A surgical or medical instrument for a surgical robot and a support structure for receiving an end effector of the instrument

Abstract

The present invention relates to a medical instrument for a medical robot, the medical instrument comprising: a support structure (116, 216, 316) for receiving at least one optionally interchangeable end effector (18) of the medical instrument, a proximal coupling portion (30, 230) provided and configured to couple to a distal end segment (10) of a medical robot (1), and a distal coupling portion (32) provided and configured to couple to the optionally interchangeable end effector (18), the support structure (116, 216, 316) being or having a connecting element extending integrally between at least the proximal coupling portion (30) and the distal coupling portion (32), thereby establishing a joint-free and / or tolerance-free connection between the proximal coupling portion (30) and the distal coupling portion (32). The present invention also relates to a support structure (116, 216, 316) for a surgical (medical) instrument for receiving at least one optionally interchangeable end effector (18) of a surgical (medical) instrument for a surgical robot (medical robot).

Description

[Technical Field]

[0001] The present invention relates to a surgical or medical instrument for a surgical robot and a support structure for supporting and receiving an end effector of a surgical or medical instrument for a surgical robot. [Background technology]

[0002] [Background of the invention] Robot-assisted handling of surgical or medical instruments is becoming increasingly important in surgical procedures. The benefits are manifold, particularly the minimally invasive use of end effectors (e.g., tools, radiofrequency tips, lighting, optics, cameras, pedicle screws, and other working devices) that can be controlled with high precision and repeatability at the patient's surgical site (operation area). At the same time, high precision and repeatability are fundamental prerequisites for robot-assisted surgical execution, especially in minimally invasive procedures where visibility at the surgical site is poor.

[0003] Therefore, it is crucial to continuously know the position and location of the working point relative to the surgical site. For this purpose, a "rigid body"—a device for 3D tracking of the working point—is provided on the medical or surgical instrument guided by the robot. The rigid body can be captured by a 3D camera and evaluated by triangulation, enabling the position and orientation of the working point to be measured. The rigid body is also used for initial calibration in situ in the operating room. Based on the calibrated initial state, the rigid body of the medical instrument and, in some cases, the rigid body of the patient are tracked. If the surgical robot needs to be repeatedly removed from the surgical field to exchange end effectors, time-consuming recalibration may be required after the exchange. An end effector is basically understood as any stationary or driven medical or surgical tool, product, or auxiliary device that can be inserted into a medical or surgical instrument. Examples of end effectors include drills, milling cutters, scalpels, radiofrequency coagulation tips, pedicle screws, overview cameras, microscopes, endoscopes, optics, light sources, sensors, and neurosensors.

[0004] [Current technology] Surgical robots have end effectors coupled to surgical instruments. In current systems, the distally located end effector is located at the end of a series of drive and housing elements in a medical or surgical instrument. Each element in the series necessarily has an inherent tolerance and an assembly tolerance when mated with adjacent elements, resulting in tolerance stacking. The greater the number of nodes in the tolerance chain, the more difficult it becomes to maintain the maximum extension (maximum deviation) of the working point (hereinafter also referred to as the "target zone") within the performance specifications for the procedure. In particular, such tolerance stacking due to the number of consecutive assembly and connection points in a medical instrument is known, for example, from the Mako system manufactured by Stryker.

[0005] The applicant of the present invention has discovered the following problems with the known prior art. In the known prior art, for example, a first housing part of a medical or surgical instrument is articulated to a mounting interface of a robot via a first coupling part, the first housing part is connected in series to another housing part of an end effector, and a receiving chuck for the end effector, which is movable relative to the end effector, is attached to the other housing part by an internal coupling for receiving the end effector. The applicant has also recognized that such a configuration generally requires comprehensive calibration in the operating room. Furthermore, calibration of the surgical instrument to the robot becomes complicated, and the target zone expands with each additional node in the tolerance chain described above as an example. Repeated removal of the end effector from the operating field for replacement can reduce the repeatability of the target zone and ultimately require time-consuming recalibration that can disrupt the operation. Summary of the Invention

[0006] In contrast, one object of the present invention is to avoid or at least alleviate the drawbacks of the prior art, and in particular to provide a surgical or medical instrument for a surgical or medical robot, or a surgical or medical instrument for a surgical or medical robot, that can improve the repeatability of the position and extension (deflection) of the working point of the end effector.A further object is to provide a support structure (in particular, a housing) for supporting and receiving an end effector in a surgical or medical instrument for a surgical or medical robot, or a surgical or medical instrument for a surgical or medical robot.

[0007] The first object is solved by a surgical or medical instrument having the features of claim 1. The second object is solved by a support structure (in particular a housing) having the features of claim 15. Advantageous further developments are part of the dependent claims and may also be claimed separately.

[0008] A surgical or medical instrument for or on a surgical or medical robot comprises a support structure for supporting and receiving an optionally replaceable stationary or driven end effector (preferably a support structure for supporting and receiving said end effector and a drive for said end effector), said support structure having a proximal coupling provided and configured to couple to a distal end segment of a robot, and further having a distal coupling provided and configured to couple to said optionally replaceable end effector. The support structure is or has a connecting element (connecting piece) extending integrally, preferably of one material, at least between said proximal coupling and said distal coupling, thereby establishing a joint-free and / or tolerance-free connection between said proximal coupling and said distal coupling.

[0009] Therefore, due to the integrality of the connecting element, there are only two toleranced connection points in the area between the robot's end segment and the optionally replaceable (insertable) end effector. One connection point is where the proximal connection is connected to the robot's end segment, and the other is where the end effector is connected to the distal connection. Therefore, the tolerance chain and resulting play in this area are minimal. Therefore, the location and extent of the working point defined at the tip of the end effector, i.e., the size of the target zone (TZ), depend only on the tolerances of the connecting element and the tolerances of the end segment and end effector used. In contrast to current technology solutions, the internal tolerances of the medical instrument itself no longer affect its position and extension. Therefore, manufacturing efforts to achieve high-precision working points with minimal extension can be focused on the manufacturing of the connecting element. If the connecting element is secured to the distal segment and initially calibrated, and the dimensions and tolerances of the newly inserted end effector are known, it is possible to eliminate recalibration after an exchange, since only the known dimensions and tolerances of the new end effector are reintroduced into the system during the exchange.

