Robotically controlled endoscopic apparatus and device
Patent Information
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Filing Date
- 2026-02-05
- Publication Date
- 2026-08-13
Smart Images
Figure IB2026051083_13082026_PF_FP_ABST
Abstract
Description
[0001] ROBOTICALLY CONTROLLED ENDOSCOPIC APPARATUS AND DEVICE FIELD OF THE INVENTION
[0002] This disclosure relates to a robotic endoscopic device for endoscopic submucosal dissection, also known by the acronym ESD. In particular, the robotic endoscopic device can be used to remove gastrointestinal lesions, such as growths, polyps, or tumours, of the gastrointestinal tract, for example during a colonoscopy or gastroscopy. The present disclosure involves the robotic control apparatus comprising said robotic endoscopic device.
[0003] BACKGROUND OF THE INVENTION
[0004] Colorectal carcinoma (CRC) is the most frequent malignant cancer originating in the colon, rectum or appendix, and ranks third in overall incidence and second in mortality rate. Given the extended timelines associated with its progression, early-stage screening has the potential to significantly reduce mortality and incidence, while increasing the 5-year survival rate from 64% to 90%.
[0005] The most widely used screening procedure is a colonoscopy, during which an apparatus comprising an endoscopic device, or colonoscope, is used, which is inserted through the anus and passively moved within the tortuous lumen of the patient’s colon to reach the cecum.
[0006] Known colonoscopes are equipped with rigid mechatronic operating components, such as forceps and small scalpels, which are electrically active and used in direct contact with the gastrointestinal tissue for operations to remove growths, polyps or tumours.
[0007] Known colonoscopes, however, have the drawback that their insertion, handling and / or removal may cause discomfort to the patient and prove invasive in relation to the normal pushing force and corresponding tangential friction against the colon wall.
[0008] The technical problem that this disclosure seeks to solve is that of realising a robotic endoscopic device that is less invasive for the patient, while also improving efficiency and safety during the aforementioned removal operations.
[0009] In particular, an aim of this disclosure is to create a robotic endoscopic device that is highly reliable and has high manoeuvrability, thus ensuring precise control and safe interaction with the patient's tissue.
[0010] Another aim of the present disclosure is to realise a robotic endoscopic device that allows for interchangeable operating components and can possibly also be installed on a known type of colonoscope, or on a known system equipped with anendoscopic camera.
[0011] A further aim of the present disclosure is to realise a robotic endoscopic device and a related robotic control apparatus that allows timely action in the event of complications.
[0012] SUMMARY
[0013] In order to solve the aforementioned technical problem and in accordance with the aforementioned purposes, achieving further advantages, a robotic control apparatus (110) including a robotic endoscopic device (100) is provided for the diagnosis and treatment of gastrointestinal lesions such as growths, polyps or tumours. For example, the device can be used during colonoscopy, gastroscopy. Moreover, the device may have potential applications in areas other than those specifically described, for instance in so-called “NOTES - Natural Orifice Translumenal Endoscopic Surgery’ procedures.
[0014] The control apparatus comprises the robotic endoscopic device, a display device and one or more manipulation interfaces operatively connected to a control unit of the robotic endoscopic device. Preferably, each manipulation interface can be operated manually.
[0015] The robotic endoscopic device comprises:
[0016] - a distal unit suitable for insertion within a patient’s body, particularly the gastrointestinal tract, and associated with a vision system of the device itself, - a proximal unit comprising one or more actuation units, each adapted to remain outside the patient’s body and operatively connected to a respective flexible arm of said distal unit,
[0017] - a control unit configured to receive, process, and transmit command inputs to each actuation unit for operation of the respective flexible arm.
[0018] Said vision system may consist of a camera, or video camera, a flexible endoscopic probe, or a conventional colonoscope.
[0019] In addition, preferably, the robotic endoscopic device can be operatively connected to:
[0020] - a manipulation unit, or interface, adapted to receive command inputs via a controller, equipped with a manipulator, or handle, ergonomically shaped like a so-called “endeffector” to facilitate perception and manipulation;
[0021] - a display device, which can be operatively connected to said vision system.
[0022] The manipulation units are connected to a pneumatic system. There may be a single pneumatic system or a dedicated one for each manipulation unit. In addition,the control unit is configured to also receive, process and transmit command inputs to the pneumatic system connected to said manipulation units.
[0023] In accordance with an aspect of this disclosure, each actuation unit is configured to independently actuate the respective flexible arm with at least three degrees of freedom.
[0024] In addition, each flexible arm is provided at one end with an interchangeable surgical instrument configured to perform removal of said gastrointestinal lesions, and wherein each proximal unit is configured to independently actuate, with the necessary degrees of freedom, i.e. at least three degrees of freedom, the respective flexible arm.
