. [Figure 13C]FIG. 13B is a plan view schematically illustrating the master device of FIG. 13A in an open configuration. [Figure 14A] FIG. 2 is a plan view of a master control device according to one embodiment, showing an open configuration. [Figure 14B] FIG. 2 is a plan view of a master control device according to one embodiment, showing a first closed configuration. [Figure 14C] FIG. 2 is a plan view of a master control device according to one embodiment, showing a second closed configuration. [Figure 14D] FIG. 2 is a plan view of a master control device according to one embodiment, showing a second closed configuration. [Figure 15A] FIG. 1B is a schematic diagram of a slave surgical instrument according to one embodiment, showing an open configuration. [Figure 15B] FIG. 10 is a schematic diagram of a slave surgical instrument according to one embodiment, showing a grasping configuration. [Figure 15C] FIG. 10 is a schematic diagram of a slave surgical instrument according to one embodiment, showing a forceful grasp configuration. [Figure 16A] FIG. 10 is a block diagram of some embodiments of a control method. [Figure 16B] FIG. 10 is a block diagram of some embodiments of a control method. [Figure 16C] FIG. 10 is a block diagram of some embodiments of a control method. [Figure 16D] FIG. 10 is a block diagram of some embodiments of a control method. [Figure 17] FIG. 2 is a schematic diagram of a master controller according to some embodiments. [Figure 18] FIG. 2 is a schematic diagram of a master controller according to some embodiments. [Figure 19] FIG. 1 illustrates a known example of a master controller. [Figure 20A] FIG. 1 is a plan view of a master control device according to one embodiment, showing an open configuration. [Figure 20B] 1 is a plan view of a master control device according to one embodiment, showing a first closed configuration. [Figure 20C]1 is a plan view of a master control device according to one embodiment, showing a second closed configuration. DETAILED DESCRIPTION OF THE INVENTION

[0076] Throughout this specification, a reference to an "embodiment" means that a particular feature, structure, or function described in connection with that embodiment is included in at least one embodiment of the invention. Thus, the appearances of "embodiments" in various parts of this specification do not necessarily all refer to the same embodiment. Furthermore, particular features, structures, or functions illustrated in different figures may be combined in any suitable manner in one or more embodiments.

[0077] According to a general embodiment, a robotic system 100 for medical or surgical teleoperation is provided.

[0078] It will be appreciated that the teachings of the present disclosure also apply in the case of a medical or surgical teleoperated simulation system 101.

[0079] The robotic system 100 comprises at least one slave surgical instrument 170 with open / close degrees of freedom GR, and at least one master control device 110 (or "gripper" 110, in the commonly used English terminology) for controlling the open / close degrees of freedom GR of the at least one slave surgical instrument 170.

[0080] For example, as shown in FIG. 2 , the robotic system 100 (and / or the simulation system 101) further includes at least one control unit 104. The control of the opening and closing degrees of freedom (GR) or gripping degrees of freedom (GR) of the slave surgical instrument 170 has two modes. The first mode (opening and closing mode) controls the relative movement of the two tips 171, 172 toward each other (closing) or away from each other (opening). The second mode (compression mode, meaning clamping or cutting) is related to adjusting the clamping / cutting force between the working parts 175 of the two tips, but does not necessarily determine the relative movement between the two tips 171, 172. The master controller 110 of the robotic system 100 is configured to control both modes of the opening and closing degrees of freedom (GR) of the slave surgical instrument 170.

[0081] 15A, the slave surgical instrument 170 can include two tips 171, 172 or jaws 171, 172 constrained by a rotational joint 173 for relative rotation about a common axis. Each tip or jaw can include a gripping surface and / or a blade and / or a counter-blade or other operating portion 175. For example, the slave surgical instrument 170 can be a gripper, a dilator, a needle driver / suture cutter, surgical scissors, an electrocautery instrument, and / or other types of instruments.

[0082] At least one slave surgical instrument 170 can belong to a slave robot assembly 120 of a robotic teleoperation system. For example, as shown in Figure 3, the slave robot assembly 120 includes, in addition to the at least one slave surgical instrument 170, at least one robotic manipulator 130 that can be actuated under the control of a master controller 110 that can move within a master workspace 144 to control the slave surgical instrument 170 within the slave workspace 174. A camera 127 or microscope 127 can be provided for viewing the surgical operation site on a dedicated display 128.

[0083] According to a preferred embodiment, the robotic system 100 is configured to control, in an operational state, at least one slave device 170 based on detection of position and / or orientation information of the at least one master device 110. For example, a control point 177 may be defined with multiple degrees of freedom relative to the slave global reference frame SFO, and the control point 177 may be located between the manipulators 175 of the tips 171, 172, and is controlled based on detection of position and / or orientation information of the master device 110 in the master workspace 144 relative to the master global reference frame MFO.

[0084] To detect position and / or orientation information of the master unit 110, tracking field emitters 142 (e.g., electromagnetic field emitters) may be provided that define a tracking volume from which a master workspace 144 is derived. Tracking of the master unit 110 may be performed by optical and / or infrared sensors, and / or accelerometers, and / or inertial platform (IMU), and / or any combination thereof.

[0085] At least one master unit 100 does not necessarily have to be a flying, i.e., kinematically untethered (not in contact with the ground) master unit relative to the operator console 140, but in a preferred embodiment, at least one master unit 100 is a flying, i.e., untethered, master unit.

[0086] The master control device 110 can be a type of master device that is kinematically constrained to the operation console by a support unit 111 (e.g., a gymbal and / or a motorized kinematic chain), as shown in FIG. 17, and the sensors 31 and 32 are used to detect positional and / or directional information to control at least the opening and closing degrees of freedom of the slave surgical instrument 170, and for example, the direction and overall positional information of the master device 110 can be controlled by the support unit 111 or the constrained unit 111.

[0087] The master control device 110 includes at least two tracking sensors 31, 32, a first tracking sensor 31 and a second tracking sensor 32. Of course, the term "tracking sensors 31, 32" refers to both electromagnetic sensors (FIGS. 11A-B), optical sensors (markers, FIG. 11C), accelerometers, inertial platforms, infrared sensors, and any combination thereof. For example, as shown in FIG. 11D, the first sensor 31 can be an infrared transmitter, and the second sensor 32 can be a detector strip including multiple detectors 33 arranged vertically. This allows information about the distance between the sensors 31, 32 to be obtained by detecting the time of flight of the return signal, and information about the angle between the sensors 31, 32 to be obtained by detecting the illuminated point on the detector strip or the position of the detector 33.

