Surgical system

Abstract

The invention relates to a surgical system for controlling at least one robot arm, the surgical system comprising: at least one robot arm on which at least one surgical instrument is arranged; at least one robot arm on which at least one structure identification unit is arranged; and at least one control unit, which is connected to the at least one robot arm on which at least one surgical instrument is arranged and to the at least one robot arm on which at least one structure identification unit is arranged, wherein the at least one control unit is at least designed to obtain information from the at least one surgical instrument and the at least one structure identification unit during the surgery and, in response to this information, to automatically select robot instruction data from a plurality of previously defined robot instruction data and adapt the control of at least one robot arm on the basis of the modified robot instruction data.

Description

[0001] P9591 PC00

[0002] 1

[0003] Operating system

[0004] The present invention relates to an operating system for the autonomous control of at least one robot arm.

[0005] Minimally invasive procedures are playing an increasingly important role in clinical surgery. While just a few years ago relatively large areas of the surgical field were opened for minor procedures to allow the surgeon to navigate using natural landmarks, many of these procedures are now performed using laparoscopy and endoscopic visual aids. As a result, minimally invasive procedures reduce the surgical impact on patients and also lower morbidity compared to open surgery. Oncological operations can be performed with the same quality as open procedures. Due to the reduced morbidity, patients can be discharged from the hospital sooner. Furthermore, faster patient mobilization and a quicker return to a normal diet are possible after minimally invasive surgery.Postoperative pain is also reduced. The widespread use of minimally invasive surgery is limited by the steep learning curve, particularly with regard to complex operations. Therefore, it is problematic to offer all patients an alternative, minimally invasive procedure, even if this would be possible in principle.

[0006] Currently, so-called surgical robots are known to assist surgeons during operations. All models share the common feature that, from a console, a surgeon remotely manipulates instruments on a control system at the operating table. These instruments are inserted into the patient's abdominal cavity through small incisions and trocars. A video image from a camera inserted into the abdomen provides visualization of the surgical field. To perform these operations, the patient's abdominal cavity must be insufflated with CO2, requiring the creation of a pneumaperitoneum. P9591 PC00

[0007] 2

[0008] A robot-assisted surgical system is known, for example, in the form of the "da Vinci" model from the company "Intuitive Surgical". This robot has a first instrument arm that carries an endoscope at its front end. Up to three additional instrument arms carry laparoscopic instruments. Furthermore, the surgical system has a control console where a surgeon is positioned to control the instrument arms.

[0009] A disadvantage of the systems currently available is that surgeons are still required to operate them. Furthermore, surgeons need more training time to use the systems for complex operations or minimally invasive procedures. Additionally, the organs in the abdominal cavity are not static; they do not remain in one position during surgery. Breathing, heartbeat, and the movement of the gastrointestinal tract all change organ positions and thus the location for the necessary surgical access. The position of diseased organs, tumors, and blood vessels is also constantly changing. This limits the usefulness of preoperative imaging studies for autonomously navigating a surgical robot.In this context in particular, surgeons are still needed to identify the organs visually or via haptic signals using surgical instruments, in order to adjust or stop the movement of the surgical instruments if necessary, so as not to endanger the life of the patient being operated on.

[0010] The object of the present invention is therefore to overcome the disadvantages of the prior art and to provide a surgical system by means of which an operation can be performed completely autonomously, thereby enabling more complex operations to be performed without the steep learning curve for surgeons and thus making them accessible to all patients. Furthermore, it is an object of the present invention to provide a surgical system that ensures patient safety.

[0011] The problem is solved by providing an operating system for controlling at least one robot arm, comprising at least one robot arm on which at least one surgical instrument is arranged, P9591 PC00

[0012] 3 at least one robot arm on which at least one structure recognition unit is arranged, and at least one control unit which is connected to the at least one robot arm on which at least one surgical instrument is arranged, and to the at least one robot arm on which at least one structure recognition unit is arranged, wherein the at least one control unit is designed to receive and store operational data before the operation and to generate robot instruction data from this operational data for controlling at least one robot arm, wherein the at least one control unit is further designed toto obtain information during the operation from the at least one surgical instrument and the at least one structure recognition unit and, in response to this information, to automatically select robot instruction data from a large number of predefined robot instruction data and to adapt the control of at least one robot arm based on the modified robot instruction data.

