CN104582629A - 用于外科机器人的触觉反馈装置 - Google Patents
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- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A61B34/74—Manipulators with manual electric input means
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- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320093—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing cutting operation
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- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
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- A61B2018/00303—Means for providing haptic feedback active, e.g. with a motor creating vibrations
Abstract
本发明公开了外科机器人控制系统的多种实施例。在一个示例性实施例中,所述外科机器人控制系统包括外壳。控制器位于所述外壳内并且联接到承窝。所述承窝在其中接收手持式外科用户接合部以控制外科器械。所述外科器械连接到所述外科机器人并且包括端部执行器和用于操纵所述端部执行器的机械接合部。所述机械接合部联接到所述控制器。至少一个传感器联接到所述控制器和所述承窝以将所述手持式外科用户接合部的运动转化成对应于所述外科器械的运动的电信号。至少一个反馈装置联接到所述控制器以向用户提供反馈。所述反馈与所述外科器械的预先确定的功能相关联。
Description
相关申请的交叉引用
本申请涉及下列同时提交的美国专利申请,这些美国专利申请全文以引用方式并入本文:
美国申请序列号_________________,名称为“Lockout Mechanism forUse with Robotic Electrosurgical Device”,代理人案卷号END7043USNP/110389;
美国申请序列号_________________,名称为“Closed Feedback Controlfor Electrosurgical Device”,代理人案卷号END7044USNP/110390;
美国申请序列号_________________,名称为“Surgical Instruments withArticulating Shafts”,代理人案卷号END6423USNP/110392;
美国申请序列号_________________,名称为“Ultrasonic SurgicalInstruments with Distally Positioned Transducers”,代理人案卷号END6819USNP/110393;
美国申请序列号_________________,名称为“Surgical Instruments withArticulating Shafts”,代理人案卷号END7047USNP/110394;
美国申请序列号_________________,名称为“Ultrasonic SurgicalInstruments with Distally Positioned Jaw Assemblies”,代理人案卷号END7248USNP/110395;
美国申请序列号_________________,名称为“Surgical Instruments withArticulating Shafts”,代理人案卷号END7049USNP/110396;
美国申请序列号_________________,名称为“Ultrasonic SurgicalInstruments with Control Mechanisms”,代理人案卷号END7050USNP/110397;和
美国申请序列号_________________,名称为“Surgical Instruments withFluid Management System”,代理人案卷号为END7051USNP/110399。
背景技术
本公开整体涉及机器人外科手术领域。具体地,本公开并非排他性地涉及以机器人方式控制的外科器械。更具体地,本公开并非排他性地涉及具有用于控制机器人外科系统的触觉反馈的控制系统。
超声外科装置(诸如超声刀)因其独特的性能特性而用于外科手术的多种应用中。根据具体的装置构型和操作参数,超声外科装置能够基本上同时进行组织的横切和通过凝固的止血,从而有利地使患者创伤最小化。超声外科装置包括定位在近侧的超声换能器和联接到超声换能器的器械,该器械具有安装在远侧的端部执行器,该端部执行器包括超声刀以切割和密封组织。端部执行器通常经由轴联接到柄部和/或机器人外科工具。刀经由延伸穿过轴的波导而在声学上联接至换能器。具有该性质的超声外科装置能被配置用于开放性外科用途、腹腔镜式或内窥镜式外科手术,包括机器人辅助的手术。
超声能量使用比用在电外科手术中的温度低的温度来切割和凝固组织。通过高频振动(例如,每秒55,500次),超声刀使组织中的蛋白变性以形成粘性凝固物。刀表面施加在组织上的压力使血管塌缩并使所述凝固物能够形成止血密封。外科医生能够通过由端部执行器施加至组织的力、施加该力的时间以及端部执行器的选定偏移水平来控制切割速度和凝固。
电外科装置还用于多种外科应用。电外科装置向组织施加电能以便对组织进行处理。电外科装置可包括具有安装在远侧的端部执行器的器械,所述端部执行器包括一个或多个电极。端部执行器可抵靠组织定位,使得电流被引入组织中。电外科装置能被配置用于双极或单极操作。在双极操作期间,电流分别通过端部执行器的有源电极和返回电极被引入组织中并从组织返回。在单极操作期间,电流通过端部执行器的有源电极被引入组织中,并通过返回电极(例如,接地垫)返回,所述有源电极与所述返回电极单独地位于患者的身体上。由流过组织的电流所产生的热可在组织内和/或在组织之间形成止血密封,并因此可尤其适用于例如密封血管。电外科装置的端部执行器有时还包括可相对于组织运动的切割构件以及用于横切组织的电极
由电外科装置施加的电能可通过发生器传递至器械。电能可以是射频(“RF”)能量的形式。射频能量是可在300kHz至1MHz频率范围内的电能形式。在其操作期间,电外科装置可将低频射频能量传递穿过组织,这会引起离子振荡或摩擦,并实际上造成电阻性加热,从而升高组织的温度。由于可在受影响的组织与周围组织之间形成明显的边界,因此外科医生能够以高精确度进行操作,并在不损伤相邻的非目标组织的情况下进行控制。射频能量的低操作温度可适用于在密封血管的同时移除、收缩软组织、或对软组织塑型。射频能量可尤其良好地适用于结缔组织,所述结缔组织主要由胶原构成,并在接触热时收缩。
现有的机器人外科系统采用为每个机器特别设计的专用控制系统。专用控制系统需要外科医生在实际外科手术中使用机器人外科系统之前经过训练并变得精通专用控制系统。除了较长的训练时间之外,专用控制系统的使用可导致外科医生不再精通非机器人外科系统和技术。因此,希望拥有一种用于机器人外科系统的控制系统,大多数外科医生能够在最少训练的情况下对其进行使用。还希望拥有一种模拟非机器人外科器械的使用的控制系统。
发明内容
本发明公开了外科机器人控制系统的多种实施例。在一个示例性实施例中,该外科机器人控制系统包括外壳。控制器位于外壳内并且联接到承窝。承窝在其中接收手持式外科用户接合部以控制外科器械。外科器械连接到外科机器人并且包括端部执行器和用于操纵端部执行器的机械接合部。机械接合部联接到控制器。至少一个传感器联接到控制器和承窝以将手持式外科用户接合部的运动转换成对应于外科器械的运动的电信号。至少一个反馈装置联接到控制器以向用户提供反馈。该反馈与外科器械的预先确定的功能相关联。
附图说明
各种实施例的特征结构在所附权利要求书中进行了详细描述。然而,参考结合如下附图的下列描述可最好地理解各种实施例(有关手术的组织和方法两者)及其优点:
图1示出包括外科器械和超声发生器的外科系统的一个实施例。
图2示出图1所示的外科器械的一个实施例。
图3示出超声端部执行器的一个实施例。
图4示出超声端部执行器的另一个实施例。
图5示出图1所示的外科器械的一个实施例的分解图。
图6示出图1所示的外科器械的一个实施例的剖视图。
图7示出图1所示的外科器械的一个示例性实施例的各种内部部件。
图8示出包括外科器械和超声发生器的外科系统的一个实施例的俯视图。
图9示出图1的外科器械的一个示例性实施例中包括的旋转组件的一个实施例。
图10示出包括外科器械的外科系统的一个实施例,该外科器械具有单个元件端部执行器。
图11是电能外科器械的一个实施例的透视图。
图12是图11的外科器械的一个实施例的柄部的侧视图,其中移除了柄部主体的一半以示出其中的一些部件。
图13示出图11的外科器械的端部执行器的一个实施例的透视图,其中钳口打开并且可轴向运动的构件的远侧端部处于回缩位置。
图14示出图11的外科器械的端部执行器的一个实施例的透视图,其中钳口闭合并且可轴向运动的构件的远侧端部处于部分推进的位置。
图15示出图11的外科器械的可轴向运动的构件的一个实施例的透视图。
图16示出图11的外科器械的端部执行器的一个实施例的截面图。
图17示出无绳电能外科器械的一个实施例的截面透视图。
图18A示出图17的外科器械的一个实施例的柄部的侧视图,其中移除了柄部主体的一半以示出其中的各种部件。
图18B示出根据一个实施例的射频驱动和控制电路。
图18C示出根据一个实施例的控制器的主要部件。
图19示出机器人外科系统的一个实施例的方框图。
图20示出机械臂车的一个实施例。
图21示出图20的机械臂车的机器人操纵器的一个实施例。
图22示出具有可供选择的装置接头结构的机械臂车的一个实施例。
图23示出可与机械臂车(诸如图19-图22的机械臂车)结合使用的控制器的一个实施例。
图24示出适于与机器人系统一起使用的超声外科器械的一个实施例。
图25示出适于与机器人系统一起使用的电外科器械的一个实施例。
图26示出器械驱动组件的一个实施例,该器械驱动组件可联接到外科操纵器以接收和控制图24所示的外科器械。
图27示出包括图24的外科器械的图26的器械驱动组件实施例的另一个视图。
图28示出包括图25的电外科器械的图26的器械驱动组件实施例的另一个视图。
图29-图31示出图26的器械驱动组件实施例的适配器部分的附加视图。
图32-图34示出图24-图25的器械安装部分的一个实施例,显示了用于将从动元件的运动转化成外科器械的运动的部件。
图35-图37示出图24-图25的器械安装部分的另选实施例,显示了用于将从动元件的旋转转化成围绕轴的轴线的旋转运动的另选示例性机构,以及用于生成一个或多个构件沿轴538的轴线的往复式平移的另选示例性机构。
图38-图42示出图24-图25的器械安装部分的另选实施例,显示了用于将从动元件的旋转转化成围绕轴的轴线的旋转运动的另一个另选示例性机构。
图43-图46A示出器械安装部分的另选实施例,显示了用于使构件沿轴的轴线发生微分平移(例如,用于进行关节运动)的另选示例性机构。
图46B-图46C示出包括内部功率和能量源的工具安装部分的一个实施例。
图47以方框图形式示出机器人外科控制系统的一个实施例。
图48-图50示出具有简化部件的机器人外科控制系统的一个实施例。
图51-图52示出包括杠杆和一个运动自由度承窝的机器人外科控制系统的一个实施例。
图53示出包括杠杆和两个运动自由度承窝的机器人外科控制系统的一个实施例。
图54示出包括杠杆和无限制的两个运动自由度承窝的机器人外科控制系统的一个实施例。
图55-图56示出包括杠杆和四个运动自由度承窝的机器人外科控制系统的一个实施例。
图57示出用于与机器人外科控制系统一起使用的独立式输入装置的一个实施例。
图58-图60示出利用温度梯度提供触知反馈的触觉反馈装置的一个实施例。
图61示出包括外科装置柄部和六个运动自由度承窝的机器人外科控制系统的一个实施例。
图62示出包括外科装置柄部和三个运动自由度承窝的机器人外科控制系统的一个实施例。
图63示出包括多个反馈装置的机器人外科控制系统。
图64-图65示出外科装置柄部与外科器械之间的关系的可能实施例。
图66示出无绳式机器人外科控制系统的一个实施例。
图67示出与标准机器人控制器整合的机器人外科控制系统的一个实施例。
图68示出用于为机器人外科控制系统生成反馈信号的系统的一个实施例。
具体实施方式
各种示例性实施例涉及机器人外科系统的控制系统。机器人外科控制系统可包括外壳。控制器位于外壳内并且联接到承窝。承窝在其中接收手持式外科用户接合部以控制外科器械。外科器械连接到外科机器人并且包括端部执行器和用于操纵端部执行器的机械接合部。机械接合部联接到控制器。至少一个传感器联接到控制器和承窝以将手持式外科用户接合部的运动转换成对应于外科器械的运动的电信号。至少一个反馈装置联接到控制器以向用户提供反馈。该反馈与外科器械的预先确定的功能相关联。
一些示例性实施例涉及具有包括杠杆的手持式外科用户接合部的机器人外科控制系统。杠杆能够沿远侧/近侧方向、上/下方向和/或左/右方向可平移地运动。杠杆也能够围绕在近侧/远侧平面、上/下平面或左/右平面的任一个中的枢转点可旋转地运动。在一些示例性实施例中,杠杆可包括一个或多个附加输入,例如触发器、开关、电阻套管或任何其他合适的输入。
其他示例性实施例涉及包括手持式外科用户接合部的机器人外科控制系统,该手持式外科用户接合部包括外科装置柄部。外科装置柄部能够模拟诸如非机器人内窥镜器械的非机器人外科器械的感觉和操作。外科装置柄部能够沿远侧/近侧方向、上/下方向和/或左/右方向可平移地运动。外科装置柄部也能够围绕在近侧/远侧平面、上/下平面或左/右平面的任一个中的枢转点可旋转地运动。在一些实施例中,外科装置柄部可包括一个或多个附加输入,例如触发器、开关、一个或多个旋转旋钮或任何其他合适的输入。
在附加的示例性实施例中,机器人外科控制系统包括一个或多个反馈装置。在一些实施例中,该一个或多个反馈装置可位于外壳中。在其他实施例中,该一个或多个反馈装置可位于手持式外科用户接合部之中或之上。该一个或多个反馈装置可提供任何合适形式的感观反馈,例如,听觉反馈(声音)、触觉或触知反馈(接触)、光学反馈(视觉)、嗅觉反馈(嗅觉)、味觉反馈(味道)和/或平衡感觉(平衡反馈)。触觉反馈可通过多种形式提供,例如,机械感受(包括但不限于振动感受(振动)和压力感受)、热感知(热)和/或低温感知(冷)。
现在将详细提及若干实施例,包括显示具有端部执行器的手动和机器人外科器械的示例性具体实施的实施例,所述端部执行器包括超声和/或电外科元件。只要可行,相似或相同的参考编号可用于多个附图并可指示相似或相同的功能。附图仅出于举例说明的目的描绘了本发明所公开的外科器械和/或使用方法的示例性实施例。本领域的技术人员将通过以下描述容易地认识到:可在不脱离本文所述原理的情况下采用本文所示的结构和方法的可供选择的示例性实施例。
图1为超声外科器械10的一个实施例的右侧视图。在该图示实施例中,超声外科器械10可用于各种外科手术,包括内窥镜式外科手术或传统的开放式外科手术。在一个示例性实施例中,超声外科器械10包括柄部组件12、伸长轴组件14和超声换能器16。柄部组件12包括触发器组件24、远侧旋转组件13和开关组件28。伸长轴组件14包括端部执行器组件26,该端部执行器组件包括用于解剖组织或相互抓紧、切割并凝固血管和/或组织的元件,以及用于致动端部执行器组件26的致动元件。柄部组件12适于在近侧端部接收超声换能器16。超声换能器16机械地接合到伸长轴组件14和端部执行器组件26的多个部分。超声换能器16经由缆线22电联接至发生器20。虽然大部分附图描绘了结合腹腔镜式外科手术使用的多端部执行器组件26,但是超声外科器械10可用于更传统的开放式外科手术中,并且在其他实施例中,可被配置用于内窥镜式手术中。出于本文的目的,从内窥镜式器械的角度来描述超声外科器械10;然而,可以设想,超声外科器械10的开放式和/或腹腔镜式形式也可包括如本文所述的相同或相似的操作部件和特征结构。
在各种实施例中,发生器20包括若干功能性元件,诸如模块和/或块。不同的功能性元件或模块可被配置用于驱动不同种类的外科装置。例如,超声发生器模块21可以驱动超声装置,诸如超声外科器械10。在一些示例性实施例中,发生器20还包括用于驱动电外科装置(或超声外科器械10的电外科实施例)的电外科手术/射频发生器模块23。在各种实施例中,发生器20可在柄部组件12内整体地形成。在此类具体实施中,电池将共同位于柄部组件12内以充当能量源。图18A和附随的公开内容提供了此类具体实施的一个例子。
在一些实施例中,电外科手术/射频发生器模块23能够生成治疗和/或亚治疗能级。在图1所示的示例性实施例中,发生器20包括与发生器20成一整体的控制系统25,以及经由缆线27连接至发生器的脚踏开关29。发生器20还可以包括用于激活外科器械(诸如器械10)的触发机构。触发机构可以包括电源开关(未示出)以及脚踏开关29。当由脚踏开关29激活时,发生器20可提供能量以驱动外科器械10的声学组件并以预先确定的偏移水平来驱动端部执行器18。发生器20以声学组件的任何合适的共振频率来驱动或激发声学组件,以及/或者形成治疗/亚治疗电磁/射频能量。
在一个实施例中,电外科/射频发生器模块23可实施为电外科手术单元(ESU),该电外科手术单元能够使用射频(RF)能量来供应足以执行双极电外科手术的功率。在一个实施例中,ESU可以是由ERBE USA,Inc.(Marietta,Ga.)销售的双极ERBE ICC 350。如此前所论,在双极电外科手术应用中,可使用具有有源电极和返回电极的外科器械,其中所述有源电极和所述返回电极可抵靠或邻近待处理的组织定位,使得电流可从有源电极通过组织流至返回电极。因此,电外科/射频发生器模块23可被配置为通过将足以处理组织T(例如,烧灼)的电能施加到组织而用于治疗目的。
在一个实施例中,电外科/射频发生器模块23能够递送亚治疗射频信号,以实施组织阻抗测量模块。在一个实施例中,电外科/射频发生器模块23包括如下文所详述的双极射频发生器。在一个实施例中,电外科/射频发生器模块12能够监控组织T的电阻抗Z,并通过在端部执行器组件26的夹持构件上提供的返回电极来控制基于组织T的时间和功率电平特性。因此,电外科/射频发生器模块23可出于亚治疗目的被配置用于测量组织T的阻抗或其他电特性。用于测量组织T的阻抗或其他电特性的技术和电路构造在共同转让的名称为“Electrosurgical Generator for Ultrasonic SurgicalInstruments”的美国专利公布No.2011/0015631中有更详细的讨论,该美国专利公布的公开内容全文以引用方式并入本文。