[0088] Advantageously, the first tracking sensor 31 and the second tracking sensor 32 are each associated with, for example fixed to, parts of the master device 110 that are movable relative to one another by movements imparted by the surgeon's hand 150. The movements imparted by the surgeon's hand 150 thus determine a change, i.e. a modification, of the geometrical relationship between the two tracking sensors 31, 32 as a result of this manipulation movement by the master control device 110.

[0089] Further advantageously, the control unit 104 of the medical or surgical teleoperated robotic system 100 is configured to detect a first change in the geometric relationship between the first tracking sensor 31 and the second tracking sensor 32 of the master controller 110 along a first direction X1, and to move the slave surgical instrument 170 in an opening or closing mode based on the detected first change in the geometric relationship. Thus, detection of movement between the two tracking sensors 31, 32 along the first direction X1 is interpreted by the system control unit as a command intended to move the slave surgical instrument 170 to open or close, for example, as a command to move the tips 171, 172 or jaws 171, 172 of the slave surgical instrument away from or towards each other.

[0090] As a further advantage, the control unit 104 of the medical or surgical telerobotic system 100 is configured to detect a second change in the geometric relationship between the first and second tracking sensors 31, 32 of the master controller 110 along the second direction X2, and to vary the clamping / cutting force / torque of the slave surgical instrument 170 based on the detected second change in the geometric relationship (compression mode). Thus, the system control unit interprets the detection of movement between the two tracking sensors 31, 32 along the second direction X2 as a command aimed at adjusting the closing / gripping / cutting (or opening) force of the slave surgical instrument 170, for example by clamping the tips 171, 172 or the operating parts 175 of the jaws 171, 172 of the slave surgical instrument together.

[0091] Such a system can recognize and distinguish between opening and closing movement commands of the slave opening and closing degree of freedom GR and force adjustment commands applied by the slave surgical instrument 170 based on the relative movement directions X1, X2 between two sensors 31, 32 operatively associated with the body of the master device 110.

[0092] In particular, relative movement between two sensors according to a first relative movement direction X1 can be associated with opening or closing the slave, and relative movement between the same two sensors according to a second, different relative movement direction X2 can be associated with grip force adjustment along the slave.

[0093] In a preferred embodiment, both the first relative movement direction according to a trajectory or relationship X1 between the two sensors and the second relative movement direction according to a trajectory or relationship X2 are obtained by actuating a control action imposed by the user according to a single movement direction or trajectory X3.

[0094] The trajectory X3 can be identified by the special control units 21 and 22 and by the relative movements exerted on these points directly from the user's fingertips.

[0095] The relative positions of the surface areas where the fingers rest on the masters 21, 22 can define the single direction of movement X3.

[0096] In a preferred embodiment, the control action lies on a defined curve or arc.

[0097] In another embodiment, the control actions lie on a straight line.

[0098] A first part of the control action may be associated with actuation in said first relative direction of movement, and thus with opening and closing.

[0099] A second part of the control action can be associated with actuating said second direction of relative movement and thus adjusting the gripping force.

[0100] The position and / or orientation information detected by the tracking sensors 31, 32 can also be used to control the position and orientation (tracking mode) of the slave surgical instrument 170, for example the control point 177.

[0101] Movement of the control point 177 of the slave surgical instrument 170 can be prevented or inhibited by the system control unit 104 during the clamping / cutting force adjustment (compression mode) state characterized by the relative movement X2 of the two sensors.

[0102] The system can store the commands of the master device during the force adjustment mode (compression mode), in particular the expected displacement of the control point 177 due to the deformation of the master device body.

[0103] Further relative movement along the first direction of movement X1 may be mechanically prevented upon reaching the stroke end P1, while movement only in the second direction of relative movement X2 may be possible.

[0104] The midpoint calculated using the distance or relative angle between the sensors can be kept mechanically invariant and constant throughout actuation of the second relative movement direction associated with force modulation.

[0105] The slave control point 177 associated with the master's position can be immobilized only during actuation and control of opening and closing and force modulation.

[0106] The calculated midpoint of the distance or relative angle between the sensors may be maintained unchanged and constant throughout actuation of said second relative movement direction associated with force modulation.

[0107] According to a preferred embodiment, the control unit 104 of the robotic teleoperation system is configured to detect a change in the distance X1 between the first tracking sensor 31 and the second tracking sensor 32, and to open or close the slave surgical instrument 170 based on the detected change in distance X1. According to this embodiment, the control unit 104 is further configured to detect a change X2 in the relative orientation between the first tracking sensor 31 and the second tracking sensor 32, and to vary the closing / gripping / cutting force / torque of the slave surgical instrument 170 based on the change in the relative orientation.

[0108] Relative movement between two sensors according to a first direction of relative movement X1 associated with opening and closing can result in a first defined curved trajectory, while relative movement between the same two sensors according to a second direction of relative movement X1 associated only with adjusting the force results in a second, different defined curved trajectory.

[0109] In one embodiment, the second, differently defined curved track has an opposite recess to said first, defined curved track.

[0110] In one embodiment, relative movement between two sensors according to a first direction of relative movement associated with opening and closing is a change in relative distance, and relative movement between the same two sensors according to a second direction of relative movement associated only with adjusting force is a change in orientation.

[0111] In one embodiment, relative movement between two sensors according to a first direction of relative movement associated with opening and closing is a change in orientation indicated by a first geometric-mathematical relationship, and relative movement between the same two sensors according to a second direction of relative movement associated only with adjusting force is a second change in orientation indicated by a second, different geometric-mathematical relationship.

[0112] The master controller 110 configured to control the open / closed GR degrees of freedom of the slave surgical instrument 170 can take a variety of forms.

[0113] According to a preferred embodiment, the master controller 110 is a type of master unit that is not kinematically constrained relative to any element of the operator console 140, ie, a flying or groundless type master unit.