[0013] For the purposes of the present invention, an operation can be, in particular, a minimally invasive procedure. Minimally invasive procedures are defined as those performed with the least possible trauma. These include, for example, laparoscopic surgery, thoracoscopic surgery, and endoscopic operations through natural body orifices. For the purposes of the present invention, the term "procedure" is used synonymously with the term "operation," both of which describe a medical intervention for the treatment of a patient.

[0014] A surgical instrument is a medical device used in surgical procedures that has a dual functionality: On the one hand, it serves as an instrument for performing mechanical, physical, or chemical manipulations on the body, and on the other hand, it contains a processing unit. The processing unit has an AI (artificial intelligence) component. The AI ​​component can consist of hardware, software, or a combination of both and is designed to process and analyze data and, based on this, make decisions or execute actions. The AI ​​component is used by P9591 PC00

[0015] Four machine learning algorithms enable the processing unit of at least one surgical instrument to identify specific features of an anatomical structure, such as its shape, tissue type, or pathological changes. Furthermore, the processing unit is designed to detect an anatomical structure and identify it based on the features learned by the AI ​​component. After identifying an anatomical structure, the processing unit of the at least one surgical instrument is designed to transmit the result of the evaluation as information in the form of data to the at least one control unit via a wired or wireless connection. The wireless connection is established via WLAN, Bluetooth, or cellular technologies.

[0016] For the purposes of the present invention, surgical data are all data that describe the patient's status, the surgical instruments used, and the surgical plan, and which are available to at least one control unit in real time. This data includes essential physiological parameters of the patient, such as heart rate, blood pressure, oxygen saturation, and temperature, as well as specific measurements directly related to the surgery, for example, the position and movement of surgical instruments, tissue properties, or the progress of the operation.

[0017] For the purposes of the present invention, a structure recognition unit is a device capable of recognizing, analyzing, and processing specific image data of a patient's anatomical structure. In the context of the present invention, the at least one structure recognition unit is the "eye" of the surgical system, analogous to the eye of a surgeon performing an operation. The at least one structure recognition unit can identify specific patterns, anomalies, or characteristic features of an anatomical structure based on image data. For example, the at least one structure recognition unit can be a medical image processing unit comprising an AI component. The AI ​​component can consist of hardware, software, or a combination of both and is designed to process and analyze data and, based on this, make decisions or execute actions. P9591 PC00

[0018] 5

[0019] The AI ​​component uses machine learning algorithms to train the image processing unit to recognize and classify organ shapes or organ states in image data. Furthermore, the at least one structure recognition unit is designed to transmit the captured image data as information to the at least one control unit. This information is transmitted as data via a wired or wireless connection using WLAN, Bluetooth, or cellular technologies.

[0020] The at least one control unit is designed to monitor and / or control at least one robot arm, with the functions being able to be performed both wired and wirelessly. The at least one control unit comprises a processing unit, at least one communication interface, and at least one power supply. The data processing unit is designed to receive, process, and store the operational data as well as the information from the at least one surgical instrument and the at least one structure recognition unit, and is further designed to generate robot instruction data for controlling the at least one associated robot arm.

[0021] The at least one communication interface enables both wired communication via USB, Ethernet or a bus system as well as a wireless connection via WLAN, Bluetooth or mobile communication technologies, so that the at least one robot arm can be flexibly controlled via one or both communication paths.

[0022] The at least one control unit is designed to use the surgical data to precisely control the at least one surgical instrument on at least one robotic arm according to a surgical plan and to react to unforeseen changes. The surgical data forms the basis for adapting and generating robot instruction data, which is transmitted to at least one robotic arm in the form of control commands to ensure precise, flexible, and safe execution of the procedure or operation. Furthermore, the control unit is designed to continuously analyze and process the surgical data in order to dynamically respond to changes in the patient's condition and to guide the at least one P9591 PC00

[0023] 6

[0024] to adapt the surgical instrument accordingly. Surgical data thus represent the central source of information for the at least one control unit in order to ensure precise, timely control of the at least one robotic arm, on which the at least one surgical instrument is located, during the procedure, adapted to the individual requirements.

[0025] The control unit is also designed to store the information received from the at least one surgical instrument and / or the at least one structure recognition unit and to convert it into robot instruction data in real time using algorithms. The processing unit, which can be implemented, for example, as a microprocessor, microcontroller, or control hardware, is designed to analyze the received information in the form of raw data and to identify relevant control information based on predefined robot instruction data and AI-supported pattern recognition.

