WO2011146019A1

WO2011146019A1 - An apparatus for positioning a surgical instrument

Info

Publication number: WO2011146019A1
Application number: PCT/SG2011/000189
Authority: WO
Inventors: Deli Li
Original assignee: Biobot Surgical Pte. Ltd.
Priority date: 2010-05-21
Filing date: 2011-05-20
Publication date: 2011-11-24
Also published as: TW201208640A; SG176329A1

Abstract

This invention relates to an apparatus for positioning a surgical instrument in relation to a target. In a preferred embodiment, the apparatus (100) comprises a first positioning mechanism (102) arranged to move the surgical instrument along a L axis; a second positioning mechanism (104) comprising a γ axis rotation mechanism (502) arranged to rotate the first positioning mechanism (102) about a γ axis perpendicular to the L axis; a β axis rotation mechanism (504) arranged to rotate the γ axis rotation mechanism (502) about a β axis perpendicular to the γ axis and the L axis; and a third positioning mechanism (106) comprising a R axis rotating mechanism (902) arranged to rotate the second positioning mechanism (104) about a R axis parallel to the β axis; a Y axis movement mechanism (904) arranged to move the R axis rotating mechanism (902) along a Y axis parallel to the R axis; and a X axis movement mechanism (906) arranged to move the Y axis movement mechanism (904) along a X axis perpendicular to the Y axis.

Description

An Apparatus for Positioning a Surgical Instrument Field of the invention The present invention relates to an apparatus for positioning a surgical instrument in relation to a target.

Background of the Invention With the help of modern technologies, especially computer technologies and image acquiring and processing technologies such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Magnetic Resonance Spectroscopy (MRS), Ultrasound Imaging (US) etc., surgical procedures have greatly improved in the recent one or two decades. More minimal invasive and non- invasive surgical procedures have replaced the traditional surgical procedures, such as open surgical procedures. This benefits both hospitals and patients. Plenty of surgical instruments or tools have also been developed to help a surgeon perform the minimal invasive and non-invasive surgical procedures better. However, most of these instruments are operated manually by the surgeon and thus, not only is an experienced surgeon required, it is also necessary for the surgeon to undergo long term training for the operation of the instruments.

To date, only a few computer controlled systems are available for performing surgical procedures. One example is the da Vinci surgical robot by Intuitive Surgical Inc. However, the da Vinci surgical robot is a Master-Slave system, in other words, a passive robot. In addition, only specially designed instruments can be used with the da Vinci surgical system in the operation room. Many surgical instruments and tools currently used by surgeons cannot be used with the da Vinci surgical system and hence will not benefit from this system. Summary of the invention

The present invention aims to provide an apparatus for positioning a surgical instrument in relation to a target.

In general, the present invention proposes an apparatus which comprises three positioning mechanisms. The three positioning mechanisms further comprise: a first positioning mechanism arranged to move the surgical instrument along an axis "L"; a second positioning mechanism arranged to rotate the first positioning mechanism about at least two axes ("γ" and "β") perpendicular to each other; and a third positioning mechanism arranged to rotate the second positioning mechanism about an axis ("R") and further arranged to move the second positioning mechanism along two axes ("X", Ύ") perpendicular to each other. These three positioning mechanisms allow the positioning of the surgical instrument to be faster, safer and more accurate.

Specifically, a first aspect of the invention is an apparatus for positioning a surgical instrument in relation to a target, the apparatus comprising: a first positioning mechanism arranged to move the surgical instrument along a L axis; a second positioning mechanism comprising: a γ axis rotation mechanism arranged to rotate the first positioning mechanism about a γ axis perpendicular to the L axis; a β axis rotation mechanism arranged to rotate the γ axis rotation mechanism about a β axis perpendicular to the γ axis and the L axis; and a third positioning mechanism comprising: a R axis rotating mechanism arranged to rotate the second positioning mechanism about a R axis parallel to the β axis; a Y axis movement mechanism arranged to move the R axis rotating mechanism along a Y axis parallel to the R axis; and a X axis movement mechanism arranged to move the Y axis movement mechanism along a X axis perpendicular to the Y axis. The apparatus may be used in hospitals (for example in an operation room or in an office), clinics or research laboratories, and may be used for the following.

(a) Carrying and positioning an ultrasound probe for acquiring a set of images at a specified speed and distance. In one example, if these images are 2D images, 3D volume images will be generated from these images.

(b) Carrying and positioning a high intensive focus ultrasound (HIFU) probe for performing non-invasive focal surgeries for any organs or diseases.

(c) Carrying and positioning an endoscopic surgical instrument for performing anorectal or colorectal surgical procedures.

(d) Carrying and positioning a urological surgical instrument for performing

urology surgery.

(e) Carrying an incision biopsy device for performing a targeted incision biopsy for any organ inside a patient's body. (f) Carrying and positioning a laparoscopic surgical instrument for minimal

invasive surgery.

(g) Carrying and positioning a brachytherapy instrument for performing focal therapy.

(h) Carrying and positioning a diathermy instrument for performing the treatment of Benign Prostatic Hyperplasia (BPH) or cancer of the urology.

Brief Description of the Figures

An embodiment of the invention will now be illustrated for the sake of example only with reference to the following drawings, in which: Fig. 1(a) is a perspective view of an apparatus according to an embodiment of the present invention and Figs. 1(b) - 1(f) are perspective views of components of the apparatus of Fig. 1(a);

Fig. 2(a) is a perspective view of a movement table of the apparatus of Fig. 1(a) and Figs. 2(b) - <L(C) are perspective views of components of the movement table of Fig. 2(a);

Fig. 3(a) is a perspective view of a linear puller of the movement table of Fig. 2(a) and Fig. 3(b) is a cross-sectional view of the linear puller of Fig. 3(a);

Fig. 4(a) is a perspective view of a spin mechanism of the movement table of Fig. 2(a) and Figs. 4(b) - 4(c) are cross-sectional views of the spin mechanism of Fig. 4(a);