[0010] Preferably, the target zone according to the present invention has a diameter of 1 mm to 2 mm.

[0011] Particularly preferably, the target zone according to the invention has a diameter of less than 1 mm.

[0012] Such small target zone diameters can be achieved with reduced manufacturing effort compared to current technology due to shorter tolerance chains.

[0013] As mentioned above, the term "target zone" refers to the maximum extension or deviation of the working point. In other words, the term target zone refers to the maximum envelope volume within which the tip of the end effector (i.e., the tool tip) is located, subject to tolerances.

[0014] For the purposes of the present invention, the term "integral" means that there is no further connection (joint point) between the proximal and distal joints, at least in particular in the force flow. This is preferably realized in that the proximal and distal joints are manufactured in one connecting part, preferably from a continuous material. Alternatively, for example, several connecting parts may be rigidly connected (in particular welded or glued) so that the proximal and distal joints are substantially manufactured in the part thus connected.

[0015] In principle, an end effector is any medical (surgical) tool, product, or auxiliary tool that is inserted into and coupled to a medical (surgical) instrument, or that is stationary or driven. Specific examples of end effectors include driven end effectors (e.g., drills or milling cutters), stationary or fixed end effectors (e.g., scalpels, coagulation tips, overview cameras, microscopes, endoscopes, optics, light sources, sensors, sensor arrays, or neurosensors), or used products (e.g., pedicle screws). It goes without saying that the type of drive in the present invention is not limited to the above-mentioned rotary configuration, but includes any type of drive commonly used in surgery (e.g., vibration drive).

[0016] Preferably, the surgical or medical instrument comprises an end effector that is optionally interchangeable by coupling to the distal coupling portion 32. Preferably, the surgical or medical instrument comprises a set of optionally interchangeable end effectors of different configurations and / or nominal sizes, where one end effector is inserted and the other end effectors are provided.

[0017] The closer the tolerances of the connecting element (especially its proximal and distal coupling portions) are manufactured, the more enhanced the aforementioned advantages. Preferably, in a further development, the connecting element has high precision shape, alignment and position tolerances, at least for the proximal and distal coupling portions.

[0018] According to a further development, the proximal and distal joints have a fixed alignment, angle or adjustment relative to one another. Thus, the main or working axis of the end effector is fixed at a predetermined angle relative to the main or working axis of the end segment of the robot. Depending on the type of end effector and its handling conditions, the connecting element may have a fixed parallel alignment or a fixed angular (in particular perpendicular) alignment of the proximal and distal joints relative to one another. The alignment may be defined via the contact surfaces of the proximal and distal joints or via the main axes of the proximal and distal joints.

[0019] To allow alignment of the end effector relative to the terminal segment (end segment) without replacing the connecting element, the connecting element is provided and configured to be variably adjusted to mutually adjust the contact surfaces or major axes of the proximal and distal joints.

[0020] In a preferred further development, the connecting element is a housing or at least a housing part of a medical instrument (in particular a housing or a housing part of a drive part of a medical instrument that can be coupled to an end effector), in this way one and the same element (part) can perform two functions (connection function from the proximal coupling part to the distal coupling part without tolerance chains and the conventional protective function of the housing).

[0021] In a further development, the housing has a shaft housing portion in which the distal coupling portion is configured, for at least partially accommodating and mounting the end effector or for at least partially accommodating and mounting the drive shaft of the drive portion and the end effector coupled to the drive shaft. Preferably, the shaft housing portion extends in a shaft-like or sleeve-like manner. Such a slim configuration allows the shaft housing portion to require less installation space.

[0022] The shaft housing portion preferably has a proximal inlet opening for insertion of an end effector or for insertion of a drive shaft and an end effector coupled to the drive shaft, and distally, the shaft housing portion preferably has an outlet opening through which the end effector passes during the intended operation (i.e., when the end effector is attached).

[0023] As mentioned above, the alignment of the proximal and distal joints of the connecting element may be predetermined in various ways (e.g., parallel, angled, or perpendicular) to optimize handling of the end effector. In a possible further development, this alignment may be predetermined depending on the shape of the shaft housing portion. In a particularly simple example, the shaft housing portion extends in a straight line from the entrance opening to the distal joint, thereby providing parallelism. In an alternative example, the shaft housing portion may extend at least partially curved in that region, thereby providing angularity.

[0024] For repeatable and smooth insertion of the end effector into the shaft housing part, the shaft housing part may have an insertion aid, preferably in the region of the entrance opening. The insertion aid is preferably configured as a continuous (preferably funnel-shaped) taper (narrowing) in the interior or receiving space of the shaft housing part. The interior or receiving space of the shaft housing part preferably extends from the entrance opening to the exit opening.

[0025] According to a further development, the shaft housing part has a radial narrowing or a radially inward collar (inner radial collar) which forms an axial stop of the distal coupling part, which axial stop is provided and configured to come into contact with a correspondingly shaped axial stop of the end effector.

[0026] Such axial contact can be direct or indirect, for example via at least one axial plain bearing or axial roller bearing arranged in the radial constriction or in the radially inward collar.

[0027] The closer the axial stop in the shaft housing part is arranged to the distal end of the shaft housing part, the easier it is to manufacture. Therefore, in a preferred further development, a radial narrowing or radially inward collar is formed by the wall of the distal end of the shaft housing part and is pierced by the outlet opening.

