JP7748263B2 - Surgery Support System - Google Patents

Description

This disclosure relates to a surgical assistance system.

Conventionally, surgical assistance systems have been disclosed. Patent Document 1 discloses technology for controlling the movement of a surgical instrument attached to a slave articulated robot arm based on the amount of operation received by an operation unit located in a master control device. In Patent Document 1, the operation unit is provided with a grip member that is held by the operator's fingers. The surgical instrument is moved when the operator operates the operation unit while holding the grip member.

US Patent Application Publication No. 2004/0243110

Generally, when a surgical assistance system operates an operating unit, the surgical instrument is moved so that a reference point set on the surgical instrument moves in response to the movement of the reference point set on the operating unit. However, it has been discovered that when the reference point set on the operating unit is set at a gimbal point, which is the intersection of multiple rotation axes of the operating unit, the operating unit does not rotate around the gimbal point even when an attempt is made to rotate the surgical instrument around the reference point set on the surgical instrument. In other words, it has been discovered that when a surgical instrument is rotated around the reference point set on the surgical instrument, the gimbal point moves over a relatively wide range. This poses a problem in that the operator may not be able to operate the surgical instrument as intended due to a mismatch between the movement of the operator's hand and the movement of the surgical instrument.

The present disclosure has been made to solve the above-mentioned problems, and aims to provide a surgical assistance system that can move surgical instruments as intended by the operator.

A surgical assistance system according to a first aspect of the present disclosure comprises a surgical apparatus including a robotic arm having a surgical instrument attached to a tip thereof; an operating device including an operating unit that receives operations on the surgical instrument; and a control device that controls movement of the surgical instrument based on the received operations, wherein the operating unit includes a first link unit, and the control device sets an operating unit reference point that displaces and rotates in synchronization with the displacement and rotation of the operating unit and is located at a position spaced apart from the operating unit , and sets a surgical instrument reference point that displaces and rotates in synchronization with the displacement and rotation of the surgical instrument and is located on the surgical instrument, and when the operating unit is operated, the control device calculates the displacement and rotation of the operating unit reference point by forward kinematics calculation based on input values from the operating unit, and controls the surgical instrument to be moved so that the surgical instrument reference point displaces and rotates in synchronization with the displacement and rotation of the operating unit reference point, and the operating unit reference point is set at a position opposite to the distal end of the first link unit with respect to the proximal end of the first link unit.

After extensive research, the inventors of the present application discovered that, as described above, by setting the control unit reference point at a position opposite the distal end of the first link unit relative to the proximal end of the first link unit, the surgical instrument can be moved as intended by the operator. In other words, because the control unit reference point is set closer to the operator than the proximal end of the first link unit, the distance between the control unit reference point and the wrist, which is considered to be the center of rotation when the operator turns the grip member attached to the first link unit, is reduced. This reduces the discrepancy between the movement of the operator's hand and the movement of the surgical instrument, thereby preventing the movement range of the control unit reference point from becoming too large. As a result, the surgical instrument can be moved as intended by the operator. Furthermore, the fact that the movement range of the control unit reference point is prevented from becoming too large by setting the control unit reference point at a position opposite the distal end of the grip member relative to the proximal end of the first link unit has been confirmed through experiments conducted by the inventors, as described below.

A surgical assistance system according to a second aspect of the present disclosure comprises a surgical apparatus including a robotic arm having a surgical instrument attached to a tip thereof; an operating device including an operating unit that receives operations on the surgical instrument; and a control device that controls movement of the surgical instrument based on the received operations, wherein the operating unit includes a first link unit, and the control device sets an operating unit reference point that displaces and rotates in synchronization with the displacement and rotation of the operating unit and is located at a position separated from the operating unit , and sets a surgical instrument reference point that displaces and rotates in synchronization with the displacement and rotation of the surgical instrument and is located on the surgical instrument, and when the operating unit is operated, the control device calculates the displacement and rotation of the operating unit reference point by forward kinematics calculation based on input values from the operating unit, and controls the surgical instrument to be moved so that the surgical instrument reference point displaces and rotates in synchronization with the displacement and rotation of the operating unit reference point, and in the reference posture of the operating unit, the operating unit reference point is set at a position closer to the operator than the proximal end of the first link unit.

As a result of careful consideration by the inventors of the present application, in the surgical assistance system according to the second aspect of the present disclosure, as described above, the operation unit reference point is set at a position closer to the operator than the proximal end of the first link unit. As a result, the operation unit reference point is set at a position closer to the operator than the proximal end of the first link unit, thereby reducing the distance between the operation unit reference point and the wrist, which is considered to be the center of rotation when the operator turns the grip member disposed on the first link unit. This reduces the discrepancy between the movement of the operator's hand and the movement of the surgical instrument, preventing the movement range of the operation unit reference point from becoming too large. As a result, it is possible to provide a surgical assistance system that is capable of moving the surgical instrument as intended by the operator.

A surgical assistance system according to a third aspect of the present disclosure comprises a surgical apparatus including a robotic arm having a surgical instrument attached to a tip thereof; an operating device including an operating unit that receives operations on the surgical instrument; and a control device that controls movement of the surgical instrument based on the received operations, wherein the operating unit includes a first link unit, and the control device sets a operating unit reference point that displaces and rotates in synchronization with the displacement and rotation of the operating unit and is located at a position spaced apart from the operating unit , and sets a surgical instrument reference point that displaces and rotates in synchronization with the displacement and rotation of the surgical instrument and is located on the surgical instrument, and when the operating unit is operated, the control device calculates the displacement and rotation of the operating unit reference point by forward kinematics calculation based on input values from the operating unit, and controls the surgical instrument to be moved so that the surgical instrument reference point displaces and rotates in synchronization with the displacement and rotation of the operating unit reference point, and the operating unit reference point is set at a position opposite to a gimbal point, which is an intersection of multiple rotation axes of the operating unit, relative to the proximal end of the first link unit.