[0025] Specifically, each flexible arm is configured to translate axially forward or backward, to flex axially, taking on a curvature, and to rotate axially, wherein axial translation determines the first degree of freedom, axial bending determines the second degree of freedom, and axial rotation determines the third degree of freedom. In addition, the actuation of the surgical instrument may constitute one or more additional degrees of freedom, managed by the manipulation unit, or interface, and the control unit. For example, the operation of said surgical instrument can result in a fourth degree of freedom.
[0026] Preferably, each flexible arm has a sleeve-like body made of a flexible and / or elastically deformable material, having an at least partially circular cross-section. In addition, each flexible arm is provided externally with a mesh having polygonal, or interwoven, geometric patterns, e.g. rhomboidal or triangular, surrounding it and configured to limit and direct the trajectory of the axial bending motion of the arm. In other words, through the conformation of said mesh it is possible to constrain the axial bending of the corresponding flexible arm. In addition, preferably, the, or each, flexible arm may have an initial curvature, so-called pre-bending, with respect to the longitudinal axis obtained, for example, by pre-tensioning said mesh or by the use of a core made of a shape memory material.
[0027] The term “interwoven geometric patterns” refers to patterns comprising shapes that are not clearly defined geometrically, e.g. defined by curved intersecting strokes, e.g. rhombuses with curved sides or similar.
[0028] This has the advantage of having a robotic endoscopic device that is of reduced invasiveness for the patient, particularly during its handling inside the colon, and whose distal units that mount surgical instruments can be safely controlled with reduced trauma during the removal of said lesions.
[0029] The body of said flexible arm is internally provided with a longitudinal channeladapted to house the respective surgical instrument, and with a longitudinal chamber made eccentrically with respect to the section of the body itself. Advantageously, said chamber is adapted to receive compressed air from the respective actuation unit, by means of said pneumatic system, and is configured to expand and deform elastically to bring about the axial bending of the respective flexible arm, wherein said axial bending is constrained at least by the conformation of said mesh.
[0030] Pneumatic actuation linked to the use of compressed air has the advantage of allowing an inherently wide movement of the arms and a low response time.
[0031] Preferably, said distal unit may comprise a support structure having a central cylinder which is associated with said front end equipped with one or more video cameras, and two hollow lateral tubular elements configured to accommodate a respective flexible arm. It should be noted that axial bending of said arms is permitted when they are at least partially extracted, or protruding, from said tubular elements.
[0032] This configuration is very advantageous in that the flexible arms are able to translate to the sides of said front end with low friction, keeping themselves constrained to the endoscopic probe.
[0033] In addition, each flexible arm can be provided, on the opposite side to the interchangeable surgical instrument, with a connection hose which is suitable for connection to a pneumatic system associated with the respective actuation unit. In addition, the presence of the connection hose allows the interchangeable surgical instrument associated with the corresponding arm to be replaced.
[0034] Each actuation unit allows for all the degrees of freedom required for the surgical instrument of the distal unit.
[0035] In a possible embodiment, the proximal unit can comprise a different number of actuation units, while still allowing control over the required number of degrees of freedom and simultaneously reducing the footprint.
[0036] Preferably, each proximal unit may comprise:
[0037] - a linear slide operable by a first actuator to translate axially forward, or backward, - a second actuator mounted on said linear slide, connected to a first flexible tube and configured to rotate the latter axially,
[0038] - an activation unit that can also be mounted on said linear slide and connected to a second flexible tube.
[0039] Preferably, the first actuator and the second actuator are electric motors. Said first flexible tube is adapted to translate axially with said linear slide and is connected to the corresponding connection hose to allow axial translation androtation of the respective flexible arm.
[0040] Said second flexible tube is adapted to translate axially with said linear slide and is connected to the respective connection hose to be associated with the corresponding surgical instrument and said activation unit is adapted to determine the activation of said corresponding surgical instrument.
[0041] Preferably, each actuation unit also comprises a third flexible tube connected on one side to said pneumatic system and on the other side to the corresponding connection hose to be associated with the expandable inner chamber of the respective arm, allowing compressed air from said pneumatic system to be fed into it.
[0042] In accordance with preferred embodiments, said pneumatic system may comprise at least one compressor, one pressure regulator and one or more proportional pneumatic valves connected to the respective third hose, to regulate and control the amount of compressed air transmitted into said chamber and, therewith, an axial deflection angle of the respective arm.