[0114] The master device 110 comprises a main body having a first surgical operation unit 11 and a second surgical operation unit 12, and these operation units are moved relative to each other by the operation of the surgeon's 150 hands.

[0115] The surgeon 150 does not necessarily have to be in contact with the surgical control elements 11, 12, but can for example be located at a certain longitudinal distance from the other special control elements 21, 22 of the master device 110. These special control elements 21, 22 are precisely intended to be directly operated by the fingers of the surgeon 150 in a surgical situation.

[0116] The master control device 110 further includes a first tracking sensor 31 operatively connected to the first surgical operation unit 11 of the main body of the master device 110, and a second tracking sensor 32 operatively connected to the second surgical operation unit 12 of the main body of the master device 110. For example, the tracking sensors 31, 32 can be fixed to the respective surgical operation units 11, 12 of the main body of the master device 110, or can be detachable.

[0117] The master device 110 main body does not necessarily have to have the first surgical operation unit 11 and the second surgical operation unit 12 integrated together, but in one embodiment, the master device 110 has the first surgical operation unit 11 and the second surgical operation unit 12 integrated together.

[0118] In one embodiment, the first surgical operation unit 11 and the second surgical operation unit 12 of the master device 110 are formed as separate bodies and assembled together.

[0119] As illustrated in FIG. 4, the tracking sensors 31 , 32 may be provided with a data connection 23 to the control unit 104 .

[0120] According to a preferred embodiment, the first surgical operation unit 11 and the second surgical operation unit 12 of the master device 110 are movable relative to one another by manual action of the surgeon 150, and are in at least an open state. In the open state, the first operation unit and the second operation unit are separated by a distance X1, as shown in, for example, FIG. 5A.

[0121] The at least one open state between the first surgical operating unit 11 and the second surgical operating unit 12 is preferably configured by the control unit 104 to control at least one slave open state of the slave surgical instrument 170, for example an open state in which the tips 171, 172 form an open angle between them that is greater than a certain threshold.

[0122] The system can be configured to allow transitions between multiple open configurations of the master device 110 with corresponding slave open configurations of the slave surgical instrument 170.

[0123] According to an embodiment, in an operating state, the opening angle between tips 171, 172 of slave surgical instrument 170 in slave workspace 174 tracks in a phase relationship with the detected distance between surgical control portions 11, 12 of master device 110 in master workspace 144. In other words, to control the transition of slave surgical instrument 170 between slave open configurations, control unit 104 can be configured to detect information regarding changes in distance X1 between sensors 31, 32 and send control signals to slave surgical instrument 170 to open or close tips 171, 172 or jaws 171, 172.

[0124] According to a preferred embodiment, the first surgical control part 11 and the second surgical control part 12 of the master device 110 are mutually movable by manual action of the surgeon 150 and assume at least a closed state. In this closed state, the first surgical control part 11 and the second surgical control part 12 each contact a respective abutment surface (e.g., formed by the other control part or, for example, formed by a third element extending between the surgical control parts 11, 12). Thus, when in the closed state, at least one contact point 17 is defined.

[0125] At least one closed state of the master device 110 is preferably adapted to control at least one enslaved closed state of the slave surgical instrument 170, for example, when the operating portions 175 of the tips 171, 172 of the slave surgical instrument 170 are in contact with each other or with a graspable object 178.

[0126] The second relative movement direction X2 associated with the force modulation is possible only when the stroke end point P1 of the first relative movement trajectory X1 associated with the opening / closing operation or the contact point 17 is reached.

[0127] Reaching the stroke end or contact point 17 of the first trajectory P1 is associated with the gripper being in a fully closed position.

[0128] The robotic system can be configured to allow transitions between multiple closed configurations of the master device 110 with corresponding enslaved closed configurations of the slave surgical instrument 170. Preferably, at least one closed configuration of the master device 110 includes a first closed configuration, e.g., as shown in Figure 5B, and a second closed configuration, e.g., as shown in Figure 5C.

[0129] The transition between the first and second closed configurations can be adapted to control changes in the closing / cutting / gripping force of the slave surgical instrument 170. In other words, adjustments to the closing force exerted by the tips 171, 172 or jaw operating portions 175 of the slave surgical instrument 170 are controlled by transitions between the first and second closed configurations of the master device 110. The body of the master device 110 is designed such that a transition between at least one open configuration and the first closed configuration results in a first change in the geometric relationship between the first tracking sensor 31 and the second tracking sensor 32, and a transition between the first and second closed configurations results in a second change in the geometric relationship between the first tracking sensor 31 and the second tracking sensor 32.

[0130] The change in the first geometric relationship and the change in the second geometric relationship occur along two different directions X1, X2.

[0131] When the stroke end P1 is reached, the two parts of the master come into contact at said contact point 17, and such contact can be felt by the user during the actuation of the forced control action X3, since it is characterized by a higher stiffness.

[0132] There may be a stroke end position P2 associated with the second direction of relative movement X2 and the transmission of maximum gripping force.

[0133] A control action along the control direction is associated with the application of a force F1 to induce the first direction of relative movement related to opening or closing, and a force F2 to induce the second direction of relative movement related only to force adjustment.

[0134] In the constructive form, F1 is constant.

[0135] In the constructive mode, F2 increases with control action until the end-of-stroke position P2 is reached.

[0136] According to a preferred embodiment, the main body of the master device 110 further comprises a first operating unit 21 and a second operating unit 22 for operation by a surgeon's hand 150, the first operating unit 21 being operatively connected to the first surgical operating unit 11 of the master device main body, and the second operating unit 22 being operatively connected to the second surgical operating unit 12 of the master device main body. In a surgical situation, the surgeon 150 grasps the master device 110 and operates the operating units 21, 22 of the main body of the master device 110 with, for example, his / her fingers. This determines a change in the geometric relationship between the respective tracking sensors 31, 32 via the master device main body itself. The main body of the master device 110 can comprise various means for transmitting the operation by the surgeon 150 between the operating units 21, 22 and the respective surgical operating units 11, 12, such as elastic devices 18, bending / flexing units 19, etc.