[0026] The conversion of raw data into robot instruction data is achieved through a multi-stage processing process: First, the received information, in the form of raw data, is prepared for further processing through filtering and normalization processes. Subsequently, an integrated deep learning module analyzes the processed data, recognizes patterns and deviations, and then generates control commands. These commands are stored as robot instruction data in the memory of at least one control unit and continuously updated to flexibly adapt the control of at least one robot arm to the operating environment.

[0027] The deep learning module is designed to recognize patterns in real time using a multi-layered neural network and automatically calculate the appropriate control parameters. These calculations enable flexible adjustment of the robot instruction data, which is then transmitted via at least one communication interface to the at least one robot arm to modify or adapt the control of the at least one robot arm as needed.

[0028] The adaptive control provided by the AI ​​component minimizes the need for manual intervention for control and ensures that at least P9591 PC00

[0029] 7. A control unit automatically reacts to changes during the operation in order to always achieve optimal control results.

[0030] Overall, the at least one control unit, through the combination of data reception, data storage, deep learning-based data processing and continuous adaptation of the robot instruction data, ensures precise, flexible and autonomous control of the at least one robot arm during an operation, thereby guaranteeing the safety of the patient.

[0031] A preferred surgical system according to the invention is one in which the at least one surgical instrument is designed to receive data before the operation and to use this data to identify an organ, an organ structure, a tumor and / or a blood vessel and to distinguish these structures from one another. According to the present invention, the processing unit of the at least one surgical instrument is designed to receive and process the data.

[0032] Furthermore, the operating system according to the invention is preferred in which the at least one control unit is designed to control the at least one surgical instrument during the operation and the at least one surgical instrument is designed to simultaneously detect by means of acoustic signals whether it recognizes an organ, an organ structure, a tumor and / or a blood vessel.

[0033] According to the invention, detection is achieved using acoustic signals via the Acoustic Emission Sensing Technique (AEST) or vibro-acoustic sensing technique. Acoustic signals (sound waves) are used to identify tissue properties. Tissue-specific characterization can be achieved through a specific tissue resonance. Following an AI-based learning process, the tissue can then be assigned to a specific structure. At least one surgical instrument is equipped with this technology. This technical "hand," similar to the human system, provides feedback to the at least one control unit and enables autonomous adjustment of the operation. Due to the AI ​​component in the processing unit, the at least one surgical instrument can be trained via "machine training" to specifically recognize different anatomical structures. P9591 PC00

[0034] 8. Differentiate between tumors and healthy tissue. Blood vessels, or the proximity to them, are also detected in order to avoid injuring them and thus preventing bleeding.

[0035] The surgical system according to the invention is particularly preferred in which the at least one surgical instrument is designed to transmit information to the at least one control unit as soon as the at least one surgical instrument has detected an organ, an organ structure, a tumor and / or a blood vessel.

[0036] Furthermore, the surgical system according to the invention is preferred in which the at least one structure recognition unit is designed to obtain data before the operation and to use this data to recognize an organ, an organ structure, a tumor and / or a blood vessel and to distinguish these structures from one another, and in which the at least one structure recognition unit is further designed to use this data to additionally differentiate whether a blood vessel is a vein or an artery.

[0037] Particularly preferred is the operating system according to the invention in which the at least one control unit is designed to control the structure recognition unit during the operation and the at least one structure recognition unit is designed to simultaneously detect by means of optical signals whether it recognizes an organ, an organ structure, a tumor, and / or a blood vessel, in particular a vein or an artery.

[0038] The operating system according to the invention is particularly preferred in which the at least one control unit is designed to transmit information to the at least one control unit as soon as the at least one structure recognition unit has recognized an organ, an organ structure, a tumor and / or a blood vessel, in particular a vein or an artery.

[0039] Furthermore, the operating system according to the invention is preferred in which the at least one control unit is designed to, as soon as it receives the P9591 PC00

[0040] 9

[0041] The robot receives information from at least one surgical instrument and / or at least one structure recognition unit indicating that a blood vessel has been detected. This information is used to modify the robot instruction data in such a way as to stop the control of the at least one robot arm to which the at least one surgical instrument is attached. An advantage of this embodiment is that, thanks to this stop function, the autonomous surgical system does not expose the patient to any risk during the operation. The operation is stopped immediately if, for example, the surgical instrument would strike an organ or blood vessel if the operation were to continue. Thus, the operation can proceed completely autonomously, while avoiding any risk of injury.Furthermore, the operating system according to the invention is preferred in which the at least one operating instrument and / or the at least one structure recognition unit are designed to continuously transmit information to the at least one control unit during the operation.