[0028] In order to minimize the radial expansion of the working point of the end effector, the shaft housing part, according to a further development, has an inner circumferential surface on which radial stops of the distal coupling part are formed. The radial stops of the distal coupling part are provided and configured to contact corresponding radial stops of the end effector. Such radial contact can be configured directly or indirectly. Indirect radial contact is achieved, for example, via at least one radial plain bearing or radial roller bearing arranged on the inner circumferential surface.

[0029] It is also possible to combine it with a plain bearing and a roller bearing.

[0030] According to a further development, a radial stop and / or an axial stop coaxial with the inlet opening is provided proximal to the shaft housing part and configured to support the end effector or the drive shaft of the drive part of the end effector.

[0031] The drive components may be, for example, a motor, a gearbox coupled to the motor, and a drive shaft coupled to the gearbox, which may in turn be coupled to the end effector. The use of a gearbox allows for either aligned or misaligned placement of the motor relative to the end effector, depending on the configuration.

[0032] In a minimal aspect, the drive section comprises a motor provided and configured for direct coupling with the end effector (preferably the shaft of the end effector). This allows for the possibility of an aligned arrangement of the motor relative to the shaft housing, particularly in the case of a rotatable end effector. Such an aligned arrangement has the advantage that the drive section has a narrow configuration. However, the aligned arrangement can result in a relatively long drive section.

[0033] In order to minimize the overall length of the drive and its housing, according to one embodiment, at least one component of the drive is arranged laterally of the provided shaft housing section. According to a preferred further development, for this purpose the housing has a motor housing section laterally of the inlet opening, which is provided and configured to accommodate at least the motor.

[0034] Preferably, the main axis of the shaft housing part and the main axis of the motor housing part are parallel, i.e. the drive shaft of the motor is parallel to the drive shaft or shaft of the end effector housed in the shaft housing part, which has the advantage that a simple spur gear can be provided for torque transmission.

[0035] Alternatively, the main axis of the shaft housing part and the main axis of the motor housing part may be angled relative to each other, whereby the installation space occupied by the drive part may be optimized for use in an operating room.

[0036] Preferably, the motor housing part is configured to be substantially cylindrical.

[0037] According to a further development, the housing comprises a gearbox housing portion provided and configured to at least partially accommodate a gearbox of the drive part of the end effector, which may be formed as a separate part or may be formed by part of the motor housing portion, the shaft housing portion, or both.

[0038] According to a first aspect of the housing, the motor housing portion is aligned and connected to the shaft housing portion. This connection may be direct, without going through a gearbox and corresponding gearbox housing portion, or indirect, with the motor housing portion, shaft housing portion, and gearbox housing portion all being aligned and connected. This allows for a relatively narrow but long configuration of the housing, and therefore the medical device, as described above.

[0039] Alternatively, the motor housing portion is connected to the side of the shaft housing portion via the gearbox housing portion. Connecting the motor housing portion to the side of the shaft housing portion has the advantage that it is not necessary to remove the motor to replace the end effector (which requires the end effector to be pulled proximally out of the shaft housing portion). This alternative therefore makes it easier to replace the end effector compared to an in-line alignment arrangement.

[0040] According to a further development of the housing for a drive with a gearbox, at least one taper (narrowing) is formed in the shaft housing part in the insertion direction, which taper is provided and configured for rotatable mounting of a drive element of the gear train of the gearbox of the drive part. The output element can be a friction wheel of a belt transmission or a cog wheel of a cog wheel transmission. The output element can be mounted directly to the gear train or indirectly via a plain bearing or a roller bearing.

[0041] In the case of a multi-stage gearbox, a further development provides for a series of ring sections made of stepped tapered sections as described above, via which the shaft housing section narrows stepwise in the insertion direction, each tapered section being provided and configured to support a drive element of another gear train of the gearbox's gear trains.

[0042] In the alternative, a row of a plurality of the above-described output elements may be arranged together (stacked) in just one radial and stepped tapered section of the shaft housing section.

[0043] As mentioned above, one advantage of the connecting element (connecting part) according to the present invention, which has only two connection points subject to tolerances, is that under certain conditions, recalibration during the procedure in the operating room after an end effector exchange can be omitted. One prerequisite is to know the characteristic dimensions and tolerances of the newly inserted end effector. In this case, the new position and new extension of the working point can be calculated based on the initially calibrated connecting element and the dimensions and tolerances of the new end effector. Recalibration in the operating room is no longer necessary.

[0044] In a preferred further development, the medical instrument has at least one end effector (preferably a set of optionally interchangeable end effectors) that are measured and recorded with respect to characteristic dimensions and tolerances. The measurements are preferably performed outside the operating room (preferably in a factory where the end effectors are manufactured), in particular during the manufacturing process of the end effectors. The dimensions and tolerances can thereby be tightened by a control unit configured to calculate the position and extension of the working point of each end effector when inserted or coupled to the medical instrument. In this way, the new position and new extension of the working point can be calculated after the insertion or coupling of the end effector, and no recalibration is required. This eliminates the need for on-site measurement or calibration efforts in the operating room, which, as mentioned above, are instead performed in the factory, which is a significant advantage over current technology.

[0045] In order to be able to determine the dimensions and tolerances for each insertable end effector or to be able to tighten the dimensions and tolerances as mentioned above, the surgical or medical instrument (preferably the connecting element) (preferably the housing) in a preferred further development comprises a detection unit configured to be able to read at least one identification, characteristic and / or dimension and tolerance of an end effector that passes the detection unit (preferably a sensor) during insertion. A prerequisite for this is preferably that the insertable end effector has a corresponding emitter or a corresponding tag in which the identification or said data is stored.