[0137] According to a preferred embodiment, the master device 110 further includes an elastic device 15 between the first operating portion 21 and the second operating portion 22 of the main body of the master device 110. The elastic device 15 is preferably configured to move the first operating portion 21 and the second operating portion 22 away from each other. Thus, the surgeon 150 moves the operating portions 21, 22 closer to each other while resisting the biasing force of the elastic device 15. The elastic device 15 can be formed integrally with the main body of the master device 110, and is formed, for example, by an elastically deformable portion of the main body of the master device 110. The elastic device 15 can include a helical axial spring and / or a torsion spring.

[0138] According to a preferred embodiment, both the first relative movement direction according to a trajectory or relationship X1 between the two sensors and the second relative movement direction according to a trajectory or relationship X2 are obtained by actuating a control action imposed by the user according to a single movement direction or trajectory X3.

[0139] In particular, the first operating part 21 and the second operating part 22 can be moved at different times and in different portions by applying a single moving direction X3, for example, a relative approaching / separating or opening / closing direction of the user's operating point.

[0140] The third direction X3 can be a linear translational direction and / or a circumferential arc and / or a rotational direction.

[0141] According to an embodiment, the first operating part 21 and the second operating part 22 are forced to move relative to each other along a single third direction, such as a relative approach / separation direction. For example, a guide 14 and / or a rotation constraint 16 may be provided to restrict the relative movement between the operating parts 21, 22.

[0142] According to an embodiment, the first operating unit 21 and the second operating unit 22 are movable relative to each other along an operating stroke having a certain magnitude, a first change in the geometric relationship between the first tracking sensor 31 and the second tracking sensor 32 defines a first tracking stroke having a certain magnitude, and a second change in the geometric relationship between the first tracking sensor 31 and the second tracking sensor 32 defines a second tracking stroke having a certain magnitude. Preferably, the sum of the first tracking stroke and the second tracking stroke is greater than the operating stroke.

[0143] The resolution of the robotic teleoperated system in adjusting the opening / closing degrees of freedom and the gripping / cutting / closing forces is improved because the relative movement of the surgical control units 11, 12 with sensors 31, 32 is greater than the relative movement of the control units 21, 22. For example, the angular change between the control units 21, 22 of the master device 110 between the open configuration and the second closed configuration is a constant angular amount that is smaller than the corresponding angular change between the surgical control units 11, 12. In other words, such a master device 110, unlike the known master device solution (FIG. 19), allows for mechanical amplification of the amount of control given by the surgeon regarding the opening / closing and gripping / cutting / closing force adjustment.

[0144] This is achieved by selectively detecting different ways of changing the geometric relationship between the tracking sensors 31, 32.

[0145] According to a preferred embodiment, the master device 110 is preferably configured to be flexible and includes a curved portion 19 that indicates a change in direction between one of the operation units 21, 22 and each of the surgical operation units 11, 12. In other words, the main body of the master device includes a flexible portion that indicates a change in direction between the operation unit and each of the operation units.

[0146] The curved portion 19 indicating the change of direction may have an elastic restoring force and / or may be a folded portion and / or may be a dashed line and / or may be a curved arc.

[0147] According to a preferred embodiment, the two different directions X1, X2 are the distance between the sensors and the angle between the sensors, respectively.

[0148] For example, as shown in FIG. 5A , which illustrates the open configuration of the master device 110, the robotic system 100 can be configured to control the opening / closing degree GR of the slave surgical instrument 170 based on the distance X1 (i.e., the first direction X1) detected between the two tracking sensors 31, 32. While the surgical control units 11, 12 of the master device 110 do not necessarily each have a free end 13, according to a preferred embodiment, each of the surgical control units 11, 12 does have a free end 13. The distance between the sensors 31, 32 can be a measure of the distance between the free ends 13 of the first surgical control unit 11 and the second control unit 13.

[0149] For example, as shown in Figures 5B and 5C, as the distance X1 between the tracking sensors 31, 32 (i.e., the first direction X1) decreases, the robotic system 100 can configure the slave surgical instrument 170 to a closed configuration in which the clamping / closing / grasping / cutting force is in phase with the angle X2 between the directions of the tracking sensors 31, 32 (i.e., the second direction X2).

[0150] Alternatively, the system can be configured such that the first direction X1 relates to detecting angular changes between the orientations of the tracking sensors 31, 32, and the second direction X2 relates to detecting changes in distance between the tracking sensors 31, 32, for example along the longitudinal direction of the body of the master device 110.

[0151] Of course, during detection of a change in distance between the tracking sensors, said tracking sensors 31, 32 may also change their relative orientation.

[0152] 5D and 5E, the angular stroke Y performed by the control unit 22 of the master device 110 during the transition between the first closed configuration (dotted line indicated by the letter B) and the second closed configuration (dotted line indicated by the letter C) is much smaller than the angular stroke Z performed by the respective surgical control unit 12, i.e., sensor 32, thereby improving the resolution in controlling the gripping / cutting force modulation mode (compression mode). For example, the ratio of the angular stroke Y to Z can be 1:5, 1:10, or greater than 1:10, e.g., the angular stroke Y is substantially 5° while the angular stroke Z is substantially 45°, 60°, or 90°.

[0153] 6A, 6B, and 6C, the operating portions 11, 12 of the master device 110 can be constrained to translate relative to each other to keep the relative orientation between the two tracking sensors 31, 32 constant during transitions between at least one open configuration and the first closed configuration, while the relative orientation between the tracking sensors 31, 32 changes during transitions between the first closed configuration and the second closed configuration.

[0154] 7A, 7B, and 7C, the tracking sensors 31, 32 may have rigid bodies (e.g., may be attached to a rigid rod). In this example, guides 34 are shown for longitudinally sliding the rigid sensors 31, 32 and the respective surgical control units 11, 12. Two first (or second) surgical control units 11 may be provided, with the first (or second) control unit 21 interposed therebetween.

[0155] The surgical control sections 11, 12 of the master device 110 may be configured with constrained ends to form a closed shape, for example, of the articulated parallelogram type.

[0156] For example, as shown in Figures 8A, 8B, 8C, and 8D, the operating units 21, 22 can move in a relative approach / separation path along a third curved direction X3 that defines a change in the distance X1 between the sensors 31, 32 when the surgical operating units 11, 12 are in an open configuration and a change in the angle between the orientations of the two sensors 31, 32 when the surgical operating units 11, 12 are in a closed configuration.