As a result of extensive research by the inventors, in the surgical assistance system according to the third aspect of the present disclosure, as described above, the operation unit reference point is set at a position opposite the gimbal point, which is the intersection of the multiple rotation axes of the operation unit, rather than the proximal end of the first link unit. This sets the operation unit reference point closer to the operator than the proximal end of the first link unit, thereby reducing the distance between the operation unit reference point and the wrist, which is considered to be the center of rotation when the operator turns the grip member disposed on the first link unit. This reduces the discrepancy between the movement of the operator's hand and the movement of the surgical instrument, preventing the movement range of the operation unit reference point from becoming too large. As a result, it is possible to provide a surgical assistance system that can move the surgical instrument as intended by the operator.

This disclosure allows surgical instruments to be moved as intended by the operator.

1 is a diagram illustrating a configuration of a surgery assistance system according to an embodiment. FIG. 1 illustrates a configuration of a robot arm according to an embodiment. FIG. FIG. 2 is a perspective view showing a configuration of an arm operating unit according to one embodiment. FIG. 10 is a diagram for explaining translational movement of a robot arm. FIG. 10 is a diagram for explaining the rotational movement of the robot arm. FIG. 2 is a diagram illustrating an operation unit according to an embodiment. 1A and 1B are diagrams illustrating a configuration of a right-hand operation unit according to an embodiment. 1A and 1B are diagrams illustrating a configuration of a left-handed operation unit according to an embodiment. FIG. 1 illustrates a foot pedal configuration according to one embodiment. FIG. 1 is a control block diagram of a surgery assistance system according to one embodiment. FIG. 2 is a control block diagram of a robot arm according to one embodiment. FIG. 2 is a control block diagram of a remote control device according to an embodiment. 10A and 10B are diagrams for explaining an operation when an operation unit receives an operation. FIG. 10 is a diagram for explaining forward kinematics calculation in which offset transformation is performed last. FIG. 10 is a diagram illustrating a forward kinematics calculation in which an offset transformation is performed before an A7 axis transformation. FIG. 10 is a diagram illustrating a touch panel that receives an operation unit reference point. 10A and 10B are diagrams showing experimental results regarding the range of movement of the reference point of the operation unit when the surgical instrument is rotated.

(Configuration of surgery support system)
The configuration of a surgery assistance system 100 according to this embodiment will be described. The surgery assistance system 100 includes a surgery assistance robot 1 and a remote control device 2. The surgery assistance robot 1 and the remote control device 2 are examples of a surgery device and an operation device, respectively.

In this specification, the longitudinal direction of the shaft 4c of the surgical instrument 4 is referred to as the Z direction. The tip side of the surgical instrument 4 is referred to as the Z1 side, and the base side of the surgical instrument 4 is referred to as the Z2 side. The direction perpendicular to the Z direction is referred to as the X direction. One side of the X direction is referred to as the X1 side, and the other side is referred to as the X2 side. The direction perpendicular to the Z direction and the X direction is referred to as the Y direction. One side of the Y direction is referred to as the Y1 side, and the other side is referred to as the Y2 side.

In addition, in this specification, the direction along the vertical direction is referred to as the Za direction. One side of the Za direction is referred to as the Za1 side, and the other side is referred to as the Za2 side. The direction perpendicular to the Z direction is referred to as the Xa direction. One side of the Xa direction is referred to as the Xa1 side, and the other side is referred to as the Xa2 side. The direction perpendicular to the Za direction and the Xa direction is referred to as the Ya direction. One side of the Ya direction is referred to as the Ya1 side, and the other side is referred to as the Ya2 side. The Xa direction and Ya direction are directions along a horizontal plane.

As shown in Figure 1, the surgical support robot 1 is placed in an operating room. The remote control device 2 is placed at a location separate from the surgical support robot 1. An operator such as a doctor inputs commands to the remote control device 2 to cause the surgical support robot 1 to perform a desired operation. The remote control device 2 transmits the input commands to the surgical support robot 1. The surgical support robot 1 operates based on the received commands. The surgical support robot 1 is placed in an operating room, which is a sterilized sterile field.

(Configuration of surgical support robot)
As shown in FIG. 1 , the surgery support robot 1 includes a medical cart 3 , a positioner 40 , an arm base 50 , a plurality of robot arms 60 , and an arm operating unit 80 .

The medical cart 3 moves the positioner 40. The medical cart 3 includes an input device 33. The input device 33 accepts operations to move and change the posture of the positioner 40, arm base 50, and multiple robot arms 60, mainly to prepare for surgery before the procedure. The medical cart 3 includes an operating handle 34 that accepts steering by the operator.

The positioner 40 is, for example, a seven-axis articulated robot. The positioner 40 is placed on the medical cart 3. The positioner 40 adjusts the position of the arm base 50. The positioner 40 moves the position of the arm base 50 three-dimensionally.

The positioner 40 includes a base 41 and multiple link sections 42 connected to the base 41. The multiple link sections 42 are connected to each other by joint sections 43.

The arm base 50 is attached to the tip of the positioner 40. The base ends of the multiple robotic arms 60 are attached to the arm base 50. The multiple robotic arms 60 can be folded into a storage position. The arm base 50 and the multiple robotic arms 60 are covered with sterile drapes when in use. The robotic arms 60 also support the surgical instrument 4.

A plurality of robot arms 60 are provided. Specifically, four robot arms 60a, 60b, 60c, and 60d are provided. Robot arms 60a, 60b, 60c, and 60d have the same configuration.

As shown in FIG. 2, the robot arm 60 includes an arm unit 61, a first link unit 72, a second link unit 73, and a translational movement mechanism unit 70. The robot arm 60 has JT1, JT2, JT3, JT4, JT5, JT6, and JT7 axes as rotational axes and a J8 axis as a linear movement axis. The JT1, JT2, JT3, JT4, JT5, JT6, and JT7 axes are rotational axes of the joint unit 64 of the arm unit 61. The JT7 axis is also the rotational axis of the first link unit 72. The JT8 axis is a linear movement axis along which the translational movement mechanism unit 70 moves the second link unit 73 relative to the first link unit 72 in the Z direction.