Fig. 5(a) is a perspective view of a rotation system of the apparatus of Fig. 1(a) and Figs. 5(b) - 5(d) are perspective views of components of the rotation system of Fig. 5(a);

Fig. 6(a) is a perspective view of a γ axis rotation mechanism of the rotation system of Fig. 5(a) and Fig. 6(b) is a cross-sectional view of the γ axis rotation mechanism of Fig. 6(a);

Fig. 7(a) is a perspective view of a β axis rotation mechanism of the rotation system of Fig. 5(a), Fig. 7(b) is a cross-sectional view of the β axis rotation mechanism of Fig. 7(a) and Fig. 7(c) is a side view of the β axis rotation mechanism of Fig. 7(a);

Fig. 8(a) is a perspective view of an a axis rotation mechanism of the rotation system of Fig. 5(a) and Figs. 8(b) - 8(c) are cross-sectional views of the a axis rotation mechanism of Fig. 8(a);

Fig. 9(a) is a perspective view of a 3D surgical positioning arm of the apparatus of Fig. 1(a) and Figs. 9(b) - 9(d) are perspective views of components of the 3D surgical positioning arm of Fig. 9(a);

Fig. 10(a) is a perspective view of a R axis rotating mechanism of the 3D surgical positioning arm of Fig. 9(a) and Figs. 10(b) - 10(c) are cross-sectional views of the R axis rotating mechanism of Fig. 10(a); Fig. 11(a) is a perspective view of a Y axis movement mechanism of the 3D surgical positioning arm of Fig. 9(a) and Fig. 11(b) is a cross-sectional view of the Y axis movement mechanism of Fig. 11(a);

Fig. 12(a) is a perspective view of a X axis movement mechanism of the 3D surgical positioning arm of Fig. 9(a) and Fig. 12(b) is a cross-sectional view of the X axis movement mechanism of Fig. 12(a);

Fig. 13(a) is a perspective view of a robotic controller of the apparatus of Fig. 1(a), Fig. 13(b) is a cut away perspective view of the robotic controller of Fig. 13(a) and Figs. 13(c) - 13(d) are cross-sectional views of the robotic controller of Fig. 13(a);

Fig. 4(a) is a perspective view of a flexible support arm of the apparatus of Fig. 1(a), Fig. 14(b) is a side view of the flexible support arm of Fig. 14(a) and Fig. 14(c) is a back view of the flexible support arm of Fig. 14(a);

Figs. 15(a) - 15(d) illustrate four examples on how the apparatus of Fig. 1(a) may be secured to a platform using the flexible support arm of Fig. 14(a);

Figs. 16(a) - 16(c) are respectively a perspective view, a side view and a front view of an example in which the apparatus of Fig. 1 (a) is used for carrying and positioning a bi-plane ultrasound probe;

Figs. 17(a) - 17(c) are respectively a perspective view, a top view and a front view of an example in which the apparatus of Fig. 1(a) is used for carrying and handling an endoscopic surgical instrument;

Figs. 18(a) - 18(c) are respectively a perspective view, a front view and a side view of an example in which the apparatus of Fig. 1(a) is arranged to integrate with a high intensive focus ultrasound (HIFU) system.

Detailed Description of the Embodiments

An apparatus 100 which is an embodiment of the invention will now be described with reference to Figs. 1 - 18. The apparatus 100 serves to position a surgical instrument in relation to a target. Fig. 1(a) is a perspective view of the apparatus 100 whereas Figs 1(b) - 1(f) are perspective views of components of the apparatus 100.

As shown in Fig. - 1(a), the apparatus 100 comprises a first positioning mechanism in the form of a movement table 102, a second positioning mechanism in the form of a rotation system 104 and a third positioning mechanism in the form of a 3D surgical positioning arm 106, a controller in the form of a robotic controller 108 and a securing mechanism in the form of a flexible support arm 110.

IG:

Fig. 1(b) is a perspective view of the movement table 102. The movement table 102 serves to move the surgical instrument along a trajectory line which may pass through the target in three-dimensional space. In one example, it further serves to spin the surgical instrument. However, this spin function is optional. 15 The movement table 102 may be driven by a two channel servo motion system.

Fig. 1(c) is a perspective view of the rotation system 104. The rotation system 104 serves to align the trajectory of the surgical instrument along a trajectory line which may pass through the target in three-dimensional space. This is 20 useful when a surgical instrument is required to operate through a pin-hole or a key-hole and when one needs to deliver energy for treatment to a target lying on the trajectory line. In one example, the trajectory line passes through a real or virtual central axis of the surgical instrument. The rotation system 104 may be driven by a three channel servo motion system.

25

Fig. 1(d) is a perspective view of the 3D surgical positioning arm 106. The 3D surgical positioning arm 106 serves to move a surgical instrument in relation to a target in three-dimensional space within a predetermined range. As shown in Fig. 1(d), the 3D surgical positioning arm 106 is designed to be compact. The 30 3D surgical positioning arm 106 may be driven by a three channel servo motion system capable of moving a surgical instrument to any part of a patient's body. Fig. 1 (e) is a perspective view of the robotic controller 108. The robotic controller 108 serves to control the movement of the movement table 102, the rotation system 104 and the 3D surgical positioning arm 106. The robotic controller 108 is a portable system arranged to be detachable from the rest of the apparatus 100. Note that the robotic controller 108 may still communicate with the rest of the apparatus 100 through a wired connection (via a set of wires not shown in Fig. 1 (a)) when it is detached from the rest of the apparatus 100. Fig. 1 (f) is a perspective view of the flexible support arm 1 10. The flexible support arm 1 10 serves to secure the apparatus 100 with a platform from which the apparatus 100 may be operated. The platform may include any one of the following: a side of a control box for parking the apparatus 100 for performing a surgical operation, a side of a patient's bed or an operation bed for performing laparoscopic surgical procedures, below an operation bed for urological and colorectal surgical procedures and on top of a research table for developing surgical instruments. In one example, the flexible support arm 1 10 is a purely mechanical device arranged to be clamped on the platform for example, sides of an operation bed or an operation table.