[0157] 9A, 9B, and 9C, a first change in the geometric relationship between the tracking sensors 31 and 32 occurs along a first direction X1. The first direction X1 is a bending direction, and is preferably an arc centered on the restraint portion 16 between the operating units 21 and 22 of the master device body 11. Meanwhile, a second change in the geometric relationship between the tracking sensors 31 and 32 occurs along a second direction X2, which is always a bending direction but has a concave surface in the opposite direction to the first bending direction X1. Preferably, the second bending direction X2 is an arc centered on the contact point 17 between the surgical operating units 11 and 12 of the master device 110.

[0158] The second change in the geometric relationship between the sensors 31, 32 can be determined by elastic deformation of the first surgical operation unit 11 and / or the second surgical operation unit 12 of the master device 110 body.

[0159] For example, the first surgical operation unit 11 and the second surgical operation unit 12 may be provided with elastic cuffs that are equipped with the tracking sensors 31, 32 and configured to be elastically deformed during operation of the master device 110.

[0160] The articulating joint between the two parts of the master can be elastically preloaded to maintain the master in maximum open abutment at the end of the stroke.

[0161] Each section may also consist of two rigid sections, a proximal section and a distal section, connected by elastic means or a thin elastic hinge.

[0162] 10A, 10B, and 10C, the surgical control portions 11, 12 of the master device 110 can be constrained to translate relative to one another to maintain a constant relative orientation between the two tracking sensors 31, 32 during transitions between at least one open configuration and a first closed configuration, while the relative orientation between the tracking sensors 31, 32 changes during transitions between the first and second closed configurations. Lateral guides 14 preloaded with elastic devices 15 can be provided to guide the movement between the two control portions 21, 22 of the master device.

[0163] The contact point 17 between the surgical control portions 11, 12 of the master device 110 can be determined by the relative sliding contact between the surgical control portions 11, 12.

[0164] For example, as shown in Figures 11A and 11B, each tracking sensor 31, 32 can sense six degrees of freedom, including three degrees of freedom in direction and three degrees of freedom in position relative to a reference point of the master global reference system MFO.

[0165] The master device 110 may comprise an elastic element 18 associated with at least one, and preferably both, of the surgical control units 11, 12. In one embodiment, an elastic element 18 is provided between each control unit 21, 22 and the respective surgical control unit 11, 12 provided with a tracking sensor 31, 32.

[0166] At least one of the tracking sensors 31, 32 may be an optical fiber sensor, for example a Bragg grating type deformation sensor.

[0167] For example, as shown in Figures 12A, 12B, and 12C, the main body of the master device 110 can integrally include both the operation units 21, 22 and the surgical operation units 11, 12, and the main body of the master device 110 includes a plurality of elastic deformation units 15, 18, including a first elastic deformation unit 15 between the interface units 21, 22, and a second elastic deformation unit 18 between each interface unit 21, 22 and each surgical operation unit 11, 12, on which sensors 31, 32 are provided, and / or which belong to each surgical operation unit 11, 12.

[0168] The first direction of change X1 of the geometric relationship between the tracking sensors 31, 32 is the direction of approach, and the second direction of change X2 of the geometric relationship between the tracking sensors 31, 32 is the direction of separation between the sensors.

[0169] As shown in Figures 13A, 13B, and 13C, the second surgical operating unit 12 of the master device 110 can include a rotating member 36 of radius R2, and the first surgical operating unit 11 of the master device 110 can include an abutment and drag surface 35 configured to be in rolling contact with the rotating member 36 of the master device 110.

[0170] The abutment and drag surface 35 is preferably a curved convex surface. The abutment and drag surface 35 may include a toothed portion that engages with a corresponding toothed counterpart on the rotating member.

[0171] For example, the first closure of the master device before contact between the rotating member and the drag surface is defined as the locus X1 of relative movement between the sensors and a relationship that can be related to the opening and closing of the slave.

[0172] The detection of the second relative movement direction X2 and the relative relationship related to the force modulation can be the detection of the relative orientation between the sensors 31 and 32, in which case the sensor 32 is arranged on the rotating member 36. Preferably, the sensor 32 is arranged on the rotation axis RR of the rotating member 36. The sensor 32 can be arranged on the edge of the rotating member at or near the contact point with the drag surface 35 of the first counterpart 11.

[0173] In operation along the second direction X2, the closure of the body of the master device 110 represents the drag due to rotation of the rotating member and the transmission of proportional force modulation to the slave.

[0174] The radius R2 of the rotating member is advantageously selected to be smaller than the distance Y2 between the arresting portion 16 and the rotation axis RR of the rotating member, thereby increasing the angular stroke or travel of the associated sensor 32 and providing an adequate resolution for force adjustment.

[0175] In one embodiment, the rotating member can be preloaded by a torsion spring into position when not being dragged by the abutment and dragging surfaces, for example, the sensor axis can be aligned with the direction of the first actuator.

[0176] Other tracking sensors may also be provided.

[0177] The abutment and drag surface 35 may be mounted on an elastic preload member 18 which ensures adequate friction on contact with the rotating member and ensures drag over the entire stroke of the rotating member from the first contact point P1 where the long orbital motion X1 ends and at point P2 where the long orbital motion X2 begins.

[0178] The contact and drag surface 35 may have a curved convex shape. The rotating member 36 may have a rotation axis RR fixed relative to the first surgical operation unit 11.

[0179] For example, as shown in FIGS. 14A, 14B, 14C, and 14D, the first direction of change X1 of the geometric relationship between the sensors 31 and 32 is an angular direction, and the second direction X2 of the geometric relationship between the sensors 31 and 32 is a distance.

[0180] 18, the master control device 110 may be of an unconstrained type and may include a gripper unit for controlling the opening and closing degrees of freedom GR of the surgical instrument 170, as well as a wearable element 113 (e.g., a bracelet or a ring) connectable to the main body of the master device 110 via a joint 112 or a joint 113. Instead of or in addition to the wearable element 113, a knob or a handle may be provided.

[0181] The master device 100 may include features to improve ergonomics, such as a rest specially designed to fit the palm of the surgeon's 150 hand holding the master device.