The arm unit 61 consists of a seven-axis articulated robot arm. The first link unit 72 is located at the tip of the arm unit 61. The arm operating unit 80 is attached to the second link unit 73. The translational movement mechanism unit 70 is located between the first link unit 72 and the second link unit 73. A holder 71 that holds the surgical instrument 4 is located on the second link unit 73.

A surgical instrument 4 is attached to the tip of each of the multiple robotic arms 60. The surgical instrument 4 includes, for example, interchangeable instruments and an endoscope 6 for capturing images of the surgical site. The surgical instrument 4 includes a driven unit 4a, forceps 4b, and a shaft 4c that connects the driven unit 4a and forceps 4b. The driven unit 4a, shaft 4c, and forceps 4b are arranged along the Z direction.

As shown in FIG. 1, an endoscope 6 is attached to the tip of one of the multiple robotic arms 60, for example, robotic arm 60c, and surgical instruments 4 other than the endoscope 6 are attached to the tips of the remaining robotic arms, for example, robotic arms 60a, 60b, and 60d. The endoscope 6 is attached to one of the two centrally located robotic arms 60b and 60c of the four robotic arms 60 arranged adjacent to each other.

(Instrument configuration)
3, the tip of the instrument is provided with, for example, forceps 4b. In addition to the forceps 4b, other jointed instruments such as scissors, graspers, needle holders, microdissectors, stable appliers, tackers, suction and irrigation tools, snare wires, and clip appliers are arranged at the tip of the instrument. Other non-jointed instruments such as cutting blades, cauterizing probes, irrigators, catheters, and suction orifices are arranged at the tip of the instrument.

The forceps 4b includes a first support 4e that supports the base ends of the jaw members 104a and 104b at the distal end so that they can rotate about the JT11 axis, and a second support 4f that supports the base end of the first support 4e at the distal end so that they can rotate about the JT10 axis. The shaft 4c rotates about the JT9 axis. The jaw members 104a and 104b open and close about the JT12 axis. The portion of the first support 4e on the distal end, or Z1 direction side, is U-shaped.

As shown in FIG. 2, the arm operating unit 80 is attached to the robot arm 60. Specifically, the arm operating unit 80 is attached to the second link unit 73.

As shown in FIG. 4, the arm operating unit 80 includes an enable switch 81, a joystick 82, a linear switch 83, a mode switching button 84, a mode indicator 84a, a pivot button 85, and an adjustment button 86.

The enable switch 81 is a switch that allows or disallows movement of the robot arm 60 using the joystick 82 and linear switch 83. The joystick 82 is an operating tool for controlling the movement of the surgical instrument 4 by the robot arm 60. The linear switch 83 is a switch for moving the surgical instrument 4 in a direction along the longitudinal direction of the surgical instrument 4. The mode switching button 84 is a button for switching between a mode for moving the surgical instrument 4 translationally as shown in Figure 5 and a mode for moving it rotationally as shown in Figure 6. The mode indicator 84a displays the switched mode. The pivot button 85 is a button for teaching the pivot position PP, which serves as the fulcrum for movement of the surgical instrument 4 attached to the robot arm 60. The adjustment button 86 is a button for optimizing the position of the robot arm 60.

(Remote control device)
1, the remote control device 2 is placed, for example, inside or outside an operating room. The remote control device 2 includes a main body 2a, an operation unit 120, a foot pedal 22, a touch panel 23, a monitor 24, a support arm 25, a support bar 26, and a foot detection unit 27.

As shown in FIG. 1, the operating unit 120 is supported by the main body 2a. As shown in FIG. 7, the operating unit 120 receives the amount of operation for the surgical instrument 4. When viewed from the operator, such as a doctor, the operating unit 120 includes a left-hand operating unit 120L located on the left side and operated with the operator's left hand, and a right-hand operating unit 120R located on the right side and operated with the operator's right hand. The left-hand operating unit 120L and the right-hand operating unit 120R have the same configuration.

The operating unit 120 includes a substantially L-shaped arm 121 and an operating handle 21. The arm 121 has link portions 121a, 121b, and 121c. The upper end of link portion 121a is attached to the main body 2a so as to be rotatable around the vertical A1 axis. The upper end of link portion 121b is attached to the lower end of link portion 121a so as to be rotatable around the horizontal A2 axis. One end of link portion 121c is attached to the lower end of link portion 121b so as to be rotatable around the horizontal A3 axis. The operating handle 21 is attached to the other end of link portion 121c so as to be rotatable around the A4 axis. The link portions are connected by joint portions 122.

The arm 121 supports the operating handle 21. The arm 121 supports the operating handle 21 so that it can move within a predetermined three-dimensional operating range. Specifically, the arm 121 supports the operating handle 21 so that it can move up and down, left and right, and front and back. The robot arm 60 moves three-dimensionally in response to the three-dimensional operation of the arm 121.

The operating handle 21 includes an operating handle 21R operated by the operator's right hand as shown in Figure 8, and an operating handle 21L operated by the operator's left hand as shown in Figure 9. Figure 8 shows the reference position of the right-hand operating unit 120R, and Figure 9 shows the reference position of the left-hand operating unit 120L. The configuration of the operating handle 21R is similar to the configuration of the operating handle 21L. The operating handle 21 includes link portions 21a, 21b, 21c, and link portion 21d operated by an operator such as a doctor. Link portion 21a rotates around the A4 axis. Link portion 21b is attached to link portion 21a so as to be rotatable around the A5 axis. Link portion 21c is attached to link portion 21b so as to be rotatable around the A6 axis. Link portion 21d is attached to link portion 21c so as to be rotatable around the A7 axis. The link portions are connected by joints 122. Link portion 21a, link portion 21b, and link portion 21c each have an L-shape. Link portion 21a, link portion 21b, link portion 21c, and link portion 21d are examples of the fourth link portion, third link portion, second link portion, and first link portion, respectively. Axis A4, A5, A6, and A7 are examples of the fourth axis, third axis, second axis, and first axis, respectively.