The movement table 102, rotation system 104, 3D surgical positioning am 106, robotic controller 108 and flexible support arm 1 10 will now be described in more details with reference to Figs. 2 - 18.

Fig. 2(a) is a perspective view of the movement table 102. Figs. 2(b) and 2(c) are perspective views of components of the movement table 102.

The movement table 102 is arranged to move the surgical instrument along a L axis as shown in Fig. 2(a). In one example, the movement table 102 is further arranged to spin the surgical instrument about an S axis parallel to the L axis wherein the S axis passes through the surgical instrument as shown in Fig. 2(a). However, this spin function is optional. The movement table 102 comprises a linear puller 202 arranged to move the surgical instrument along the L axis. In an example surgical procedure, the linear puller 202 functions as a human arm to move a surgical instrument in and out of a hole on a patient's body. In the example shown in Fig. 2(a), the movement table 102 further comprises a spin mechanism 204 for rotating the surgical instrument about the S axis. In an example surgical procedure, the spin mechanism 204 rotates the surgical instrument about the S axis through an angle in the range of 0 to 360 degrees. Fig 3(a) is a perspective view of the linear puller 202 whereas Fig. 3(b) is a cross-sectional view of the linear puller 202.

The linear puller 202 comprises a first lead screw 306 arranged with the surgical instrument such that the surgical instrument moves along the L axis when the first lead screw 306 is rotated. In one example as shown in Figs. 3(a) and 3(b), the linear puller 202 further comprises an adaptor table 312 arranged to move along the L axis when the first lead screw 306 is rotated and a surgical instrument is arranged to lock with the adaptor table 312, thereby allowing it to move along the L axis when the first lead screw 306 is rotated. In one example, the adaptor table 312 is arranged to move along a linear guide 314 whose length is parallel to the L axis. The first lead screw 306 is further arranged to be supported on a bearing base 308 and a puller base 3 0.

The linear puller 202 further comprises a servo motor 302 arranged to cooperate with a coupling element 304 to drive the first lead screw 306. The servo motor 302 is arranged to be driven by a switch, for example a press button switch 322, which is in turn arranged to be operated by a switch handle 320.

The linear puller 202 further comprises a locking shaft 316 arranged to lock a surgical instrument with the adaptor table 312 when turned by a handle 318. In one example, an instrument adaptor is arranged to hold the surgical instrument and the locking shaft 316 is arranged to lock the instrument adaptor with the adaptor table 312, thereby locking the surgical instrument with the adaptor table 312. In one example, the instrument adaptor is the spin mechanism 204. The linear puller 202 also comprises a motor cover 324 fixed on the puller base 310.

Fig. 4(a) is a perspective view of the spin mechanism 204 and Figs. 4(b) - 4(c) are cross-sectional views of the spin mechanism 204. .

The spin mechanism 204 comprises a support block 416 arranged to engage with the locking shaft 316 of the linear puller 202 to allow the spin mechanism 204 to lock with the adaptor table 312. The spin mechanism 204 also comprises a slide ring 418 arranged to hold a device adaptor which is in turn arranged to hold the surgical instrument. As shown in Figs. 4(a) - 4(c), the spin mechanism 204 further comprises a first worm wheel 404 arranged to rotate about the S axis and a first worm gear 402 arranged to mesh with the first worm wheel 404 such that the first worm wheel 404 rotates when the first worm gear 402 rotates and the first worm wheel 404 is locked in a stationary position when the first worm gear 402 is stationary. The first worm wheel 404 is arranged on a worm wheel base 408 whereas the first worm gear 402 is arranged on a gear base 406. A servo motor 410 and a hand wheel 412 are arranged to independently drive the first worm gear 402. In other words, the first worm gear 402 may either be automatically driven by the servo motor 410 or manually driven by the hand wheel 412. The spin mechanism 204 further comprises a motor cover 414 fixed with the gear base 406 which is in turn fixed with the worm wheel base 408.

Fig. 5(a) is a perspective view of the rotation system 104 whereas Figs. 5(b) - 5(c) are perspective views of components of the rotation system 104. As shown in Fig. 5(a), the rotation system 104 comprises a γ axis rotation mechanism 502 for rotating the movement table 102 about a γ axis perpendicular to the L axis, and a β axis rotation mechanism 504 for rotating the γ axis rotation mechanism 502 about a β axis perpendicular to the γ axis and the L axis. The rotation system 104 further comprises a support member 508 arranged to support the movement table 102.

In one example as shown in Fig. 5(a), the rotation system 04 further comprises a a ; axis rotation mechanism 506 arranged to rotate the β axis rotation mechanism 504 about an a axis parallel to the L axis. However, the a axis rotation mechanism 506 is optional.

Figs. 5(b) - 5(d) are perspective views of the γ axis rotation mechanism 502, the β axis rotation mechanism 504 and the a axis rotation mechanism 506 respectively. In one example, rotation about the three axes (α, β, γ) is achieved by a three channel servo motion system as described below. The three channel servo motion system may in turn be controlled by the robotic controller 108.

Fig. 6(a) is a perspective view of the γ axis rotation mechanism 502 whereas Fig. 6(b) is a cross-sectional view of the γ axis rotation mechanism 502.

As shown in Figs. 6(a) and 6(b), the γ axis rotation mechanism 502 comprises a second worm wheel 604 arranged to rotate about the γ axis and a second worm gear 602 arranged to mesh with the second worm wheel 604 such that the second worm wheel 604 rotates when the second worm gear 602 rotates and the second worm wheel 604 is locked in a stationary position when the second worm gear 602 is stationary. Both the second worm gear 602 and the second worm wheel 604 are arranged on a gear base 610. A servo motor 606 and a hand wheel 608 are arranged to independently drive the second worm gear 602. In other words, the second worm gear 602 may either be automatically driven by the servo motor 606 or manually driven by turning the hand wheel 608.