[0182] 20A, 20B, and 20C, the first operating part 21 includes abutment and traction surfaces 35 extending on a cantilevered appendage extending from the first operating part 21 towards the second operating part 22, with a rotating member 36 attached to the appendage. An elastic element 18 can be provided between the tracking sensor 31 and the abutment and traction surfaces 35 of the first operating part 21.

[0183] With reference to the above description, a method for controlling the robotic system 100 for medical or surgical teleoperation will now be described.

[0184] This control method is for controlling the degree of freedom of opening and closing GR of the slave surgical instrument 170 controlled by the master controller 110.

[0185] The control method includes detecting a change in the geometric relationship between the first tracking sensor 31 and the second tracking sensor 32 of the master device 110 along a first direction X1, and moving the slave surgical instrument 170 in an open / close GR mode.

[0186] Advantageously, the method further comprises the steps of detecting a change in the geometric relationship between said first tracking sensor 31 and second tracking sensor 32 of the master device along a second direction X2, and varying, i.e. adjusting, the clamping force / cutting force / torque of the slave surgical instrument 170.

[0187] The opening and closing degree of freedom GR of the slave surgical instrument 170 follows changes in the geometric relationship between the sensors 31, 32 along the first direction X1, and the adjustment of the clamping force / cutting force / torque of the same slave surgical instrument 170 follows changes in the geometric relationship between the sensors 31, 32 along the second direction X2.

[0188] The control method may include the further step of performing one or more checks on the detected information regarding changes in the geometric relationship between the sensors 31, 32 and allowing the control transition between the open / close mode and the clamp cut (compression mode) mode only if said one or more checks are passed.

[0189] According to an embodiment, the one or more controls include controlling the detected value of the change in the geometric relationship along the direction X1 to belong to a set of tolerance values, which may be predetermined or determined iteratively in real time.

[0190] According to an embodiment, the one or more controls include verifying the structural integrity of the master device, which may include verifying the existence of a predefined mathematical relationship between the sensors 31, 32, for example imposed by the shape of the body of the master device 110.

[0191] The method can include entering a limited teleoperation state during the step of varying the clamping / cutting force in which a subset of the degrees of freedom is not transmitted to the slave surgical instrument 170 or the control point 177. Preferably, during compression mode, movement of the control point 177 is constrained to avoid undesired repositioning of the slave device's positioning kinematic chain, which can include articulation ends and / or motorized robotic axes. For example, movement of the control point is prohibited only in a particular direction, such as the longitudinal direction L of the master device 110 in the master workspace and, consequently, the longitudinal direction L of the surgical instrument 170 in the slave workspace.

[0192] Referring to the above, directions X1 and X2 may be different directions, e.g., a change in linear distance and a change in angular distance (i.e., an angle between directions), or vice versa, a rotation about a first center of rotation and a rotation about a second center of rotation, etc., and the first center of rotation and the second center of rotation may define very different radii, a change in distance along the first direction, and a change in distance along the second direction (e.g., a direction perpendicular to the first direction).

[0193] The control method is adapted to be implemented by a medical or surgical teleoperation system 100 that includes at least one master controller 110 according to any of the previously described embodiments.

[0194] Of course, the steps of detecting movement, detecting attitude, and detecting changes in the geometric relationship between the tracking sensors 31, 32 may include steps of detecting information about the position and orientation of each tracking sensor 31, 32, and steps of processing (e.g., calculating) the information processed by the sensors to derive information about the movement / attitude / changes in the geometric relationship.

[0195] According to an embodiment, for example as shown in FIG. 16C, the method includes the following steps.

[0196] - detecting movement and / or changes in the position or relative orientation of the sensors 31, 32 along a first trajectory X1.

[0197] - controlling the opening and closing of the tips 171, 172 of the surgical instrument 170;

[0198] If the detected amount is below a defined threshold, then:

[0199] - detecting the movement and / or change in position or relative orientation of the sensors 31, 32 along a second trajectory X2.

[0200] - Adjusting the clamping force of the surgical instrument 170.

[0201] The method may further include the step of providing the master control device 110 with an opening or closing action according to the movement trajectory X3.

[0202] The master device 110 may be configured to control electrosurgical instruments, such as active monopolar and / or bipolar surgical instruments, in which case a SQUEEZE mode may be implemented to manage the intensity of electrical energy delivery through the slave surgical instruments 170.

[0203] According to a general embodiment, a computer program is provided that is configured to carry out the steps of the control method according to any of the above-described embodiments.

[0204] The above-mentioned features, taken individually or in combination where applicable, address the above-mentioned needs and provide, among other advantages:

[0205] -On the master side, the open / close command and the clamping / cutting force adjustment command can be separated.

[0206] Thus, the detection resolution of the commands given by the surgeon to the master device is improved.

[0207] Furthermore, it allows for simpler and more precise control of critical variables (position / orientation of the tracking sensor) and allows for faster and more efficient data processing, and for these reasons offers a safer solution compared to known examples of teleoperated systems for surgery or microsurgery.

[0208] A master control device is provided that is not kinematically constrained by the flywheel type or any element of the motion setup, which provides improved performance compared to known solutions, especially with regard to controlling the opening and closing forces and clamping / cutting forces of the surgical instrument.

[0209] The same tracking sensors (e.g., two tracking sensors) can also be used to control the position and orientation of a slave surgical instrument, which can have articulated ends actuated by actuation cables, e.g., pitch, yaw, and / or roll rotational joints, and can also have a snake-type positioning mechanism with multiple stacked vertebrae.

[0210] Furthermore, in the case of remote microsurgery, surgeons may desire to control the opening and closing, and therefore the grasping / cutting, of the slave device with minimal finger movement, similar to traditional microsurgery without the assistance of a robotic system. Therefore, the present invention can meet this need by improving the detection resolution on the master side. This reduces the displacement of the interface where the surgeon manipulates the master device body compared to known solutions, allowing for the desired degree of opening, closing, grasping, and cutting force.

[0211] In particular, as mentioned above, the mode of change in geometry between the sensors improves the readout resolution of the master unit's tracking system.