The operating handle 21 includes a pair of grip members 21f that can be opened and closed by the operator. The grip members 21f are made of elongated, plate-like lever members, and the proximal ends of the pair of grip members 21f are rotatably connected to the proximal end G1 of the link portion 21d. Cylindrical finger insertion portions 21e are disposed on the grip members 21f. The operator inserts the fingers of their right hand into the pair of finger insertion portions 21e to operate the operating handle 21R. The operator inserts the fingers of their left hand into the pair of finger insertion portions 21e to operate the operating handle 21L. The base ends of the pair of grip members 21f are connected to the link portion 21d, and the opening angle between the jaw members 104a and 104b can be changed by increasing or decreasing the angle between the pair of grip members 21f. A magnet is disposed on one side of the grip members 21f, and a Hall sensor is disposed on the link portion 21d. When the operator opens or closes the grip member 21f, as shown in Figure 11, the magnet and Hall sensor function as angle detection sensor 21g, and the Hall sensor outputs the opening angle. Alternatively, the angle detection sensor 21g may be a Hall sensor located on the grip member 21f and a magnet located on the link portion 21d. Alternatively, a magnet or Hall sensor may be located on both grip members 21f as angle detection sensors 21g.

The intersection of the multiple rotation axes of the operation unit 120 is called the gimbal point GP. Specifically, the gimbal point GP is the point where the A4 axis, the A5 axis, the A6 axis, and the A7 axis intersect. The gimbal point GP is located on the link portion 21d to which the pair of grip members 21f are attached. A separate gimbal point GP exists on each of the left-hand operation unit 120L and the right-hand operation unit 120R.

In the reference posture, the A4 and A6 axes of the operating unit 120 are aligned along the Za direction. The A5 axis is aligned along the Ya direction. The A7 axis is aligned along the Xa direction. As shown in Figure 8, in the reference posture, the link portions 21a and 21b of the operating handle 21R are aligned along the Ya-Za plane and on the Ya1 side of the A7 axis. In the reference posture, the link portion 21c is aligned along the Xa-Za plane. In the reference posture, the link portion 21d is aligned along the A7 axis.

As shown in Figure 9, in the reference position, link portion 21a and link portion 21b of operating handle 21L are arranged along the Ya-Za plane and on the Ya2 side of the A7 axis. In the reference position, link portion 21c is arranged along the Xa-Za plane. In the reference position, link portion 21d is arranged along the A7 axis.

As shown in FIG. 10, multiple foot pedals 22 are provided to perform functions related to the surgical instrument 4. The multiple foot pedals 22 are arranged on the base 28. The foot pedals 22 include a switch pedal 22a, a clutch pedal 22b, a camera pedal 22c, an incision pedal 22d, and a coagulation pedal 22e. The switch pedal 22a, the clutch pedal 22b, the camera pedal 22c, the incision pedal 22d, and the coagulation pedal 22e are operated by the operator's feet. The incision pedals 22d include an incision pedal 22dR for the right robot arm 60 and an incision pedal 22dL for the left robot arm 60. The coagulation pedals 22e include a coagulation pedal 22eR for the right robot arm 60 and a coagulation pedal 22eL for the left robot arm 60.

The switching pedal 22a switches the robot arm 60 operated by the operating handle 21. The clutch pedal 22b performs a clutch operation that temporarily disconnects the operational connection between the robot arm 60 and the operating handle 21. While the clutch pedal 22b is depressed by the operator, operation by the operating handle 21 is not transmitted to the robot arm 60. Furthermore, while the operator is depressing the camera pedal 22c, the operating handle 21 can be used to operate the robot arm 60 to which the endoscope 6 is attached. While the operator is depressing the incision pedal 22d or coagulation pedal 22e, the electrosurgical device is activated.

The foot detection unit 27 detects the feet of the operator operating the foot pedal 22. The foot detection unit 27 detects the feet in a hover state located above the foot pedal 22. The foot detection unit 27 is disposed on the base unit 28.

As shown in FIG. 1, the monitor 24 is a scope-type display device for displaying images captured by the endoscope 6. The support arm 25 supports the monitor 24 so that its height is at the same height as the face of an operator, such as a doctor. The touch panel 23 is mounted on a support bar 26. A sensor provided near the monitor 24 detects the operator's head, enabling the remote control device 2 to operate the surgical support robot 1. The operator operates the operation unit 120 and foot pedals 22 while visually checking the affected area on the monitor 24. This inputs commands to the remote control device 2. The commands input to the remote control device 2 are transmitted to the surgical support robot 1. The touch panel 23 is an example of a reception unit.

(Control system configuration)
As shown in FIG. 11, the surgery assistance system 100 includes a control device 130, an arm control unit 31a, a positioner control unit 31b, and an operation control unit 110.

The control device 130 communicates with each of the arm control unit 31a, positioner control unit 31b, and operation control unit 110 inside the medical cart 3. The control device 130 controls each of the arm control unit 31a, positioner control unit 31b, and operation control unit 110. The control device 130 is connected to the arm control unit 31a, positioner control unit 31b, and operation control unit 110 via a LAN or the like. Note that although Figure 11 shows the control device 130 separately from the medical cart 3, Figure 11 is a diagram for explaining the control block, and in reality, the control device 130 is located inside the medical cart 3, as shown in Figure 1.

An arm control unit 31a is disposed for each of the multiple robot arms 60. Note that while Figure 11 shows the arm control unit 31a as being disposed inside the robot arm 60, Figure 11 is a diagram for explaining the control block, and in reality, the arm control unit 31a is disposed inside the medical cart 3, as shown in Figure 1. In other words, there are as many arm control units 31a disposed inside the medical cart 3 as there are multiple robot arms 60.

As shown in FIG. 12, the arm 61 is provided with multiple servo motors M1, encoders E1, and reducers to correspond to the multiple joints 64. The encoder E1 detects the rotation angle of the servo motor M1. The reducer decelerates the rotation of the servo motor M1 to increase the torque.