[0042] Furthermore, the operating system according to the invention is preferred in which the at least one control unit is designed to continuously modify the robot instruction data based on the received data. An advantage of this embodiment is that the at least one control unit is designed to control the at least one robot arm in real time based on the robot instruction data.

[0043] The surgical system according to the invention is particularly preferred in which the at least one structure recognition unit is selected from a video camera, a hyperspectral camera, and / or an ultrasound probe, the ultrasound probe optionally comprising a continuous-wave Doppler. The selection of the at least one structure recognition unit depends on the requirements of the procedure. In a preferred embodiment, a video camera, such as those currently used for laparoscopic surgery, serves for the intraoperative visualization of the surgical field. The video camera sends information in the form of a video signal to the at least one control unit, thus providing a real-time visualization of the surgical field. The surface of the surgical field and anatomical structures such as organs, organ structures, tumors, and blood vessels are visualized.

[0044] The video camera captures 10 images. Furthermore, it is capable of displaying a three-dimensional surface and conveying the distance of at least one surgical instrument, particularly a minimally invasive surgical instrument, to the area of ​​the patient's body being operated on. The video camera, which provides real-time video visualization in the operating area, such as the abdominal cavity, is equipped with a hyperspectral imaging sensor. This allows tumors, organs, and organ structures to be detected and identified via autofluorescence. The ultrasound probe is used for intraoperative real-time recognition of the morphology of structures that cannot be captured by the video signal of a video camera. The ultrasound probe is capable of detecting structures within organs, far from the surface. A continuous-wave Doppler sensor can also be integrated into the ultrasound probe.Continuous-wave Doppler ultrasound can be used to measure blood flow in blood vessels. Depending on the flow velocity, arteries and veins, as well as large and small blood vessels, can be distinguished. Regardless of the type of structure recognition unit selected for the operation, the unit always includes a computer-assisted (CA) component. This component continuously trains the recognition of anatomical structures, enabling the detection and identification of the respective structures using at least one structure recognition unit.

[0045] The present invention is explained in more detail with reference to the accompanying drawing. It shows:

[0046] Fig. 1 is a flowchart for a schematic representation of an embodiment of the operating system according to the invention.

[0047] The following description of the figures explains the operating system according to the invention in more detail, without limiting the scope of the invention.

[0048] Figure 1 shows an embodiment of the operating system according to the invention in the form of a flowchart. Three control units 1 are shown, which are designed to control at least one robot arm of an operating system to perform an operation. (P9591 PC00)

[0049] In the present embodiment, each control unit 1 is connected to a structure recognition unit 2 and to at least one surgical instrument 3. The connection between a control unit 1 and the respective structure recognition unit 2, as well as to the at least one surgical instrument 3, is established via a wired connection or wirelessly via WLAN, Bluetooth, or mobile communication technologies.

[0050] In the illustrated embodiment, the structure recognition units 2 comprise a video camera 2a, a hyperspectral camera 2b, and an ultrasound probe with CW Doppler 2c. These structure recognition units 2 are image processing units incorporating AI components. The AI ​​components are used to train the structure recognition units 2 to recognize and classify anatomical structures 4 from image data using machine learning algorithms. Depending on which structure recognition unit 2 is used, different anatomical structures 4 can be recognized.

[0051] Using video camera 2a as structure recognition unit 2, organs, organ structures, tumors, and blood vessels can be distinguished from image data via video signals using the learned data and AI component. Using hyperspectral camera 2b as structure recognition unit 2, organs, organ structures, tumors, and blood vessels can also be distinguished based on the learned data and AI component. If structure recognition unit 2 is an ultrasound probe with continuous-wave Doppler, the learned data and AI component can distinguish whether an anatomical structure 4 is an organ, an organ structure, a tumor, or a blood vessel. The continuous-wave Doppler also allows for differentiation between large and small blood vessels, and between veins and arteries.