[0212] At the same time, since the first closed configuration of the master device body actually corresponds to the closed configuration of the slave device, increasing the clamping force of the master device determines a second change in the geometric relationship between the sensors, which intuitively increases the clamping force / cutting force of the slave device, thereby improving the surgeon's operating feel.

[0213] A closed master device corresponds to a closed slave device, and an open master device corresponds to an open slave device, so that it is intuitive for the operator that the adjustment of the closing force is performed when the master device is in the closed state.

[0214] The master control device's shape can be designed to maximize the surgeon's or microsurgeon's proficiency and can substantially replicate traditional surgical or microsurgical instruments (i.e., operate directly without robotic intervention).

[0215] It will be understood that combinations of features in the appended claims form an integral part of this specification.

[0216] To meet specific contingency needs, those skilled in the art can make some modifications and adaptations to the above embodiments and substitute functionally equivalent elements for other elements without departing from the scope of the appended claims. [Explanation of symbols]

[0217] 11 First operation unit of master unit 12 Second operation unit of master unit 13 Free end 14 Guide or restraint 15 Elastic Device 16 Rotation restriction section 17 contact points 18 Elastic Device 19 Curved or folded sections 21 First operation unit of master device 22 Second operation unit of master device 23 Data Cable 31 First tracking sensor 32 Second Tracking Sensor 33 detector strip detector 34 Guide or Track 35 Contact and traction surfaces 36 Rotating member 100 Medical or surgical teleoperated robotic systems 101 Systems for simulating medical or surgical teleoperations 104 System Control Unit 110 Master control device or master device of remote control system 111 Master unit operation console support 112 Master device joint 113 Wearable elements of the master device 120 Remote Control System Slave Assembly 127 Camera or microscope 128 displays 130 Slave Robot Manipulator 140 Master Console 142 Tracking Field Emitter 144 Master Workspace 150 User, Operator, or Surgeon 170 Slave Surgical Instruments 171 Tip or jaw of slave surgical instrument 172 Tip or jaw of slave surgical instrument 173 Slave surgical instrument rotation joint 174 Slave Workspace 175 Tip or jaw operating part 177 control points 178 Clamp target body MFO Master Global Reference System SFO Slave Global Reference System GR slave surgical instrument opening and closing freedom X1 1st direction X2 2nd direction X3 3rd direction P1 Stroke end point P2 Stroke end point L Longitudinal direction of the master unit R Rotation axis of the rotating part R2 Radius of rotating member B. First closed configuration direction C. Direction of the second closed configuration Y2 distance Y Angle Stroke Z angle stroke F Clamping / Cutting Force

Claims

1. A robotic system (100) for medical or surgical teleoperation and / or simulation of teleoperation, comprising: - at least one slave surgical instrument (170) with at least one degree of freedom (GR), at least one master control device (110) comprising a first tracking sensor (31) and a second tracking sensor (32) for controlling at least the opening and closing degrees of freedom (GR) of said slave surgical instrument (170); at least one control unit (104) configured to detect the orientation and / or relative movement of the tracking sensors (31, 32) and to command at least one said slave surgical instrument (170) to perform opening / closing actions and / or adjust the clamping / cutting force (F) based on the detected relative movement of said tracking sensors (31, 32); Equipped with By actuation of the control actions imposed by the user on the master control device (110) according to a single close / open movement trajectory (X3): a first relative movement between the two tracking sensors (31, 32) of the master control device (110) along a first direction of relative movement (X), detected by the control unit (104) and based on which the control unit (104) commands an opening or closing movement of the slave surgical instrument (170); and / or a second relative movement between the same tracking sensors (31, 32) of the master control device (110) along a second relative movement direction (X2), detected by the control unit (104) and based on which the control unit (104) exclusively commands adjustment of the clamping / cutting force of the slave surgical instrument (170); A robot system (100) that performs the above.

2. A control unit (104) - detecting a first relative movement between the first tracking sensor (31) and the second tracking sensor (32) of the master control device (110) along a first direction of relative movement (X1) associated with a first geometric relationship between the first tracking sensor (31) and the second tracking sensor (32); - opening and closing said slave surgical instrument (170) based on the detected first relative movement; - detecting a second relative movement between the first tracking sensor (31) and the second tracking sensor (32) of the master control device (110) along a second direction of relative movement (X2) related to a second geometric relationship, different from the first direction of relative movement (X1); - adjusting the clamping / cutting force (F) of said slave surgical instrument (170) based on the detected second relative movement; and / or the control unit (104) instructs the slave surgical instrument (170) only to adjust the clamping / cutting force of the slave surgical instrument (170) without instructing the slave surgical instrument (170) to open or close; The system (100) of claim 1 configured to:

3. a first relative movement between the two sensors (31, 32) along a first direction of relative movement (X1), which is a change in the relative distance between the two sensors (31, 32); A system (100) according to claim 1 or 2, wherein the second relative movement between the same two sensors (31, 32) along the second direction of relative movement (X-fu) is a change in orientation between the two sensors (31, 32).

4. - the first relative movement between the two sensors (31, 32) along a first direction of relative movement (X1) is a first defined curved trajectory and / or a circumferential arc; A system (100) according to claim 1 or 2, wherein a second relative movement between the same two sensors (31, 32) along a second direction of relative movement (X2) is a second, differently defined, curved trajectory and / or circumferential arc.

5. 5. The system (100) of claim 4, wherein the second, differently defined, curved trajectory [LS1] in the second direction of relative movement (X2) has an opposite concavity to the first, defined curved trajectory in the first direction of relative movement (X1).

6. The control unit (104) - detecting a change in distance between said first tracking sensor (31) and said second tracking sensor (32); - opening and closing said slave surgical instrument (170) based on the detected change in distance; - detecting a change in relative orientation between said first tracking sensor (31) and said second tracking sensor (32); - adjusting the clamping / cutting force (F) of said slave surgical instrument (170) based on the change in relative orientation; The system (100) of any one of claims 1 to 3, configured to:

7. 7. The system (100) of claim 1, wherein during adjusting the clamping / cutting force (F) and / or during the second relative movement between the two sensors (31, 32) along the second direction of relative movement (X2), the control unit (104) is configured to suppress translational movement of the slave surgical instrument (170) or the control point (177) caused by further relative movement between the two sensors (31, 32) along the first direction of relative movement (X1).