[0046] Preferably, the detection unit is configured as a sensor, in particular an NFC antenna for reading an RFID tag of the end effector. The data stored in the RFID tag preferably include the part number, serial number, type, model and nominal size of the end effector, and in particular characteristic dimensions and tolerances of the end effector, in particular the characteristic distance from the axial stop of the end effector to the working point, the nominal size of the end effector, the concentricity of the end effector, etc. Preferably, the detection unit is arranged in the region of the entrance opening or the above-mentioned insertion aid. Preferably, the detection unit has a reception capability over at least one cross section of the shaft housing part, preferably the entrance opening or the insertion aid. Preferably, the detection unit extends over the entire shaft housing part or at least partially over the entire shaft housing part, preferably evenly distributed.

[0047] In preferred embodiments, the proximal coupling portion of the connecting element is straight and beam-shaped, or configured as a pincer or clamp, which provides other advantageous coupling actions for attaching the connecting element to the end segment of the robot.

[0048] To define the position and orientation of the proximal connector relative to the end segment in the simplest way, the proximal connector in a preferred embodiment has three point-like proximal connector elements, with a proximal connector surface extending across these proximal connector elements. The three proximal connector elements are specifically designed and configured to engage with three connector elements on the end segment that match them. Preferably, the three proximal connector elements are arranged to form the corners of an equilateral triangle.

[0049] According to a possible further development, at least one proximal coupling element has a centering hole or a centering recess and another proximal coupling element has a centering pin or a centering sphere.

[0050] According to a possible further development, at least one proximal coupling element has a stop acting laterally on the proximal coupling surface.

[0051] With the configuration according to the invention, the connecting element extends integrally up to the distal stop, i.e., close to the working point of the end effector. This facilitates guiding a supply duct to this area. According to an advantageous further development, the connecting element has at least one of the aforementioned channels leading or opening distally, preferably opening at the distal end face and / or the distal outer surface of the connecting element (in particular the shaft housing part). The channels preferably extend within and along the wall of the shaft housing part. Each channel may be provided and configured to accommodate a light guide for illuminating the surgical area, an optical system for viewing the surgical area, a coolant for cooling the end effector or its bearings, or data lines for a distally mountable camera or sensor (in particular a force sensor for detecting forces and / or moments at the working end), or for extracting fluids from the surgical area.

[0052] Preferably, the connecting element has a fastening interface configured to allow attachment of a drape.

[0053] In a preferred embodiment, the connecting element is a sterile product.

[0054] The drive may be manual or electric, or the drive may be manual and servo motor assisted.

[0055] In manual or servomotor-assisted configurations, the drive comprises a handpiece. In manual configurations, the handpiece is preferably provided and configured to couple directly to the end effector. In servomotor-assisted embodiments, the handpiece is preferably provided and configured to couple to a specific gear train of a gearbox.

[0056] In a preferred embodiment, the gearbox of the drive unit has several gear trains, which makes the drive unit particularly flexible in terms of speed and torque. Preferably, each gear train is assigned an output element, which is rotatably mounted axially and circumferentially in a stepped tapered section (narrowed section) of the shaft housing section.

[0057] For a simple coupling of one of the output elements with the end effector (in particular the shaft of the end effector) assigned to said output element, the output element preferably has a central through-hole with an inner circumferential coupling portion.

[0058] According to a further development, a particularly simple allocation and coupling of each gear train to the end effector assigned to it is possible if the inner diameter of the through hole decreases in stages in the insertion direction.

[0059] The drive unit preferably includes a set of multiple, interchangeable end effectors each having a shaft of the same length, each end effector having an outer peripheral coupling portion at the same height measured from the coupling portion of the end effector, the outer peripheral coupling portion being configured and arranged to couple to one of the inner peripheral coupling portions.

[0060] In a further development, each outer coupling portion has a unique pair of values ​​(tuple) for outer diameter and length, which facilitates accurate coupling between a specific end effector and a gear train (i.e., a specific output element) assigned to that end effector. In the unique pair of values ​​(tuple), the outer coupling portion with the largest outer diameter is assigned the smallest length (the outer coupling portion with the largest outer diameter has the smallest length), and the outer coupling portion with the smallest outer diameter is assigned the largest length (the outer coupling portion with the smallest outer diameter has the largest length). In addition, intermediate outer diameters (outer diameters between the maximum and minimum) gradually decrease in stages toward the insertion direction, and intermediate lengths (lengths between the maximum and minimum) gradually increase in stages toward the insertion direction. [Brief explanation of the drawings]

[0061] [Figure 1] FIG. 1 is a perspective view showing a current surgical robot with a surgical instrument attached thereto. [Figure 2] 1 is a perspective view showing a connecting element configured as a housing in a surgical instrument (medical instrument) of a surgical robot according to a first configuration example. FIG. [Figure 3] FIG. 3 is a partially cutaway perspective view showing the housing of FIG. 2. [Figure 4] FIG. 4 is a perspective view showing a drive unit having the housing of FIGS. 2 and 3 according to a first configuration example. [Figure 5] FIG. 4 is a vertical cross-sectional view showing the housing of FIGS. 2 and 3. [Figure 6] FIG. 10 is a longitudinal cross-sectional view showing a connecting element configured as a housing in a surgical instrument (medical instrument) of a surgical robot according to a second configuration example. [Figure 7] FIG. 7 is a view of the housing of FIG. 6 from the proximal side. [Figure 8] FIG. 6 is a partial cross-sectional view of the housing of FIG. 5 with an end effector inserted therein. [Figure 9] FIG. 10 is a longitudinal sectional view showing a drive unit of a surgical instrument (medical instrument) according to a second configuration example. [Figure 10] FIG. 10 is a longitudinal sectional view showing a drive unit of a surgical instrument (medical instrument) according to a third configuration example. [Figure 11] FIG. 10 is a longitudinal sectional view showing a drive unit of a surgical instrument (medical instrument) according to a fourth configuration example. [Figure 12] 1 shows the same end effector with different couplings for coupling with different gear trains in the drive of a surgical (medical) instrument. [Figure 13] FIG. 12 is a perspective view showing details of the drive unit of FIG. 11. [Figure 14] FIG. 14 is a perspective view showing the drive unit of FIG. 13 with the end effector inserted. [Figure 15] FIG. 6 is a vertical cross-sectional view showing a drive unit having the housing of FIG. 5 according to a fifth configuration example. [Figure 16] 16 shows the drive of FIG. 15 with the end effector inserted. [Figure 17] 10 is a longitudinal cross-sectional view showing a drive section of a surgical instrument (medical instrument) according to a seventh configuration example and the housing of FIGS. 6 and 7. FIG. [Figure 18] 17 shows the drive of FIGS. 15 and 16 with a channel passing through the housing. DETAILED DESCRIPTION OF THE INVENTION