[0043] In addition, preferably, each proximal unit may comprise two or more detection and control elements operatively connected to said first and second motor and configured to control the operation of the latter, in relation to the detection of the translation and rotation movements determined by them. Said detection and control elements, said motors, said actuation unit and said pneumatic system can be operatively connected to said control unit, which is programmed to control and coordinate their operations.
[0044] The control unit is operatively connected to the display device, which is connected to said vision system to display the images acquired therefrom.
[0045] In addition, each manipulation interface is configured to control the operation of a respective actuation unit and the pneumatic system of said device. Each manipulation interface is configured to provide control inputs via corresponding operable means, or activation means, to said proximal unit and said pneumatic system, to operate a respective flexible arm.
[0046] Each manipulation interface of the apparatus comprises a manipulatable structure defined by operable means and having a sufficient number of degrees of freedom to support the control of all the degrees of freedom belonging to said distal unit. The operable means, or activation means, can be push buttons, foot pedals, conventional manipulators and / or ergonomic solutions.
[0047] In other words, the operable means are configured to independently transmit a corresponding command input to said control unit to control a respective componentof the proximal unit and said pneumatic system.
[0048] The operating mode of certain degrees of freedom of the distal unit is appropriately and advantageously adapted to ensure ease of use by the operator.
[0049] BRIEF DESCRIPTION OF THE DRAWINGS
[0050] Further advantages, characteristics and methods of use of the subject matter of the present disclosure will be apparent from the following detailed description of its embodiments, presented for illustrative and non-limiting purposes, with references to the accompanying drawings, wherein:
[0051] - Fig. 1 is an operational schematic representation of a robotic control apparatus comprising a robotic endoscopic device according to the present disclosure, in which an enlargement of a distal unit of the device is visible;
[0052] - Fig. 2 is a perspective, schematic and exemplifying view of the robotic endoscopic device in Fig. 1;
[0053] - Fig. 3 is a detailed perspective view of the distal unit of the device in Fig. 2; - Fig. 4 is a detailed perspective view of one of the two flexible arms of the device in Fig. 3;
[0054] - Fig. 5 is a sectional view of the arm in Fig. 4;
[0055] - Fig. 6 is an operating sequence illustrating the movement of the arms of the distal unit according to three degrees of freedom;
[0056] - Fig. 7 is an axonometric view of a manipulation interface according to a possible embodiment.
[0057] It is however clear that each embodiment of the subject matter of the present disclosure can present one or more of the advantages listed above; however, each embodiment is not required to simultaneously present all the listed advantages.
[0058] DETAILED DESCRIPTION OF EMBODIMENTS
[0059] With reference to the accompanying figures, a robotic endoscopic device 100 according to the present disclosure, hereinafter device 100, is arranged and usable for endoscopic submucosal dissection, also known by the acronym ESD.
[0060] Preferably, the device 100 is configured to be partially inserted within the gastrointestinal tract of a patient to remove any intestinal or gastrointestinal lesions, such as growths, polyps, or tumours. For example, to inspect the colon, the device 100 can be partially inserted through the anus and guided up to the cecum. The expression “to be partially inserted” means that at least part of the device 100 is configured to be inserted within the patient’s gastrointestinal tract.The device 100 (Fig. 1) is part of a robotic endoscopic apparatus 110, hereafter apparatus 110, which is configured to control its operation.
[0061] In other words, the robotic control apparatus 110 comprises the device 100 and is configured to control its operation to perform the aforementioned removal of said intestinal lesions.
[0062] The device 100 comprises at least one control unit 10 configured to receive, process and transmit command inputs. In addition, the device 100 may comprise a pneumatic system 20 operatively connected to the control unit 10.
[0063] The device 100 further comprises a distal unit 40 adapted to be inserted within the gastrointestinal tract of the patient and associated with a front end 104 of a vision system 103. The vision system 103 may consist of a camera, or video camera, a flexible endoscopic probe, or a conventional colonoscope.
[0064] In other words, the flexible vision system 103 comprises a front end 104 having one or more video cameras 105 configured to acquire images, for example of lesions in the internal tissue of the gastrointestinal tract.
[0065] The device 100 also comprises a proximal unit 30 comprising one or more actuation units 31, 32, each adapted to remain outside the body of the patient and operatively connected to a respective flexible arm 41, 42 of said distal unit 40.
[0066] Each actuation unit 31, 32 is connected to the control unit 10 to actuate the respective flexible arm 41, 42.
[0067] The connections between the manipulation interface 102, the control unit 10 and the proximal unit 30 can be physical, e.g. by means of connecting cables. Or, preferably, the connections between the manipulation interface 102, the control unit 10 and the proximal unit 30 may be wireless, for example via radio channels or Wi-Fi. Alternatively, the connection between the manipulation interface 102 and the control unit 10 may be wireless, while the connection between the control unit 10 and the proximal unit 30 may be physical.