The support member 508 of the rotation system 104 is arranged to rotate with the second worm wheel 604 and is further arranged to support the movement table 102 such that the movement table 102 rotates with the second worm wheel 604. In one example, the support member 508 is connected between the γ axis rotation mechanism 502 and the linear puller 202 of the movement table 102.

The γ axis rotation mechanism 502 further comprises a coupling member for coupling the γ axis rotation mechanism 502 and the β axis rotation mechanism 504. The coupling member comprises a gear base support 612 and a support plate 614.

Fig. 7(a) is a perspective view of the β axis rotation mechanism 504, Fig. 7(b) is a cross-sectional view of the β axis rotation mechanism 504 and Fig. 7(c) is a side view of the β axis rotation mechanism 504.

As shown in Figs. 7(a) - 7(c), the β axis rotation mechanism 504 comprises a third worm wheel 704 arranged to rotate about the β axis and a third worm gear 702 arranged to mesh with the third worm wheel 704 such that the third worm wheel 704 rotates when the third worm gear 702 rotates and the third worm wheel 704 is locked in a stationary position when the third worm gear 702 is stationary. A servo motor 706 and a hand wheel 708 are in turn arranged to independently drive the third worm gear 702. In other words, the third worm gear 702 may either be automatically driven by the servo motor 706 or manually driven by the hand wheel 708. The third worm wheel 704 is arranged to be disengageable from the third worm gear 702 such that the third worm wheel 704 is operable to move independently of the third worm gear 702. For example, when the third worm wheel 704 is disengaged from the third worm gear 702, the third worm wheel 704 may be manually rotated by an operator of the apparatus 100. In one example as shown in Figs. 7(a) - 7(c), the servo motor 706, the third worm gear 702 and the hand wheel 708. are arranged on a gear base 710 and are supported by two pins 712 to enable the third worm gear 702 to be disengageable from the third worm wheel 704. A locking mechanism is arranged to lock the disengagement of the third worm wheel 704 from the third worm gear 702. The locking mechanism comprises a slide latch 714 and a hand nut 716 arranged to operate the slide latch 714. Locking the disengagement maintains the third worm wheel 704 in a stationary position when the third worm wheel 704 is not manually rotated.

The coupling member of the γ axis rotation mechanism is arranged with the third worm wheel 704 of the β axis rotation mechanism 504 such that the γ axis rotation mechanism 506 rotates with the third worm wheel 704. In one example, the gear base support 612 is fixed with the support plate 614 which is in turn fixed with the third worm wheel 704. The β axis rotation mechanism 504 further comprises an extension arm 718 arranged on a worm wheel base 720. The extension arm 718 serves to couple the β axis rotation mechanism 504 to the a axis rotation mechanism 502 in one embodiment. In another embodiment, the a axis rotation mechanism 502 is absent and the extension arm 718 serves to couple the β axis rotation mechanism 504 to the 3D surgical positioning frame 106.

Fig. 8(a) is a perspective view of the a axis rotation mechanism 506 and Figs. 8(b) - 8(c) are cross-sectional views of the a axis rotation mechanism 506.

As shown in Figs. 8(a) - 8(c), the a axis rotation mechanism 506 comprises a fourth worm wheel 804 arranged to rotate about the a axis and a fourth worm gear 802 arranged to mesh with the fourth worm wheel 804 such that the fourth worm wheel 804 rotates when the fourth worm gear 802 rotates and the fourth worm wheel 804 is locked in a stationary position when the fourth worm gear 802 is stationary. A servo motor 806 and a hand wheel 808 are in turn arranged to independently drive the fourth worm gear 802. In other words, the fourth worm gear 802 may either be automatically driven by the servo motor 806 or manually driven by the hand wheel 808.

The a axis rotation mechanism 506 further comprises a support block 814 arranged to rotate with the fourth worm wheel 804. The support block 814 serves to couple the extension arm 718 of the β axis rotation mechanism 504 with the fourth worm wheel 804 such that the β axis rotation mechanism 504 rotates with the fourth worm wheel 804. In one example, the support block 814 is fixed with the fourth worm wheel 804 and the extension arm 718 is fixed with the support block 814. The a axis rotation mechanism 506 further comprises a cover 810 arranged on a base 812.

Fig. 9(a) is a perspective view of the 3D surgical positioning arm 106 whereas Figs. 9(b) - 9(c) are perspective views of components of the 3D surgical positioning arm 106.

As shown in Fig. 9(a), the 3D surgical positioning arm 106 comprises an R axis rotating mechanism 902 arranged to rotate the rotation system 104 about an R axis parallel to the β axis, a Y axis movement mechanism 904 arranged to move the R axis rotating mechanism 902 along a Y axis parallel to the R axis and a X axis movement mechanism 906 arranged to move the Y axis movement mechanism 904 along an X axis perpendicular to the Y axis.

Figs. 9(b) - 9(d) are perspective views of the R axis rotating mechanism 902, the Y axis movement mechanism 904 and the X axis movement mechanism 906 respectively. In one example, movement along and about the three axes (X, Y, R) is achieved by a three channel servo motion system as described below. The three channel servo motion system may in turn be controlled by the robotic controller 108 for the positioning of the surgical instrument in a three- dimensional space.