[0062] FIG. 1 shows a robotic arm of a surgical robot 1 according to the current state of the art, which includes a drive for an end effector 18 having a housing 16. The robotic arm has multiple articulated segments 2, 4, 6, 8, and 10 and an end segment 10. A surgical instrument (medical instrument) 14 is coupled to the end segment 10 via a connecting arm 12. The surgical instrument 14 is secured to a receiving portion of the connecting arm 12 at its housing 16. A working end, or end effector 18, of the surgical instrument 14 protrudes from the distal end of the housing 16. A working point 20 of the surgical instrument 14, which is effective in the surgical field, is located at the tip of the end effector 18. Between the end segment 10 and the end effector 18, the surgical instrument 14 has a series of attachment points 22, 24, 26, and 28. In the system shown in Figure 1, the drive and housing 16 components of the end effector 18 are connected to one another via multiple connection points 22, 24, 26, and 28 between the distal segment 10 and the end effector 18. This creates tolerance chains, and therefore play, that cause the working point 20 to expand spherically, increasing the target zone. These effects must be minimized or eliminated.

[0063] For this purpose, a preferably high-precision connecting element (connection fixture) for medical instruments (surgical instruments) is proposed, several configuration examples of which are described below with reference to Figures 2 to 18. In the following configuration examples, the connecting element is configured as a housing-like part (housing-like element), hereinafter simply referred to as "housing". The connecting element (housing) is characterized in particular by the absence of several connection points, which minimizes tolerance chains. This significantly reduces and optimizes the target zone of the end effector 18.

[0064] FIG. 2 shows a perspective view of a first example of a connecting element. The connecting element according to the first example is configured as a housing 116 (support structure) for a medical instrument (surgical instrument) including an end effector 18. The housing 116 has a proximal coupling portion 30 that can be coupled to the end segment 10 (see FIG. 1) and a distal coupling portion 32 to which the end effector 18 is coupled. The housing 116 extends integrally between the proximal coupling portion 30 and the distal coupling portion 32, i.e., the frictional coupling between the end segment 10 and the end effector 18 does not involve any other coupling points. In this way, the number of coupling points is reduced to a minimum of two. Therefore, compared to prior art solutions, the internal coupling points of the drive unit of the end effector 18 or other coupling points of the housing 116 do not affect the position of the working point 20. Only the tolerance between the proximal coupling portion 30 and the distal coupling portion 32 determines the target zone. To minimize target zone expansion, proximal and distal joints 30, 32 are manufactured to high precision with respect to shape, alignment, and position tolerances.

[0065] As shown in FIG. 2 , the housing 116 includes a tubular or sleeve-shaped shaft housing portion 34. The proximal coupling portion 36 of the end effector 18 passes through the shaft housing portion 34. The coupling arm 12 is laterally mounted at an obtuse angle to the shaft housing portion 34. The coupling arm 12 is weight-optimized by a hole (recess) 38. The proximal coupling portion 30 branches into two coupling legs 40. Each coupling leg 40 has a spherical coupling element 42 (one not shown) of the proximal coupling portion 30 formed radially inward. At the apex of the branching point, the proximal coupling portion 30 includes an additional coupling element 44. The additional coupling element 44 is configured as a through-hole and opens toward the hole 38. An advantage of this embodiment is the precision of the relative position of the coupling surfaces defined by the coupling elements 42, 44 of the proximal coupling portion 30 relative to the coupling surface defined by the distal coupling portion 32.

[0066] As shown in FIG. 2, the housing 116 further includes a gearbox housing portion 46, which will be described in more detail below.

[0067] FIG. 3 is a perspective view of the housing 116 of FIG. 2 in longitudinal section without the end effector 18. The gearbox housing portion 46 is shown in a non-sectional view. The distal coupling portion 32 is shown in FIG. 3 as an internally disposed sleeve-like extension of the shaft housing portion 34. The distal coupling portion 32 has an axial stop in the extension direction of the end effector 18. In the illustrated example, the axial stop is formed by a radial narrowing at the end face of the shaft housing portion 34. This radial narrowing forms the periphery of an outlet opening 48 of the shaft housing portion 34, through which the end effector 18 (see FIG. 1) is configured to exit.

[0068] FIG. 4 illustrates a manual, servo-assisted drive 50 with the housing 116 of FIGS. 2 and 3. The drive 50 includes a handpiece 52 that can be used to initiate rotation of the end effector 18. The handpiece 52 is detachably configured and operatively connected to a gearbox insert (not shown) of the drive 50 within the gearbox housing portion 46. This allows rotation of the handpiece 52 to produce servo-assisted rotation. In this manner, for example, pedicle screw driving is motor-assisted, allowing the surgeon to retain a sense of the torque being applied.