8. A system (100) according to any one of claims 1 to 7, wherein the control movement of the master control device (110) in the opening and closing directions according to a single movement trajectory (X3) is such that the translational movement of the slave surgical instrument (170) or the control point (177) is not mechanically transmitted and / or the midpoint calculated from the distance or relative angle between the sensors (31, 32) is kept constant without being mechanically changed.

9. - by applying a control movement also in the closing direction according to a single movement trajectory (X3), when a contact point between two different detection areas of the master control device (110), comprising the first tracking sensor (31) and the second tracking sensor (32), respectively, is reached and exceeded, further relative movement along the first direction of relative movement (X1) is mechanically prevented and movement only along the second direction of relative movement (X2) is mechanically permitted; A system (100) according to any one of claims 1 to 8, wherein, by applying a control movement in the opening direction according to a single movement trajectory (X3), once the contact point is reached and exceeded, relative movement along the second direction of relative movement (X2) is mechanically prevented and movement only along the first direction of relative movement (X1) is mechanically permitted.

10. The system (100) according to any one of claims 1 to 9, wherein by applying a control movement in the closing direction according to a single movement trajectory (X3), when a contact point between two different detection areas of the master control device (110), each comprising the first tracking sensor (31) and the second tracking sensor (32), is reached and exceeded, a force (F2) in the closing direction must be applied to the master control device (110) during movement along the second relative movement direction (X2) that is greater than the force (F1) required to move the two sensor parts (31, 32) of the master control device (110) along the first relative movement direction (X1).

11. 11. The system (100) according to any one of claims 1 to 10, wherein the single movement trajectory (X3) is a curve and / or a circular arc, or a straight line.

12. A system (100) according to any one of claims 1 to 11, wherein a first part of the control operation according to a single movement trajectory (X3) imposed by a user on the master control device (110) is associated with the actuation of a first relative movement direction (X1) and thus with the actuation of the adjustment of the clamping / cutting force (F) of the slave surgical instrument (170).

13. 13. The system (100) of claim 1, wherein a change in the geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) is amplified relative to a change in the geometric relationship between operation interface portions (21, 22) of the master control device (110) configured to receive a finger of an operator (150).

14. 14. The system (100) of claim 1, wherein the second change in the geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) is determined by elastic deformation of the body of the master control device (110).

15. 15. The system (100) according to any one of the preceding claims, further comprising a resilient device (15) intended to influence the master control device (110) in an open configuration.

16. 1. A master controller (110) for a robotic, medical, or surgical teleoperation system configured to control an open / close degree of freedom (GR) of a slave surgical instrument (170), comprising: The surgical instrument comprises a main body having a first surgical operation section (11) and a second surgical operation section (12) that are mutually movable by manual operation of a surgeon (150); - at least one open configuration of said first surgical control part (11) and said second surgical control part (12) spaced apart from each other by a distance (X1), said at least one open configuration being configured to command at least one slave open configuration of said slave surgical instrument (170); - at least one closed configuration in which the first surgical control part (11) and the second surgical control part (12) are in contact with corresponding abutment surfaces, the at least one closed configuration being configured to command at least one slave closed configuration of the slave surgical instrument (170), At least one closed configuration comprises: a first closed configuration, and - second closed configuration Including, a transition between the first closed configuration and the second closed configuration is adapted to command an adjustment of the clamping / cutting force (F) of said slave surgical instrument (170); The master control device (110) a first tracking sensor (31) operatively connected to the first surgical operating section (11) of the body; a second tracking sensor (32) operatively connected to the second surgical operating part (12) of the body; Equipped with a transition between at least one open configuration and a first closed configuration results in a first change in the geometric relationship between said first tracking sensor (31) and said second tracking sensor (32); the transition between the first closed configuration and the second closed configuration results in a second change in the geometric relationship between said first tracking sensor (31) and said second tracking sensor (32); - A master controller (110), in which the first and second changes in the geometric relationship occur along two different directions (X1, X2).

17. It further comprises a first operating part (21) and a second operating part (22) for operation by the hands of a surgeon, - said first operating part (21) is operatively connected to said first surgical operating part (11) of said body, - said second operating part (22) is operatively connected to said second surgical operating part (12) of said body; the first operating part (21) and the second operating part (22) are movable relative to one another along a single movement trajectory (X3), for example moving towards / away from one another; and / or the first operating part (21) and the second operating part (22) are forced to move relative to each other along a single movement trajectory (X3), for example towards / away from each other; and / or The master control unit (110) of claim 16, wherein the master control unit (110) is a flying or untethered master unit.

18. 1. A method for controlling a system for simulating medical or surgical teleoperation, comprising: providing at least one master control device (110) for controlling at least one open / close degree of freedom (GR) of a simulation of a slave surgical instrument (170), the master control device (110) comprising a first tracking sensor (31) and a second tracking sensor (32); - detecting a first change in the geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) of the master control device (110) along a first direction (X1), and opening or closing the simulated slave surgical instrument (170) based on the detected first change in the geometric relationship; - detecting a second change in the geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) of the master control device (110) along a second direction (X2), and adjusting the clamping / cutting force (F) of the simulated slave surgical instrument (170) based on the detected second change in the geometric relationship; A control method comprising:

19. 20. A computer program configured to perform the steps of the method according to claim 18.

20. A robotic system (100) for medical or surgical teleoperation and / or simulation of teleoperation, comprising: - at least one slave surgical instrument (170) with at least one degree of freedom (GR), - at least one master control device (110) comprising a first tracking sensor (31) and a second tracking sensor (32) for controlling at least the opening and closing degrees of freedom (GR) of said slave surgical instrument (170); Equipped with Furthermore, - detecting a first change in the geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) of the master control device (110) along a first direction (X1); - opening or closing said slave surgical instrument (170) based on a first change in the detected geometric relationship; - detecting a second change in the geometric relationship between the first tracking sensor (31) and the second tracking sensor (32) of the master control device (110) along a second, different direction (X2); - varying the clamping / cutting force (F) of said slave surgical instrument (170) based on a second change in the detected geometric relationship; A system (100) comprising at least one control unit (104) configured to perform:

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