[0068] It should be noted that the terms “distal” and “proximal” are used with reference to the position of the manipulation interface 102, i.e. the position of the physician, or operator.
[0069] The apparatus 110 may comprise a display device 101 and a manipulation interface 102 operatively connected to the control unit 10.
[0070] The display device 101 is operatively connected to the vision system 103 of the robotic endoscopic device 100, to receive the images acquired by the latter and make them usable for the physician, or operator.The manipulation interface 102 is operatively connected to the control unit 10 and operable to control the pneumatic system 20 and the proximal unit 30, or each of the manipulation units 31, 32. The manipulation interface 102 is adapted for manual operation by an experienced physician, or operator, as will be described in detail below.
[0071] In other words, the vision system 101 and the manipulation interface 102 connected to the control unit 10 define an interface system for the physician, or operator, to view any lesions and to control surgical procedures on the device 100.
[0072] Each actuation unit 31, 32 is configured to independently actuate the respective flexible arm 41, 42 with at least three degrees of freedom. The term “flexible” means that the arms 41, 42 and the endoscopic probe 103 can flex, bend, or elastically deform without breaking and without causing severe friction with the inner walls of the colon, thus defining a “soft” structure.
[0073] In other words, each actuation unit 31, 32 is configured to independently actuate a respective flexible arm 41 , 42 in the degrees of freedom required for the surgical task, or manipulator (see Fig. 6).
[0074] Each arm is configured to allow the removal of any lesions in the gastrointestinal tract.
[0075] Preferably, each arm 41, 42 may be configured to translate axially forward or backward, to flex axially, to bend axially, to rotate axially, and may have an initial curvature, or pre-bending, with respect to the longitudinal axis to meet medical needs. Axial translation determines the first degree of freedom G1, axial bending determines the second degree of freedom G2, and axial rotation determines the third degree of freedom G3. A fourth degree of freedom G4 can be represented by the operation of the surgical instrument.
[0076] In addition, each actuation unit 31, 32 (Fig. 1) is also connected to the control unit 10 and the pneumatic system 20 for the correct actuation of the respective arm 41, 42.
[0077] This has the advantage that the robotic endoscopic device 100 is less invasive for the patient, particularly during its handling within the gastrointestinal tract.
[0078] Each arm 41, 42 (Figures 3 to 6) is equipped at one end with a surgical instrument 43, 44 configured to perform the removal of said lesions.
[0079] In a possible embodiment, a first arm 41 may be provided with a first surgical instrument 43, e.g., a forceps, and the second arm 42 is provided with a second surgical instrument 44, e.g., a needle scalpel, each operable via a manipulationinterface 102 by the operator.
[0080] The axial translation, axial bending and axial rotation of the arms 41, 42 allow the position of the respective surgical instruments 43, 44 to be adjusted, in particular to make them translate forward or backward, to expand their range of action and to make them reach the correct operating point in order to operate with maximum precision, avoiding invasive torsion and other operations that are uncomfortable for the patient.
[0081] Preferably, the distal unit 40 comprises a support structure 48 configured to support the front end 104 of the endoscopic probe 103 and the arms 41, 42. Preferably, the support structure 48 may comprise a central cylinder 45 with which the front end 104 of the endoscopic probe 103 is associated, and two hollow lateral tubular elements 46,47 associated on opposite sides with the central cylinder 45 and configured to slidably house a respective arm 41 , 42.
[0082] This configuration is very advantageous in that the arms 41 , 42 are able to translate to the sides of the front end 104 with low friction, keeping themselves constrained to the endoscopic probe 103.
[0083] According to embodiments, the position of the tubular elements 46, 47 is adjustable with respect to the central cylinder 45.
[0084] Preferably, each arm 41, 42 (Figures 4 and 5) has a sleeve-like body 49 with an at least partly circular cross-section 52 and is provided externally with a mesh 50 with polygonal, or interlaced, e.g. rhomboidal, geometric patterns, which partially surrounds it. The body 49 is made of a flexible and / or elastically deformable material. For example, the body can be made of silicone and can be provided with grooves in which to place the mesh 50 defined by polyethylene PE threads.
[0085] The mesh 50 is configured to limit and direct the trajectory of the bending movement of each arm 41, 42. In addition, the geometry of the body 49 itself advantageously optimises the bending capacity of the arm 41, 42, also increasing axial asymmetry.