A servo control unit C1 for controlling the servo motor M1 is disposed on the robot arm 60. The servo control unit C1 is also electrically connected to an encoder E1 for detecting the rotation angle of the servo motor M1.

As shown in FIG. 12, the second link section 73 is provided with a servo motor M2 for rotating a driven member disposed in the driven unit 4a of the surgical instrument 4, an encoder E2, and a reducer. The encoder E2 detects the rotation angle of the servo motor M2. The reducer decelerates the rotation of the servo motor M2 to increase the torque. The robot arm 60 is also provided with a servo control unit C2 for controlling the servo motor M2 that drives the surgical instrument 4. The servo control unit C2 is electrically connected to an encoder E2 for detecting the rotation angle of the servo motor M2. Note that multiple servo motors M2, encoders E2, and servo control units C2 are provided.

As shown in FIG. 12, the translational movement mechanism 70 is provided with a servo motor M3 for translating the surgical instrument 4, an encoder E3, and a reducer. The encoder E3 detects the rotation angle of the servo motor M3. The reducer decelerates the rotation of the servo motor M3 to increase the torque. The robot arm 60 also has a servo control unit C3 for controlling the servo motor M3 for translating the surgical instrument 4. The servo control unit C3 is electrically connected to an encoder E3 for detecting the rotation angle of the servo motor M3.

As shown in FIG. 13, the positioner control unit 31b is disposed on the medical cart 3. The positioner control unit 31b controls the positioner 40 and the medical cart 3. The positioner 40 is provided with a servo motor SM, an encoder EN, a reducer, and a servo control unit SC, which correspond to the multiple joints 43 of the positioner 40. The medical cart 3 is provided with a servo motor SM, an encoder EN, a reducer, a servo control unit SC, and a brake, which drive each of the multiple front wheels of the medical cart 3.

As shown in FIG. 13, servo motors M6a, M6b, M6c, M6d, M6e, M6f, and M6g are arranged in the operation unit 120 to correspond to the rotation axes A1, A2, A3, A4, A5, A6, and A7, respectively. Servo controllers C6a, C6b, C6c, C6d, C6e, C6f, and C6g are arranged to control each servo motor. Encoders E6a, E6b, E6c, E6d, E6e, E6f, and E6g are electrically connected to each servo controller to detect the rotation angle of each servo motor. Note that each servo motor, each servo controller, and each encoder are provided in the left-hand operation unit 120L and the right-hand operation unit 120R, respectively. Note that while Figure 11 shows the operation control unit 110 as being located inside the operation unit 120, Figure 11 is a diagram for explaining the control block, and in reality, the operation control unit 110 is located inside the main body 2a of the remote control device 2, as shown in Figure 1.

The control device 130 controls each servo motor via the operation control unit 110 to generate a torque that counteracts the gravitational torque generated on the rotation axis of each servo motor, depending on the attitude of the operation unit 120. This allows the operator to operate the operation unit 120 with a relatively small force.

The control device 130 controls each servo motor via the operation control unit 110 to generate torque on each rotation axis of each servo motor in response to the operation of the operation unit 120, thereby assisting the operator in their operation. This allows the operator to operate the operation unit 120 with a relatively small amount of force.

In this embodiment, the control device 130 sets an operation unit reference point MP for the operation unit 120. The operation unit reference point MP is also called a mapping point. The control device 130 sets a surgical instrument reference point CP for the surgical instrument 4. When the operation unit 120 is operated, the control device 130 controls the movement of the surgical instrument 4 so that the surgical instrument reference point CP moves in response to the movement of the operation unit reference point MP. The action of moving the surgical instrument 4 so that the surgical instrument reference point CP moves in response to the movement of the operation unit reference point MP is called following. As shown in Figure 3, the surgical instrument reference point CP is set at the center of the Z1 direction side of the first support 4e in the JT12 axis direction. The surgical instrument reference point CP is called the tool center point or clevis point.

In this embodiment, as shown in FIG. 8, the operation unit reference point MP is set at a position opposite the distal end G2 of link portion 21d with respect to the proximal end G1 of link portion 21d. The proximal end G1 of link portion 21d is the end portion on the Xa1 side of link portion 21d. The distal end G2 of link portion 21d is the end portion on the Xa2 side of link portion 21d. The position opposite the distal end G2 from the proximal end G1 includes not only a position on the A7 axis, but also a range on the Y1a side of the A7 axis and a range on the Y2a side of the A7 axis. Note that the operation unit reference point MP as described above is set for a robot arm 60 to which a surgical instrument 4 other than an endoscope 6 is attached.

Specifically, the control device 130 sets the operation unit reference point MP as an offset value from the coordinates of the gimbal point GP in the operation unit coordinate system. The offset value to be added is defined as the amount of displacement in the coordinate system defined on link unit 21d or link unit 21c of the operation unit 120.

In this embodiment, the operation unit reference point MP is set at a position closer to the operator than the proximal end G1 of the link portion 21d. Specifically, when the operator is holding the grip member 21f, the operation unit reference point MP is located near the operator's wrist. "Near the wrist" is a concept that includes the position of the wrist itself and a position near the wrist.

In this embodiment, the operating unit reference point MP is set at a position opposite the gimbal point GP, which is the intersection of multiple rotation axes of the operating unit 120, relative to the proximal end G1 of the link unit 21d. The gimbal point GP is located on the Xa2 direction side relative to the proximal end G1 of the link unit 21d. The gimbal point GP is located between the proximal end G1 and the distal end G2 of the link unit 21d.

In this embodiment, the operating unit reference point MP is set at a position opposite the distal end G2 of the grip member 21f relative to the proximal end G1 of the link portion 21d and offset from the A7 axis. "A position offset from the A7 axis" refers to the range on the Y1a side of the A7 axis and the range on the Y2a side of the A7 axis.