合适的超声发生器模块21能够在功能上以与Ethicon Endo-Surgery,Inc.(Cincinnati,Ohio)销售的GEN300相似的方式运作,如在以下美国专利中的一者或多者中所公开,所有这些专利均以引用方式并入本文:美国专利No.6,480,796(“Method for Improving the Start Up of an Ultrasonic System UnderZero Load Conditions”);美国专利No.6,537,291(“Method for DetectingBlade Breakage Using Rate and/or Impedance Information”);美国专利No.6,662,127(“Method for Detecting Presence of a Blade in an UltrasonicSystem”);美国专利No.6,678,899(“Method for Detecting TransverseVibrations in an Ultrasonic Surgical System”);美国专利No.6,977,495(“Detection Circuitry for Surgical Handpiece System”);美国专利No.7,077,853(“Method for Calculating Transducer Capacitance to DetermineTransducer Temperature”);美国专利No.7,179,271(“Method for Driving anUltrasonic System to Improve Acquisition of Blade Resonance Frequency atStartup”);和美国专利No.7,273,483(“Apparatus and Method for AlertingGenerator Function in an Ultrasonic Surgical System”)。
应当理解,在各种实施例中,发生器20能够以若干模式运作。在一种模式中,发生器20可被配置成使得超声发生器模块21和电外科/射频发生器模块23可被独立地操作。
例如,可将超声发生器模块21激活以向端部执行器组件26施加超声能量,随后,可通过电外科/射频发生器模块23向端部执行器组件26施加治疗或亚治疗射频能量。如此前所论述,可向夹持在端部执行器组件26的受权利要求保护元件(claim element)之间的组织施加亚治疗电外科/射频能量以测量用于控制超声发生器模块21的激活或改变其激活的组织阻抗。由施加亚治疗能量获得的组织阻抗反馈还可用于激活电外科/射频发生器模块23的治疗电平,从而将夹持在端部执行器组件26的受权利要求保护元件之间的组织(例如,血管)密封。
在另一个实施例中,超声发生器模块21和电外科/射频发生器模块23可被同时激活。在一个例子中,超声发生器模块21与用于测量组织阻抗的亚治疗射频能级被同时激活,与此同时,端部执行器组件26的超声刀切割并凝固夹持在端部执行器组件26的夹持元件之间的组织(或血管)。这种反馈可用于(例如)改变超声发生器模块21的驱动输出。在另一个例子中,超声发生器模块21可与电外科/射频发生器模块23被同时驱动,使得在将端部执行器组件26的超声刀部分用于切割受损组织的同时,电外科/射频能量被施加到端部执行器夹持组件26的电极部分以便将组织(或血管)密封。
当发生器20经由触发机构激活时,在一个实施例中,电能由发生器20连续地施加到声学组件的换能器叠堆件或组件。在另一个实施例中,电能由发生器20以间歇方式施加(例如,为脉冲的)。发生器20的控制系统中的锁相环路可监控来自声学组件的反馈。锁相环路调节由发生器20发送的电能的频率,使其与声学组件的选定纵向振动模式的共振频率匹配。此外,控制系统25中的第二反馈回路将提供给声学组件的电流维持在预选的恒定水平,以便在声学组件的端部执行器18处实现基本上恒定的偏移。在又一个实施例中,控制系统25中的第三反馈回路监控位于端部执行器组件26中的电极之间的阻抗。虽然图1-图9显示了手动操作的超声外科器械,但是应当理解,超声外科器械还可以用于(例如)如本文所述的机器人应用中,以及手动和机器人应用的组合中。
在超声操作模式下,提供给声学组件的电信号可使端部执行器18的远侧端部在例如大约20kHz至250kHz的范围内纵向振动。根据各种实施例,刀22可在约54kHz至56kHz的范围内振动,例如以约55.5kHz振动。在其他实施例中,刀22可以其他频率振动,包括例如约31kHz或约80kHz。可通过例如控制由发生器20施加到声学组件的换能器组件的电信号的幅值来控制刀的振动偏移。如上所述,发生器20的触发机构允许用户激活发生器20,以便可将电能连续地或间歇地提供给声学组件。发生器20还具有电源线以便插入电外科单元或常规电源插座。据设想,还可以通过直流(DC)源诸如电池对发生器20供电。发生器20可包括任何合适的发生器,诸如可得自Ethicon Endo-Surgery,Inc的GEN04型和/或GEN11型发生器。
图2是超声外科器械10的一个示例性实施例的左侧透视图,显示了柄部组件12、远侧旋转组件13、伸长轴组件14和端部执行器组件26。在该图示实施例中,伸长轴组件14包括尺寸被设计为机械地接合端部执行器组件26的远侧端部52,以及机械地接合柄部组件12和远侧旋转组件13的近侧端部50。伸长轴组件14的近侧端部50接收在柄部组件12和远侧旋转组件13内。关于伸长内窥镜式轴组件14、柄部组件12和远侧旋转组件13之间的连接的更多细节在图5和图7的描述中提供。
在该图示实施例中,触发器组件24包括与固定柄部34结合操作的触发器32。固定柄部34和触发器32以符合人体工程学的方式形成,并且适于与用户舒适地接合。固定柄部34与柄部组件12整体地相关联。触发器32可相对于固定柄部34以枢转方式运动,如在下文相对于超声外科器械10的操作更详细地解释。触发器32可在用户施加相对于触发器32的挤压力时沿朝着固定柄部34的方向33A以枢转方式运动。弹簧元件98(图5)使触发器32在用户释放相对于触发器32的挤压力时沿方向33B以枢转方式运动。
在一个示例性实施例中,触发器32包括伸长触发器钩36,其在伸长触发器钩36与触发器32之间限定孔38。孔38的大小被设计成适于接收用户的从中穿过的一根或多根手指。触发器32还可以包括在触发器32基底上模制的弹性部分32a。形成包覆成型的弹性部分32a,从而得到更加舒适的接触表面,用于沿向外方向33B控制触发器32。在一个示例性实施例中,可在伸长触发器钩36的一部分上提供包覆成型的弹性部分32a。伸长触发器钩32的近侧表面保持未涂布状态或用非弹性基材进行涂布,以便用户能够轻易地将其手指滑入和滑出孔38。在另一个实施例中,触发器的几何形状形成完全闭合的套环,其限定大小被设计成适于接收用户的从中穿过的一根或多根手指的孔。完全闭合的套环触发器还可以包括在触发器基底上模制的弹性部分。
在一个示例性实施例中,固定柄部34包括近侧接触表面40和握持锚定件或鞍形表面42。鞍形表面42倚靠在手上拇指和食指结合的指蹼上。近侧接触表面40具有手枪式握把轮廓,其在没有环或孔的普通手枪式握把上接收手掌。可以设置近侧接触表面40的轮廓曲线以适应或接收手掌。稳定化尾部44位于朝向柄部组件12的更近侧的部分。稳定化尾部44可以与手的位于拇指与食指之间的最上方指蹼部分接触,以稳定柄部组件12并使柄部组件12更易于控制。
在一个示例性实施例中,开关组件28可包括拨动开关30。拨动开关30可以实施为位于柄部组件12内部的具有中心枢轴304的单个部件,以消除同时激活的可能性。在一个示例性实施例中,拨动开关30包括第一突出旋钮30a和第二突出旋钮30b,用于将超声换能器16的功率设置设定在最小功率电平(例如,MIN)与最大功率电平(例如,MAX)之间。在另一个实施例中,摇臂开关可在标准设置与特殊设置之间枢转。特殊设置可允许由装置执行一个或多个特殊程序。当第一突出旋钮30a和第二突出旋钮30b被致动时,拨动开关30围绕中心枢轴旋转。一个或多个突出旋钮30a,30b联接到一个或多个臂,所述一个或多个臂运动通过一小段弧并且使电触点根据第一突出旋钮30a或第二突出旋钮30b的启动情况闭合或断开电路从而以电气方式为超声换能器16供能或使超声换能器16去能。拨动开关30联接到发生器20以控制超声换能器16的启动。拨动开关30包括用于启动超声换能器16的一个或多个电功率设置开关,旨在为超声换能器16设定一项或多项功率设置。启动拨动开关30所需的力被导向为大致朝向鞍形点42,由此避免了在启动拨动开关30时器械在手中旋转的任何趋势。
在一个示例性实施例中,第一突出旋钮30a和第二突出旋钮30b位于柄部组件12的远侧端部上,使得它们能被用户轻易地触及,从而在最低程度或基本上无需重新定位握把的情况下激活电源,因此适于在启动拨动开关30的同时维持控制并将注意力集中在手术位点(例如,腹腔镜式手术中的监视器)上。突出旋钮30a,30b能够卷绕柄部组件12的侧面至一定程度,以便更易于被不同长度的手指触及,且允许不顺手位置启动或手指较短时具有较大的触及自由度。
在该图示实施例中,第一突出旋钮30a包括多个触觉元件30c,如该图示实施例中的纹理突出或“凸耳”,以允许用户区分第一突出旋钮30a和第二突出旋钮30b。本领域的技术人员应当理解,可将若干人体工程学特征结构结合到柄部组件12中。此类人体工程学特征结构在名称为“ErgonomicSurgical Instruments”的美国专利申请公布No.2009/0105750中有所描述,该专利申请公布全文以引用方式并入本文。
在一个示例性实施例中,拨动开关30可以由用户的手操作。用户可以在任何点轻易地触及第一突出旋钮30a和第二突出旋钮30b,同时还避免在任何时间意外或无意启动。拨动开关30可以方便地由手指操作以控制传输至超声组件16和/或超声组件16的功率。例如,食指可用于启动第一接触部分30a以将超声组件16接通到最大(MAX)功率电平。食指可用于启动第二接触部分30b以将超声组件16接通到最小(MIN)功率电平。在另一个实施例中,摇臂开关可使器械10在标准设置与特殊设置之间枢转。特殊设置可允许由器械10执行一个或多个特殊程序。用户无需观察第一突出旋钮30a或第二突出旋钮30b便可以操作拨动开关30。例如,第一突出旋钮30a或第二突出旋钮30b可以包括纹理或突出,因而无需观察便可以触觉方式区分第一突出旋钮30a和第二突出旋钮30b。
在其他实施例中,触发器32和/或拨动开关30可以单独地用于或与超声发生器模块21的激活相结合地用于致动电外科/射频发生器模块23。
在一个示例性实施例中,远侧旋转组件13可绕纵向轴线“T”在任一方向上不受限制地旋转。远侧旋转组件13机械地接合到伸长轴组件14。远侧旋转组件13位于柄部组件12的远侧端部上。远侧旋转组件13包括圆柱形毂46和在毂46上形成的旋转旋钮48。毂46机械地接合伸长轴组件14。旋转旋钮48可包括带凹槽的聚合物特征结构,并可以用手指(例如,食指)接合以旋转伸长轴组件14。毂46可以包括在主结构上模制的用于形成旋转旋钮48的材料。旋转旋钮48可在毂46上包覆成型。毂46包括在远侧端部露出的端盖部分46a。在腹腔镜式手术期间,毂46的端盖部分46a可以接触套管针的表面。毂46可以由诸如聚碳酸酯的硬质耐用塑料形成,用于缓解端盖部分46a与套管针之间可能出现的任何摩擦。旋转旋钮48可以包括由突肋48a形成的“扇形凹口”或凹槽以及位于肋48a之间的凹面部分48b,从而得到更加精确的旋转握持。在一个示例性实施例中,旋转旋钮48可以包括多个凹槽(例如,三个或更多个凹槽)。在其他实施例中,可以采用任何合适数量的凹槽。旋转旋钮48可以由在硬质塑性材料上包覆成型的较软聚合材料形成。例如,旋转旋钮48可以由柔韧的、有弹性的、柔性的聚合材料(包括例如GLS公司制造的TPE合金)形成。这种较软的包覆成型材料可以提供更好的握持,以及对旋转旋钮48的运动的更加精确的控制。应当理解,任何充分地耐受灭菌处理、具有生物相容性且对外科手套提供足够摩擦阻力的材料都可以用于形成旋转旋钮48。
在一个示例性实施例中,柄部组件12由包括第一部分12a和第二部分12b的两(2)个外壳部分或护罩形成。从用户的角度由远侧端部朝近侧端部观察柄部组件12,第一部分12a被视为右侧部分,第二部分12b被视为左侧部分。第一部分12a和第二部分12b中的每一个包括多个接合部69(图5),接合部的尺寸被设计为彼此机械地对准并接合以形成柄部组件12并且封闭其内部工作部件。与柄部组件12整体地相关联的固定柄部34在组装柄部组件12的第一部分12a和第二部分12b后成形。可以在柄部组件12的第一部分12a和第二部分12b的周边周围的多个点处设置多个附加的接合部(未示出),例如能量方向点/挠曲点,以用于超声焊接的目的。可以按本领域已知的任何方式将第一部分12a和第二部分12b(以及下文所述的其他部件)组装在一起。例如,定位销、按扣型接合部、舌状物接合部和沟槽接合部、锁定接片、粘结口可以单独或组合用于组装目的。
在一个示例性实施例中,伸长轴组件14包括适于机械地接合柄部组件12和远侧旋转组件13的近侧端部50;以及适于机械地接合端部执行器组件26的远侧端部52。伸长轴组件14包括外部管状护套56和位于外部管状护套56内的往复式管状致动构件58。管状往复式管状致动构件58的近侧端部机械地接合到柄部组件12的触发器32,以响应于触发器32的致动和/或释放而以方向60A或60B运动。可以枢转方式运动的触发器32可以生成沿着纵向轴线“T”的往复式运动。这种运动可用于例如致动端部执行器组件26的钳口或夹紧机构。一系列连杆将触发器32的枢转旋转转化成联接到致动机构的轭的轴向运动,该轴向运动控制端部执行器组件26的夹紧机构的钳口的打开和闭合。管状往复式管状致动构件58的远侧端部机械地接合到端部执行器组件26。在该图示实施例中,管状往复式管状致动构件58的远侧端部机械地接合到可绕枢转点70枢转的夹持臂组件64,以响应于触发器32的致动和/或释放而打开和闭合夹持臂组件64。例如,在该图示实施例中,当沿方向33A挤压触发器32时,夹持臂组件64可绕枢转点70沿方向62A从打开位置运动到闭合位置。当沿方向33B释放触发器32或使其向外接触时,夹持臂组件64可绕枢转点70沿方向62B从闭合位置运动到打开位置。
在一个示例性实施例中,端部执行器组件26附接在伸长轴组件14的远侧端部52处,并且包括夹持臂组件64和刀66。端部执行器组件26的夹紧机构的钳口由夹持臂组件64和刀66形成。刀66可超声致动并在声学上联接至超声换能器16。柄部组件12上的触发器32最终连接至驱动组件,它们一起机械地配合以实现夹持臂组件64的运动。沿方向33A挤压触发器32使夹持臂组件64沿方向62A从打开位置运动到夹持或闭合位置,在打开位置,夹持臂组件64和刀66相对于彼此间隔设置,在夹持或闭合位置,夹持臂组件64和刀66配合以夹持其间的组织。夹持臂组件64可以包括夹持垫69以接合刀66与夹持臂64之间的组织。沿方向33B释放触发器32使夹持臂组件64沿方向62B从闭合关系运动到打开位置,在打开位置,夹持臂组件64和刀66相对于彼此间隔设置。
柄部组件12的近侧部分包括近侧开口68,用于接收超声组件16的远侧端部。超声组件16插入近侧开口68并且机械地接合到伸长轴组件14。
在一个示例性实施例中,触发器32的伸长触发器钩36部分提供较长的触发器杠杆以及较短的跨度和旋转行程。伸长触发器钩36的较长杠杆允许用户在孔38内使用多根手指来操作伸长触发器钩36,并且使触发器32沿方向33B枢转以打开端部执行器组件26的钳口。例如,用户可以将三根手指(例如,中指、无名指和小指)插入孔38中。多根手指使得外科医生可在触发器32和伸长触发器钩36上施加较高的输入力来启动端部执行器组件26。当沿方向33A闭合或挤压触发器32或沿方向33B通过向外开启运动开启触发器32时,较短的跨度和旋转行程产生更舒适的握持,从而减少进一步向外伸出手指的需求。这将显著减轻与触发器32沿方向33B的向外开启运动相关联的手部疲劳和紧张。触发器的向外开启运动可以由弹簧元件98(图5)弹簧协助以有助于缓解疲劳。开启弹簧力足以协助轻易地开启,但不足以在展开解剖期间对组织张力的触觉反馈造成不利影响。
例如,在外科手术期间,任意食指可用于控制伸长内窥镜式轴组件14的旋转,以将端部执行器组件26的钳口定位在合适的取向上。中指和/或其他较短手指可用于挤压触发器32和抓握钳口内的组织。一旦钳口位于期望位置并且钳口夹持住组织,食指就可用于启动拨动开关30,从而调整超声换能器16的用于处理组织的功率电平。一旦已经处理了组织,用户就可以使用中指和/或较短手指抵靠伸长触发器钩36沿远侧方向向外推动来释放触发器32,从而打开端部执行器组件26的钳口。用户不必调整其对柄部组件12的握持即可执行此基本过程。
图3-图4示出伸长轴组件14相对于端部执行器组件26的连接。如前所述,在该图示实施例中,端部执行器组件26包括夹持臂组件64和刀66以形成夹紧机构的钳口。刀66可以是在声学上联接至超声换能器16的可超声致动的刀。触发器32机械地连接至驱动组件。触发器32和驱动组件共同机械地配合以沿方向62A将夹持臂组件64运动到打开位置,在该位置夹持臂组件64和刀66相对于彼此间隔设置,并且沿方向62B将夹持臂组件运动到夹持或闭合位置,在该位置夹持臂组件64和刀66配合以夹持其间的组织。夹持臂组件64可以包括夹持垫69以接合刀66与夹持臂64之间的组织。管状往复式管状致动构件58的远侧端部机械地接合到端部执行器组件26。在该图示实施例中,管状往复式管状致动构件58的远侧端部机械地接合到可绕枢转点70枢转的夹持臂组件64,以响应于触发器32的致动和/或释放而打开和闭合夹持臂组件64。例如,在该图示实施例中,当沿方向33A挤压触发器32时,夹持臂组件64可绕枢转点70沿方向62B从打开位置运动到闭合位置。当沿方向33B释放触发器32或使其向外接触时,夹持臂组件64可绕枢转点70沿方向62A从闭合位置运动到打开位置。
如此前所论述,夹持臂组件64可包括电联接至电外科/射频发生器模块23以接收治疗和/或亚治疗能量的电极,其中电外科/射频能量可在或不在超声能量施加至刀66的同时被施加到电极。此类能量激活可以任何合适的组合施加,以便与算法或其他控制逻辑部件相配合而实现期望的组织效应。