[0086] Within the body 49 of each arm 41, 42 a longitudinal channel 51 is adapted to house the respective surgical instrument 43, 44 without interruption. In addition, a longitudinal chamber 53 is eccentrically constructed inside the body 49. In other words, each body 41, 42 is internally provided with a longitudinal channel 51 and an eccentric longitudinal chamber 53. For example, the longitudinal chamber 53 may have a semi-circular shape. It should be noted that the term “longitudinal” means that the channel 51 and chamber 53 are made along the main extension direction of thebody 49.
[0087] In addition, each arm 41 , 42 is provided, on the opposite side to the respective surgical instrument 43, 44, with a hollow connection hose 63, 64 to connect the arms 41, 42 with the respective actuation units 31, 32.
[0088] The channel 51 and chamber 53 of each arm 41, 42 are in communication with the hollow connection hose 63, 64.
[0089] The chamber 53, through the corresponding connection hose 63, 64, is adapted to receive compressed air from the pneumatic system 20, and is configured to expand and deform elastically, to determine the axial deflection of the respective arm 41 , 42 when it is at least partially extracted, or protruded, from the corresponding tubular element 46, 47, wherein such axial deflection is constrained at least by the conformation of the mesh 50 and the shape of the body 49 itself.
[0090] In other words, each arm 41, 42, when at least partially extracted, or protruding, from the corresponding tubular element 46, 47, is configured to flex axially, taking on a curvature, in relation to the expansion and consequent deformation of the chamber 53 under the action of the compressed air from the pneumatic system 20.
[0091] Thus, since the control of the deflection angle of the arms 41, 42 requires highly precise actuation, a pneumatic system 20 is used, which advantageously allows inherently wide movement and a low response time. Furthermore, each arm 41 , 42 may have a predetermined initial curvature, or pre-bending, without the action of the compressed air from the pneumatic system 20 connected, for example, to the pre-tensioning of the mesh or, to the insertion of a core made of a shape memory material.
[0092] Each actuation unit 31, 32 (Figures 2 and 3) may comprise a linear slide, or carriage, 33 operable by a first actuator 35 and adapted to axially translate between a forward and a backward position. Preferably, the linear slide 33 is connected to the first actuator 35 via worm screw 34 to move the linear slide 33 forward or backward in relation to its direction of rotation. In an embodiment, the first actuator 35 is an electric stepper motor.
[0093] Each actuation unit 31 , 32 can comprise a second actuator 36 mounted on the linear slide 33. The second actuator 36 is connected to a first hose 60 and configured to rotate the latter axially. Preferably, the second actuator 36 is an electric motor.
[0094] The first hose 60 is adapted to translate axially together with the linear slide 33, by means of the action of the first actuator 35, and to rotate axially by means of the action of the second actuator 36. The first flexible tube 60 of each actuation unit31 , 32 is connected to the respective connection hose 63, 64 and, by means of the action of the corresponding first 35 and second 36 actuator, determines the translation and axial rotation of the corresponding arm 41, 42.
[0095] Each actuation unit 31, 32 may also comprise an instrument activation unit 37 which may also be mounted on the linear slide 33 for actuation of the instrument mounted on the corresponding arm 41, 42. According to embodiments, the activation unit 37 can be mounted on a support part of the linear slide 33, above the second actuator 36.
[0096] In other embodiments, the activation unit 37 may be integrated into an operable means, or an actuation system of the instrument itself (e.g., foot pedal for an electric scalpel).
[0097] The activation unit 37 of the instrument is connected to a respective second flexible tube 61, which also translates axially together with the linear slide 33. The second flexible tube 61 is connected to the respective connection hose 63, 64 to be associated with the surgical instrument 43, 44 of the corresponding arm 41, 42. In particular, the activation unit 37 is adapted to determine the activation of the corresponding surgical instrument 43, 44.
[0098] Each actuation unit 31, 32 may also comprise a third flexible tube 62 connected on one side to the pneumatic system 20 and on the other side to the respective connection hose 63, 64. Specifically, one end of the third hose 63, 64 is associated with the chamber 53 of the respective arm 41, 42 in order to feed compressed air from the pneumatic system 20 into it and to determine the axial deflection of the respective arm 41, 42, when it is at least partially extracted, or protruding from the seat defined by the tubular element 46, 47.
[0099] Preferably, the pneumatic system 20 may comprise at least one air compressor 23, at least one pressure regulator 22 and one or more proportional pneumatic valves 21 connected to the respective third hose 62 to regulate and control the amount of compressed air transmitted to the corresponding chamber 53 and, with it, an axial deflection angle of the respective arm 41, 42.