In this embodiment, in the reference posture of the operation unit 120, the operation unit reference point MP is set at a position opposite the distal end G2 of the grip member 21f with respect to the proximal end G1 of the link unit 21d and at a position opposite the link unit 21a with respect to the A7 axis. Here, the operation unit reference point MP is set separately for each of the right-handed operation unit 120R and the left-handed operation unit 120L. As shown in FIG. 8, in the reference posture of the right-handed operation unit 120R, the operation unit reference point MP is set at a position opposite the distal end G2 of the grip member 21f with respect to the proximal end G1 of the link unit 21d and at a position on the Ya2 side opposite the link unit 21a with respect to the A7 axis. As shown in Figure 9, in the reference position of the left-hand operating unit 120L, the operating unit reference point MP is set at a position opposite the distal end G2 of the grip member 21f with respect to the proximal end G1 of the link unit 21d, and on the Ya1 side of the A7 axis, opposite the link unit 21a.

In this embodiment, in the reference posture of the operation unit 120, the operation unit reference point MP is set at a position opposite the distal end G2 of the grip member 21f with respect to the proximal end G1 of the link unit 21d, at a position opposite the link unit 21a with respect to the A7 axis, and on an axis that is horizontally perpendicular to the A7 axis. As shown in FIG. 8, in the reference posture of the right-handed operation unit 120R, the operation unit reference point MP is set on the BR axis that is horizontally perpendicular to the A7 axis. As shown in FIG. 9, in the reference posture of the left-handed operation unit 120L, the operation unit reference point MP is set on the BL axis that is horizontally perpendicular to the A7 axis. The BR axis and BL axis are axes parallel to the A5 axis.

In the direction along the A7 axis, the operation unit reference point MP is set, for example, within a range of 0 to 100 mm from the proximal end G1 of the grip member 21f toward the Xa1 side. Also, as shown in FIG. 8, in the right-hand operation unit 120R, the operation unit reference point MP is set, for example, within a range of 0 to 80 mm from the A7 axis toward the Ya2 side in the direction along the BR axis. Also, as shown in FIG. 9, in the left-hand operation unit 120L, the operation unit reference point MP is set, for example, within a range of 0 to 80 mm from the A7 axis toward the Ya1 side in the direction along the BL axis.

(Method of calculating the manipulated variable)
A method for calculating input values for the operation unit 120 when an operation by the operator is accepted will be described. As shown in FIG. 14 , an operation by the operator is accepted by the operation unit 120. As a result, axis values of the A1, A2, A3, A4, A5, A6, and A7 axes of the operation unit 120 are input to the operation control unit 110. The control device 130 performs forward kinematics calculation based on the axis values input to the operation control unit 110. As a result, a homogeneous transformation matrix representing the displacement and rotation of the operation unit reference point MP from the reference posture is updated as an input value from the operation unit 120. The forward kinematics calculation is a means for calculating the displacement and rotation of a focused portion of the mechanism from the axis values of the link mechanism. Specific details of the forward kinematics calculation will be described later. The control device 130 converts the homogeneous transformation matrix representing the input from the operation unit 120 according to the field of view of the endoscope 6. The obtained homogeneous transformation matrix includes a translational component for the translational movement of the surgical instrument 4 and a rotational component for the rotation of the surgical instrument 4, which produce a movement corresponding to the input from the operation unit 120 within the field of view of the endoscope 6. The control device 130 performs scaling on the translational component and the rotational component. Scaling means multiplying the translational component and the rotational component by a scaling value, which is the ratio between the operation amount received by the operation unit 120 and the actual movement amount of the surgical instrument 4. The control device 130 calculates a target homogeneous transformation matrix based on the scaled translational component and rotational component. The control device 130 performs inverse kinematics calculation on the target homogeneous transformation matrix. The control device 130 calculates each target axis value of the robot arm 60 and the surgical instrument 4 through the inverse kinematics calculation.

As shown in Figure 15, in the forward kinematics calculation, a 4x4 identity matrix is sequentially multiplied by homogeneous transformation matrices representing transformations determined from the axis values of the A1, A2, A3, A4, A5, A6, and A7 axes, and transformations corresponding to the addition of offsets, in order to correspond to the operation received by the operation unit 120. This results in a final homogeneous transformation matrix representing the displacement and rotation of the operation unit reference point MP from the reference posture. In the example shown in Figure 15, the operation unit reference point MP is displaced as the grip member 21f rotates around the A7 axis.

In the example shown in FIG. 16, the forward kinematics calculation sequentially multiplies a 4-row, 4-column identity matrix by homogeneous transformation matrices representing transformations determined from the axis values of the A1, A2, A3, A4, A5, and A6 axes, transformations corresponding to the addition of offsets, and transformations determined from the rotation of the A7 axis, so as to correspond to the operation received by the operation unit 120. This results in a final homogeneous transformation matrix representing the displacement and rotation of the operation unit reference point MP from the reference attitude. In the example shown in FIG. 16, even if the grip member 21f rotates around the A7 axis, the operation unit reference point MP does not displace.

In this embodiment, as shown in FIG. 17, the touch panel 23 of the remote control device 2 accepts changes to the operation unit reference point MP. The touch panel 23 includes multiple selection sections 23a for selecting one of multiple preset operation unit reference points MP.

In this embodiment, the touch panel 23 accepts changes to the operation unit reference point MP before the start of surgery using the surgery assistance system 100. In other words, the touch panel 23 does not accept changes to the operation unit reference point MP during following. Note that the touch panel 23 may also accept changes to the operation unit reference point MP during surgery using the surgery assistance system 100.

(experiment)
Referring to FIG. 18 , an experiment will be described to determine how the operating unit reference point moves when the surgical instrument 4 is rotated. In the experiment, as shown in FIG. 8 , the following operating unit reference points were used: gimbal point GP; point MP1 on the Xa1 side of the proximal end G1 of the link portion 21d and on the A7 axis; and point MP on the Xa1 side of the proximal end G1 of the link portion 21d and offset from the A7 axis toward the Ya2 side. Point MP is the operating unit reference point MP in the above-described embodiment. In the experiment, the operating unit 120 was operated with the pair of grip members 21f closed. The experiment confirmed that when the operating unit reference point was the gimbal point GP, the gimbal point GP moved over a relatively large range. When the operation unit 120 is operated with the intention of not moving the gimbal point GP, the operation unit 120 should not move around the A1, A2, and A3 axes. However, experiments have confirmed that the operation unit 120 does move around the A1, A2, and A3 axes. It has also been confirmed that when the operation unit reference point is set to point MP1, the range of movement of point MP1 is smaller than when the operation unit reference point is set to gimbal point GP. It has also been confirmed that when the operation unit reference point is set to point MP, the range of movement of point MP is even smaller than when the operation unit reference point is set to point MP1. In other words, it has been confirmed that by setting the operation unit reference point to point MP, the surgical instrument 4 can be moved as intended by the operator.