图5为图2所示超声外科器械10的分解图。在该图示实施例中,分解图显示了柄部组件12的内部元件、柄部组件12、远侧旋转组件13、开关组件28和伸长内窥镜式轴组件14。在该图示实施例中,第一部分12a和第二部分12b配合以形成柄部组件12。第一部分12a和第二部分12b各自包括多个接合部69,接合部的尺寸被设计为彼此机械地对准并接合以形成柄部组件12并且封闭超声外科器械10的内部工作部件。旋转旋钮48机械地接合到外部管状护套56,使得其可以沿圆形方向54旋转多至360°。外部管状护套56位于往复式管状致动构件58之上,该往复式管状致动构件经由多个联接元件72机械地接合到柄部组件12并保留在其内。联接元件72可包括O形环72a、管套环帽72b、远侧垫圈72c、近侧垫圈72d和螺纹管套环72e。往复式管状致动构件58位于往复式轭84内,该往复式轭保留在柄部组件12的第一部分12a和第二部分12b之间。轭84是往复式轭组件88的一部分。一系列连杆将伸长触发器钩32的枢转旋转转化成往复式轭84的轴向运动,该轴向运动控制超声外科器械10远侧端部处的端部执行器组件26的夹紧机构的钳口的打开和闭合。在一个示例性实施例中,四连接件设计提供例如在相对短的旋转跨度方面的机械优势。
在一个示例性实施例中,超声传输波导78设置在往复式管状致动构件58的内部。超声传输波导78的远侧端部52在声学上联接(例如,直接或间接机械联接)至刀66,并且超声传输波导78的近侧端部50接收在柄部组件12内。超声传输波导78的近侧端部50适于在声学上联接至超声换能器16的远侧端部,如下文更详细地讨论。超声传输波导78通过保护护套80和多个隔离元件82(诸如硅胶环)与伸长轴组件14的其他元件隔离。外部管状护套56、往复式管状致动构件58和超声传输波导78通过销74机械地接合。开关组件28包括拨动开关30和电气元件86a,b,用于根据第一突出旋钮30a或第二突出旋钮30b的启动来以电气方式为超声换能器16供能。
在一个示例性实施例中,外部管状护套56将用户或患者与超声传输波导78的超声振动隔离。外部管状护套56通常包括毂76。外部管状护套56通过螺纹连接到柄部组件12的远侧端部上。超声传输波导78延伸穿过外部管状护套56的开口,而隔离元件82将超声传输波导24与外部管状护套56隔离。外部管状护套56可使用销74附接到波导78。波导78中用于接收销74的洞可以标称地出现在位移波节处。波导78可通过双头螺栓螺旋进入或卡合到手持式柄部组件12中。毂76上的平坦部分可以允许组件扭转至所需的程度。在一个示例性实施例中,外部管状护套56的毂76部分优选地由塑料构造,并且外部管状护套56的管状伸长部分由不锈钢制成。作为另外一种选择,超声传输波导78可以包括围绕在其周围的聚合材料,以隔离其与外部接触。
在一个示例性实施例中,超声传输波导78的远侧端部可以通过内部螺纹连接而联接到刀66的近侧端部,优选地位于或靠近波腹。据设想,刀66可通过诸如焊接接头等任何合适的手段附接到超声传输波导78。虽然刀66可以从超声传输波导78上拆下,但另据设想,单个元件端部执行器(例如,刀66)和超声传输波导78可形成为单个一体件。
在一个示例性实施例中,触发器32联接到连杆机构以将触发器32沿方向33A和33B的旋转运动转化为往复式管状致动构件58沿对应方向60A和60B的线性运动。触发器32包括其中形成有开口以接收第一轭销92a的第一组凸缘98。第一轭销92a还定位穿过在轭84的远侧端部处形成的一组开口。触发器32还包括用于接收连接件92的第一端部92a的第二组凸缘96。触发器销90接收在形成于连接件92和第二组凸缘96中的开口内。触发器销90接收在形成于连接件92和第二组凸缘96中的开口内,并适于联接到柄部组件12的第一部分12a和第二部分12b以形成触发器32的触发器枢转点。连接件92的第二末端92b接收在形成于轭84的近侧端部中的狭槽384内,并通过第二轭销94b保留在其中。随着触发器32绕由触发器销90形成的枢转点190以枢转方式旋转,轭在箭头60A,B指示的方向上沿着纵向轴线“T”水平平移。
图8示出超声外科器械10的一个示例性实施例。在该图示实施例中,在柄部组件12的局部剖面图内显示了超声换能器16的剖视图。超声外科器械10的一个示例性实施例包括:联接到超声换能器16的超声信号发生器20,该超声换能器包括手持式外壳99;以及可超声致动的单个元件或多个元件端部执行器组件26。如此前所论述,端部执行器组件26包括可超声致动的刀66和夹持臂64。超声换能器16(被称为“Langevin叠堆件”)通常包括换能部分100、第一共振器部分或端罩102、第二共振器部分或前罩104、以及辅助部件。这些部件的总体构造是共振器。超声换能器16的长度优选地为整数个系统半波长(nλ/2;其中“n”为任何正整数;例如,n=1、2、3……),如下文将更详细地描述。声学组件106包括超声换能器16、鼻部锥108、速度变换器118和表面110。
在一个示例性实施例中,端罩102的远侧端部连接至换能部分100的近侧端部,而前罩104的近侧端部连接至换能部分100的远侧端部。前罩104和端罩102的长度由多个变量确定,这些变量包括换能部分100的厚度、用于制造端罩102和前罩22的材料的密度和弹性模量、以及超声换能器16的共振频率。前罩104可以与速度变换器118一样,从其近侧端部到其远侧端部向内成锥形以放大超声振动振幅,也可以不具有放大作用。合适的振动频率范围可以为约20Hz至32Hz,且最合适的振动频率范围可以为约30-10kHz。例如,合适的工作振动频率可以为大约55.5kHz。
在一个示例性实施例中,压电元件112可由诸如锆钛酸铅、间铌酸铅、钛酸铅、钛酸钡或其他压电陶瓷材料等任何合适的材料制成。正电极114、负电极116和压电元件112中的每一个都具有延伸穿过中心的镗孔。正电极114和负电极116分别电联接至电线120和122。电线120和122封闭在缆线22内,并且可电连接到超声信号发生器20。
声学组件106的超声换能器16将来自超声信号发生器20的电信号转化为机械能,该机械能主要致使超声换能器16以及端部执行器组件26的刀66部分出现以超声频率纵向振动运动的声学驻波。在另一个实施例中,超声换能器的振动运动可以在不同的方向起作用。例如,振动运动可包括伸长轴组件14的顶端的更复杂运动的局部纵向分量。合适的发生器为得自EthiconEndo-Surgery,Inc.(Cincinnati,Ohio)的GEN11型发生器。当声学组件106被供能时,振动运动驻波通过声学组件106生成。超声外科器械10被设计为在共振下工作,使得产生预先确定的振幅的声学驻波图案。沿着声学组件106的任何点处的振动运动振幅取决于沿着声学组件106测量振动运动的位置。振动运动驻波的最小或零交点通常称为波节(即运动最小的位置),驻波的局部最大绝对值或峰值通常称为波腹(即局部运动最大的位置)。波腹与距其最近的波节之间的距离为四分之一波长(λ/4)。
电线120和122将电信号从超声信号发生器20传输到正电极114和负电极116。由超声信号发生器20响应于致动器224(诸如脚踏开关)而提供的电信号为压电元件112供能,从而在声学组件106中产生声学驻波。电信号在压电元件112中产生反复小位移形式的扰动,导致材料内出现较大的交替压缩力和张力。反复的小位移使压电元件112沿电压梯度的轴线以连续方式伸展和收缩,从而生成超声能量的纵波。通过伸长轴组件14的传输部件或超声传输波导部分78将超声能量穿过声学组件106传输至端部执行器组件26的刀66部分。
在一个示例性实施例中,为了使声学组件106能够向端部执行器组件26的刀66部分递送能量,声学组件106的所有部件必须在声学上联接至刀66。超声换能器16的远侧端部可以在表面110处通过螺纹连接(诸如双头螺栓124)在声学上联接至超声传输波导78的近侧端部。
在一个示例性实施例中,优选地对声学组件106的部件进行声学调谐,使得任何组件的长度均为整数个半波长(nλ/2),其中波长λ是声学组件106的预选或操作的纵向振动驱动频率fd的波长。另据设想,声学组件106可以包括任何合适的声学元件布置方式。
在一个示例性实施例中,刀66的长度可基本上等于系统半波长的整数倍(nλ/2)。刀66的远侧端部可设置在波腹附近,以便提供远侧端部的最大纵向偏移。当换能器组件被供能时,刀66的远侧端部能够以例如55kHz的预先确定的振动频率在例如大约10至500微米峰到峰的范围内运动,并且优选地在约30至64微米的范围内运动。
在一个示例性实施例中,刀66可联接到超声传输波导78。所示的刀66和超声传输波导78由适于传输超声能量的材料形成为单个单元构造。此类材料的例子包括Ti6Al4V(含有铝和钒的钛合金)、铝、不锈钢、或其他合适的材料。作为另外一种选择,刀66可以与超声传输波导78分开(并且由不同的组合物制成),并且通过例如双头螺栓、焊接、胶水、快速连接或其他合适的已知方法联接这两个部件。超声传输波导78的长度可基本上等于例如整数个半波长(nλ/2)。超声传输波导78可以优选地由使用适合高效传播超声能量的材料(诸如上述钛合金(即,Ti6Al4V)、或任何合适的铝合金、或其他合金)构造的实芯轴制成。
在一个示例性实施例中,超声传输波导78包括在近侧端部处的纵向突出的附接柱,用于通过诸如双头螺栓124的螺纹连接而联接到超声传输波导78的表面110。超声传输波导78可包括定位在多个波节处的多个起稳定作用的硅胶环或适形支撑件82(图5)。硅胶环82抑制不可取的振动并将超声能量与外部保护护套80(图5)隔离,以确保纵向的超声能量流以最大的效率到达刀66的远侧端部。
图9示出近侧旋转组件128的一个示例性实施例。在该图示实施例中,近侧旋转组件128包括插在圆柱形毂135上的近侧旋转旋钮134。近侧旋转旋钮134包括多个径向突出138,这些突出被接收在形成于圆柱形毂135的近侧端部上的相应狭槽130中。近侧旋转旋钮134限定用于接收超声换能器16的远侧端部的开口142。径向突出138由柔软的聚合材料形成,并且限定了尺寸比超声换能器16的外径相对较小的直径,以便在超声换能器16的远侧端部时形成摩擦过盈配合。聚合物径向突出138沿径向突起到开口142中,以形成牢牢地抓住超声换能器16的外壳的“抓具”肋。因此,近侧旋转旋钮134牢固地抓住超声换能器16。
圆柱形毂135的远侧端部包括周边唇缘132和周边支承表面140。周边唇缘与形成于外壳12中的沟槽接合,周边支承表面140则与外壳12接合。这样,圆柱形毂135便机械地保留在外壳12的两个外壳部分(未示出)内。圆柱形毂135的周边唇缘132位于或“被捕获”在第一外壳部分12a和第二外壳部分12b之间,并且可在沟槽内适当地自由旋转。周边支承表面140倚靠着外壳的内部,以协助正确的旋转。这样,圆柱形毂135便可在外壳内适当地自由旋转。用户利用其手指或拇指接合在近侧旋转旋钮134上形成的凹槽136,以旋转外壳12内的圆柱形毂135。
在一个示例性实施例中,圆柱形毂135可以由耐用塑料诸如聚碳酸酯形成。在一个示例性实施例中,圆柱形毂135可以由硅化聚碳酸酯材料形成。在一个示例性实施例中,近侧旋转旋钮134可以由柔韧的、有弹性的、柔性的聚合材料(包括例如GLS公司制造的TPE合金)形成。例如,近侧旋转旋钮134可以由弹性体材料、被称为的热塑性橡胶、其他热塑性硫化橡胶(TPV)、或弹性体形成。然而,实施例并不限于此背景中。
图10示出了包括外科器械210的外科系统200的一个示例性实施例,该外科器械具有单个元件端部执行器278。系统200可包括联接到端部执行器278的换能器组件216,以及围绕如图所示的端部执行器278的近侧部分定位的护套256。换能器组件216和端部执行器278可以与上述换能器组件16和端部执行器18相似的方式工作,从而产生可通过刀226'传输至组织的超声能量。
图11-图18C示出了外科器械的各种实施例,这些外科器械利用治疗和/或亚治疗电能来处理组织或向发生器提供反馈(例如,电外科器械)。图11-图18C的实施例适于以手动或用手操作的方式使用,但电外科器械也可用于机器人应用中。图11为包括电能外科器械310的外科器械系统300的一个示例性实施例的透视图。电外科器械310可包括近侧柄部312、远侧工作端部或端部执行器326,以及设置在它们之间的导入器或伸长轴314。
电外科系统300能够要么独立地、要么同时地向患者的组织提供诸如电能、超声能量、热能或它们的任意组合的能量,如结合例如图1所述。在一个示例性实施例中,电外科系统300包括与电外科器械310电连通的发生器320。发生器320经由合适的传输介质(诸如缆线322)连接到电外科器械310。在一个示例性实施例中,发生器320联接到控制器,诸如控制单元325。在各种实施例中,控制单元325可与发生器320整体地形成,或可作为电联接到发生器320的单独电路模块或装置提供(以虚线显示,以示出这种选择)。虽然在本发明所公开的实施例中,发生器320被显示为与电外科器械310分开,但在一个示例性实施例中,发生器320(和/或控制单元325)可与电外科器械310整体地形成以形成一体的电外科系统300,在该情况下,位于电外科器械310内的电池为能量源,而联接到电池的电路产生合适的电能、超声能量或热能。一个这样的例子在下文结合图17-图18C进行描述。
发生器320可包括位于发生器320控制台的前面板上的输入装置335。输入装置335可包括生成适于对发生器320的操作进行编程的信号的任何合适的装置,诸如键盘或输入端口。在一个示例性实施例中,第一钳口364A和第二钳口364B中的各电极可联接至发生器320。缆线322可包括多个电导体,用于将电能施加到电外科器械310的正(+)电极和负(-)电极。控制单元325可用于激活可充当电源的发生器320。在各种实施例中,发生器320可包括例如可被独立地或同时地激活的射频源、超声源、直流电源、和/或任何其他合适类型的电能量源。
在各种实施例中,电外科系统300可包括至少一个供给导体331和至少一个返回导体333,其中电流能够经由供给导体331提供至电外科器械300并且其中电流能够经由返回导体333流回发生器320。在各种实施例中,供给导体331和返回导体333可包括绝缘电线和/或任何其他合适类型的导体。在某些实施例中,如下文所述,供给导体331和返回导体333可容纳在缆线322内和/或可包括在发生器320与电外科器械310的端部执行器326之间或至少部分地在它们之间延伸的缆线。在任何情况下,发生器320都能够在供给导体331与返回导体333之间施加足够的电压差,使得可将足够的电流提供至端部执行器110。
图12为外科器械310的柄部312的一个示例性实施例的侧视图。在图12中,显示了柄部312,其中第一柄部主体312A(参见图11)的一半被移除以示出第二柄部主体312B内的各种部件。柄部312可以包括杠杆臂321(例如,触发器),该杠杆臂可以沿着路径33被牵拉。杠杆臂321可通过往复运动件384联接到设置在伸长轴314内的可轴向运动构件378(图13-图16),该往复运动件可操作地接合到杠杆臂321的延伸件398。往复运动件384还可以连接到偏置装置,诸如弹簧388,以沿近侧方向偏置往复运动件384并因而沿近侧方向偏置可轴向运动的构件378,由此将钳口364A和364B推压到打开位置,如图11中所见,其中该偏置装置还可以连接至第二柄部主体312B。另外,参见图11-图12,锁定构件190(参见图12)可通过锁定开关328(参见图11)在锁定位置和解锁位置之间运动,在锁定位置,基本上防止往复运动件384朝远侧运动,如图所示;在解锁位置,可允许往复运动件384自由地沿远侧方向朝伸长轴314运动。柄部312可以是任何类型的手枪式握把或本领域中已知的其他类型的柄部,其能够承载用于致动第一钳口364A和第二钳口364B的致动器杠杆、触发器或滑动件。伸长轴314可具有例如圆柱形或矩形横截面,并且可包括从柄部312延伸的薄壁管状套筒。伸长轴314可包括贯穿其延伸的镗孔,用于承载用于致动钳口的致动器机构(例如,可轴向运动的构件378),并且用于承载将电能递送到端部执行器326的电外科部件的电引线。
端部执行器326可以适于捕获并横切组织,且同时通过能量(例如,射频能量)的受控施加而焊接捕获的组织。第一钳口364A和第二钳口364B可以闭合,由此围绕由可轴向运动的构件378限定的纵向轴线“T”来捕获或接合组织。第一钳口364A和第二钳口364B还可对组织施加压缩。在一些实施例中,伸长轴314连同第一钳口364A和第二钳口364B一起能够相对于柄部312旋转完整的360°,如箭头196(参见图11)所示。例如,旋转旋钮348可绕轴314的纵向轴线旋转,并且可联接到轴314以使得旋钮348的旋转导致轴314的相应旋转。第一钳口364A和第二钳口364B能够在旋转的同时保持为可打开和/或可闭合的。
图13显示了钳口364A,364B打开的端部执行器326的一个示例性实施例的透视图,而图14显示了钳口364A,364B闭合的端部执行器326的一个实施例的透视图。如上所述,端部执行器326可以包括上部第一钳口364A和下部第二钳口364B,它们可以是直的或弯曲的。第一钳口364A和第二钳口364B各自可以分别包括沿着它们的相应中间部分向外设置的伸长狭槽或通道362A和362B。另外,第一钳口364A和第二钳口364B各自可以具有设置在第一钳口364A和第二钳口364B的内部部分上的组织夹持元件,诸如齿状物363。第一钳口364A可以包括上部第一钳口主体200A,该上部第一钳口主体具有上部第一向外表面202A和上部第一能量递送表面365A。第二钳口364B可以包括下部第二钳口主体200B,该下部第二钳口主体具有下部第二向外表面202B和下部第二能量递送表面365B。第一能量递送表面365A和第二能量递送表面365B均可围绕端部执行器326的远侧端部以“U”形延伸。
柄部312的杠杆臂321(图12)可适于致动可轴向运动的构件378,该可轴向运动的构件还可以充当钳口闭合机构。例如,当沿路径33朝近侧牵拉杠杆臂321时,可经由往复运动件384朝远侧推压可轴向运动的构件378,如图12所示且如上所述。图15是外科器械310的可轴向运动的构件378的一个示例性实施例的透视图。可轴向运动的构件378可以包括一个或若干个零件,但是在任何情况下,其均可以相对于伸长轴314和/或钳口364A,364B运动或平移。另外,在至少一个示例性实施例中,可轴向运动的构件378可以由17-4沉淀硬化不锈钢制成。可轴向运动的构件378的远侧端部可以包括带凸缘的“I”形梁,该“I”形梁能够在钳口364A和364B中的通道362A和362B内滑动。可轴向运动的构件378可在通道362A,362B内滑动,以打开和闭合第一钳口364A和第二钳口364B。可轴向运动的构件378的远侧端部还可以包括上部凸缘或“c”形部分378A和下部凸缘或“c”形部分378B。凸缘378A和378B分别限定内部凸轮表面367A和367B,用于与第一钳口364A和第二钳口364B的向外表面接合。钳口364A和364B的打开和闭合可以使用凸轮机构在组织上施加非常高的压缩力,所述凸轮机构可以包括可运动的“I形梁”、可轴向运动的构件378以及钳口364A,364B的向外表面369A,369B。