Fig. 10(a) is a perspective view of the R axis rotating mechanism 902, Fig. 10(b) is a cross-sectional view of the R axis rotating mechanism 902 and Fig. 10(c) is a side view of the R axis rotating mechanism 902. The R axis rotating mechanism 902 comprises a fifth worm wheel 1004 arranged to rotate about the R axis. A fifth worm gear 1002 is arranged to mesh with the fifth worm wheel 1004 such that the fifth worm wheel 1004 rotates when the fifth worm gear 1002 rotates and the fifth worm wheel 1004 is locked in a stationary position when the fifth worm gear 1002 is stationary. A servo motor 1006 and a hand wheel 1008 are in turn arranged to independently drive the fifth worm gear 1002. In other words, the fifth worm gear 1002 may either be automatically driven by the servo motor 1006 or manually driven by turning the hand wheel 1008. The fifth worm wheel 1004 is arranged to be disengageable from the fifth worm gear 1002 such that the fifth worm wheel 1004 is operable to move independently of the fifth worm gear 1002. For example, when the fifth worm wheel 1004 is disengaged from the fifth worm gear 1002, the fifth worm wheel 1004 may be manually rotated by an operator of the apparatus 100. In one example as shown in Figs. 10(a) - 10(c), the R axis rotating mechanism 902 further comprises a shaft 1010 which is arranged with the servo motor 1006, the hand wheel 1008 and the fifth worm gear 1002 to enable the fifth worm gear 1002 to be disengageable from the fifth worm wheel 1004. The R rotating mechanism 902 further comprises a locking element arranged to lock the disengagement of the fifth worm wheel from the fifth worm gear. The locking element comprises a slide latch 1012 and a hand nut 1014 for operating the slide latch 1012. Locking the disengagement maintains the fifth worm wheel 1004 in a stationary position when the fifth worm wheel 1004 is not manually rotated.

The rotation system 104 is carried by the 3D surgical positioning arm 106 and is arranged to rotate with the fifth worm wheel 1004 of the R axis rotating mechanism 902. In one embodiment, the rotation system 104 comprises the a axis rotation mechanism 504 and is connected to the 3D surgical positioning arm 106 via the a axis rotation mechanism 504. In another embodiment, the rotation system 104 does not comprise the a axis rotation mechanism 504 and is connected to the 3D surgical positioning arm 102 via the extension arm 718 of the β axis rotation mechanism.

Fig. 1 1 (a) is a perspective view of the Y axis movement mechanism 904 and Fig. 1 (b) is a cross-sectional view of the Y axis movement mechanism 904.

As shown in Figs. 1 1 (a) and 1 1 (b), the Y axis movement mechanism 904 comprises a second lead screw 1 106 arranged with the R axis rotating mechanism 902 such that the R axis rotating mechanism 902 moves along the Y axis when the second lead screw 1 106 is rotated. In one example, the second lead screw 1 106 is supported by bearings at its ends. The number of bearings may be two. A servo motor 1 1 10 and a hand wheel 1 1 12 are arranged to independently rotate the second lead screw 1 106. In other words, the second lead screw 1 106 may either be automatically rotated by the servo motor 1 1 10 or manually rotated by turning the hand wheel 1 1 12. The servo motor 1 1 10 cooperates with a gear box 1 108 to rotate the second lead screw 1106.

The Y axis movement mechanism further comprises a support frame 1 102 arranged to move along the Y axis when the second lead screw 1 106 is rotated. In one example, the support frame 1 102 is arranged to move along a linear guide 1 104 whose length is parallel to the Y axis. The R axis rotating mechanism 902 is arranged to lock with the support frame 1 102, thereby allowing it to move along the Y axis when the second lead screw 1 106 is rotated. In one example, the servo motor 1 1 10 is connected with the second lead screw 1 106 via the gear box 1 108 to move the support frame 1 102. The Y axis movement mechanism 904 further comprises two covers 1 1 14 and

1 1 16 arranged on a base 1 1 18.

Fig. 12(a) is a perspective view of the X axis movement mechanism 906 and Fig. 12(b) is a cross-sectional view of the X axis movement mechanism 906.

The X axis movement mechanism 906 comprises a third lead screw 1208 arranged with the Y axis movement mechanism 904 such that the Y axis movement mechanism 904 moves along the X axis when the third lead screw 1208 is rotated. In one example, the third lead screw 1208 is supported by bearings at each of its ends. A servo motor 1206 and a hand wheel 1216 are arranged to independently rotate the third lead screw 1208. In other words, the third lead screw 1208 may either be automatically rotated by the servo motor 1206 or manually rotated by turning the hand wheel 1216. The servo motor 1206 is arranged to cooperate with a gear mechanism 1210 to rotate the third lead screw 1208.

The X axis movement mechanism 906 further comprises a support component 1204 arranged to move along the X axis when the third lead screw 1208 is rotated. In one example, the support component 1204 is arranged to move along a linear guide 1202 whose length is parallel to the X axis. The Y axis movement mechanism 904 is arranged to lock with the support component 1204, thereby allowing it to move along the X axis when the third lead screw 1208 is rotated. In one example, the servo motor 1206 is connected with the third lead screw 1208 via the gear mechanism 1210 to move the support component 1204. The X axis movement mechanism 906 further comprises a cover 1218 arranged on top of a base 1214 which comprises two holes 1214a, 1214b, and a handle 1212. In one example, the handle 1212 is fixed on the base 1214 of the X axis movement mechanism 906.

Fig. 13(a) is a perspective view of the robotic controller 108, Fig. 13(b) is a cut away perspective view of the robotic controller 08 and Figs. 13(c) - 13(d) are cross-sectional views of the robotic controller 108. The robotic controller 108 comprises an integrated user-device interface for receiving user inputs. The integrated user-device interface comprises one of more of an advanced graphic user interface (GUI), a touchpad control, a voice control and a wireless control for providing a user-friendly operation system. The robotic controller 108 further comprises a multi channel servo control system 1302 for controlling the movement of the movement table 102, the rotation system 104 and the 3D surgical positioning system 106. The robotic controller 108 also comprises a control computer 1310 for controlling the multi channel servo control system 1302. The control computer 1310 may be in the form of a tablet PC and may be installed on a surface of a robotic controller box 1312. In one example, application programs are preloaded into the control computer 1310 and are run based on the received user inputs. The application programs may be based on one or more of imaging technologies or artificial intelligence technologies and the multi channel servo control system 1302 is controlled based on the outputs from the application programs. The apparatus 100 may also be connected to a higher level control system using web technology via the control computer 1310.

The robotic controller 108 further comprises an image acquiring and processing system in the form of a USB frame grabber 1304 for capturing image signals from a surgical imaging system. In one example, the application programs are run based on the received user inputs and the captured image signals. Furthermore, the robotic controller 108 comprises an image input adaptor 1306, a DC power supply 1308 and an Electric Data Capture (EDP) system for recording a surgical procedure in which the surgical instrument is used. This recording may be used for subsequent patient assessment or for facilitating a reproduction of the surgical procedure at a later time.