[0052] The structure recognition units 2 are designed, after detecting and identifying an anatomical structure 4, to transmit information about the type of anatomical structure 4 detected in the form of data to the associated control unit 1. P9591 PC00

[0053] 12

[0054] In the illustrated embodiment, the surgical instrument 3 is specifically designed for minimally invasive surgery. Figure 1 shows that the surgical instrument 3 incorporates an acoustic emission sensing technique or vibro-acoustic sensing technique, enabling it to recognize anatomical structures 4 using acoustic signals. Furthermore, the surgical instrument 3 also includes a processing unit with an AI component. Using the AI ​​component, the processing unit employs machine learning algorithms to recognize and analyze the type of anatomical structure 4 identified by the acoustic signals. Thus, the surgical instrument is capable of recognizing whether an organ, an organ structure, a tumor, or a blood vessel has been detected.

[0055] The surgical instrument 3 is designed, after detecting and identifying the anatomical structure 4, to transmit the relevant information about the type of anatomical structure 4 in the form of data to the control units 1.

[0056] Each control unit 1 of the operating system according to the invention, as shown in Figure 1, has a processing unit designed to receive and store information from at least one structure recognition unit 2 and / or the operating instrument 3. Furthermore, the control units 1 are designed to receive operation data prior to the operation, containing information about the planned operation, for example, in the form of an operation plan. The processing unit is designed to store the operation data and convert it into robot instruction data using specialized algorithms. The control units 1 are designed to control at least one robot arm using the robot instruction data.Surgical instruments 3 and / or structure recognition units 3 are attached to the at least one robot arm, which can be controlled by means of the surgical system according to the invention in such a way that the operation can be carried out autonomously according to the previously defined surgical plan. P9591 PC00.

[0057] 13

[0058] Furthermore, the processing unit of control unit 1 is designed to continuously convert the data received from structure recognition units 2 and / or operating instrument 3 into robot instruction data and compare it with the existing operational data. The processing unit comprises an AI component with a deep learning module based on neural networks. First, the received information is processed by the AI ​​component in the form of raw data through filtering and normalization processes for further processing in the processing unit. Subsequently, the integrated deep learning module analyzes the processed data, recognizes patterns and deviations from the operational data, and in a further step generates control commands in the form of robot instruction data. The control units 1 have a memory in which the generated robot instruction data is stored and continuously updated.

[0059] Thus, the control units 1 also communicate with the structure recognition units 2, the operating instrument 3, and the control units 1 themselves. The control units 1 are designed to continuously transmit, analyze, store, and adapt continuously changing robot instruction data to each other.

[0060] This allows for flexible, real-time, and autonomous adjustment of the control of the respective robot arms via the control units 1.

[0061] The operating system according to the invention is summarized below in other words.

[0062] The goal is to develop surgical systems capable of autonomously performing minimally invasive procedures. However, intraoperative real-time control requires an "eye" that, analogous to a surgeon's eye, recognizes structures based on incoming information. Once the structures are recognized, a decision can be made as to whether the operation can continue or whether critical structures impede progress, requiring evasive maneuvers or alternative strategies. In addition to this so-called "eye," a surgeon also makes decisions within the framework of a P9591 PC00

[0063] 14

[0064] Tumor surgery can also be performed using haptic feedback from the surgeon's hand regarding the extent and progress of the operation. This can be technically simulated using minimally invasive surgical instruments via the so-called Acoustic Emission Sensing Technique or vibro-acoustic sensing technique. After appropriate training, anatomical structures and tumors can be identified via acoustic signals from the surgical instruments used to perform the operation. This technical "hand" provides hand-eye feedback and allows for adjustments to the operation, just as in the human system.Against this background, an autonomous navigation system for minimally invasive real-time navigation is realized through a combination of video signals and hyperspectral imaging from a camera, in conjunction with an intraoperative ultrasound device serving as the "eye," and the AEST (Automated Electronic Stability Program) on surgical instruments, which are connected via artificial intelligence using machine learning. This system then controls the surgical instruments in the operating room, for example, in the patient's abdominal cavity, depending on the detected signals and the organs and organ structures identified by them. The following components are used for this purpose and are networked together:

[0065] Video camera, hyperspectral camera, intraoperative ultrasound, acoustic emission sensing or vibro-acoustic sensing technique, artificial intelligence

[0066] The artificial intelligence is trained to:

[0067] 1. To distinguish organs, organ structures, tumors and blood vessels via video signals,

[0068] 2. to differentiate organs, organ structures, tumors and blood vessels using hyperspectral imaging,

[0069] 3. To differentiate organs, organ structures, tumors and blood vessels using ultrasound,

[0070] 4. To differentiate veins and arteries, as well as large and small blood vessels, using CW Doppler, P9591 PC00

[0071] 15

[0072] 5. to differentiate between AEST organs, organ structures, tumors and blood vessels.