更具体地,现在参见图13-图15,可轴向运动的构件378的远侧端部的内部凸轮表面367A和367B可共同地适于分别可滑动地接合第一钳口364A的第一向外表面369A和第二钳口364B的第二向外表面369B。第一钳口364A内的通道362A和第二钳口364B内的通道362B的大小可被设计成且能够适应可轴向运动的构件378的运动,该可轴向运动的构件可包括组织切割元件371,例如,包括锐利的远侧边缘。图14例如显示了至少部分地推进穿过通道362A和362B(图13)的可轴向运动的构件378的远侧端部。可轴向运动的构件378的推进可以将端部执行器326从图13所示的打开构型闭合。在图14所示的闭合位置,上部第一钳口364A和下部第二钳口364B分别限定第一钳口364A的第一能量递送表面365A和第二钳口364B的第二能量递送表面365B之间的间隙或尺寸D。在各种实施例中,尺寸D可例如等于约0.0005英寸至约0.040英寸,并且在一些实施例中,例如介于约0.001英寸至约0.010英寸之间。另外,第一能量递送表面365A和第二能量递送表面365B的边缘可以被倒圆以防止将组织切开。
图16是外科器械310的端部执行器326的一个示例性实施例的截面图。下部钳口364B的接合或组织接触表面365B适于至少部分地通过导电-电阻基质(诸如可变电阻正温度系数(PTC)主体)向组织递送能量,如下文更详细地讨论。上部钳口364A和下部钳口364B中的至少一者可以承载至少一个能够将能量从发生器320递送到捕获组织的电极373。上部钳口364A的接合或组织接触表面365A可承载类似的导电-电阻基质(即,PTC材料),或者在一些实施例中,该表面可以是例如导电电极或绝缘层。作为另外一种选择,钳口的接合表面可以承载2001年10月22日提交的名称为“ELECTROSURGICAL JAW STRUCTURE FOR CONTROLLED ENERGYDELIVERY”的美国专利No.6,773,409中所公开的任何能量递送部件,该专利的全部公开内容以引用方式并入本文。
第一能量递送表面365A和第二能量递送表面365B各自可以与发生器320电连通。第一能量递送表面365A和第二能量递送表面365B能够接触组织并且将适于密封或焊接组织的电外科能量递送至捕获的组织。控制单元325调节由电发生器320递送的电能,继而向第一能量递送表面365A和第二能量递送表面365B递送电外科能量。可通过激活按钮328(图12)来启动能量递送,该激活按钮与杠杆臂321可操作地接合并经由缆线322与发生器320电连通。在一个示例性实施例中,电外科器械310可通过脚踏开关329(图11)由发生器320供能。当被致动时,脚踏开关329触发发生器320,以例如将电能递送至端部执行器326。控制单元325可在激活期间对由发生器320生成的功率进行调节。尽管脚踏开关329可能适用于许多情况,但可以使用其他合适类型的开关。
如上文所提及,由电发生器320递送并由控制单元325调节或者说是控制的电外科能量可包括射频(RF)能量或其他合适形式的电能。另外,相对的第一能量递送表面365A和第二能量递送表面365B可以承载可变电阻正温度系数(PTC)主体,所述主体与发生器320和控制单元325电连通。有关电外科端部执行器、钳口闭合机构、以及电外科能量递送表面的额外细节在以下美国专利和已公布的专利申请中有所描述:美国专利No.7,087,054、No.7,083,619、No.7,070,597、No.7,041,102、No.7,011,657、No.6,929,644、No.6,926,716、No.6,913,579、No.6,905,497、No.6,802,843、No.6,770,072、No.6,656,177、No.6,533,784和No.6,500,312,以及美国专利申请公布No.2010/0036370和No.2009/0076506,所有这些专利和专利申请公布均全文以引用方式并入本文并构成本说明书的一部分。
在一个示例性实施例中,发生器320可被实施为电外科手术单元(ESU),该电外科手术单元能够使用射频(RF)能量来供应足以执行双极电外科手术的功率。在一个示例性实施例中,ESU可以是ERBE USA,Inc.(Marietta,Georgia)销售的双极ERBE ICC 350。在一些实施例中,诸如对于双极电外科手术应用,可以利用具有有源电极和返回电极的外科器械,其中有源电极和返回电极可以抵靠、邻近待处理的组织定位以及/或者被定位成与待处理的组织电连通,使得电流能够从有源电极通过正温度系数(PTC)主体并通过组织而流至返回电极。因此,在各种实施例中,电外科系统300可包括供应路径和返回路径,其中正被处理的捕获组织使所述电路完整或将该电路闭合。在一个示例性实施例中,发生器320可以是单极射频ESU而电外科器械310可以包括单极端部执行器326,在该单极端部执行器中整合了一个或多个有源电极。对于这样的系统,发生器320可能需要在远离手术位点的位置处与患者紧密接触的返回垫和/或其他合适的返回路径。返回垫可经由缆线连接到发生器320。在其他实施例中,操作员20可提供亚治疗射频能级以用于评估组织状态且在电外科系统300中提供反馈的目的。可使用这种反馈来控制电外科器械310的治疗性射频能量输出。
在电外科器械300的操作过程中,用户通常抓紧组织,向捕获的组织提供能量以形成焊接或密封(例如,通过致动按钮328和/或踏板216),然后驱动可轴向运动的构件378远侧端部处的组织切割元件371穿过捕获的组织。根据各种实施例,可放缓(paced)或以其他方式控制可轴向运动的构件378的轴向运动的平移,从而有助于以合适的行进速率驱动可轴向运动的构件378。通过控制行进速率,提高了在用切割元件371横切之前适当地且功能性地密封所捕获组织的可能性。
图17为包括无绳电能外科器械410的外科器械系统的一个示例性实施例的透视图。该电外科系统与电外科系统300类似。该电外科系统能够要么独立地、要么同时地向患者的组织提供诸如电能、超声能量、热能或它们的任意组合的能量,如结合例如图1和图11所述。该电外科器械可利用本文结合无绳近侧柄部412所述的端部执行器326和伸长轴314。在一个示例性实施例中,柄部412包括发生器电路420(参见图18A)。发生器电路420执行与发生器320的该电路基本上类似的功能。在一个示例性实施例中,发生器电路420联接到控制器,诸如控制电路。在该图示实施例中,控制电路整合到发生器电路420中。在其他实施例中,控制电路可与发生器电路420分开。
在一个示例性实施例中,端部执行器326(包括其钳口364A,364B)中的各电极可以联接到发生器电路420。控制电路可用于激活可充当电源的发生器420。在各种实施例中,发生器420可包括例如射频源、超声源、直流电源和/或任何其他合适类型的电能量源。在一个示例性实施例中,可提供按钮328,用于激活发生器电路420从而向端部执行器326,326提供能量。
图18A为无绳外科器械410的柄部412的一个示例性实施例的侧视图。在图18A中,显示了柄部412,其中第一柄部主体的一半被移除以示出第二柄部主体434内的各种部件。柄部412可以包括杠杆臂424(例如,触发器),该杠杆臂可以沿着路径33围绕枢转点被牵拉。杠杆臂424可以通过往复运动件联接到设置在伸长轴314内的可轴向运动的构件478,该往复运动件可操作地接合到杠杆臂424的延伸部。在一个示例性实施例中,杠杆臂424限定包括远侧触发器钩424a和近侧触发器部分424b的牧羊杖钩形状。如图所示,远侧触发器钩424a可具有第一长度,而近侧触发器部分424可具有第二长度,其中第二长度大于第一长度。
在一个示例性实施例中,无绳电外科器械包括电池437。电池437向发生器电路420提供电能。电池437可以是适于以期望的能级驱动发生器电路420的任何电池。在一个示例性实施例中,电池437为1030mAhr三芯锂离子聚合物电池。该电池可在用于外科手术之前充满电,并可保持约12.6V的电压。电池437可具有装配到无绳电外科器械410的两条保险丝,它们与每个电池端子成一直线地布置。在一个示例性实施例中,提供用于将电池437连接到直流电源(未示出)的充电口439。
发生器电路420可以任何合适的方式配置。在一些实施例中,发生器电路包括射频驱动和控制电路440以及控制器电路482。图18B示出根据一个实施例的射频驱动和控制电路440。图18B是示出用于该实施例中以生成和控制提供给端部执行器326的射频电能的射频驱动和控制电路440的局部方框示意图。如下文将更详细地解释,在该实施例中,驱动电路440是包括基于射频放大器输出的并联谐振网络的谐振模式射频放大器,而控制电路工作以控制驱动信号的工作频率以使得其保持在驱动电路的谐振频率,继而控制提供给端部执行器326的功率的量。根据以下说明,实现这点的方式将是显而易见的。
如图18B中所示,射频驱动和控制电路440包括上述电池437,在该例子中其被布置成提供约0V和约12V的导轨。输入电容器(Cin)442连接在0V与12V之间,用于提供低源阻抗。一对FET开关443-1和443-2(在该实施例中,此二者均为N型通道以减少功率损耗)串联在0V导轨与12V导轨之间。提供生成两个驱动信号的FET栅极驱动电路805,这两个驱动信号中的一个用于驱动所述两个FET 443中的每一个。该FET栅极驱动电路445生成驱动信号,其在当下部FET(443-2)截止时使得上部FET(443-1)导通,反之亦然。这使得节点447交替地连接到12V导轨(当FET 443-1导通时)和0V导轨(当FET 443-2导通时)。图18B还显示了相应FET 443的内部寄生二极管448-1和448-2,它们在FET 443导通的任意期间传导。
如图18B所示,节点447连接到由电感器Ls 452和电感器Lm 454形成的电感器-电感器谐振电路450。FET栅极驱动电路445被布置成以驱动频率(fd)生成驱动信号,该驱动信号以并联谐振电路450的谐振频率导通和截止FET开关443。由于谐振电路450的谐振特性,在节点447处的方波电压将使得在驱动频率(fd)下的基本上呈正弦的电流在谐振电路450内流动。如图18B所示,电感器Lm 454是变压器455的主线圈,该变压器的次线圈由电感器Lsec 456形成。变压器455次线圈的电感器Lsec 456连接到通过电感器L2458、电容器C4460和电容器C2462形成的电感器-电容器-电容器并联谐振电路457。变压器455将电感器Lm 454两端的驱动电压(Vd)升压转换成施加到输出并联谐振电路457的电压。负载电压(VL)由并联谐振电路457输出,并施加到与镊子的钳口和由端部执行器326所夹持的任何组织或血管的阻抗对应的负载(在图18B中由负载电阻R负载459表示)。如图18B所示,提供了一对直流阻塞电容器CbI 480-1和480-2以防止任何直流电信号施加到负载459。
在一个实施例中,变压器455可由符合以下规格的芯直径(mm)、网丝直径(mm)和二次绕组之间的间隙实施:
芯直径,D(mm)
D=19.9×10-3
22AWG电线的网丝直径,W(mm)
W=7.366×10-4
二次绕组之间的间隙,间隙=0.125
G=间隙/25.4
在该实施例中,通过改变用于切换FET 443的转换信号的频率而对提供给端部执行器326的电量进行控制。这是可行的,因为谐振电路450充当频率相依性(无损耗)衰减器。驱动信号越接近谐振电路450的谐振频率,驱动信号衰减得就越少。相似地,随着驱动信号的频率从电路450的谐振频率移除,该驱动信号衰减得就越多,因此提供给负载的功率减少。在该实施例中,基于将递送到负载459的期望功率和由常规电压感测电路483和电流感测电路485获得的负载电压(VL)和负载电流(IL)的测量值,由控制器481对FET栅极驱动电路445所生成的转换信号的频率进行控制。控制器481运行的方式将在下文中更详细地描述。
在一个实施例中,电压感测电路483和电流感测电路485可以用高带宽、高速轨到轨放大器(例如,由National Semiconductor制造的LMH6643)实施。然而,此类放大器在其操作时消耗相对高的电流。因此,可提供节电电路以降低放大器在不用于电压感测电路483和电流感测电路485中时的供电电压。在一个实施例中,节电电路可使用降压稳压器(例如,由Linear Technologies制造的LT3502)来降低轨到轨放大器的供电电压并因此延长电池437的寿命。
图18C示出根据一个实施例的控制器481的主要部件。在图18C所示的实施例中,控制器481是基于微处理器的控制器,因此图16中所示的大部分部件为基于软件的部件。然而,也可以使用基于硬件的控制器481。如图所示,控制器481包括同步I,Q取样电路491,其从感测电路483和485接收感测到的电压和电流信号,并且获得传送到功率、Vrms和Irms计算模块493的相应样本。计算模块493使用接收到的样本以计算施加到负载459(图18B;端部执行器326及因而夹持的组织/血管)的RMS电压和RMS电流,并通过它们计算目前正施加给负载459的功率。然后将确定值传送到频率控制模块495和医疗装置控制模块497。医疗装置控制模块497使用该值确定负载459的当前阻抗,并且基于该确定的阻抗和预定义的算法,确定应当将何种设定点功率(P设定)施加到频率控制模块495。医疗装置控制模块497继而由从用户输入模块499接收的信号来控制,用户输入模块从用户(例如,按下按钮或启动柄部104上的控制杠杆114,110)接收输入,并且还经由用户输出模块461来控制柄部104上的输出装置(灯、显示器、扬声器等)。
频率控制模块495使用得自计算模块493的值和得自医疗装置控制模块497的设定点功率(P设定)以及预定义的系统限制(将在下文中阐释)确定是否要提高或降低所施加的频率。然后,将该决定的结果传送到方波发生模块463,其在该实施例中根据接收到的决定将自身生成的方波信号的频率提高或降低1kHz。如本领域的技术人员将会知道的那样,在可供选择的实施例中频率控制模块495可不仅确定是否要提高或降低频率,还确定所需的频率变化的量。在这种情况下,方波发生模块463将生成与期望的频移对应的方波信号。在该实施例中,将由方波发生模块463生成的方波信号输出到FET栅极驱动电路445,该FET栅极驱动电路将该信号放大然后将其施加到FET443-1。该FET栅极驱动电路445还转换施加到FET 443-1的信号并且将转换的信号施加到FET 443-2。
电外科器械410可包括如相对于电外科系统300所讨论的另外的特征结构。本领域的技术人员将认识到,电外科器械410可包括旋转旋钮348、伸长轴314和端部执行器326。这些元件以与上文相对于电外科系统300所讨论的那些方式基本上类似的方式发挥作用。在一个示例性实施例中,无绳电外科器械410可包括视觉指示器435。视觉指示器435可向操作员提供视觉指示信号。在一个示例性实施例中,视觉指示信号可警示操作员装置已开启,或者装置正在向端部执行器施加能量。本领域的技术人员将认识到,视觉指示器435能够提供关于装置的多种状态的信息。
多年以来,已经开发出多种微创机器人(或“远距离外科手术”)系统以增加外科手术的灵巧性,并允许外科医生以直观的方式对患者进行手术。机器人外科系统可以与许多不同类型的外科器械一起使用,这些外科器械包括例如超声或电外科器械,如本文所述。示例性机器人系统包括由IntuitiveSurgical,Inc.(Sunnyvale,California,U.S.A)制造的那些。此类系统以及得自其他制造商的机器人系统在以下美国专利中进行了公开,这些美国专利各自全文以引用方式并入本文:名称为“Articulated Surgical Instrument ForPerforming Minimally Invasive Surgery With Enhanced Dexterity andSensitivity”的美国专利No.5,792,135、名称为“Robotic Arm DLUS ForPerforming Surgical Tasks”的美国专利No.6,231,565、名称为“RoboticSurgical Tool With Ultrasound Cauterizing and Cutting Instrument”的美国专利No.6,783,524、名称为“Alignment of Master and Slave In a Minimally InvasiveSurgical Apparatus”的美国专利No.6,364,888、名称为“Mechanical ActuatorInterface System For Robotic Surgical Tools”的美国专利No.7,524,320、名称为“Platform Link Wrist Mechanism”的美国专利No.7,691,098、名称为“Repositioning and Reorientation of Master/Slave Relationship in MinimallyInvasive Telesurgery”的美国专利No.7,806,891以及名称为“Surgical ToolWith Writed Monopolar Electrosurgical End Effectors”的美国专利No.7,824,401。然而,许多此类系统在过去尚未能生成有效切割和紧固组织所需量级的力。
图19-图46C示出机器人外科系统的示例性实施例。在一些实施例中,所公开的机器人外科系统可以利用本文所述的超声或电外科器械。本领域的技术人员将会知道,所示的机器人外科系统不仅仅限于本文所述的那些器械,而是可以利用任何相容的外科器械。本领域的技术人员还将认识到,虽然本文所述的各种实施例可以与所述的机器人外科系统一起使用,但是公开内容并不如此受到限制,而是可以与任何相容的机器人外科系统一起使用。
图19-图25示出若干示例性机器人外科系统及其部件的结构和操作。图19示出示例性机器人外科系统1000的方框图。系统1000包括至少一个控制器508和至少一个臂车510。臂车510可机械地联接到一个或多个由方框512指示的机器人操纵器或机器人臂。机器人臂512中的每一个可以包括一个或多个外科器械514,用于对患者504执行各种手术任务。臂车510(包括臂512和器械514)的操作可由临床医生502从控制器508进行指挥。在一些实施例中,由第二临床医生502'操作的第二控制器508'也可与第一临床医生502'协力指挥臂车510的操作。例如,临床医生502,502'中的每一位可以控制臂车的不同臂512,或在一些情况下,可在临床医生502,502'之间传递对臂车510的完全控制。在一些实施例中,可将另外的臂车(未示出)用于患者504。这些另外的臂车可由控制器508,508'中的一个或多个控制。臂车510和控制器508,508'可经由通信链路516彼此通信,该通信链路可以是根据任何合适的通信协议承载任何合适类型的信号(例如,电信号、光信号、红外信号等)的任何合适类型的有线或无线通信链路。机器人外科系统(诸如系统1000)的示例性具体实施在已经以引用方式并入本文的美国专利No.7,524,320中有所公开。因而,本文将不详细描述此类装置的各个细节,除了理解受权利要求书保护的装置的各种实施例可能必需的细节外。