[0069] FIG. 5 shows the housing 116 in longitudinal cross section. The gearbox housing portion 46 is not shown in FIG. 5. The proximal entrance opening 54 of the shaft housing portion 34 (not shown in FIGS. 2-4) is also shown in FIG. 5. The end effector 18 can be inserted into the housing 116 through this entrance opening 54. The entrance opening 54 is relatively wide. In the insertion direction, the shaft housing portion 34 has a relatively strong stepped taper (radial narrowing) 56 near the entrance opening 54. The stepped taper (radial narrowing) 56 forms a cylindrical receiving space 58 for an output element set of a gearbox (not shown). A funnel-shaped taper (narrowing) 60 is adjacent to the stepped taper (radial narrowing) 56. The funnel-shaped taper (narrowing) 60 is an insertion aid that functions as an insertion aid when the end effector 18 is inserted. The distal end of the shaft housing portion 34 shows in cross section an axial stop 62 and a radial stop 64 at the distal joint portion 32. The axial stop 62 is an inward-facing annular front surface machined with high precision to surround the outlet opening 48, and the radial stop 64 is part of the inner surface of the shaft housing portion 34 adjacent to the annular front surface (axial stop 62).

[0070] 6 and 7 show a housing 216 (support structure) in a second configuration example of an end effector of a surgical instrument for a surgical robot. Regarding the second configuration example, only the differences from the first configuration example will be discussed to avoid repetition. In contrast to the housing 116 in FIGS. 2 to 5, the shaft housing portion 34 extends from the inlet opening 54 to the outlet opening 48 so as to have only one stepped tapered portion (radial narrowing portion) 56. In the second configuration example, an insertion aid (see reference numeral 60 in FIG. 5) is not provided. The stepped tapered portion (radial narrowing portion) 56 in the housing 216 is maintained relatively flat. Therefore, the stepped tapered portion (radial narrowing portion) 56 is suitable for holding only one drive element in a gear train. Alternatively, the stepped taper 56 may serve as a proximal bearing point for the shaft of the end effector or drive motor, which shaft may be coupled to the stepped taper 56. This is further described below in connection with FIG. 17 . In the illustrated configuration, the proximal coupling portion 230 of the housing 216 has an axial coupling surface 66 for forward contact with a corresponding coupling surface of the end segment 10 and a lateral coupling surface 68 for lateral contact with a corresponding coupling surface of the end segment 10. According to the configuration of FIGS. 6 and 7 , the dimension H defining the distance between the axial coupling surface 66 of the proximal coupling portion 230 and the axial stop 62, the dimension L defining the distance between the lateral coupling surface 68 of the proximal coupling portion 230 and the center of the radial stop 64, and the dimension d defining the diameter of the radial stop in the region of the inlet opening 54 are manufactured with high precision in terms of shape, positioning, and location tolerances.

[0071] FIG. 8 shows in detail the distal coupling portion 32 of each of the shaft housing portions 34 of FIGS. 2-7 with an end effector 18 coupled thereto. The end effector 18 includes a shaft 70 extending within the shaft housing portion 34, an expanded collar 72 distally adjacent the shaft 70, and a working end 74 projecting from the outlet opening 48, the working end 74 having a working point 20 at its distal end. As shown, a distally facing annular front surface 76 of the expanded collar 72 is in sliding contact with the axial stop 62 of the distal coupling portion 32. The end effector 18 can be centered either via the outer peripheral surface of the expanded collar 72, which rests against the inner surface forming the radial stop 64, or via a frusto-conical centering collar 78 seated in the outlet opening 48.

[0072] As mentioned above, according to this embodiment, a target zone having a diameter of less than 2 mm (and more preferably less than 1 mm) can be achieved with less manufacturing effort. This is due to the fact that fewer surfaces need to be machined due to the shortened tolerance chain compared to prior art solutions. Regardless of the configuration of the present disclosure, the term target zone refers to the enclosed volume or tolerance space that extends around the tip of the end effector 18, as shown in FIG. 8, where the tip of the end effector 18 is positioned according to the tolerances after assembly of the end effector 18.

[0073] FIG. 9 shows a longitudinal cross section of a drive unit (drive device) 150 of an end effector of a surgical robot according to a second configuration example. In contrast to the previous description, the housing 316 (support structure) has a motor housing portion 80 connected laterally to the shaft housing portion 34. The motor housing portion 80 accommodates a drive motor 82 having a drive shaft 84 parallel to the shaft 70. The shaft housing portion 34 and the motor housing portion 80 are connected to each other via a gearbox housing portion 46, which partially accommodates a gearbox 88 configured as a spur gear. The gearbox 88 has a drive spur gear 90 coupled to the drive shaft 84 and an output spur gear 94 coupled to the shaft 70. The output spur gear 94 is non-rotatably connected to the drive spur gear 90 via a gear 92. The drive spur gear 90, gear 92, and output spur gear 94 form a gear train 91 with a fixed transmission ratio of the drive unit 150. For the purpose of coupling, the shaft 70 of the end effector 18 has an outer coupling portion 96 which is rotationally fixedly connected to an inner coupling portion 98 of the through hole of the output spur gear 94. In contrast to the previous configuration, the end effector 18 is not supported by an enlarged collar but by the annular front face 76 of the shaft 70 and two ball bearings on the axial stop 62 of the distal coupling portion 32.

[0074] 10 shows a longitudinal section of a drive unit (drive device) 250 of an end effector 18 of a surgical robot according to a third configuration example. In contrast to the configuration example according to FIG. 9, the shaft housing portion 34 does not extend linearly but is curved. The shaft housing portion 34 is rigid and is adapted to the specific requirements of the surgical field by the curvature. In this configuration example, the shaft 70 must be flexible.

[0075] FIG. 11 shows a longitudinal cross section of a drive unit (drive device) 350 of an end effector 18 of a surgical robot according to a fourth configuration example. Unlike the configuration examples shown in FIGS. 9 and 10, a second gear train 93 is provided in addition to the first gear train 91. Like the drive spur gear 90 of the first gear train 91, the drive spur gear 95 of the second gear train 93 is firmly (fixedly) coupled to the drive shaft 84. Therefore, the drive spur gear 90 of the first gear train 91 and the drive spur gear 95 of the second gear train 93 always rotate together with the drive shaft 84. As a result, the drive spur gear 90 of the first gear train 91 drives the output spur gear 94 of the first gear train 91, and the drive spur gear 95 of the second gear train 93 drives the output spur gear 99 of the second gear train 93. As a result, the output spur gear 94 of the first gear train 91 and the output spur gear 99 of the second gear train 93 rotate at different speeds. The end effector 18, which can be coupled to the inner peripheral coupling portions 98, 100 of the first gear train 91 and the second gear train 93, respectively, is driven at different speeds depending on which inner peripheral coupling portion 98, 100 it engages.