[0073] P9591 PC00

[0074] 16

[0075] Reference symbol list

[0076] 1 control unit

[0077] 2 Structure recognition unit

[0078] 2a Video camera

[0079] 2b Hyperspectral Camera

[0080] 2c ultrasound probe with cw Doppler

[0081] 3 surgical instruments

[0082] 4 Anatomical structure

Claims

P9591 PC00 17 Patent claims 1. Operational system for controlling at least one robot arm, comprising at least one robot arm on which at least one surgical instrument (3) is arranged, at least one robot arm on which at least one structure recognition unit (2) is arranged, and at least one control unit (1) connected to the at least one robot arm on which at least one surgical instrument (3) is arranged and to the at least one robot arm on which at least one structure recognition unit (2) is arranged, wherein the at least one control unit (1) is designed to receive and store operational data prior to an operation and to generate robot instruction data from this operational data for controlling at least one robot arm, wherein the at least one control unit (1) is further designed toduring the operation, information is obtained from the at least one surgical instrument (3) and the at least one structure recognition unit (2), and in response to this information, robot instruction data is automatically selected from a variety of predefined robot instruction data, and the control of at least one robot arm is adapted based on the modified robot instruction data.

2. Surgical system according to claim 1, characterized in that the at least one surgical instrument (3) is designed to obtain data before the operation and to use this data to identify an organ, an organ structure, a tumor and / or a blood vessel and to distinguish these structures from one another.

3. Operational system according to claim 2, characterized in that the at least one control unit (1) is designed to control at least one surgical instrument (3) during the operation and the at least one surgical instrument (3) is designed to P9591 PC00 18 simultaneously detecting, using acoustic signals, whether it recognizes an organ, an organ structure, a tumor and / or a blood vessel.

4. Surgical system according to claim 3, characterized in that the at least one surgical instrument (3) is designed to transmit information to the at least one control unit (1) as soon as the at least one surgical instrument (3) has detected an organ, an organ structure, a tumor and / or a blood vessel.

5. Surgical system according to claim 1, characterized in that the at least one structure recognition unit (2) is designed to receive data before the operation and to use this data to recognize an organ, an organ structure, a tumor and / or a blood vessel and to distinguish these structures from one another, and wherein the at least one structure recognition unit (2) is further designed to use this data to additionally differentiate whether a blood vessel is a vein or an artery.

6. Operational system according to claim 5, characterized in that the at least one control unit (1 ) is designed to control the at least one structure recognition unit (2) during the operation and the at least one structure recognition unit (2) is designed to simultaneously detect by means of optical signals whether it recognizes an organ, an organ structure, a tumor, and / or a blood vessel, in particular a vein or an artery.

7. Operational system according to claim 6, characterized in that the at least one structure recognition unit (2) is designed to transmit information to the at least one control unit (1) as soon as the at least one structure recognition unit (2) has recognized an organ, an organ structure, a tumor and / or a blood vessel, in particular a vein or an artery.

8. Operational system according to claim 4 or 7, characterized in that the at least one control unit (1) is designed to, as soon as it receives the information from the at least one operational instrument (3) P9591 PC00 19 and / or the at least one structure recognition unit (2) receives that a blood vessel has been detected, to modify the robot instruction data in such a way as to stop the control of the at least one robot arm to which the at least one surgical instrument (3) is attached.

9. Operational system according to at least one of the preceding claims, characterized in that the at least one operational instrument (3) and / or the at least one structure recognition unit (2) are designed to continuously transmit information to the at least one control unit (1) during the operation.

10. Operational system according to claim 9, characterized in that the at least one control unit (1 ) is designed to continuously modify the robot instruction data based on the data received. 1 1 . Operational system, according to at least one of the preceding claims, characterized in that the at least one structure recognition unit (2) is selected from a video camera (2a), a hyperspectral camera (2b) and / or an ultrasound probe, wherein the ultrasound probe optionally comprises a cw Doppler (2c).

12. Method for controlling at least one robot arm by means of at least one operating system according to at least one of claims 1 to 1 1 .

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