图20示出机械臂车520的一个示例性实施例。机械臂车520能够致动多个外科器械或器械,它们在工作包封空间519内一般被指定为522。名称为“Multi-Component Telepresence System and Method”的美国专利No.6,132,368中公开了使用主控制器和机械臂车布置的各种机器人外科手术系统和方法,该专利的全部公开内容以引用方式并入本文。在各种形式中,机械臂车520包括基座524,在该图示实施例中,该基座支撑有三个外科器械522。在各种形式中,外科器械522各自由一系列可在手动操作下进行关节运动的连杆(一般称为装置接头526)和机器人操纵器528支撑。本文示出的这些结构具有在机器人连杆的大部分之上延伸的护盖。这些护盖可以是任选的,并且可在尺寸上有所限制或在一些实施例中完全消除,以使用于操纵此类装置的伺服机构遇到的惯性最小化、限制运动部件的体积以避免碰撞、并且限制车520的总重量。车520将通常具有适于在手术室之间传送车520的尺寸。车520能够通常适于穿过标准的手术室门并放置到标准的医院电梯上。在各种形式中,车520将优选地具有一定的重量并包括轮(或其他传送)系统,该轮系统使得车520可被单个维护人员邻近手术台定位。
图21示出机械臂车520的机器人操纵器528的一个示例性实施例。在图21所示的例子中,机器人操纵器528可包括约束外科器械522的运动的连杆530。在各种实施例中,连杆530包括由旋转接头以平行四边形布置方式联接在一起的刚性连接件,使得外科器械522围绕空间532中的某一点旋转,如在已公布的美国专利No.5,817,084中更完整地描述,该专利的全部公开内容以引用方式并入本文。平行四边形布置方式将旋转约束为围绕轴线534a(有时称为俯仰轴)枢转。支撑平行四边形连杆的连接件以枢转方式安装到装置接头526(图20),使得外科器械522还围绕轴线534b(有时称为偏航轴)旋转。俯仰轴534a和偏航轴534b在远程中心536处相交,该远程中心沿着外科器械522的轴538对齐。当由操纵器540支撑时,外科器械522可具有另外的从动自由度,包括外科器械522沿着纵向器械轴线“LT-LT”的滑动运动。当外科器械522沿着器械轴线LT-LT相对于操纵器540滑动时(箭头534c),远程中心536相对于操纵器540的基座542保持固定。因此,整个操纵器540通常发生运动,从而使远程中心536重新定位。操纵器540的连杆530由一系列马达544驱动。这些马达544响应于控制系统处理器的命令而主动运动连杆530。如将在下文中进一步详细论述,马达544还用于操纵外科器械522。
图22示出具有可供选择的装置接头结构的机械臂车520'的一个示例性实施例。在该示例性实施例中,外科器械522由位于两个组织操纵器械之间的可供选择的操纵器结构528'支撑。本领域的普通技术人员将会知道,受权利要求书保护的装置的各种实施例可以包括多种可供选择的机器人结构,包括在美国专利No.5,878,193中描述的那些结构,该专利的全部公开内容以引用方式并入本文。另外,虽然本文结合外科器械522和控制器之间的通信初步描述了机器人部件和机器人外科系统的处理器之间的数据通信,但应当理解,类似的通信可发生在操纵器、装置接头、内窥镜或其他图像捕获装置等的电路和机器人外科系统的处理器之间,所述机器人外科系统的处理器用于部件相容性核实、部件类型识别、部件校准(诸如偏移等)通信、部件与机器人外科系统的联接确认等。
图23示出控制器518的一个示例性实施例,该控制器可以与机械臂车诸如在图20-图22中描绘的机械臂车520,520'结合使用。控制器518通常包括主控制器(在图23中一般表示为519),在临床医生通过立体显示器521观察手术的同时,该主控制器由临床医生抓持并在空间操纵。外科医生反馈计515可通过显示器521观察并为外科医生提供正施加于切割器械或动态夹紧构件的力的大小的视觉指示。主控制器519通常包括手动输入装置,该手动输入装置优选地以多个自由度并且通常还具有用于致动工具(例如,用于闭合抓持锯、施加电势到电极等)的柄部或触发器。
图24示出适于与机器人外科系统一起使用的超声外科器械522的一个示例性实施例。例如,外科器械522可以联接到上文所述的外科操纵器528,528'中的一个。如在图24中可以看出,外科器械522包括外科端部执行器548,该外科端部执行器包括超声刀550和夹持臂552,该外科端部执行器可联接到伸长轴组件554,在一些实施例中,该伸长轴组件可包括关节运动接头556。图25示出用电外科器械523替代超声外科器械522的另一个示例性实施例。外科器械523包括外科端部执行器548,该外科端部执行器包括可闭合的钳口551A,551B,它们具有能量递送表面553A,553B,用于接合钳口551A,551B之间的组织并向该组织提供电能。组织切割元件或刀555可定位在可轴向运动的构件557的远侧端部处,该可轴向运动的构件可延伸穿过伸长轴组件554到达器械安装部分558。图26示出器械驱动组件546的一个实施例,该器械驱动组件可联接到外科操纵器528,528'中的一个,用于接收和控制外科器械522,523。器械驱动组件546还可以操作地联接到控制器518,用于接收来自临床医生的输入而对器械522,523进行控制。例如,夹持臂552的致动(即,打开和闭合)、钳口551A,551B的致动(即,打开和闭合)、超声刀550的致动、刀555的延伸以及能量递送表面553A,553B的致动等可通过器械驱动组件546基于来自临床医生通过控制器518提供的输入而加以控制。外科器械522通过器械安装部分(一般称为558)可操作地联接到操纵器。外科器械522还包括在机械和电气上将器械安装部分558联接到操纵器的接合部560。
图27示出包括超声外科器械522的图26的器械驱动组件的另一个视图。图28示出包括电外科器械523的图26的器械驱动组件的另一个视图。器械安装部分558包括工具安装板562,该工具安装板可操作地支撑多个(图26中示出四个)可旋转主体部分、从动盘或从动元件564,所述每个从动盘或从动元件包括从从动元件564的表面延伸的一对销566。一个销566比同一个从动元件564上的另一个销566更靠近每个从动元件564的旋转轴线,这有助于确保从动元件564的正向角对齐。从动元件564和销566可定位在器械安装板562的适配器侧567上。
接合部560还包括能够与安装板562以安装方式接合的适配器部分568,如将在下文中进一步论述。适配器部分568可包括一系列电连接销570,这些电连接销可通过器械安装部分558内的电路板而联接到存储器结构。虽然结合机械联接元件、电联接元件和磁力联接元件在本文中描述了接合部560,但是应当理解,可以使用多种遥测形式,包括红外、电感联接等。
图29-图31示出图26的器械驱动组件546的适配器部分568的附加视图。适配器部分568通常包括器械侧572和夹持器侧574(图29)。在各种实施例中,将多个可旋转主体576安装到浮动板578,该浮动板相对于垂直于适配器568主表面的周围适配器结构具有受限的运动范围。当致动沿着器械安装部分外壳582的侧面的杠杆580时(参见图24和图25),浮动板578的轴向运动有助于使可旋转主体576从器械安装部分558脱离。可采用其他机构/布置以可释放的方式将器械安装部分558联接到适配器568。在至少一种形式中,通过弹性径向构件将可旋转主体576弹性地安装到浮动板578,该弹性径向构件围绕可旋转主体576延伸到周边凹痕中。可旋转主体576可通过偏转这些弹性结构而相对于板578轴向运动。当设置在第一轴向位置(朝器械侧572)时,可旋转主体576自由旋转而没有角度限制。然而,当可旋转主体576朝器械侧572轴向运动时,突出部584(从可旋转主体576径向延伸)横向接合浮动板上的棘爪以便限制可旋转主体576围绕其轴线的角旋转。当驱动销586将可旋转主体576推动至受限的旋转位置直到销586与开口590对准(并滑动到其中)时,可使用该受限的旋转来帮助可旋转主体576与机器人系统的对应器械架部分588的驱动销586驱动接合。
可旋转主体576的器械侧572上的开口590以及夹持器侧574上的开口590能够将器械安装部分558的从动元件564(图27、图28)与器械架588的驱动元件592准确对准。如上文关于从动元件564的内部和外部销566所述,开口590位于相距其各自的可旋转主体576的旋转轴线不同的距离处,以便确保与之要达到的位置不呈33度对齐。另外,每个开口590可能略微径向伸长,以便适当地接收周边方向上的销566。这使得销566在开口590内径向滑动并适应器械522,523和器械架588之间的一些轴偏差,同时使驱动元件和从动元件之间的任何角偏差和角侧隙最小化。器械侧572上的开口590可与夹持器侧574上的开口590(以虚线示出)成约90度的偏移,如在图31中可以最清楚地看到。
各种实施例还可以包括位于适配器568的夹持器侧574上的一系列电连接销570,并且适配器568的器械侧572可包括狭槽594(图31),用于接收器械安装部分558的销阵列(未示出)。除了在外科器械522,523和器械架588之间传输电信号外,可通过适配器568的电路板将这些电连接中的至少一些联接到适配器存储器装置596(图30)。
可使用可拆卸的闩锁布置598以可释放的方式将适配器568附连至工具架588。如本文所用,术语“器械驱动组件”在用于机器人系统的背景中时至少涵盖适配器568和器械架588的各种实施例,并且其在图26中一般称为546。例如,如在图26中可以看出,器械架588可包括第一闩锁销布置600,该第一闩锁销布置的大小被设计成接收在适配器568中相应的连接叉狭槽602中。另外,器械架588还可以具有第二闩锁销604,该第二闩锁销的尺寸被设计成保持在适配器568中相应的闩锁连接叉606中。参见图30。在至少一种形式中,闩锁组件608被活动地支撑在适配器568上,并且能够在第一闩锁位置和未闩锁位置之间偏置,在第一闩锁位置中,闩锁销600保持在它们各自的闩锁连接叉606中,在未闩锁位置中,第二闩锁销604可进入闩锁连接叉606或从中移除。使用一个或多个弹簧(未示出)以将闩锁组件偏置到闩锁位置。适配器568的器械侧572上的唇缘可能够滑动地接收器械安装外壳582的横向延伸的突出部。
如前所述,从动元件564可与器械架588的驱动元件592对准,使得驱动元件592的旋转运动导致从动元件564的相应旋转运动。驱动元件592和从动元件564的旋转可(例如)响应于经由控制器508从临床医生502接收的指令而受到机械臂612的电子控制。器械安装部分558可将从动元件564的旋转转化成外科器械522,523的运动。
图32-图34示出器械安装部分558的一个示例性实施例,显示了用于将从动元件564的运动转化成外科器械522,523的运动的部件。图32-图34示出具有轴538的器械安装部分,该轴在其远侧端部处具有外科端部执行器610。端部执行器610可以是用于对患者执行外科任务的任何合适类型的端部执行器。例如,端部执行器能够向手术位点处的组织提供射频和/或超声能量。轴538可旋转地联接到器械安装部分558并在轴538的联轴器650处由顶部轴夹持器646和底部轴夹持器648固定。
在一个示例性实施例中,器械安装部分558包括将各种从动元件564的旋转转化成轴538的旋转、构件沿轴的轴线的微分平移(例如,用于进行关节运动)、以及一个或多个构件沿轴538的轴线的往复式平移(例如,用于延伸和缩回组织切割元件诸如555、外套管和/或其他部件)的机构。在一个示例性实施例中,可旋转主体612(例如,可旋转卷轴)联接到从动元件564。可旋转主体612可与从动元件564整体地形成。在一些实施例中,可旋转主体612可与从动元件564分别形成,前提是可旋转主体612和从动元件564固定地联接以使得驱动从动元件564将导致可旋转主体612旋转。可旋转主体612中的每一个联接到齿轮系或齿轮机构,用于提供轴的关节运动和旋转、夹持钳口的打开/闭合、以及刀致动。
在一个示例性实施例中,器械安装部分558包括用于引起两个或更多个构件沿轴538的轴线发生微分平移的机构。在图32-图34提供的例子中,该运动用于操纵关节运动接头556。在该图示实施例中,例如,器械安装部分558包括齿条与小齿轮传动机构以提供微分平移并因而提供轴关节运动功能。在一个示例性实施例中,齿条与小齿轮传动机构包括联接到可旋转主体612的第一小齿轮614,使得相应从动元件564的旋转导致第一小齿轮614旋转。轴承616联接到可旋转主体612并在从动元件564与第一小齿轮614之间提供。第一小齿轮614啮合到第一齿条618以将第一小齿轮614的旋转运动转化成第一齿条618的线性运动,从而控制轴组件538的关节运动段556沿向左方向620L的关节运动。第一齿条618附接到第一关节运动带622(图32),使得第一齿条618沿远侧方向的线性运动导致轴组件538的关节运动段556沿向左方向620L进行关节运动。第二小齿轮626联接到另一个可旋转主体612,使得相应从动元件564的旋转导致第二小齿轮626旋转。轴承616联接到可旋转主体612并在从动元件564与第二小齿轮626之间提供。第二小齿轮626啮合到第二齿条628以将第二小齿轮626的旋转运动转化成第二齿条628的线性运动,从而控制关节运动段556沿向右方向620R的关节运动。第二齿条628附接到第二关节运动带624(图33),使得第二齿条628沿远侧方向的线性运动导致轴组件538的关节运动段556沿向右方向620R进行关节运动。可以在可旋转主体与相应齿轮之间提供另外的轴承。可以提供任何合适的轴承以支撑和稳定安装,并且减小例如轴和齿轮的旋转摩擦。
在一个示例性实施例中,器械安装部分558还包括用于将从动元件564的旋转转化成围绕轴538的轴线的旋转运动的机构。例如,旋转运动可以是轴538自身的旋转。在该图示实施例中,第一螺旋蜗轮630联接到可旋转主体612,第二螺旋蜗轮632联接到轴组件538。轴承616(图17)联接到可旋转主体612并在从动元件564与第一螺旋蜗轮630之间提供。第一螺旋蜗轮630啮合到第二螺旋蜗轮632,后者可联接到轴组件538和/或器械522,523的需要其纵向旋转的另一个部件。旋转可基于第一螺旋蜗轮630和第二螺旋蜗轮632的旋转方向而沿顺时针(CW)方向和逆时针(CCW)方向进行。因此,第一螺旋蜗轮630绕第一轴线的旋转被转换为第二螺旋蜗轮632绕第二轴线的旋转,第二轴线与第一轴线正交。如图32-图33所示,例如,第二螺旋蜗轮632的顺时针旋转导致轴组件538以634CW所指示的方向顺时针旋转。第二螺旋蜗轮632的逆时针旋转导致轴组件538以634CCW所指示的方向逆时针旋转。可以在可旋转主体与相应齿轮之间提供另外的轴承。可以提供任何合适的轴承以支撑和稳定安装,并且减小例如轴和齿轮的旋转摩擦。
在一个示例性实施例中,器械安装部分558包括用于生成一个或多个构件沿轴538的轴线的往复式平移的机构。这种平移可用于例如驱动组织切割元件诸如555、驱动外套管以使端部执行器610闭合以及/或者进行关节运动等。在该图示实施例中,例如,齿条与小齿轮传动机构可提供往复式平移。第一齿轮636联接到可旋转主体612,使得相应从动元件564的旋转导致第一齿轮636以第一方向旋转。第二齿轮638围绕在器械安装板562中形成的柱640自由旋转。第一齿轮636啮合到第二齿轮638,使得第二齿轮638以与第一齿轮636相反的方向旋转。在一个示例性实施例中,第二齿轮638是啮合到沿线性方向运动的齿条642的小齿轮。齿条642联接到平移块644,该平移块可与齿条642一起朝远侧和近侧平移。平移块644可联接到轴组件538和/或端部执行器610的任何合适的部件以便提供往复式纵向运动。例如,平移块644可机械地联接到射频外科装置523的组织切割元件555。在一些实施例中,平移块644可以联接到外套管,或端部执行器610或轴538的另一个部件。
图35-图37示出器械安装部分558的另选实施例,显示了用于将从动元件564的旋转转化成围绕轴538的轴线的旋转运动的另选示例性机构,以及用于生成一个或多个构件沿轴538的轴线的往复式平移的另选示例性机构。现在参见另选旋转机构,第一螺旋蜗轮652联接到第二螺旋蜗轮654,该第二螺旋蜗轮联接到第三螺旋蜗轮656。可出于各种原因提供这样的布置,这些原因包括维持与现有机器人系统1000的相容性以及/或者实际情况是空间可能有限。第一螺旋蜗轮652联接到可旋转主体612。第三螺旋蜗轮656与联接到轴组件538的第四螺旋蜗轮658啮合。轴承760联接到可旋转主体612并在从动元件564与第一螺旋蜗轮738之间提供。另一个轴承760联接到可旋转主体612并在从动元件564与第三螺旋蜗轮652之间提供。第三螺旋蜗轮652啮合到第四螺旋蜗轮658,该第四螺旋蜗轮可联接到轴组件538和/或器械522,523的需要其纵向旋转的另一个部件。旋转可基于螺旋蜗轮656,658的旋转方向而沿顺时针方向和逆时针方向进行。因此,第三螺旋蜗轮656绕第一轴线的旋转被转换为第四螺旋蜗轮658绕第二轴线的旋转,第二轴线与第一轴线正交。如图36和图37所示,例如,第四螺旋蜗轮658联接到轴538,并且第四螺旋蜗轮658的顺时针旋转导致轴组件538以634CW所指示的方向顺时针旋转。第四螺旋蜗轮658的逆时针旋转导致轴组件538以634CCW所指示的方向逆时针旋转。可以在可旋转主体与相应齿轮之间提供另外的轴承。可以提供任何合适的轴承以支撑和稳定安装,并且减小例如轴和齿轮的旋转摩擦。
现在参见用于生成一个或多个构件沿轴538的轴线的往复式平移的另选示例性机构,工具安装部分558包括齿条与小齿轮传动机构以提供沿轴538的轴线的往复式平移(例如,射频外科装置523的组织切割元件555的平移)。在一个示例性实施例中,第三小齿轮660联接到可旋转主体612,使得相应从动元件564的旋转导致第三小齿轮660以第一方向旋转。第三小齿轮660啮合到沿线性方向运动的齿条662。齿条662联接到平移块664。平移块664可联接到装置522,523的部件,诸如,射频外科装置的组织切割元件555和/或外套管或期望其纵向平移的其他部件。
图38-图42示出器械安装部分558的另选实施例,显示了用于将从动元件564的旋转转化成围绕轴538的轴线的旋转运动的另一个另选示例性机构。在图38-图42中,轴538经由联轴器676和轴衬678联接到安装部分558的其余部分。联接到可旋转主体612的第一齿轮666、包括第一和第二开口672的固定柱668、联接到轴组件的第一和第二可旋转销674、以及缆线670(或绳索)。缆线缠绕在可旋转主体612周围。缆线670的一个末端定位穿过固定柱668的顶部开口672并固定地联接到顶部可旋转销674。缆线670的另一个末端定位穿过固定柱668的底部开口672并固定地联接到底部旋转销674。出于各种原因提供这样的布置,这些原因包括维持与现有机器人系统1000的相容性以及/或者实际情况是空间可能有限。因此,可旋转主体612的旋转基于可旋转主体612的旋转方向导致围绕轴组件538以顺时针和逆时针方向旋转(例如,轴538自身的旋转)。因此,可旋转主体612绕第一轴线的旋转被转换为轴组件538绕第二轴线的旋转,第二轴线与第一轴线正交。如图38和图39所示,例如,可旋转主体612的顺时针旋转导致轴组件538以634CW所指示的方向顺时针旋转。可旋转主体612的逆时针旋转导致轴组件538以634CCW所指示的方向逆时针旋转。可以在可旋转主体与相应齿轮之间提供另外的轴承。可以提供任何合适的轴承以支撑和稳定安装,并且减小例如轴和齿轮的旋转摩擦。