Fig. 14(a) is a perspective view of the flexible support arm 1 10 whereas Figs. 14(b) and 14(c) are respectively a side view and a back view of the flexible support arm 1 10. The flexible support arm 1 10 serves as a securing mechanism for securing the apparatus 100 to a platform which may be for example, the side rails of an operation bed or an operating table.

As shown in Figs. 14(a) - 14(c), the flexible support arm 1 10 comprises a clamping mechanism in the form of a quick clamp 1402. In one example, the quick clamp 1402 is arranged to clamp onto a platform by turning a locking screw 1404.

The flexible support arm 10 further comprises a support arm 1408 arranged to couple the clamping mechanism and the X axis movement mechanism 906. In one example, this coupling is performed using two side support plates 1410a and 1410b which are arranged to be slotted through the holes 1214a and 1214b of the X axis movement mechanism 906. The support arm 1408 is arranged to be connected with the quick clamp 1402 in different configurations (three different configurations in one example).

The flexible support arm 1 10 further comprises a swing support 1406 arranged to couple the support arm 1408 and the quick clamp 1402. In one example, the support arm 1408 is arranged to rotate about a nut 1414 (which serves as the pivot point for the rotation) such that the support arm 1408 can be connected with the quick clamp 1402 in three different configurations (the configuration as shown in Fig. 14(a) and two further configurations in which the support arm 1408 is rotated 90 degrees clockwise and anti-clockwise about the nut 1414 from the configuration shown in Fig. 14(a)). The flexible support arm 110 further comprises a locking nut 1412 arranged to secure the clamp 1402, the swing support 1406 and the support arm 1408 with each other. Figs. 15(a) - 15(d) illustrate four examples on how the apparatus 100 (with the robotic controller 108 detached) may be secured to a platform using the flexible support arm 110.

Fig. 15(a) is a first example wherein the apparatus 100 is secured on an operation bed 1502 for up bed or on bed operation for laparoscopic surgical procedures such as throacoscopic surgical procedures or otolaryngology surgical procedures. In Fig. 15(a), the apparatus 100 is secured on the right side of the bed 1502. However, the apparatus 100 may also be secured on the left side of the bed 1502.

Fig. 15(b) is a second example wherein the apparatus 100 is secured on an operation bed 1504 for under bed or on bed operation for urological surgical procedures, colorectal surgical procedures or gynecological surgical procedures. In Fig. 15(b), the apparatus 100 is secured on the left side of the bed 1504. However, the apparatus 100 may also be secured on the right side of the bed 1504.

Fig. 15(c) is a third example wherein the apparatus 100 is secured on an operation table 1506 for developing surgical instruments in a laboratory.

Fig. 15(d) is a fourth example wherein the apparatus 100 is secured on a mobile cart 1508 for enabling a mobile operation system.

Although the robotic controller 108 is shown only in Fig. 15(c), it may also be used with the rest of the apparatus 100 in any of Figs. 15(a), 15(b) or 15(d). Furthermore, the robotic controller 108 may be attached with the rest of the apparatus 108 to achieve a portable operation system. Figs. 16 - 18 show example applications of the apparatus 100.

Figs. 16(a) - 16(c) are respectively a perspective view, a side view and a front view of an example in which the apparatus 100 is used for carrying and positioning a bi-plane ultrasound probe 1602 for obtaining a set of 2D images Which may be used for forming a 3D volume image. In one example, the ultrasound probe 1602 is an Aloka ultrasound system.

Figs. 17(a) - 17(c) are respectively a perspective view, a top view and a front view of an example in which the apparatus 100 is used for carrying and handling an endoscopic surgical instrument 1702 for performing a colorectal surgical procedure. In one example, the endoscopic surgical instrument 1702 is an Olympus endoscopic system. Figs. 18(a) - 18(c) are respectively a perspective view, a front view and a side view of an example in which the apparatus 100 is arranged to integrate with a high intensive focus ultrasound (HIFU) system 1802 for performing a noninvasive focus therapy for treating prostrate cancer. In one example, the HIFU system 1802 comprises an Aloka ultrasound system for acquiring images and a Biobot Surgical's HIFU ablate knife for performing the treatment of prostrate cancer.

The apparatus 100 provides the following advantages. The use of the apparatus 100 is not limited to specially designed surgical tools and instruments. Instead, it may be used with conventional and advanced surgical instruments or tools, such as instruments for laparoscopic surgical procedures, endoscopic surgical procedures, urological surgical procedures, colorectal surgical procedures etc. The apparatus 100 may also carry and handle a two dimension (2D) ultrasound probe for acquiring a set of 2D images which may be used to form a three dimension (3D) volume image. Furthermore, the apparatus 100 can function as a portable system. With the securing mechanism, the apparatus 100 can be easily fixed with a patient's bed for performing under bed or up bed operation and thus, the apparatus 100 is suitable for any surgical procedure regardless of which part of the patient's body the surgical procedure is to be performed on. The apparatus 100 may also be fixed onto a table for performing research on either a surgical instrument or a surgical procedure.

The three positioning mechanisms (movement table 102, rotation system 104 and 3D surgical positioning system 106) provide the apparatus 100 with 8 degrees of freedom. This allows the apparatus 100 to serve as a compact instrument placement platform to meet not only the base requirement but also the advanced requirement of surgical operations performed within a limited space and a harsh environment. Thus, the apparatus 100 may be used for many surgical procedures, including head surgical procedures, throacoscopic surgical procedures, otolaryngology surgical procedures, gynecological surgical procedures, abnormal surgical procedures, urological surgical procedures, colorectal surgical procedures and so on. The apparatus 100 can achieve an automatic positioning of surgical instruments and tools during a surgical procedure. This can achieve a higher accuracy as compared to manually positioning the surgical instruments and tools. Furthermore, the apparatus 100 is arranged to operate as an active system (or in other words, an active robot) through the use of applications uploaded into a control computer of the controller. As compared to prior art systems wherein a robot merely mimics the movement of a surgeon's hands to manipulate a surgical instrument, using the apparatus 100 can reduce the amount of inaccuracies caused by human errors and hence achieve a higher accuracy. In addition, the apparatus 100 is able to position either a traditional or an advanced surgical instrument used for a complex surgical procedure in a manner which is faster and safer. The apparatus 100 thus provides a basic intelligent digital surgical platform (iDSP) for arming a surgeon with the necessary digital technology. In other words, the apparatus 100 provides a basic platform to integrate modern technologies into the medical industry and bridges the gap between advanced technologies and the surgical procedures currently performed by a surgeon. This will hence benefit several patients.