[0076] To achieve this, Figure 12 shows an example in which the end effector 18 is equipped with different circumferential couplings 96, 101. The end effector 18 can be driven at different speeds by selectively engaging these circumferential couplings 96, 101. Depending on which of the circumferential couplings 96, 101 shown in Figure 12 is used, the end effector 18 is driven by either the first gear train 91 at its own speed n1 or the second gear train 93 at its own speed n2.

[0077] FIG. 13 shows a drive unit (drive device) 350 as shown in FIG. 11 in a perspective view from above in the region of the gears (output spur gears 94, 99) of the power transmission path.

[0078] Figure 14 shows the drive unit 350 according to Figure 13. In the state shown in Figure 14, the end effector 18 on the left side of Figure 12, which has an outer peripheral coupling portion 96, is inserted. Due to its small diameter and large height, the outer peripheral coupling portion 96 is coupled only to the lower inner peripheral coupling portion, i.e., the inner peripheral coupling portion 98 of the output spur gear 94 of the first gear train 91. Therefore, the second gear train 93 only co-rotates without being engaged, i.e., does not transmit torque to the end effector 18.

[0079] Figure 15 shows a drive 450 that differs from those shown in Figures 11, 13, and 14 only in that it has more gear trains (three instead of two). This can be seen from the three tiers of output spur gears 94, 99, and 103. Here, output spur gears 94 and 99 make up the first and second gear trains 91 and 93 described above, and output spur gear 103 makes up the additional third gear train.

[0080] FIG. 16 shows further details of the drive unit (driver) 450. This drive unit 450 allows the inserted end effector 18 to be uniquely identified and transmit its ID (identification information) or other characteristic data record to the control unit of the surgical robot. The drive unit 450 has an antenna (RFID antenna or NFC antenna) 104. The antenna 104 extends axially within the wall of the shaft housing portion 34, entirely in the region of the insertion aid (funnel-shaped tapered portion 60). The inserted end effector 18 has an RFID chip 106. The RFID chip 106 is read by the antenna 104 when it passes by it. The end effector 18 may have any type of surgical working end. According to this embodiment, the specific calibration dimensions of the surgical working end are recorded during its production, and according to this embodiment, these dimensions are dimensions that affect the position of the working point in space (e.g., the distance from the annular front surface 76 or axial stop to the working point 20, the tolerance of this distance, the concentricity of the working point 20 (see FIG. 8), or other information (e.g., diameter, surface roughness, sharpness, etc.)). The RFID chip 106 may, for example, transmit the part number and serial number of the end effector 18 as a minimum data set. When the RFID chip 106 passes the antenna 104, this information is read and transmitted to the control unit. The type of end effector 18 is uniquely assigned to the part number and serial number in a removable database. Due to the part number mapping, all other dimensions and tolerances of the inserted end effector 18 can be applied and used to uniquely calculate the position of the new working point without recalibration. Alternatively, the aforementioned data may already be stored on the RFID chip 106 itself and may be read directly and transmitted to the control unit.

[0081] FIG. 17 shows a drive unit (drive device) 550 including the housing 216 and motor 582 shown in FIGS. 6 and 7. The motor 582 is positioned in line with the shaft housing portion 34, not to the side of the shaft housing portion 34. Therefore, to replace the end effector 18, the motor 582 must first be lifted out of the housing 216. The shaft 70 is then separated from the motor 582, and a new end effector 18 is inserted into the shaft housing portion 34 until the expanded collar 72 of the end effector 18 is axially stopped by the axial stop of the distal coupling portion 32 (see the center of FIG. 17). Finally, the motor 582 is connected to the proximal coupling portion 36 of the end effector 18.

[0082] FIG. 18 illustrates a drive unit (driver) 450 including the housing 316 of FIGS. 15 and 16. The housing 316 (see the left side of FIG. 18) includes multiple channels 108, 110, 112, and 114 extending from the proximal coupling 30 to the distal coupling 32 within the solid material (wall) of the housing 316. The channels 108, 110, 112, and 114 are either distally open (see the right side of FIG. 18) or configured as blind-hole channels. The integrated construction of the housing 316 in this example configuration allows light, data, imaging data, coolant, and the like to be safely and interference-freely routed, transmitted, or conveyed within the channels in this area. For example, the illustrated example configuration includes four fiber optic channels 108 for illuminating the surgical field, a sensor channel 110 for a sensor capable of detecting bearing force of the end effector 18, a cooling channel 112, and a heating channel 114. [Explanation of symbols]

[0083] 1. Surgical robot 2, 4, 6, 8 segments 10 Terminal Segments 12 binding arms 10 Surgical instruments 16,116,216,316 Housing 18 End Effector 20 Working Points 22,24,26,28 connection point 30,230 Proximal junction 32 Distal junction 34 Shaft housing part 36 Proximal joint of end effector 38 holes 40 Connecting legs 42,44 Coupling elements 46 Gearbox housing 48 Exit opening 50,150,250,350,450,550 Drive unit 52 Handpiece 54 Inlet opening 56 Stepped tapered section (diametrically narrowed section) 58 Reception Space 60 Funnel-shaped tapered section (insertion aid section) 62 Axial stopper 64 Radial stopper 66 Axial connection surface 68 Lateral joint surface 70 shaft 72 Expanding collar 74 Working End 76 Axial stopper 78 Centering Collar 80 Motor housing 82 Drive motor 84 Drive shaft 88 Gearbox 90 Drive spur gear 91 First Gear Train 92 Gears 93 Second Gear Train 94 Output spur gear 95 Drive spur gear 96 Periphery joint 98 Inner joint 99 Output spur gear 100 Inner joint 101 Outer periphery joint 103 Output spur gear 104 NFC antenna 106 RFID chips 108 Fiber Optic Channels 110 sensor channels 112 Cooling Channel 114 Heating Channel H Distance between axial stoppers L Distance from the rotation axis to the side stop d Distance between radial stoppers