[0100] Preferably, the maximum axial deflection angle of the arms 41, 42 depending on the surgery to be performed, varies within the optimal working range of the surgical instruments used. In terms of actuation, this angle depends not only on the amount of compressed air transmitted into the chamber 53 by the pneumatic system 20, but also on the longitudinal translation of the arms 41 and 42 from the tubular element 46, 47 in which they are housed, which determines their variable flexibility.The first 60, second 61 and third 62 flexible tube of each actuation unit 31, 32 are connected to the corresponding connection hose 63, 64 of the first 41 and second 42 arm. In other words, the first 60, the second 61 and the third 62 tube are joined into a single tube, defined by the corresponding connection hose 63, 64. This has the advantage that each arm 41 , 42 of the distal unit 40 can be controlled independently of the actuation units 31 , 32.
[0101] Each actuation unit 31, 32 may comprise two or more detection and control elements, connected to the first 35 and second 36 actuator respectively, configured to control the operation of the latter in relation to the detection of translation and rotation movements determined by them. Preferably, the first 35 and second 36 actuators are electric motors, e.g. stepper motors.
[0102] Preferably, a first detection and control element is configured to detect and control the translatory range of motion of the linear slide 33 and a second detection and control element is configured to detect and control the rotation of the second actuator 36. The detection and control elements can be optical sensors.
[0103] In addition, the detection and control elements, actuators 35, 36 and activation unit 37 of the instrument are connected to the control unit 10, which is configured to control and coordinate their operations.
[0104] The manipulation interface 102 (Fig. 1) is configured to independently control the actuation of a respective proximal unit 31, 32 by providing command inputs to the control unit 10, by means of operable means, or activation means. This makes it possible to operate the corresponding first 35 and second 36 actuator and activation unit 37 independently, and thus to control the respective arms 41 , 42 of the distal unit 40 independently and with said necessary degrees of freedom.
[0105] In a possible embodiment, the manipulation interface 102 may comprise a manipulatable structure comprising operable means and having a sufficient number of degrees of freedom to support the control of all degrees of freedom belonging to the robotic endoscopic device 100, i.e. the distal unit 40, where the tissue manipulation takes place. For example, the manipulable structure may comprise three manipulation joints and a laparoscopic manipulator or handle for a total of four degrees of freedom for each arm 41 , 42 of the distal unit 40.
[0106] Preferably, it is desirable to use an interface that not only facilitates the manipulation of the distal unit 40 in its degrees of freedom, but which, in addition, has a shape and possible movements such as to suggest the movement generated by the movable components integrated into the distal unit 40, such as arms 41 and 42 andtogether with them, the actuation of the surgical instruments 43 and 44.
[0107] In other words, the ergonomics and feasible degrees of freedom of said structure optimise the user's experience of controlling the movable elements of the distal unit 40, i.e. the arms 41 and 42 and the appropriate surgical instruments 43, 44 selected for the operation. For certain degrees of freedom such as actuation of the surgical instruments 43 and 44 in the distal unit 40, commands should be provided in the corresponding manipulation interface 102 to facilitate operator reach and control of said display device 101.
[0108] For example, control over the degree of freedom responsible for the actuation of surgical instruments 43 and 44 can be appointed to operable means such as push buttons, foot pedals or ergonomic solutions integrated into the respective manipulation interface 102. These operable means can be configured to provide control inputs relating to the actuation of the activation unit 37 and more generally of the respective actuation units 31 , 32 to control the activation of the surgical instrument 43, 44 of the corresponding flexible arm 41, 42.
[0109] In order to implement the independent movement control of the arms 41, 42, the movements are expressed with three degrees of freedom of the manipulation interface 102 advantageously uncoupled from one another.
[0110] Furthermore, according to embodiments, the manipulation interface 102 consists of two symmetrically positioned conventional manipulation systems.
[0111] Preferably, the control unit 10 is programmed to process the command inputs of each manipulation interface 102, and then transmit actuation commands to the actuators 35, 36 and the activation unit 37 of the respective actuation unit 31 , 32 to control the corresponding arms 41, 42 of the distal unit 40.
[0112] Specifically, the control unit 10 is able to receive the information detected by the detection and control elements and consequently manage the operation of the actuators 35, 36 and the activation unit 37 of the instrument. In addition, the control unit 10 is also able to control the operation of the pneumatic system 20 and, in particular, the pneumatic valves 21. The control of the pressure regulator 22 and pneumatic valves 21 is particularly important as it determines the amount of compressed air transmitted to the chamber 53 of each arm 41 , 42 and consequently the axial deflection angle of the latter.
[0113] For example, the control unit 10 may comprise:
[0114] - a microcontroller to receive command inputs from the manipulation interface 102 via serial communication and its reverse transmission, and to manage the variouselements of the operating mode of the actuators 35, 36, the instrument’s activation unit 37 and the pneumatic valves 21, by means of detection information from the detection and control elements;
[0115] - voltage stabilisers to properly manage the power supply of the various components, or operating means;
[0116] - other operating means configured to manage the operation of the actuators 35, 36, the instrument activation unit 37 and the pneumatic system 20.