Claims

1. An apparatus for positioning a surgical instrument in relation to a target, the apparatus comprising:

a first positioning mechanism arranged to move the surgical instrument along a L axis;

a second positioning mechanism comprising:

a γ axis rotation mechanism arranged to rotate the first positioning mechanism about a γ axis perpendicular to the L axis;

a β axis rotation mechanism arranged to rotate the γ axis rotation mechanism about a β axis perpendicular to the γ axis and the L axis; and

a third positioning mechanism comprising:

a R axis rotating mechanism arranged to rotate the second positioning mechanism about a R axis parallel to the β axis;

a Y axis movement mechanism arranged to move the R axis rotating mechanism along a Y axis parallel to the R axis; and

a X axis movement mechanism arranged to move the Y axis movement mechanism along a X axis perpendicular to the Y axis.

2. An apparatus according to claim 1 , wherein the first positioning mechanism is further arranged to rotate the surgical instrument about an S axis parallel to the L axis wherein the S axis passes through the surgical instrument.

3. An apparatus according to claim 2, wherein the first positioning mechanism comprises a first lead screw arranged with the surgical instrument such that the surgical instrument moves along the L axis when the first lead screw is rotated.

4. An apparatus according to claim 3, wherein the first positioning mechanism further comprises an adaptor table arranged to move along the L axis when the first lead screw is rotated and the surgical instrument is arranged to lock with the adaptor table, thereby allowing the surgical instrument to move along the L axis when the first lead screw is rotated.

5. An apparatus according to claim 4, wherein the adaptor table is arranged to move along a linear guide whose length is parallel to the L axis.

6. An apparatus according to any of claims 3— 5, wherein the first lead screw is arranged to be supported on a puller base and a bearing base.

7. An apparatus according to any claims 3 - 6, wherein the first positioning mechanism further comprises a servo motor arranged to cooperate with a coupling element to drive the first lead screw.

8. An apparatus according to claim 7, wherein the servo motor is arranged to be driven by a switch, the switch in turn arranged to be operated by a switch handle.

9. An apparatus according to any of claims 4 - 8, wherein the first positioning mechanism further comprises

an instrument adaptor arranged to hold the surgical instrument; and a locking shaft arranged to lock the instrument adaptor with the adaptor table, thereby locking the surgical instrument with the adaptor table.

10. An apparatus according to claim 8, wherein the instrument adaptor is a spin mechanism arranged to rotate the surgical instrument about the S axis.

11. An apparatus according to claim 10, wherein the spin mechanism further comprises a support block arranged to engage with the locking shaft to allow the spin mechanism to lock with the adaptor table.

12. An apparatus according to claim 10 or 11 , wherein the spin mechanism further comprises a slide ring arranged to hold a device adaptor which is in turn arranged to hold the surgical instrument.

13. An apparatus according to any of claims 10 - 12, wherein the spin mechanism further comprises

a first worm wheel arranged to rotate about the S axis; and

a first worm gear arranged to mesh with the first worm wheel such that the first worm wheel rotates when the first worm gear rotates and the first worm wheel is locked in a stationary position when the first worm gear is stationary.

14. An apparatus according to claim 13, wherein the spin mechanism further comprises a servo motor and a hand wheel arranged to independently drive the first worm gear.

15. An apparatus according to any of the preceding claims, wherein the second positioning device further comprises a a axis rotation mechanism arranged to rotate the β axis rotation mechanism about an a axis parallel to the L axis.

16. An apparatus according to claim 15, wherein the γ axis rotation mechanism comprises

a second worm wheel arranged to rotate about the γ axis; and

a second worm gear arranged to mesh with the second worm wheel such that the second worm wheel rotates when the second worm gear rotates and the second worm wheel is locked in a stationary position when the second worm gear is stationary.

17. An apparatus according to claim 16, wherein the γ axis rotation mechanism further comprises a servo motor and a hand wheel arranged to independently drive the second worm gear.

18. An apparatus according to claim 16 or 17, wherein the second positioning mechanism further comprises a support member arranged to rotate with the second worm gear and further arranged to support the first positioning device such that the first positioning device rotates with the second worm gear.

19. An apparatus according to any of the preceding claims, wherein the β axis rotation mechanism comprises

a third worm wheel arranged to rotate about the β axis; and

a third worm gear arranged to mesh with the third worm wheel such that the third worm wheel rotates when the third worm gear rotates and the third worm wheel is locked in a stationary position when the third worm gear is stationary.

20. An apparatus according to claim 19, wherein the β axis rotation mechanism further comprises a servo motor and a hand wheel arranged to independently drive the third worm gear.

21. An apparatus according to claim 19 or 20, wherein the third worm wheel is arranged to be disengageable from the third worm gear such that the third worm wheel is operable to move independently of the third worm gear.

22. An apparatus according to claim 21 , wherein the β axis rotation mechanism further comprises a locking mechanism arranged to lock the disengagement of the third worm wheel from the third worm gear.

23. An apparatus according to claim 22, wherein the locking mechanism comprises

a slide latch; and

a hand nut arranged to operate the slide latch.

24. An apparatus according to any of claims 19 - 23, wherein the γ axis rotation mechanism further comprises a coupling member arranged with the third worm wheel such that the γ axis rotation mechanism rotates with the third worm wheel.