Claims

1. A medical device for a medical robot (1), comprising: a support structure (116, 216, 316) for supporting and receiving at least one optionally interchangeable end effector (18) of said medical instrument, preferably for supporting and receiving said end effector (18) and a drive portion (50, 150, 250, 350, 450, 550) thereof; a proximal coupling portion (30, 230) provided and configured to couple to a distal end segment (10) of the medical robot (1); a distal coupling portion (32) provided and configured to couple to said optionally interchangeable end effector (18); the support structure (116, 216, 316) is or has a connecting element; the connecting element extends integrally, preferably of one material, at least between the proximal connecting portion (30) and the distal connecting portion (32), thereby establishing a joint-free connection and / or a tolerance-free connection between the proximal connecting portion (30) and the distal connecting portion (32); Medical equipment.

2. the connecting element forms a housing (116, 216, 316) or housing portion of the medical device; or the connecting element forms a framework disposed parallel to the housing of the medical device, thereby defining the relative position of the distal coupling portion with respect to the proximal coupling portion; The medical device of claim 1 .

3. the connecting element (116, 216, 316) has high precision shape, positioning, and / or location tolerances at least with respect to the proximal coupling portion (30) and the distal coupling portion (32); The medical device according to claim 1 or claim 2.

4. The contact surfaces or major axes of the proximal and distal joints (30, 32) are fixedly positioned parallel, inclined, or perpendicular to each other. The medical device according to any one of claims 1 to 3.

5. a shaft housing portion (34) provided with the distal coupling portion (32); The shaft housing portion (34) has an entrance opening (54) through which the end effector (18) can be inserted and a distal exit opening (48) through which the end effector (18) passes during the intended operation. The medical device according to any one of claims 1 to 4.

6. the shaft housing portion (34) has a radial narrowing or radially inward collar at its distal end, the radial narrowing or radially inward collar defines an axial stop (62) of the distal coupling portion (32) for axial coupling with an axial stop (76) of the end effector (18). The medical device according to claim 5.

7. The shaft housing portion (34) has an inner peripheral surface, the inner peripheral surface of the shaft housing portion (34) forms a radial stop (64) of the distal coupling portion (32) for radial coupling with a radial stop of the end effector (18). The medical device according to claim 5 or claim 6.

8. a radial stop (56) coaxial with the inlet opening (54) and / or an axial stop (56) is provided for the drive unit or for the drive system of the drive unit; The medical device according to any one of claims 5 to 7.

9. a motor housing portion (80) disposed on the side of the inlet opening (54); The motor housing portion (80) is provided and configured to at least partially house a motor (82) of the drive portion. The medical device according to any one of claims 5 to 8.

10. a gearbox housing portion (46) provided and configured to at least partially receive a gearbox (88) of said drive portion; The medical device according to any one of claims 1 to 9.

11. The motor housing portion (80) is connected to the shaft housing portion (34) via the gearbox housing portion located in the same straight line (116) or to the side (316) of the shaft housing portion (34).

11. The medical device of at least claim 10.

12. At least one tapered portion (56) formed in the shaft housing portion (34) in a stepped manner in the insertion direction is provided to rotatably support at least one drive element (94, 99, 103) of at least one gear train (91, 92, 93) in a gear box of the drive portion.

6. A medical device according to at least claim 5.

13. a sensor (104) capable of reading at least one identification, characteristic, and / or dimension and tolerance of the end effector (18); The medical device according to any one of claims 1 to 12.

14. a plurality of gear train output elements (94, 99, 103) of the gearbox of the drive section (350, 450) are rotatably mounted in the area of ​​the stepped tapered section (56); each of said output elements (94, 99, 103) preferably having a central through-hole with an inner peripheral coupling portion (98, 100, 105); The inner diameter of the through hole gradually decreases in a stepwise manner in the insertion direction, a pair of optionally interchangeable end effectors each having a shaft with a preferably cylindrical outer circumferential coupling portion (96, 101) that terminates at the same height in the insertion direction; The outer peripheral joints (96, 101) each have a unique pair of values ​​for outer diameter and length; The pair of values ​​is such that the length of the outer peripheral joint portion (101) having the largest outer diameter is the smallest, the length of the outer peripheral joint portion (96) having the smallest outer diameter is the largest, the outer diameter between the maximum and minimum is gradually decreased in a stepwise manner in the insertion direction, and the length between the maximum and minimum is gradually increased in a stepwise manner in the insertion direction.

13. The medical device of at least claim 12.

15. A support structure (116, 216, 316), preferably a housing, for a surgical or medical instrument for a surgical or medical robot, comprising: the support structure (116, 216, 316) for supporting and receiving at least one optionally interchangeable end effector (18) of the surgical or medical instrument, preferably the end effector (18) and its drive portion (50, 150, 250, 350, 450, 550); a proximal coupling portion (30, 230) provided and configured to couple to a distal end segment (10) of the surgical or medical robot (1); a distal coupling portion (32) provided and configured to couple to the optionally interchangeable end effector (18) of the surgical or medical instrument; the support structure (116, 216, 316) is or has a connecting element; the connecting element extends integrally, preferably of one material, at least between the proximal connecting portion (30) and the distal connecting portion (32), thereby establishing a joint-free connection and / or a tolerance-free connection between the proximal connecting portion (30) and the distal connecting portion (32); Support structure.

Images