[Effects of this embodiment]
The operation unit reference point MP is set at a position opposite the distal end G2 of the link portion 21d relative to the proximal end G1 of the link portion 21d. This allows the operation unit reference point MP to be set closer to the operator than the proximal end G1 of the link portion 21d, thereby reducing the distance between the operation unit reference point MP and the wrist, which is considered to be the center of rotation when the operator turns the grip member 21f arranged on the link portion 21d. This reduces the discrepancy between the movement of the operator's hand and the movement of the surgical instrument 4, thereby preventing the movement range of the operation unit reference point MP from becoming too large. As a result, the surgical instrument 4 can be moved as intended by the operator.

The operating unit reference point MP is set at a position opposite the distal end G2 of the grip member 21f, relative to the proximal end G1 of the link portion 21d, and offset from the A7 axis. This reduces the distance between the operating unit reference point MP and the wrist, allowing the surgical instrument 4 to be moved more as intended.

In the reference position of the operating unit 120, the operating unit reference point MP is set at a position opposite the distal end G2 of link unit 21d relative to the proximal end G1 of link unit 21d and opposite link unit 21a relative to the A7 axis. As a result, in the reference position of the operating unit 120, the operator's wrist is positioned opposite link unit 21a relative to the A7 axis, making it easy to reduce the distance between the operating unit reference point MP and the wrist.

In the reference position of the right-handed operating unit 120R, the operating unit reference point MP is set at a position opposite the distal end G2 of link unit 21d relative to the proximal end G1 of link unit 21d, opposite the A7 axis from link unit 21a, and on the BR axis that is horizontally perpendicular to the A7 axis. As a result, in the reference position of the right-handed operating unit 120R, the operator's wrist is positioned near the BR axis that is horizontally perpendicular to the A7 axis, making it easy to reduce the distance between the operating unit reference point MP and the wrist. A similar effect is achieved for the left-handed operating unit 120L.

A touch panel 23 is provided to accept changes to the operation unit reference point MP. This allows the operation unit reference point MP to be set appropriately to suit the operator's physique.

The touch panel 23 includes multiple selection sections 23a for selecting one of multiple preset operation unit reference points MP. This allows the operator to easily select the operation unit reference point MP, unlike when the operator inputs the coordinates of the operation unit reference point MP.

The touch panel 23 accepts changes to the operation unit reference point MP before surgery begins using the surgery assistance system 100. This allows the operation unit 120 to be used during surgery with the operation unit reference point MP set to an appropriate position.

The operation unit reference point MP is set separately for the right-hand operation unit 120R and the left-hand operation unit 120L. This allows the surgical instrument 4 to be moved as intended by the operator regardless of whether the right-hand operation unit 120R or the left-hand operation unit 120L is used.

[Modification]
It should be noted that the embodiments disclosed herein should be considered to be illustrative and not restrictive in all respects. The scope of the present disclosure is defined by the claims, not by the description of the above embodiments, and further includes all modifications and variations within the meaning and scope of the claims.

In the above embodiment, an example was shown in which the control device 130 was disposed on the medical cart 3, but the present disclosure is not limited to this. For example, the control device 130 may be disposed in a location other than the medical cart 3.

In the above embodiment, an example was shown in which the operating unit reference point MP was set at a position opposite the distal end G2 of link portion 21d relative to the proximal end G1 of link portion 21d and offset from the A7 axis, but the present disclosure is not limited to this. For example, the operating unit reference point MP may be set at a position opposite the distal end G2 of link portion 21d relative to the proximal end G1 of link portion 21d and on the A7 axis.

In the above embodiment, an example was shown in which, in the reference posture of the operating unit 120, the operating unit reference point MP was set at a position opposite the link unit 21a with respect to the A7 axis, but the present disclosure is not limited to this. For example, the operating unit reference point MP may be set at a position opposite the distal end G2 of the grip member 21f with respect to the proximal end G1 of the link unit 21d, and closer to the link unit 21a with respect to the A7 axis.

In the above embodiment, an example was shown in which, in the reference posture of the operation unit 120, the operation unit reference point MP was set on the BR axis or the BL axis that is horizontally perpendicular to the A7 axis, but the present disclosure is not limited to this. For example, in the reference posture of the operation unit 120, the operation unit reference point MP may be set at a position offset from the BR axis or the BL axis that is horizontally perpendicular to the A7 axis.

In the above embodiment, an example was shown in which the touch panel 23 included multiple selection units 23a for selecting one of multiple preset operation unit reference points MP, but the present disclosure is not limited to this. For example, the operator may input the coordinates of the operation unit reference point MP into the touch panel 23.

Furthermore, while the above embodiment illustrates an example in which four robot arms 60 are provided, the present disclosure is not limited to this. In the present disclosure, the number of robot arms 60 may be any other number as long as there is at least one.

Furthermore, in the above embodiment, an example was shown in which the arm unit 61 and the positioner 40 were configured as a seven-axis articulated robot, but the present disclosure is not limited to this. For example, the arm unit 61 and the positioner 40 may be configured as an articulated robot with an axis configuration other than a seven-axis articulated robot. An axis configuration other than a seven-axis articulated robot may be, for example, a six-axis or eight-axis configuration.

In addition, in the above embodiment, an example was shown in which the surgical support robot 1 was equipped with a medical cart 3, a positioner 40, and an arm base 50, but the present disclosure is not limited to this. For example, the medical cart 3, positioner 40, and arm base 50 are not necessarily required, and the surgical support robot 1 may be composed of only the robot arm 60.