25. An apparatus according to claim 24, wherein the coupling member further comprises a support plate fixed with the third worm wheel and a gear base support fixed with the support plate.

26. An apparatus according to any of claims 15 - 25, wherein the a axis rotation mechanism further comprises

a fourth worm wheel arranged to rotate about the a axis; and

a fourth worm gear arranged to mesh with the fourth worm wheel such that the fourth worm wheel rotates when the fourth worm gear rotates and the fourth worm wheel is locked in a stationary position when the fourth worm gear is stationary.

27. An apparatus according to claim 26, wherein the a axis rotation mechanism further comprises a servo motor and a hand wheel arranged to independently drive the fourth worm gear.

28. An apparatus according to claim 26 or 27, wherein the β axis rotation mechanism further comprises an extension arm being arranged with the fourth worm wheel such that the β axis rotation mechanism rotates with the fourth worm wheel.

29. An apparatus according to claim 28, wherein the a axis rotation mechanism further comprises a support block arranged to rotate with the fourth worm wheel, the support block coupling the extension arm with the fourth worm wheel such that the β axis rotation mechanism rotates with the fourth worm wheel.

30. An apparatus according to any of the preceding claims, wherein the R axis rotating mechanism further comprises

a fifth worm wheel arranged to rotate about the R axis; and

a fifth worm gear arranged to mesh with the fifth worm wheel such that the fifth worm wheel rotates when the fifth worm gear rotates and the fifth worm wheel is locked in a stationary position when the fifth worm gear is stationary.

31. An apparatus according to claim 30, wherein the R axis rotating mechanism further comprises a servo motor and a hand wheel arranged to independently drive the fifth worm gear.

32. An apparatus according to claim 30 or 31 , wherein the fifth worm wheel is arranged to be disengageable from the fifth worm wheel such that the fifth worm wheel is operable to move independently of the fifth worm gear.

33. An apparatus according to claim 32, wherein the R axis rotating mechanism further comprises a locking element arranged to lock the disengagement of the fifth worm wheel from the fifth worm gear.

34. An apparatus according to claim 33, wherein the locking element comprises

a slide latch; and

a hand nut arranged to operate the slide latch of the locking device.

35. An apparatus according to any of the preceding claims, wherein the Y axis movement mechanism further comprises a second lead screw arranged with the R axis rotating mechanism such that the R axis rotating mechanism moves along the Y axis when the second lead screw is rotated.

36. An apparatus according to claim 35, wherein the Y axis movement mechanism further comprises a servo motor and a hand wheel arranged to independently rotate the second lead screw.

37. An apparatus according to claim 35 or 36, wherein the second lead screw is supported by bearings at each of its ends.

38. An apparatus according to claim 36 or 37, wherein the servo motor of the Y axis movement mechanism is arranged to cooperate with a gear box to rotate the second lead screw.

39. An apparatus according to any of claims 35 - 38, wherein the Y axis movement mechanism further comprises a support frame arranged to move along the Y axis when the second lead screw is rotated and the R axis rotating mechanism is arranged to lock with the support frame, thereby allowing it to move along the Y axis when the second lead screw is rotated.

40. An apparatus according to claim 39, wherein the support frame is arranged to move along a linear guide whose length is parallel to the Y axis.

41. An apparatus according to any of the preceding claims, wherein the X axis movement mechanism further comprises a third lead screw arranged with the Y axis movement mechanism such that the Y axis movement mechanism moves along the X axis when the third lead screw is rotated.

42. An apparatus according to claim 41 , wherein the X axis movement mechanism further comprises a servo motor and a hand wheel arranged to independently rotate the third lead screw.

43. An apparatus according to claim 41 or 42, wherein the third lead screw is supported by bearings at each of its ends.

44. An apparatus according to claim 42 or 43, wherein the servo motor of the X axis movement mechanism is arranged to cooperate with a gear mechanism to rotate the third lead screw.

45. An apparatus according to any of claims 41 - 44, wherein the X axis movement mechanism further comprises a support component arranged to move along the X axis when the third lead screw is rotated and the Y axis movement mechanism is arranged to lock with the support component, thereby allowing it to move along the X axis when the third lead screw is rotated.

46. An apparatus according to claim 45, wherein the support component is arranged to move along a linear guide whose length is parallel to the X axis.

47. An apparatus according to any of the preceding claims, further comprising a controller for controlling the movement of the first, second and third positioning mechanisms.

48. An apparatus according to claim 47, wherein the controller comprises a user-device interface for receiving user inputs;

a servo control system for controlling the movement of the first, second and third positioning mechanisms; and

a control computer for controlling the servo control system;

wherein the servo control system is controlled based on outputs from application programs preloaded into the control computer, the application programs being run based on the user inputs.

49. An apparatus according to claim 48, wherein the user-device interface further comprises one or more of an advanced graphic user interface, a touchpad control, a voice control and a wireless control.

50. An apparatus according to claim 48 or 49, wherein the application programs are based on one or more of imaging technologies or artificial intelligence technologies.

51. An apparatus according to any of claims 47 - 50, wherein the controller further comprises an image acquiring and processing system for capturing image signals and the application programs are run based on the user inputs and the captured image signals.

52 An apparatus according to any of claims 47 - 51 , wherein the controller further comprises an Electric Data Capture system for recording a surgical procedure in which the surgical instrument is used.

53. An apparatus according to any of the preceding claims, further comprising a securing mechanism for securing the apparatus to a platform.

54. An apparatus according to claim 53, wherein the securing mechanism further comprises

a clamping mechanism arranged to clamp onto the platform; and a support arm arranged to couple the clamping mechanism and the X axis movement mechanism, the support arm being further arranged to be connected with the clamping mechanism in different configurations.

55. An apparatus according to claim 54, wherein the securing mechanism further comprises a swing support arranged to couple the clamping mechanism and the support arm.

56. An apparatus according to claim 54 or 55, wherein the clamping mechanism is arranged to clamp onto the platform by turning a locking screw.