图43-图46A示出器械安装部分558的另选实施例,显示了用于使构件沿轴538的轴线发生微分平移(例如,用于进行关节运动)的另选示例性机构。例如,如图43-图46A所示,器械安装部分558包括双凸轮机构680以提供轴关节运动功能。在一个示例性实施例中,双凸轮机构680包括第一凸轮部分680A和第二凸轮部分680B。第一从动臂682和第二从动臂684可枢转地联接到相应的枢转卷轴686。当联接到双凸轮机构680的可旋转主体612旋转时,第一凸轮部分680A作用于第一从动臂682,而第二凸轮部分680B作用于第二从动臂684。当凸轮机构680旋转时,从动臂682,684绕枢转卷轴686枢转。第一从动臂682可附接到待发生微分平移的第一构件(例如,第一关节运动带622)。第二从动臂684附接到待发生微分平移的第二构件(例如,第二关节运动带624)。当顶部凸轮部分680A作用于第一从动臂682时,第一构件和第二构件发生微分平移。在第一构件和第二构件为相应的关节运动带622和624的示例性实施例中,轴组件538沿向左方向620L进行关节运动。当底部凸轮部分680B作用于第二从动臂684时,轴组件538沿向右方向620R进行关节运动。在一些示例性实施例中,两个单独的轴衬688,690安装在相应的第一从动臂682和第二从动臂684之下,以允许轴在不影响第一从动臂682和第二从动臂684的关节运动位置的情况下旋转。对于关节运动动作,这些轴衬与第一从动臂682和第二从动臂684一起进行往复运动,而不影响钳口902的旋转位置。图46A示出轴衬688,690和双凸轮组件680,该双凸轮组件包括第一凸轮部分680B和第二凸轮部分680B,且第一从动臂682和第二从动臂684被移除以提供更详细且更清楚的视图。
如图46B-图46C所示,器械安装部分558'可包括远侧部分702。远侧部分702可包括用于将驱动元件612的旋转联接到例如如上文所述的各种外科器械522,523的端部执行器的各种机构。在远侧部分702的近侧,器械安装部分558'包括内部直流(DC)能量源以及内部驱动和控制电路704。在该图示实施例中,能量源包括第一电池706和第二电池708。在其他方面,工具安装部分558'与上文所述的工具安装部分558的各种实施例类似。
控制电路704可以与上文关于发生器20,320所述相似的方式工作。例如,当利用超声器械522时,控制电路704可以与上文关于发生器20所述相似的方式提供超声驱动信号。另外,例如,当使用能够提供治疗或非治疗射频信号的射频器械523或超声器械522时,控制电路704可提供射频驱动信号,例如,如上文关于发生器20和/或发生器300的模块23所述。在一些实施例中,控制电路704可以与上文关于图18B-图18C所述的控制电路440相似的方式进行配置。
用于控制机器人外科系统500的控制系统的各种实施例在下文中有所论述。本领域的技术人员应当理解,如结合控制系统所用,术语“近侧”和“远侧”相对于握持控制系统的手持件的临床医生而定义。因此,沿远侧方向的运动将是沿远离临床医生的方向的运动。还应当理解,为简洁和清楚起见,相对于握持手持件组件的临床医生而言,本文还使用了诸如“顶部”和“底部”之类的专门术语。然而,控制系统可用于许多取向和位置中,并且这些术语并非意图是限制的或绝对的。
将结合上述机器人外科系统500描述各种实施例。此类说明以举例而非进行限制的方式提供,并且不旨在限制其范围和应用。例如,本领域技术人员应当理解,所述控制系统中的任一个都可以结合多个机器人外科系统使用。
图47以方框图形式示出外科机器人控制系统700的一个实施例。图48-图50示出具有简化部件的外科机器人控制系统700的一个实施例。外科机器人控制系统700可结合各种机器人外科系统使用,例如上述机器人外科系统500。在图47所示实施例中,外科机器人控制系统700可包括联接到手持式外科用户接合部726的控制器724。手持式外科用户接合部726可通过任何合适的联接系统联接到控制器724,例如,机械联接、电联接、光学联接或它们的任意组合。控制器724与机器人外科系统722信号通信。在控制器724和机器人外科系统722之间的信号通信可使用各种介质和协议实现,包括但不限于直接有线通信、直接无线通信、经由LAN、WAN、无线LAN或任何其他合适的通信系统通信。机器人外科系统722可以是任何合适的机器人外科系统,包括但不限于本文所述的那些。机器人外科系统722包括机械联接且电联接至机器人外科系统的臂车710。
在一个示例性实施例中,用户可操纵手持式外科用户接合部726以控制机器人外科系统722和臂车710。在各种实施例中,至少一个传感器712检测手持式外科用户接合部726的一种或多种运动。传感器712将这些运动通信至控制器724。在一些实施例中,至少一个传感器712可将这些运动直接转化成用于机器人外科系统的控制信号。在另一个实施例中,至少一个传感器712可将这些运动直接通信至控制器724,该控制器将手持式外科用户接合部726的运动转化成用于机器人外科系统722和臂车710的电气控制信号。
机器人外科系统722从控制器724接收控制信号。在各种实施例中,控制信号可以控制机器人外科系统722和臂车710以引起机器人外科系统722的一个或多个部分运动。这些运动可包括但不限于端部执行器或机器人操纵器的远侧或近侧平移、端部执行器或机器人操纵器的向左或向右平移、端部执行器或机器人操纵器的向上或向下平移、端部执行器或机器人操纵器的旋转、端部执行器或机器人操纵器的关节运动、以及诸如超声能量或电外科能量的各种形式的能量的施加。
在各种实施例中,手持式外科用户接合部726可以是适于为用户提供可容易操纵的柄部的任何形状。在一些实施例中,手持式外科用户接合部726可以是操纵杆。在其他实施例中,手持式外科用户接合部726可以是外科装置柄部,类似于结合图1-图18所描述的那些。手持式外科用户接合部726提供允许外科医生经过最少的培训即可操作机器人外科系统的优点。在一些实施例中,手持式外科用户接合部726通过在机器人外科手术中模拟将在非机器人外科手术中使用的运动和程序而提供维持用户在标准非机器人外科手术中的技能的优点,从而允许外科医生在机器人外科系统和非机器人外科手术之间无缝地运动,而不丧失灵巧性或技能。
在一些实施例中,手持式外科用户接合部可包括一个或多个开关。所述一个或多个开关能够控制外科器械的端部执行器的一个或多个功能。例如,第一开关能够控制电外科能量向端部执行器523的施加。在另一个实施例中,第二开关能够控制端部执行器523的第一钳口构件551A和第二钳口构件551B的致动。本领域的技术人员应当理解,任何合适的开关都可并入手持式外科用户接合部726中以提供对外科器械的一个或多个功能的控制。
在一个示例性实施例中,外科机器人控制系统700可包括至少一个反馈装置714。至少一个反馈装置714可联接到控制器724、承窝716或两者。至少一个反馈装置为用户提供对应于机器人外科系统722的一个或多个预先确定的条件的信号。预先确定的条件中的一些或全部可与能量递送的状态有关。例如,可以提供表明能量递送开启、能量递送关闭、能量递送完成的反馈。预先确定的条件中的一些或全部也可与端部执行器和/或所包括的刀的温度有关。此类预先确定的条件的例子可包括温度高、温度安全和/或实际温度的指示。预先确定的条件中的一些或全部也可与(通过闭合或击发)施加在端部执行器上的力有关。这些条件可涉及被处理的组织的厚度和/或阻塞。
反馈装置714可提供对应于预先确定的器械条件的任何合适形式的感观反馈。合适的感观反馈的例子可包括听觉反馈(声音)、触觉或触知反馈(接触)、光学反馈(视觉或图形)、嗅觉反馈(嗅觉)、味觉反馈(味道)和/或平衡感觉(平衡反馈)。触觉反馈可通过多种形式提供,例如,机械感受(包括但不限于振动感受(振动)和压力感受)、热感知(热)和/或低温感知(冷)。本领域的技术人员应当理解,任何单种反馈类型或它们的任意组合都可用于为用户提供来自机器人外科系统722的反馈。在一些实施例中,反馈的性质可提供预先确定的条件的定量指示。例如,端部执行器的温度的定量指示可由音高随温度变化的音频音、脉冲频率随温度变化的一系列脉冲等提供。
反馈装置714可位于任何合适的位置以向用户提供适当反馈。在一个示例性实施例中,反馈装置714位于外科机器人控制系统700的外壳728内。在另一个实施例中,反馈装置714可位于手持式外科用户接合部726内。这在图48-图50中示出,其中反馈装置714以虚线示出在外壳728和手持式外科用户接合部726两者中。在又一个实施例中,反馈装置可位于机器人外科控制系统的诸如立体显示器521(参见图23)的某个其他部分内,或者可以是单独的单元,其通过安装在外壳728上的第二承窝(未示出)与控制器724接合。
在各种实施例中,手持式外科用户接合部726通过承窝716(参见图49)连接到控制器722和至少一个传感器712。在各种实施例中,承窝716可安装在外壳728的外表面上。在其他实施例中,承窝716可凹陷在外壳728中。在一个示例性实施例中,承窝716和至少一个传感器712可包括单个装置,例如能够接收手持式外科用户接合部726的六个运动自由度输入装置。
如图48-图50所示,承窝716和至少一个传感器712可允许以多个运动自由度操纵手持式外科用户接合部726。承窝716和传感器712可允许以从一个运动自由度到六个运动自由度(或自由运动度)的任意个运动自由度操纵手持式外科用户接合部726。在六个运动自由度的实施例中,手持式外科用户接合部726可通过在三个垂直轴线上平移并围绕三个垂直轴线旋转而被操纵。平移运动可称为例如沿着远侧/近侧轴线、上/下轴线或左/右轴线的运动。旋转运动可称为例如俯仰、偏航或横滚。本领域技术人员将认识到,这些术语仅用于说明,而并非意图以任何方式限制。
在一个示例性实施例中,手持式外科用户接合部726能够与附接到机器人外科系统722的一个或多个具体的外科器械一起工作。例如,如上所述,超声外科器械522可附接到机器人外科系统以允许将超声能量递送至组织位点。手持式外科用户接合部可为超声外科器械提供具体控制,例如,触发器以激活超声外科器械的夹持运动,或开关以启动超声发生器,以将超声能量递送至超声刀550。
在一个示例性实施例中,外科机器人控制系统700可包括外科器械相容性逻辑部件715。外科器械相容性逻辑部件715能够提供指示连接到臂车520的外科器械是否与连接到外科机器人控制系统700的手持式外科用户接合部726相容的信号。通过检查来确保外科器械和手持式外科用户接合部726之间的相容性,外科器械相容性逻辑部件715可防止外科器械的意外致动并确保用户可访问外科器械的所有功能。
在一个示例性实施例中,通过从外科器械接收唯一的识别代码,并且将该识别代码与从手持式外科用户接合部726接收的识别代码相比较,外科器械相容性逻辑部件715可检查外科器械和手持式外科用户接合部726之间的相容性。如果识别代码匹配,则可将相容性信号提供至控制器724,以允许将由控制器724接收的信号转化成用于机器人外科系统722的控制信号。例如,如果超声外科器械522附接到臂车520,则可以将唯一的代码发送至识别超声外科器械522的外科器械相容性逻辑部件715。在另一个实施例中,通过将可从手持式外科用户接合部726接收的输入与可从外科器械接收的控制信号相比较,外科器械相容性逻辑部件715可检查外科器械和手持式外科用户接合部726之间的相容性。如果输入信号匹配控制信号,那么外科器械相容性逻辑部件可将相容性信号提供至控制器724。本领域的技术人员将认识到,外科器械相容性逻辑部件可使用任何合适形式的相容性检查来比较外科器械与手持式外科用户接合部726,而不仅限于本文所述的方法。
在一个示例性实施例中,外科器械相容性逻辑部件715可由在控制器724或任何其他合适的处理器上运行的软件程序执行。在另一个实施例中,外科器械相容性逻辑部件715可由一个或多个逻辑门执行。逻辑门可以作为机器人外科控制系统700的一部分被硬连线,或者可以由诸如现场可编程门阵列的可编程逻辑装置执行。在另一个实施例中,外科器械相容性逻辑部件715可由一个或多个状态机执行。本领域的技术人员应当理解,任何合适的硬件、软件或它们的组合都可用于执行外科器械相容性逻辑部件715。
在一个示例性实施例中,机器人外科控制系统可包括一个或多个灵敏度旋钮,用于调整手持式外科用户接合部726和外科器械的一个或多个运动之间的比率。在一个示例性实施例中,可调整灵敏度旋钮以改变在手持式外科用户接合部726沿近侧或远侧方向的运动与外科器械沿相应的近侧或远侧方向的运动之间的运动比率。在另一个实施例中,一个或多个灵敏度旋钮可控制由控制器从端部执行器和反馈装置714接收的反馈信号之间的比率,以在递送给用户的反馈中提供不同水平的灵敏度。
图51-图52示出机器人外科控制系统800的一个实施例。机器人外科控制系统800包括手持式外科用户接合部806。手持式外科用户接合部包括与一个运动自由度承窝816接合的杠杆822。一个运动自由度承窝816允许杠杆822绕枢转点沿远侧/近侧方向枢转。在一个示例性实施例中,将杠杆822沿远侧方向的运动转化成外科器械或机器人操纵器沿远侧方向相对于臂车520的运动,并且将杠杆822的近侧运动转化成外科器械或机器人操纵器沿近侧方向相对于臂车520的运动(参见图22)。
在图51-图52所示的实施例中,机器人外科控制系统800包括安装在杠杆822上的触发器820。触发器820可由用户压下以激活附接到臂车510的外科器械的功能,例如,端部执行器523的夹持运动。在图51-图52所示的实施例中,触发器820通过承窝816与控制器724电连通。在其他实施例中,触发器820可通过安装到外壳808的第二承窝(未示出)联接到控制器724。
杠杆822还可以包括开关,用于激活附接到机器人外科系统500的外科器械的一个或多个功能。在该图示实施例中,开关为顶帽开关818。在一个示例性实施例中,顶帽开关818控制一种或多种形式的能量向外科器械522的端部执行器的施加。顶帽开关818能够将超声能量、电外科能量或两者提供至端部执行器。顶帽开关818可通过承窝816或通过第二承窝(未示出)接合到控制器724。在一个示例性实施例中,开关可包括通过第二承窝(未示出)连接到控制器724的脚踏板。脚踏板可由用户操作以控制一种或多种形式的能量向外科器械522的端部执行器的施加。在另一个实施例中,该开关可以是置于杠杆822上的电阻套管。用户可通过挤压杠杆822而将压力施加到电阻套管。通过将压力施加到电阻套管,用户可控制外科器械522的一个或多个功能的施加,例如,一种或多种类型的能量向端部执行器的施加。
图53示出机器人外科控制系统900的一个实施例。机器人外科控制系统900包括两个运动自由度承窝916,用于接合手持式电外科器械806。两个运动自由度承窝916允许绕枢转点930沿远侧/近侧方向和在左/右方向操纵杠杆822。类似于上文参照机器人外科控制系统800所述,杠杆822的运动导致机器人外科系统500的运动。杠杆822沿左/右方向的运动导致臂车520沿顺时针或逆时针方向旋转(参见图35-图36)。在图53所示的实施例中,两个运动自由度承窝916包括T形形状,以允许仅沿近侧/远侧方向和左/右方向运动。在另一个实施例中,两个运动自由度承窝916可具有置于承窝916上且附接到外壳908的板,用于将杠杆822的运动限制到仅近侧/远侧方向或左/右方向。
图54示出包括无限制的两个运动自由度承窝1016的机器人外科控制系统1000的一个实施例。无限制的两个运动自由度承窝1016允许杠杆式手持外科用户接合部1006沿近侧/远侧方向和左/右方向绕枢转点1030旋转。无限制的两个运动自由度承窝1016允许沿近侧/远侧方向和左/右方向同时旋转,从而允许同时推进或回缩和旋转外科器械。通过允许外科器械同时推进和旋转,无限制的两个运动自由度承窝1016可以有利地用于例如辅助刺穿组织或器官。杠杆式手持外科用户接合部1006包括用于激活外科器械的功能的顶帽开关1018。顶帽开关1018可用于激活外科器械的任何合适功能,例如,超声或电外科能量的施加。
图55-图56示出包括无限制的四个运动自由度承窝1116的机器人外科控制系统1100的一个实施例。无限制的四个运动自由度承窝1116允许杠杆1122沿近侧/远侧方向和左/右方向绕枢转点1130旋转。无限制的四个运动自由度承窝1116还允许杠杆1122绕竖直轴线“V”旋转。手持式外科用户接合部1106通过允许沿着竖直轴线“V”的横向运动而具有第四个运动自由度。
手持式外科用户接合部1106包括牧羊杖钩触发器1120和顶帽开关1118。牧羊杖钩触发器1120和顶帽开关1118可控制附接到机器人外科系统的外科器械的一个或多个功能。例如,牧羊杖钩触发器1120可控制端部执行器523的夹持运动,并且顶帽开关1118可控制诸如电外科能量的一种或多种类型的能量向端部执行器523的施加。本领域的技术人员将认识到,牧羊杖钩触发器1120和顶帽开关1118能够控制外科器械的任何合适的功能。
在一个示例性实施例中,机器人外科控制系统1100的外壳1108具有安装在其上的视觉反馈装置1114。视觉反馈装置1114可向操作员提供关于外科器械或机器人外科控制系统1100的一个或多个功能的视觉信号。在一个示例性实施例中,视觉反馈装置1114包括LED灯,其响应于能量施加到外科器械的端部执行器(例如,端部执行器548)而被点亮。在另一个实施例中,可启动视觉反馈装置1114以发送外科器械的预编程功能(例如,计算机控制的切割和密封操作)结束的信号。本领域的技术人员将认识到,视觉反馈装置1114能够显示任何相容的外科器械功能的状态。
图57示出包括独立式输入装置1201的机器人外科控制系统1200的一个实施例。独立式输入装置1201包括连接至基座1208的手持式外科用户接合部1206。基座1208容纳承窝1216、传感器1212和缆线1222。缆线1222连接至外壳1108上的第二承窝1116’。第二承窝1116’允许独立式输入装置1201电联接至控制器724。独立式输入装置1201提供这样的优点:允许输入系统针对具体的外科器械设计,同时仍通过由手持式外科用户接合部1106使用的相同控制器724接合,而不必直接插入外壳1108上的承窝1116中。图57还示出其中可通过与位于外壳1108上的多个承窝1116,1116’接合而同时使用多个独立式输入装置1201或一个独立式输入装置1201和手持式外科用户接合部726的实施例。独立式输入装置1201可容纳位于基座1208上、手持式外科用户接合部1206内或两者的一个或多个反馈装置1214,1214’。机器人外科控制系统1200还可利用位于外壳1108上的反馈装置714,1114。