[0117] A possible embodiment of the manipulation interface 102 is represented by two devices configured to control the degrees of freedom at the respective actuation unit 31, 32.
[0118] In accordance with embodiments, illustrated by way of example in Fig.7, each manipulation interface comprises three manipulation joints and a handle or manipulator to control the instrument of each arm 41, 42. Specifically, a first manipulation joint is configured to rotate axially and to provide control inputs relating to the actuation of a first actuator 35 of the respective actuation unit 31 , 32, to control the axial translation of the corresponding flexible arm 41, 42 (G1); a second manipulation joint is configured to tilt and / or rotate and to provide control inputs relating to the actuation of the pneumatic system 20 connected to the respective actuation unit 31 , 32, to control the axial bending of the corresponding flexible arm 41, 42 (G2); a third manipulation joint is configured to rotate axially and to provide command inputs related to the actuation of a second actuator 36 of the respective actuation unit 31 , 32, to control the axial rotation of the corresponding flexible arm 41 , 42 (G3); and a handle or actuation manipulator is configured to provide command inputs related to the actuation of an instrument activation unit 37 of the respective actuation unit 31, 32 to control the activation of the surgical instrument 43, 44 of the corresponding flexible arm 41, 42 (G4).
[0119] The fourth degree of freedom (G4) can also be controlled by another operable means, such as a push button or foot pedal, and / or operatively connected to the instrument (e.g. a foot pedal for activating an electric scalpel).
[0120] The object of the present disclosure has so far been described with reference to particular embodiments thereof. It is to be understood that there may be other embodiments which relate to the same inventive nucleus, all falling within the scope of protection of the claims provided below.
[0121] INDEXcontrol unit
[0122] pneumatic system pneumatic valve pressure regulator
[0123] air compressor proximal unit
[0124] first actuation unit second actuation unit linear slide
[0125] worm screw
[0126] first motor
[0127] second motor
[0128] instrument actuation unit distal unit
[0129] first flexible arm
[0130] second flexible arm
[0131] first surgical instrument second surgical instrument central cylinder
[0132] first tubular element second tubular element support structure
[0133] flexible arm body rhomboidal mesh channel
[0134] chamber
[0135] first flexible tube1 second flexible tube
[0136] 2 third flexible tube
[0137] 3 first connection hose
[0138] 4 second connection hose 100 robotic endoscopic device 101 display device
[0139] 102 manipulation interface 103 vision system
[0140] 104 front ends
[0141] 105 video cameras
[0142] 110 robotic control apparatus G1 first degree of freedom G2 second degree of freedom G3 third degree of freedom G4 fourth degree of freedom
Claims
CLAIMS1. A robotic control apparatus (110) comprising a robotic endoscopic device (100) for the diagnosis and treatment of gastrointestinal lesions comprising:- a distal unit (40) suitable for insertion within the gastrointestinal tract of a patient and associated with a front end (104) of a vision system (103) of the flexible type of said device (100), said distal unit (40) comprising a plurality of flexible arms (41, 42); - a proximal unit (30) comprising one or more actuation units (31, 32), each adapted to remain outside the patient’s body and operatively connected to a respective flexible arm (41, 42) of said distal unit (40);- a control unit (10) configured to receive, process, and transmit command inputs to each actuation unit (31, 32) for operation of the respective flexible arm (41, 42), wherein each arm (41 , 42) is provided at one end with an interchangeable surgical instrument (43, 44) configured to perform removal of said lesions, and wherein each actuation unit (31, 32) is configured to independently actuate, with at least three degrees of freedom, the respective flexible arm (41, 42), the apparatus further comprising:a display device (101) and at least one manipulation interface (102) operatively connected to said control unit (10), wherein said control unit (10) is operatively connected to a pneumatic system (20) and to said proximal unit (30) of said robotic endoscopic device (100), wherein said display device (101) is connected to said vision system (103) of said robotic endoscopic device (100) for displaying images acquired therefrom, and wherein said manipulation interface (102) is configured to independently control the actuation of a respective actuation unit (31, 32) and said pneumatic system (20) of said robotic endoscopic device (100) by providing command inputs to said control unit (10), which is adapted to transmit said inputs to said pneumatic system (20) and said respective actuation unit (31, 32), to actuate a respective flexible arm (41, 42) of said distal unit (40).