The functions of the elements disclosed herein can be performed using circuits or processing circuits, including general-purpose processors, special-purpose processors, integrated circuits, ASICs (Application Specific Integrated Circuits), conventional circuits, and/or combinations thereof, configured or programmed to perform the disclosed functions. Processors are considered processing circuits or circuits because they include transistors and other circuitry. In this disclosure, a circuit, unit, or means is hardware that performs the recited functions or hardware that is programmed to perform the recited functions. The hardware may be hardware disclosed herein or other known hardware that is programmed or configured to perform the recited functions. Where the hardware is a processor, which is considered a type of circuit, the circuit, means, or unit is a combination of hardware and software, and the software is used to configure the hardware and/or processor.

1. Surgical support robot (surgical device)
2. Remote control device (operation device)
4 Surgical instrument 21a Link portion (fourth link portion)
21b Link portion (third link portion)
21c link portion (second link portion)
21d link portion (first link portion)
21f Grip member 23 Touch panel (reception unit)
23a Selection unit 60 Robot arm 100 Surgery support system 120 Operation unit 120R Right-hand operation unit 120L Left-hand operation unit 130 Control device CP Surgical instrument reference point G1 Proximal end G2 Distal end GP Gimbal point MP Operation unit reference point

Claims (11)

a surgical device including a robotic arm having a surgical instrument attached to its tip;
an operating device including an operating unit that accepts operations on the surgical instrument;
a control device that controls the movement of the surgical instrument based on the received operation,
the operating unit includes a first link unit,
The control device
setting an operation unit reference point that is displaced and rotated in synchronization with the displacement and rotation of the operation unit and is located at a position separated from the operation unit ;
a surgical instrument reference point that is displaced and rotated in synchronization with the displacement and rotation of the surgical instrument and is located on the surgical instrument ;
When the operation unit is operated, the displacement and rotation of the operation unit reference point are calculated by forward kinematics calculation based on the input value from the operation unit, and the surgical instrument is controlled to be moved so that the surgical instrument reference point is displaced and rotated in synchronization with the displacement and rotation of the operation unit reference point;
A surgical assistance system, wherein the operating unit reference point is set at a position opposite the distal end of the first link unit relative to the proximal end of the first link unit. The operation unit includes:
a second link portion to which the first link portion is attached so as to be rotatable about a first axis;
The surgical support system of claim 1, wherein the operating unit reference point is set at a position opposite the distal end of the first link portion and offset from the first axis relative to the proximal end of the first link portion. the second link portion rotates around a second axis along a vertical direction,
The operation unit includes:
a third link portion connected to the second link portion and rotatable about a third axis that is horizontal and perpendicular to the first axis;
a fourth link portion connected to the third link portion and configured to rotate about a fourth axis along the vertical direction,
3. The surgical support system of claim 2, wherein in the reference posture of the operating unit, the operating unit reference point is set at a position opposite the distal end of the first link unit with respect to the proximal end of the first link unit and at a position opposite the fourth link unit with respect to the first axis. The surgical assistance system of claim 3, wherein, in the reference posture of the operating unit, the operating unit reference point is set at a position opposite the distal end of the first link unit relative to the proximal end of the first link unit, at a position opposite the fourth link unit relative to the first axis, and on an axis horizontally perpendicular to the first axis. The surgical assistance system described in any one of claims 1 to 4, wherein the operating device further includes a grip member whose proximal end is rotatably connected to the proximal end of the first link portion. The surgical support system of any one of claims 1 to 5, further comprising a reception unit that receives changes to the operation unit reference point. The surgical assistance system of claim 6, wherein the reception unit includes a plurality of selection units for selecting one of a plurality of preset operation unit reference points. The surgical assistance system of claim 6 or 7, wherein the reception unit receives a change to the operation unit reference point before the start of surgery using the surgical assistance system. the operation unit includes a right-hand operation unit and a left-hand operation unit,
The surgery support system according to claim 1 , wherein the operation unit reference point is set individually for the right-hand operation unit and the left-hand operation unit. a surgical device including a robotic arm having a surgical instrument attached to its tip;
an operating device including an operating unit that accepts operations on the surgical instrument;
a control device that controls the movement of the surgical instrument based on the received operation,
the operating unit includes a first link unit,
The control device
setting an operation unit reference point that is displaced and rotated in synchronization with the displacement and rotation of the operation unit and is located at a position separated from the operation unit ;
a surgical instrument reference point that is displaced and rotated in synchronization with the displacement and rotation of the surgical instrument and is located on the surgical instrument ;
When the operation unit is operated, the displacement and rotation of the operation unit reference point are calculated by forward kinematics calculation based on the input value from the operation unit, and the surgical instrument is controlled to be moved so that the surgical instrument reference point is displaced and rotated in synchronization with the displacement and rotation of the operation unit reference point;
A surgical support system, wherein in the reference posture of the operating unit, the operating unit reference point is set at a position closer to the operator than the proximal end of the first link unit. a surgical device including a robotic arm having a surgical instrument attached to its tip;
an operating device including an operating unit that accepts operations on the surgical instrument;
a control device that controls the movement of the surgical instrument based on the received operation,
the operating unit includes a first link unit,
The control device
setting an operation unit reference point that is displaced and rotated in synchronization with the displacement and rotation of the operation unit and is located at a position separated from the operation unit ;
a surgical instrument reference point that is displaced and rotated in synchronization with the displacement and rotation of the surgical instrument and is located on the surgical instrument ;
When the operation unit is operated, the displacement and rotation of the operation unit reference point are calculated by forward kinematics calculation based on the input value from the operation unit, and the surgical instrument is controlled to be moved so that the surgical instrument reference point is displaced and rotated in synchronization with the displacement and rotation of the operation unit reference point;
A surgical assistance system in which the operating unit reference point is set at a position opposite to the gimbal point, which is the intersection of multiple rotation axes of the operating unit, relative to the proximal end of the first link unit.