参照图55-图60,现在将描述适合与手持式外科用户接合部726,806,1006,1106,1206一起使用的各种反馈装置。图55-图57示出位于杠杆式手持外科用户接合部1106,1206内的至少一个反馈装置714的使用。在一个示例性实施例中,至少一个反馈装置714可包括振动模块1114’,1214’以将振动运动提供至杠杆式手持外科用户接合部1106,1206。振动模块1114’,1214’可从外科器械接收指示通过与组织位点相互作用而施加到外科器械的力的反馈信号。在一个示例性实施例中,振动模块1114’,1214’可生成与由组织位点施加到外科器械的力的总量成比例的振动运动。在其他实施例中,振动模块1114’,1214’可生成与由组织位点在单个方向或平面中施加到外科器械的力的量成比例的振动运动。在另一个实施例中,振动模块1114’,1214’能够生成与递送至端部执行器的能量(例如,递送至端部执行器548的电外科能量)的量成比例的振动运动。在又一个实施例中,振动模块1114’,1214’能够在执行预编程的功能(例如,端部执行器548的自动密封和切割算法)后生成振动运动。可对由振动模块1114’,1214’生成的振动运动进行调整以向用户提供不同水平的灵敏度。
在一些实施例中,一个或多个反馈装置714可通过一个或多个力反馈装置1214”提供触觉反馈。力反馈在具体方向上提供力或运动,以抵抗手持式外科用户接合部在相对方向上的运动。在一个示例性实施例中,一个或多个力反馈装置1214”可包括任何合适的装置,例如,伺服马达、螺线管或可变压力开关。在一个示例性实施例中,由一个或多个力反馈装置1214”施加的力可与外科器械在与组织位点相互作用时遇到的总力成比例。在其他实施例中,一个或多个力反馈装置1214”可提供与端部执行器和组织位点之间的具体相互作用成比例的力。例如,在一个示例性实施例中,力反馈装置1214”可提供对牧羊杖钩触发器1120的运动的抗力,该抗力与在组织夹持操作期间端部执行器548的钳口551A,551B所遇到的力成比例。
图58-图60示出包括热元件1314的至少一个反馈装置714的一个实施例。如图58所示,热元件1314可包括能够置于手持式外科用户接合部1006的杠杆1022上的热套管。热元件1314包括缆线1315,用于使热元件1314与位于外壳1008上的第二承窝1016’接合。图59-图60示出置于杠杆1022上的热元件1314。一旦热元件1314正确地放置并且通过第二承窝1016’与控制器724接合,热元件就可向用户提供温度梯度形式的触知反馈。在一个示例性实施例中,温度梯度可包括与由附接到外科器械的端部执行器(例如,端部执行器548)递送至组织位点的能量水平成比例地加热热元件1314。通过以与递送至组织位点的能量成比例的速率加热,热元件1314为用户提供对将足够水平的能量施加到组织位点的时间的触知指示。在另一个实施例中,热元件1314可递送指示警告或过热状态的温度梯度,以向用户警示不安全状态。本领域的技术人员应当理解,温度梯度与递送至组织位点的能量之间的比例可以是任何比例,但理想的是对其进行校准以将足够的信息提供给用户,而不造成用户的不适或伤害。
在一个示例性实施例中,一个或多个反馈装置714可向用户提供光学反馈。光学反馈可由任何视觉指示器(例如,LED灯、表计、比例尺或任何其他视觉指示)提供。在一个示例性实施例中,可响应于向诸如端部执行器548的端部执行器施加能量而提供光学反馈。
在一个示例性实施例中,机器人外科系统500包括用于向控制器724提供一个或多个反馈信号的一个或多个传感器,用于控制一个或多个反馈装置714。附接到机器人外科系统500的一个或多个传感器可以是用于提供反馈信号的合适传感器,例如,线性位置传感器、旋转位置传感器、力传感器、热传感器或任何其他传感器类型。一个或多个传感器可与附接到机器人外科系统的外科器械522,523整体地结合,或者可以是连接到外科器械522,523的附加模块以生成必要的反馈信号。
图61显示了机器人外科控制系统1300的一个实施例。机器人外科控制系统1300包括手持式外科用户接合部1306。手持式外科用户接合部1306能够模拟内窥镜式、腹腔镜式或开放式外科装置(例如,图1-图18所示外科器械)的感觉和操作。在一个示例性实施例中,手持式外科用户接合部包括外科装置柄部1322、牧羊杖钩触发器1320、开关1318、旋转旋钮1326和接合部轴1324。接合部轴1324连接到位于外壳1308上的六个运动自由度承窝1316。六个运动自由度承窝1316允许由用户自由操纵外科装置柄部1322。外科装置柄部1322可以沿远侧/近侧方向推进或回缩。在一个示例性实施例中,外科装置柄部1322沿远侧/近侧方向的运动导致外科器械沿远侧/近侧方向相对于臂车520的相应运动。手持式外科用户接合部1306也可通过沿左/右方向和上/下方向平移而运动。手持式外科用户接合部1306沿左/右方向或上/下方向的平移运动可转化成外科器械沿对应方向的运动。六个运动自由度承窝1316允许外科装置柄部1322绕枢转点1317旋转。在一个示例性实施例中,枢转点1317可对应于接合部轴1324和承窝1316之间的连接。手持式外科用户接合部1306可绕三个运动轴线中的任一个或它们的任意组合旋转。
六个运动自由度承窝1316和外科装置柄部1322允许用户以类似于非机器人外科器械(例如,图1-图18所示外科器械)的操作方式操作机器人外科控制系统1300。通过模拟非机器人外科器械的运动,机器人外科控制系统1300允许外科医生经过很少的培训即可操作机器人外科系统,例如,图19-图46所示机器人外科系统500。机器人外科控制系统1300也提供允许外科医生在机器人外科系统的操作期间保持其在标准外科手术中的技能的优点。
在一个示例性实施例中,外科装置柄部1322可包括用于控制外科器械的一个或多个功能的一个或多个附加输入。在图61所示实施例中,外科装置柄部1322包括牧羊杖钩触发器1320、开关1318和旋转旋钮1326。牧羊杖钩触发器1320能够控制例如附接到外科器械的端部执行器的夹持运动。通过朝柄部1322牵拉牧羊杖钩触发器1320,用户可使端部执行器的钳口枢转到夹持位置,例如,端部执行器548的第一钳口551A和第二钳口551B。在一个示例性实施例中,释放牧羊杖钩触发器1320可使端部执行器的钳口返回到非夹持位置或打开位置。
在一个示例性实施例中,开关1318可控制一种或多种形式的能量向附接到外科器械522的端部执行器的施加。开关1318能够将例如超声能量递送至超声外科器械522或将电外科能量递送至电外科器械523。在另一个实施例中,开关1318可以是多位置开关,其可包括断开位置、能够递送超声能量的第一位置、能够递送电外科能量的第二位置、以及能够递送超声能量和电外科能量两者的第三位置。
如图61所示,手持式外科用户接合部1306可包括旋转旋钮1326,该旋转旋钮安装到外科装置柄部1322且可操作地联接到接合部轴1324。旋转旋钮1326能够允许接合部轴1324绕近侧/远侧轴线的旋转,而不是整个外科装置柄部1322的旋转。通过将旋转旋钮1326进行旋转,用户可使伸长轴(例如,外科器械522的伸长轴组件554)旋转,同时保持外科装置柄部1322的相同取向。这种运动模拟旋转旋钮在非机器人外科器械(例如,图1-图18所示外科器械)上的使用。
在一个示例性实施例中,一个或多个附加输入(例如,牧羊杖钩触发器1320、开关1318或旋转旋钮1326)可通过一根或多根电线(未示出)连接到控制器724,该一根或多根电线延伸穿过接合部轴1324并且通过六个运动自由度承窝1316连接。在另一个实施例中,一个或多个附加输入可通过电线连接到控制器,该电线从外科装置柄部1322延伸并且通过位于外壳1308上的第二承窝(未示出)连接到控制器724。在又一个实施例中,一个或多个附加输入可通过无线通信链路(例如,无线蓝牙链路)与控制器724通信。本领域的技术人员将认识到,任何合适的通信协议或介质都可用于将一个或多个附加输入连接到控制器724。
在一个示例性实施例中,机器人外科控制系统1300包括一个或多个反馈装置714。一个或多个反馈装置714可位于外壳1308、外科装置柄部1322或两者中。反馈装置714可提供任何合适形式的感观反馈。此类感观反馈可包括例如听觉反馈(声音)、触觉或触知反馈(接触)、光学反馈(视觉)、嗅觉反馈(嗅觉)、味觉反馈(味道)和/或平衡感觉(平衡反馈)。触觉反馈可通过多种形式提供,例如,机械感受(包括但不限于振动感受(振动)和压力感受)、热感知(热)和/或低温感知(冷)。本领域的技术人员应当理解,任何单一反馈类型或它们的任意组合可由一个或多个反馈装置714提供。
图62示出机器人外科控制系统1400的一个实施例。机器人外科控制系统1400包括外壳1408和手持式外科用户接合部1406。手持式外科用户接合部1406包括类似于上述外科装置柄部1322的外科装置柄部1422。外科装置柄部1422包括第二旋转旋钮1428,该第二旋转旋钮能够控制外科器械522的一个或多个功能,例如,伸长轴组件554的关节运动角度。在该图示实施例中,外科装置柄部1422包括牧羊杖钩触发器1320、按钮1318和旋转旋钮1326。在其他实施例中,外科装置柄部1400可包括一个或多个附加输入中的一些或不包括一个或多个附加输入。
在一个示例性实施例中,诸如第二旋转旋钮1428的旋转输入可包括一个或多个棘爪,以允许精确设置各种旋转位置。棘爪可对应于位于外科装置柄部1422上的一个或多个肋,以允许第二旋转旋钮1428采用对应于外科器械522的一个或多个精确位置的精确旋转位置。例如,在一个示例性实施例中,第二旋转旋钮1428可控制外科器械522的关节运动功能,例如,伸长轴组件554的关节运动。在该实施例中,第二旋转旋钮1428可包括一个或多个棘爪,这些棘爪对应于伸长轴组件554的一个或多个预先确定的关节运动位置。
在一个示例性实施例中,机器人外科控制系统1400包括三个运动自由度承窝1416。三个运动自由度承窝1416允许外科装置柄部1422通过接合部轴1324连接到外壳1408和控制器724。三个运动自由度承窝1416允许外科装置柄部1422沿远侧/近侧方向相对于装置用户横向推进或回缩。此外,三个运动自由度承窝1416允许外科装置柄部1422沿上/下或左/右方向绕由三个运动自由度承窝1416和接合部轴1324之间的接合部限定的枢转点1430枢转。如上所述,诸如三个运动自由度承窝1416的三个运动自由度输入承窝允许用户同时控制外科器械的三种运动。在一个示例性实施例中,三个运动自由度承窝1416能够响应于外科装置柄部1422沿远侧或近侧方向的横向运动而控制外科器械沿远侧/近侧方向的横向运动。在一个示例性实施例中,外科装置柄部1422沿向左或向右方向绕枢转点1430的旋转运动可转化成外科器械522沿左/右方向相对于臂车520的横向运动。外科装置柄部1422沿上/下方向绕枢转点1430的旋转运动可导致外科器械522相对于臂车520的横向运动。
图63示出可与外科装置柄部1322,1422一起使用的各种反馈装置。在该图示实施例中,外科装置柄部1422示出为外表面的一部分被移除,并且外壳1308显示为侧壁被移除以示出其中的内部部件。在一个示例性实施例中,外壳1308可容纳联接到六个运动自由度承窝1316的反馈装置(例如,电磁离合器1438)以提供力反馈形式的触觉反馈。在一个示例性实施例中,电磁离合器1438能够提供对六个运动自由度承窝1316的运动的抗力。该抗力通过接合部轴1324传递到外科装置柄部1422。运动外科装置柄部1422的用户将通过外科装置柄部1422感测抗力。由电磁离合器1438生成的抗力可与接触目标组织位点的外科器械522所遇到的抗力成比例。在一个示例性实施例中,由电磁离合器1438生成的抗力与接触目标组织位点的外科器械522所遇到的力成正比。在其他实施例中,由电磁离合器1438生成的力可以大一个或多个数量级,以便向用户提供更大的反馈。电磁离合器1438可在可用运动自由度中的任一个中提供抗力。例如,在该图示实施例中,电磁离合器1438联接到六个运动自由度承窝1316。电磁离合器可以在可用的六个运动自由度中的任一个或任意组合中提供对六个运动自由度承窝1316的运动的抗力。
在一个示例性实施例中,一个或多个力反馈装置可位于外科装置柄部1422内。在该图示实施例中,两个触发器反馈装置1432a,1432b连接到牧羊杖钩触发器1320。触发器反馈装置1432a,1432b在牵拉或释放牧羊杖钩触发器1320时提供抗力形式的触觉反馈。在一个示例性实施例中,触发器反馈装置1432a,1432b提供对牧羊杖钩触发器1320的运动的抗力,该抗力与连接到外科器械的端部执行器的钳口(例如,电外科端部执行器548的钳口551A,551B)所遇到的力成比例。仅仅出于说明性目的,将结合端部执行器548描述触发器反馈装置1432a,1432b。在操作中,组织部分定位在端部执行器548的钳口551A,551B之间。牧羊杖钩触发器1320可沿远侧方向运动,以使钳口551A,551B从打开位置枢转至闭合位置。当钳口551A,551B运动至闭合位置时,位于钳口551A,551B之间的组织提供对钳口551A,551B的闭合的抗力。触发器反馈装置1432a,1432b可提供对牧羊杖钩触发器1320的运动的阻力,该阻力与端部执行器548的钳口551A,551B所遇到的力成比例。通过向牧羊杖钩触发器1320提供反馈,该装置向用户提供关于位于端部执行器548的钳口551A,551B之间的组织的指示,例如,正确量的组织是否位于钳口551A,551B之间或者何种类型的组织位于钳口551A,551B之间。
如图63所示,外科装置柄部1422还可包括一个或多个旋转反馈装置。诸如关节运动旋转反馈装置1430的旋转反馈装置可对诸如第二旋转旋钮1428的一个或多个输入的旋转提供抗力形式的触觉反馈。在一个示例性实施例中,由关节运动旋转反馈装置1430提供的抗力可与施加到接触组织位点的端部执行器的力成比例。在一个示例性实施例中,传感器可检测施加到外科器械522的关节运动接头(例如,关节运动接头556)的力。在一个示例性实施例中,第二旋转旋钮1428的旋转可由控制器724转化成致使关节运动接头556使轴554进行关节运动的控制信号。诸如端部执行器548的端部执行器可由于关节运动而与组织接触。当端部执行器548与组织接触时,外科装置523上的传感器可为控制器724提供指示由组织位点施加到端部执行器548的力的量的信号(参见图68)。控制器724可使关节运动旋转反馈装置1430施加对第二旋转旋钮1428的旋转的抗力,该抗力与端部执行器548所遇到的力成比例。
如图63所示,外科装置柄部1422还可包括振动模块1440,该振动模块能够将振动运动提供至外科装置柄部1422。在一个示例性实施例中,振动模块1440可接收来自联接到端部执行器(例如,端部执行器528(参见图68))的传感器的反馈信号。当端部执行器528与组织接触时,由组织将力施加到端部执行器528上。在一个示例性实施例中,反馈信号可以指示端部执行器528所遇到的力的量。振动模块1440可将反馈信号转化成外科装置柄部1422的振动运动,以向用户提供与由组织位点施加到端部执行器528的力的量成比例的触知反馈信号。在一个示例性实施例中,当反馈信号增加时,振动模块1440可以指数方式增加振动的速率,以向用户提供可能的组织损害的触觉警告。在另一个实施例中,振动模块1440能够从端部执行器528接收指示由端部执行器528施加到组织位点的能量的量的反馈信号。在该实施例中,响应于能量的施加,振动模块1440可随着组织位点的温度升高而增加振动的速率。在另一个实施例中,振动模块可启动以向用户指示预先确定量的时间已过,从而表明能量充分地施加到组织位点。
在一个示例性实施例中,诸如第一旋转旋钮1326和第二旋转旋钮1428的可旋转输入装置可连接到旋转编码器,用于将可旋转输入装置的旋转转化成用于传输到控制器724的电信号。在该图示实施例中,经由第一旋转旋钮1326的旋转实现的接合部轴1324的旋转由旋转编码器1436转化成电信号。旋转编码器1436将接合部轴1324的角位置或运动转化成可由控制器724接收的模拟或数字信号。旋转编码器1436可以是任何合适类型的旋转编码器,例如,绝对编码器或增量编码器。在另一个实施例中,可旋转输入装置可连接到一个或多个电位计,例如,旋转输入电位计1442。旋转输入电位计1442基于牧羊杖钩触发器1320的旋转位置调整输出电压,以允许将牧羊杖钩触发器的机械位置转化成可由控制器724接收的信号。本领域的技术人员应当理解,用于转化输入装置的机械旋转或运动的任何合适的电子部件都可用于生成可由控制器724接收的信号。
图64-图65示出了手持式外科用户接合部1406和端部执行器528的运动之间的关系的两个可能实施例。在图64所示的一个示例性实施例中,手持式外科用户接合部1406绕枢转点1430的旋转导致端部执行器528在相同方向上的关节运动,例如,手持式外科用户接合部1406在向右方向(如箭头“A”所示)上的旋转导致端部执行器528在相同的向右方向上的运动。在图65所示的另一个实施例中,手持式外科用户接合部1406绕枢转点1430的旋转导致端部执行器528的镜像旋转,例如,手持式外科用户接合部1406在向右方向(如箭头“A”所示)上的旋转导致端部执行器528在相对的向左方向(如箭头“B”所示)上的旋转。可对手持式外科用户接合部1406和端部执行器528的行进方向之间的关系进行选择以模拟非机器人外科装置的手持件和端部执行器之间的关系,例如,图1-图18所示外科器械。
图66示出无线机器人外科控制系统1500的一个实施例,其利用在无线手持式外科用户接合部1506和无线承窝1516之间的光学接合部。无线承窝1516能够从无线手持式外科用户接合部1506接收任何合适的无线信号,例如,光学信号(利用在可见或非可见光谱中的激光)、射频信号、微波信号或红外信号。在一个示例性实施例中,无线手持式外科用户接合部1506包括无线轴1524,用于将相容的无线信号从手持式外科用户接合部1506传输至无线承窝1516。在一个示例性实施例中,传输至承窝1516的信号可包括由位于无线手持式外科用户接合部1506的无线外科装置柄部1522之上或之内的一个或多个附加输入(例如,牧羊杖钩触发器1320、第一旋转旋钮1326或第二旋转旋钮1428)生成的信号。在另一个实施例中,一个或多个附加输入可利用单独的无线信号(例如,无线蓝牙信号)来与控制器724通信。
在一些实施例中,无线承窝1516和无线轴1524可包括双向通信系统。在该实施例中,无线承窝1516能够接收来自无线轴1524的信号并且将这些信号传输至位于外壳1508中的控制器724。无线承窝1516还能够将信号从控制器724传输至无线手持式外科用户接合部1506,以用于控制无线手持式外科用户接合部的功能,例如,为位于无线外科装置柄部1522内的一个或多个反馈装置714提供控制信号。在另一个实施例中,第二无线承窝(未示出)可位于外壳1508中以将信号从控制器724传输至无线手持式外科用户接合部1506,以用于控制位于无线外科装置柄部1522内的一个或多个反馈装置174。