2. Apparatus according to claim 1, wherein each flexible arm (41, 42) is configured to translate axially forward or backward, to flex axially, taking on a curvature, and to rotate axially, wherein axial translation determines the first degree of freedom (G1), axial bending determines the second degree of freedom (G2), and axial rotation determines the third degree of freedom (G3), and wherein the operation of said surgical instrument (43, 44) determines a fourth degree of freedom (G4).
3. Apparatus according to claim 1 or 2, wherein each arm (41, 42) has a sleeve-like body (49) made of a flexible and / or elastically deformable material, havingan at least partially circular cross-section, and is provided externally with a mesh (50) having polygonal, or interwoven, geometric patterns surrounding it and configured to limit and direct the trajectory of the axial bending motion of the arm (41 , 42).
4. Apparatus according to claim 1, 2 or 3, wherein each arm (41, 42) is provided internally with a longitudinal channel (51) adapted to house the respective surgical instrument (43, 44), and a longitudinal chamber (53) made eccentrically with respect to the section of the arm itself, and wherein said chamber (53) is adapted to receive compressed air from the respective actuation unit by means of a pneumatic system (20) connected to it, and is configured to expand and deform elastically to bring about axial bending of the respective arm (41, 42).
5. Apparatus according to any one of claims 2 to 4, wherein said distal unit (40) also comprises a support structure (48) having a central cylinder (45) associated with said front end (104) provided with one or more video cameras (105), and two hollow lateral tubular elements (46, 47) configured to slidably accommodate a respective flexible arm (41, 42), wherein said axial bending of said arms (41, 42) is permitted when they are at least partially extracted, or protruding, from said tubular elements (46, 47).
6. Apparatus according to any one of the preceding claims, wherein each flexible arm (41, 42) is provided, on the opposite side from the interchangeable surgical instrument (43, 44), with a connection hose (63, 64) which is suitable for connection with a pneumatic system (20) associated with the respective actuation unit (31, 32).
7. Apparatus according to claim 6, wherein each actuation unit (31, 32) comprises:- a linear slide (33) operable by a first actuator (35) to translate axially forward, or backward,- a second actuator (36) mounted on said linear slide (33), connected to a first flexible tube (60) and configured to rotate the latter axially, wherein said first flexible tube (60) is also adapted to axially translate with said linear slide (33) and is connected to the corresponding connection hose (63, 64) to allow axial translation and rotation of the respective flexible arm (41, 42),- an activation unit (37) of the corresponding instrument (43, 44) also mounted on said linear slide (33) and connected to a second flexible tube (61), wherein said second flexible tube (61) is adapted to translate axially with said linear slide (33) and is connected to the respective connection hose (63, 64) to be associated with thecorresponding surgical instrument (43, 44), and wherein said activation unit (37) is adapted to determine the activation of said corresponding surgical instrument (43, 44).
8. Apparatus according to claim 7, wherein each actuation unit (31, 32) comprises two or more detection and control elements operatively connected to said first (35) and second (36) actuators and configured to control the operation of the latter with respect to detection of translation and rotation movements determined therefrom, wherein said detection and control elements, said actuators (35, 36) and said actuation unit (37) are operatively connected to said control unit (10), which is programmed to control and coordinate the operations thereof.
9. Apparatus according to claim 6 or 7, wherein each actuation unit (31, 32) comprises a third flexible tube (62) connected on one side to a pneumatic system (20) and on the other side to the corresponding connection hose (63, 64) to be associated with an expandable chamber (53) of the respective arm (41 , 42), allowing compressed air from said pneumatic system (20) to be fed therein.
10. Apparatus according to claim 4 or 9, wherein said pneumatic system (20) comprises at least one air compressor (23), at least one pressure regulator (22) and one or more proportional pneumatic valves (21) adapted to regulate and control the amount of compressed air transmitted to the chamber (53) and, therewith, an axial deflection angle of the respective arm (41, 42).
11. Apparatus according to any one of the preceding claims, wherein the at least one manipulation interface (102) comprises a manipulatable structure adapted to provide a number of control inputs sufficient to support control of all degrees of freedom of said distal unit (40).
12. Apparatus (110) according to claim 11, wherein said at least one manipulation interface (102) is configured to provide control inputs capable of:- operating a first actuator (35) of the respective actuation unit (31, 32), to control axial translation of a corresponding flexible arm (41, 42),- operating said pneumatic system (20), to control the axial deflection of the corresponding flexible arm (41, 42),- operating a second actuator (36) of the respective actuation unit (31, 32), to control the axial rotation of the corresponding flexible arm (41, 42),- operating an activation unit (37) of the respective actuation unit (31, 32) to control the activation of an interchangeable surgical instrument (43, 44) of the corresponding flexible arm (41, 42).