图67示出与诸如控制器518的标准机器人外科控制系统接合的机器人外科控制系统1300的一个实施例。如图67所示,机器人外科控制系统1300可连接到控制器518以将附加的控制功能提供至控制器518。如上所述,控制器518可通过显示器521提供工作位点的图像。控制器724可通过任何合适的通信介质(例如,从外壳1308延伸的缆线)与控制器518接合。在图示实施例中,控制器518还包括一个或多个控制旋钮1346a,1346b,1346c,以用于控制手持式外科用户接合部1506的各种功能。
在一个示例性实施例中,可对一个或多个控制旋钮1346a,1346b,1346c进行调整以控制手持式外科用户接合部1306和外科器械522的运动之间的比率。例如,在一个示例性实施例中,第一控制旋钮1346a可控制手持式外科用户接合部1306沿远侧或近侧方向的纵向运动和外科器械522的纵向运动之间的运动比率。第二控制旋钮1346b能够控制手持式外科用户接合部1306绕枢转点1330沿向左或向右方向的运动与外科器械522沿向左或向右方向的横向运动之间的比率。本领域的技术人员应当认识到,控制旋钮1346a,1346b,1346c能够控制机器人外科控制系统1300的任何部分和机器人外科系统500的任何部分之间的运动比率。在一个示例性实施例中,手持式外科用户接合部1306和外科器械522之间的运动比率可具有1:1运动的最大比率。在该实施例中,手持式外科用户接合部的1cm的运动被转化成外科器械的1cm的相应运动。在一些实施例中,可对运动的比率进行调整使得外科器械以手持式外科用户接合部的运动的分数值运动。例如,在一个示例性实施例中,可对控制旋钮1346a进行调整使得手持式外科用户接合部沿远侧方向的1cm运动导致外科器械522沿远侧方向的0.25cm运动。本领域的技术人员将认识到,这些示例是非限制性的,并且手持式外科用户接合部1306和外科器械522之间的运动比率可以是合适的比率。
在一个示例性实施例中,一个或多个灵敏度旋钮可位于手持式外科用户接合部1306的外科装置柄部1322上。一个或多个灵敏度旋钮可位于外科装置柄部1322的任何部分上。在一个示例性实施例中,灵敏度旋钮可位于外科装置柄部1322的最近侧部分上,以允许用户容易地调整外科装置柄部1322和外科器械522之间的运动比率。
在一个示例性实施例中,一个或多个控制旋钮1346a,1346b,1346c能够控制显示器521的一个或多个功能。例如,在一个示例性实施例中,可旋转第三控制旋钮1346c以调整通过显示器521看到的视图。对视图的调整可包括例如改变视图的放大率、改变视角或改变观察位置。
图68示出用于为一个或多个反馈装置714生成反馈信号的一种方法。外科器械1522是适合与机器人外科系统500一起使用的外科器械,例如,外科器械522。在该图示实施例中,外科器械1522可绕轴1538的纵向轴线旋转。当轴1538绕纵向轴线旋转时,端部执行器1523可与组织位点1530接触。组织位点1530提供对轴1538的旋转的抗力。反馈齿轮1524位于轴1538上并且与轴1538一致地旋转。反馈齿轮1524操作地联接到抗力测量装置1526。抗力测量装置1526能够测量由接触组织位点1530的端部执行器1523遇到的抗力并生成反馈信号,该反馈信号被传输至控制器724以控制一个或多个反馈装置714。本领域的技术人员应当理解,图68仅示出为一个或多个反馈装置714生成反馈信号的可能方法中的一种。反馈信号可由其他合适的装置生成,例如,电位计、变阻器、位置传感器、线性位移传感器、电容传感器、电阻传感器或用于为一个或多个反馈装置生成反馈信号的任何其他合适传感器。
本文所公开的控制装置可以被设计成在单次使用之后丢弃,或者它们可以被设计成与一种或多种不同类型的端部执行器一起使用多次。然而无论是哪种情况,该装置都可在至少使用一次后经过修复再行使用。修复可包括如下步骤的任意组合:拆卸装置、然后清洗或更换特定零件、以及重新组装。具体地,可将该装置拆卸,并且可以任意组合选择性地更换、添加或移除任何数目的特定零件或部件。本领域的技术人员应当理解,装置的修复可利用用于拆卸、更换、再编程或再配置的多种技术。此类技术的使用以及所得的修复装置均在本申请的范围内。
非限制性实例
在一个实施例中,提供了一种机器人外科系统。该机器人外科系统包括外科机器人,该外科机器人包括外科器械,该外科器械包括端部执行器和用于操纵端部执行器的机械接合部;控制系统,该控制系统包括外壳;控制器,该控制器位于外壳中并联接到承窝,该承窝用于接收手持式外科用户接合部以控制外科器械的功能,其中控制器操作地联接到机械接合部;联接到控制器和承窝的至少一个传感器,该至少一个传感器用于将手持式外科用户接合部的运动转化成对应于外科器械的运动的电信号;以及至少一个反馈装置,该至少一个反馈装置操作地联接到控制器,以向用户提供与外科器械的预先确定的功能相关联的反馈。
在一个实施例中,提供了一种用于控制机器人外科装置的方法。该方法包括经由承窝接合控制器和手持式外科用户接合部;由用户操纵手持式外科用户接合部以经由可操作地联接到手持式外科用户接合部和控制器的传感器产生一个或多个电信号;经由控制器将该一个或多个电信号转化成用于机器人外科装置的一个或多个控制信号;经由控制器从机器人外科装置接收一个或多个反馈信号,以及经由反馈装置生成一个或多个反馈条件以模拟机器人外科装置与组织位点之间的一个或多个交互作用。
申请人还拥有以下专利申请,这些专利申请各自以其相应全文以引用的方式并入:
2012年6月28日提交并且名称为“Flexible Drive Member”(代理人案卷号END7131USNP/120135)的美国专利申请序列号13/536,271;
2012年6月28日提交并且名称为“Multi-Functional Powered SurgicalDevice with External Dissection Features”(代理人案卷号END7132USNP/120136)的美国专利申请序列号13/536,288;
2012年6月28日提交并且名称为“Rotary Actuatable ClosureArrangement for Surgical End Effector”(代理人案卷号END7134USNP/120138)的美国专利申请序列号13/536,295;
2012年6月28日提交并且名称为“Surgical End Effectors HavingAngled Tissue-Contacting Surfaces”(代理人案卷号END7135USNP/120139)的美国专利申请序列号13/536,326;
2012年6月28日提交并且名称为“Interchangeable End EffectorCoupling Arrangement”(代理人案卷号END7136USNP/120140)的美国专利申请序列号13/536,303;
2012年6月28日提交并且名称为“Surgical End Effector Jaw andElectrode Configurations”(代理人案卷号END7137USNP/120141)的美国专利申请序列号13/536,393;
2012年6月28日提交并且名称为“Multi-Axis Articulating and RotatingSurgical Tools”(代理人案卷号END7138USNP/120142)的美国专利申请序列号13/536,362;和
2012年6月28日提交并且名称为“Electrode Connections for RotaryDriven Surgical Tools”(代理人案卷号END7149USNP/120153)的美国专利申请序列号13/536,417。
应当理解,结合临床医生操纵用来治疗患者的器械的一端在说明书中通篇使用术语“近侧”和“远侧”。术语“近侧”是指器械的最靠近临床医生的部分,并且术语“远侧”是指离临床医生最远的部分。还应当理解,为简明和清楚起见,本文可以参考所示实施例使用诸如“竖直”、“水平”、“上”或“下”之类的空间术语。然而,外科器械可以在许多取向和位置使用,并且这些术语并非意图是限制的或绝对的。
本文描述了外科器械和机器人外科系统的各种实施例。本领域的技术人员应当理解,本文所述的各种实施例可以与所述的外科器械和机器人外科系统一起使用。提供的说明只是为了举例,本领域的技术人员应当理解,所公开的实施例不只是限于本文所公开的装置,而是可以与任何相容的外科器械或机器人外科系统一起使用。
本说明书通篇提及的“各种实施例”、“一些实施例”、“一个示例性实施例”或“实施例”意味着结合所述实施例描述的具体特征、结构或特性包括在至少一个示例性实施例中。因此,在整篇说明书中出现的短语“在各种实施例中”、“在一些实施例中”、“在一个示例性实施例中”或“在实施例中”并不一定都指相同的实施例。此外,在没有限制的情况下,结合一个示例性实施例示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施例的特征、结构或特性组合。
虽然已经通过描述若干实施例来例示了本文的各种实施例,并且虽然已经相当详细地描述了例示性实施例,但是申请人的意图不在于将所附权利要求的范围约束或以任何方式限制到这些细节中。本领域的技术人员可容易看出其他优点和修改形式。例如,普遍认为,内窥镜式手术比腹腔镜式手术更常见。因此,本发明对内窥镜式手术和设备进行了讨论。然而,本文使用的诸如“内窥镜式”的术语不应被理解为将本发明限于仅结合内窥镜式管(例如,套管针)使用的器械。与此相反,本发明据认为可用于进入受限于小切口的任何手术中,包括但不限于腹腔镜式手术以及开放式手术。
应当理解,本文的附图和描述中的至少一些已被简化以示出适于清楚地理解本公开的元件,同时为清晰起见移除了其他元件。然而,本领域的普通技术人员将认识到,这些和其他元件可为期望的。然而,由于此类元件为本领域所熟知并且由于它们不利于较好地理解本公开,因此本文未提供对这些元件的论述。
虽然已经描述了若干实施例,但应当知道,本领域技术人员在掌握了本公开的一些或全部优点之后可能对这些实施例作出各种修改、改变和改型。例如,根据各种实施例,单个部件可替换为多个部件,并且多个部件也可替换为单个部件,以执行给定的一种或多种功能。因此,在不脱离所附权利要求书限定的本公开的范围和实质的情况下,本专利申请旨在涵盖所有此类修改、变型和改型形式。
以引用方式全文或部分地并入本文的任何专利、专利公布或其他公开材料均仅在所并入的材料不与本公开所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。由此,在必要的程度下,本文所明确阐述的公开内容将取代以引用方式并入本文的任何相冲突的材料。据述以引用方式并入本文但与本文所述的现有定义、陈述或其他公开材料相冲突的任何材料或其部分仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
Claims (26)
1.一种外科机器人控制系统,包括:
外壳;
位于所述外壳中的控制器,所述控制器联接到承窝,所述承窝用于接收手持式外科用户接合部以控制外科器械的功能,所述外科器械包括端部执行器和用于操纵所述端部执行器的机械接合部,所述机械接合部操作地联接到所述控制器;
至少一个传感器,所述至少一个传感器联接到所述控制器和所述承窝,所述至少一个传感器用于将所述手持式外科用户接合部的运动转化成对应于所述外科器械的运动的电信号;和
至少一个反馈装置,所述至少一个反馈装置电联接至所述控制器,以向用户提供与所述外科器械的预先确定的功能相关联的反馈。
2.根据权利要求1所述的控制系统,包括:
手持式外科用户接合部,所述手持式外科用户接合部联接到所述承窝,电子手持式用户接合部用于控制外科器械的功能,所述外科器械包括端部执行器和用于操纵所述端部执行器的机械接合部,所述机械接合部操作地联接到所述控制器。
3.根据权利要求2所述的控制系统,其中所述至少一个反馈装置位于所述手持式外科用户接合部内。
4.根据权利要求1所述的控制系统,其中所述至少一个反馈装置位于所述外壳内。
5.根据权利要求1所述的控制系统,包括:
外科器械相容性逻辑部件,所述外科器械相容性逻辑部件用于产生指示所述外科器械与所述手持式外科用户接合部的相容性的信号。
6.根据权利要求1所述的控制系统,其中所述至少一个传感器包括六个自由度的输入装置。
7.根据权利要求1所述的控制系统,包括:
灵敏度旋钮,所述灵敏度旋钮联接到所述控制器以调整运动比率,其中所述运动比率是所述手持式外科用户接合部的运动与所述外科器械的运动的比率。
8.根据权利要求7所述的控制系统,其中所述运动比率具有1:1运动的最大比率。
9.根据权利要求1所述的控制系统,其中所述反馈装置包括至少一个触觉反馈装置以向用户提供触知反馈。
10.根据权利要求9所述的控制系统,其中:
所述外科器械的预先确定的功能包括将能量递送至组织位点;并且
其中,所述至少一个触觉反馈装置包括热元件,以产生与由所述端部执行器递送至所述组织位点的能级成比例的温度梯度。
11.根据权利要求10所述的控制系统,其中所述加热元件包括能够滑动地接收在所述手持式外科用户接合部上的套管。
12.根据权利要求9所述的控制系统,其中所述外科器械的预先确定的功能包括向所述组织位点施加力。
13.根据权利要求12所述的控制系统,其中所述触觉反馈装置包括:
力反馈装置,所述力反馈装置能够在所述手持式外科用户接合部中产生抗力,其中所述抗力与由所述组织位点施加到所述外科器械的抗力成比例。
14.根据权利要求13所述的控制系统,其中所述力反馈装置包括电磁离合器。
15.根据权利要求13所述的控制系统,其中所述力反馈装置包括伺服马达。
16.根据权利要求1所述的控制系统,其中所述反馈装置包括听觉反馈装置,以基于所述外科机器人的至少一个预先确定的条件向用户提供听觉信号。
17.根据权利要求1所述的控制系统,其中所述反馈装置包括视觉反馈装置,以基于所述外科机器人的至少一个预先确定的条件向用户提供视觉指示。
18.根据权利要求1所述的控制系统,其中所述手持式外科用户接合部包括:
杠杆,所述杠杆操作地联接到所述至少一个传感器,其中所述至少一个传感器检测所述杠杆绕枢转点的运动,其中沿远侧方向绕所述枢转点的运动对应于所述外科器械的远侧运动,沿近侧方向绕所述枢转点的运动对应于所述外科器械的近侧运动,并且沿横向于所述远侧方向的方向绕所述枢转点的运动对应于所述外科器械的旋转;
设置在所述杠杆上的触发器,所述触发器能够控制所述外科器械的活动;和
开关,所述开关设置在所述杠杆上以控制被联接到所述外科器械的能量源。
19.根据权利要求18所述的控制系统,其中所述杠杆能够绕所述枢转点旋转。
20.根据权利要求1所述的控制系统,其中所述手持式外科用户接合部包括:
外科装置柄部,所述外科装置柄部包括:
外壳,所述外壳具有近侧端部和远侧端部;
旋转旋钮,所述旋转旋钮能够旋转地联接到所述外壳的远侧端部以控制所述外科器械的旋转取向;
关节运动旋钮,所述关节运动旋钮能够旋转地联接到主体的中部以控制所述外科器械的关节运动取向;和
触发器,所述触发器操作地联接到所述手持件以控制所述外科器械的功能。
21.根据权利要求1所述的控制系统,其中所述手持式外科用户接合部包括触发器,所述触发器包括:
近侧触发器部分,所述近侧触发器部分具有第一长度;和
远侧触发器钩,所述远侧触发器钩包括具有第二长度的远侧部分,其中所述第二长度小于所述第一长度,并且其中所述远侧触发器钩联接到所述近侧触发器部分。
22.一种机器人外科系统,包括:
外科机器人,所述外科机器人包括外科器械,所述外科器械包括端部执行器和用于操纵所述端部执行器的机械接合部;和
控制系统,所述控制系统包括:
外壳;
位于所述外壳中的控制器,所述控制器联接到承窝,所述承窝用于接收手持式外科用户接合部以控制所述外科器械的功能,其中所述控制器操作地联接到所述机械接合部;
至少一个传感器,所述至少一个传感器联接到所述控制器和所述承窝,所述至少一个传感器用于将所述手持式外科用户接合部的运动转化成对应于所述外科器械的运动的电信号;和
至少一个反馈装置,所述至少一个反馈装置能够操作地联接到控制器,以向用户提供与所述外科器械的预先确定的功能相关联的反馈。
23.根据权利要求22所述的机器人外科系统,包括:
手持式外科用户接合部,所述手持式外科用户接合部联接到所述承窝,电子手持式用户接合部用于控制外科器械的功能,所述外科器械包括端部执行器和用于操纵所述端部执行器的机械接合部,所述机械接合部操作地联接到所述控制器。
24.根据权利要求22所述的机器人外科系统,其中所述手持式外科用户接合部包括:
杠杆,所述杠杆操作地联接到所述至少一个传感器,其中所述至少一个传感器检测所述杠杆绕枢转点的运动,其中沿远侧方向绕所述枢转点的运动对应于所述外科器械的远侧运动,沿近侧方向绕所述枢转点的运动对应于所述外科器械的近侧运动,并且沿横向于所述远侧方向的方向绕所述枢转点的运动对应于所述外科器械的旋转;
设置在所述杠杆上的触发器,所述触发器能够控制所述外科器械的活动;和
开关,所述开关设置在所述杠杆上以控制被联接到所述外科器械的能量源。
25.根据权利要求22所述的机器人外科系统,其中所述手持式外科用户接合部包括:
外科装置柄部,所述外科装置柄部包括:
外壳,所述外壳具有近侧端部和远侧端部;
旋转旋钮,所述旋转旋钮能够旋转地联接到所述外壳的远侧端部以控制所述外科器械的旋转取向;
关节运动旋钮,所述关节运动旋钮能够旋转地联接到主体的中部以控制所述外科器械的关节运动取向;和
触发器,所述触发器操作地联接到所述手持件以控制所述外科器械的功能。
26.一种用于控制机器人外科装置的方法,包括:
经由承窝接合控制器和手持式外科用户接合部;
由用户操纵所述手持式外科用户接合部以经由操作地联接到所述手持式外科用户接合部和所述控制器的传感器产生一个或多个电信号;
经由所述控制器将所述一个或多个电信号转化成用于所述机器人外科装置的一个或多个控制信号;
经由所述控制器从所述机器人外科装置接收一个或多个反馈信号,以及
经由反馈装置产生一个或多个反馈条件以模拟所述机器人外科装置与组织位点之间的一个或多个交互作用。
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US9737326B2 (en) | 2017-08-22 |
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EP2866716B1 (en) | 2019-12-25 |
CN104582629B (zh) | 2017-05-31 |
US10335183B2 (en) | 2019-07-02 |
US20170319228A1 (en) | 2017-11-09 |
US10966747B2 (en) | 2021-04-06 |
JP6309514B2 (ja) | 2018-04-11 |
EP2866716A1 (en) | 2015-05-06 |
WO2014004114A1 (en) | 2014-01-03 |
BR112014032921A2 (pt) | 2017-06-27 |
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