WO2017050201A1

WO2017050201A1 - Minimally invasive medical robot system

Info

Publication number: WO2017050201A1
Application number: PCT/CN2016/099359
Authority: WO
Inventors: 张旭; 俞鸿凯; 时一宝; 边东东; 石浩森; 金义; 孟宪全; 张茜
Original assignee: 拜耳斯特医疗机器人技术（天津）有限公司
Priority date: 2015-09-25
Filing date: 2016-09-19
Publication date: 2017-03-30
Also published as: CN105125289A; CN105125289B

Abstract

Disclosed are a minimally invasive medical robot system and a use thereof, and a method for positioning an intervention device. The minimally invasive medical robot system comprises a working mechanism (3), an adjustment mechanism (4), a control mechanism (5) and a man-machine interaction mechanism (1), wherein the working mechanism (3) comprises a double-hole protection position orifice plate (31) and a guide syringe (34). Positioning the guide syringe (34) of the working mechanism (3) ensures that the guide syringe (34) is on the straight line defined by the target sampling point and one hole of the double-hole protection position orifice plate (31). When the minimally invasive medical robot system is used, diagnosis and treatment of prostate cancer can be carried out precisely with image guidance.

Description

Minimally invasive medical robot system

The present invention claims priority from September 25, 2015, the application number is CN 201510623072.6, and the application filed by the applicant is entitled "Minimally Invasive Medical Robot System". The entire contents of the above application are hereby incorporated by reference in its entirety.

Technical field

The invention relates to a minimally invasive medical robot system, in particular to a medical robot system for diagnosis and treatment of prostate cancer, which can increase the detection rate, improve the safety of surgery and avoid iatrogenic cross infection.

The invention also relates to a method of using a minimally invasive medical robotic system, including its specific field of application and methods of applying the same to locate an interventional device.

Background of the invention

Prostate cancer occurs mostly in the male genitourinary system. It is a malignant tumor. It is often asymptomatic in the early stage, with a long incubation period, and the morbidity and mortality are increasing year by year. How to diagnose and treat prostate cancer early has important clinical significance. At present, the clinical use of real-time 2D transrectal ultrasound-guided sextant through a rectal biopsy with a puncture template for screening and diagnosis.

Chinese patent application CN 104720853 A discloses an ultrasound guided automatic prostate biopsy particle implantation system and a needle insertion method. A positioning module and an image acquisition module are fixed on the support platform, and a horizontal piercing positioning plate is disposed at a front end of the support platform. The positioning module is adjusted so that the biopsy guns are placed in a horizontal position, and sampling is performed one by one according to the gap of the positioning plate.

However, the conventional template puncture method similar to that disclosed in the above patent documents has the following problems.

1. The template method has short lead and large deviation: Firstly, compared with the length of the biopsy gun/particle implant gun used in clinical practice, the guide hole length of the template is short, which is easy to cause the positioning deviation of the biopsy gun/particle implant gun; secondly, The position of the guide hole of the template and the distance between the holes cannot be adjusted, which limits the selection of the puncture point of the biopsy gun. For lesions less than 5 mm in diameter, the sample may not be completely sampled, resulting in an increase in the rate of missed detection, false negative rate, or restriction of particle implantation. The path selection causes the radiation dose distribution of the implanted particles to be inconsistent with the target; thirdly, when the biopsy gun or the particle implanted gun encounters the pubic occlusion, the tissue sample near the pubic bone (high cancer area) is difficult to collect, or it is difficult to radioactively Particles are implanted into the expected location with high limitations and blindness. Therefore, the template method may affect the pathological test results, or cause the actual radiation dose distribution of the implanted particles to deviate from the plan, affecting the radiotherapy effect.

2. Lack of self-test mechanism before intervention, lack of real-time monitoring in the intervention: First, when the position of the positioning module is adjusted, the biopsy needle is inserted, there is no verification process, and it is impossible to judge whether the insertion position or posture of the biopsy gun is accurate, if due to software Causes of abnormal positioning of the positioning module and/or the biopsy gun. The system cannot detect the biopsy gun before it reaches the surface of the subject's skin. It may accidentally injure the subject, such as urinary tract, causing complications, etc. There is a lack of self-test mechanism before; secondly, the existing imaging technology mostly reconstructs all scanned 2D sequences and obtains static 3D images as intraoperative guidance, losing real-time performance when biopsy gun/particle implant gun After entering the body, it is difficult to accurately obtain the depth, angle, trajectory and other information, depending on the experience and skill level of the surgeon, the possibility of misoperation and accidental injury to other organs is increased, that is, the lack of real-time monitoring in the intervention.

3. High maintenance cost: In the existing equipment, due to the inherent characteristics of the structure, the blood of the operator may flow back into the equipment to cause pollution, increase the maintenance cost of the hospital, and even affect the function of the equipment and the surgical process.

Summary of the invention

In view of the above, the technical problem to be solved by the present invention is to overcome one or more of the aforementioned drawbacks.

According to one aspect of the invention, a minimally invasive medical robotic system is provided. The minimally invasive medical robot system includes: a working mechanism, an adjustment mechanism, a control mechanism, and a human-computer interaction mechanism. The working mechanism is positioned on the adjustment mechanism and the adjustment mechanism is positioned on the control mechanism. The working mechanism further comprises: a double-hole protection positioning orifice plate, a guiding syringe, an ultrasonic probe, an ultrasonic probe moving mechanism, a base and a guiding syringe motion control mechanism. The guide barrel motion control mechanism is slidably mounted on the base. The two-hole protective positioning orifice plate is detachably mounted on the front curved plate of the base, the ultrasonic probe moving mechanism is slidably mounted on the upper support plate of the base, and the ultrasonic probe can be clamped to the ultrasonic probe movement In the organization. The adjustment mechanism is configured to adjust the horizontal position, the vertical position, and/or the pitch angle of the working mechanism according to the position of the patient and/or the position of the operating table. The human-machine interaction mechanism is configured to display real-time images acquired by the work organization, receive external inputs, and is also configured to communicate with the control mechanism to control components in the work mechanism through the control mechanism.

According to one embodiment of the invention, the guide barrel movement control mechanism may include a guide barrel seat for mounting the guide barrel. At least one end of the guiding pin holder can be connected with a universal joint for assisting the adjustment of the posture of the guiding cylinder.

According to an embodiment of the present invention, the guide cylinder motion control mechanism may include a left control mechanism and a right control mechanism. An assembly for controlling the positioning of the guide barrel is provided within the left control mechanism and the right control mechanism and/or in the area defined by the left control mechanism and the right control mechanism. The control and movement of the left and right control mechanisms can be independent of each other to achieve positioning of the guide barrel, which can include adjustments to its own attitude and spatial position.

Further, the positioning of the guide barrel includes one or more of the following movements of the guide barrel: a lifting motion, a pitch motion, a left and right translation motion, a horizontal rotational motion, and a back and forth motion.

In one embodiment, the guide barrel motion control mechanism can include, for example, a screw drive structure or a hydraulic drive structure for controlling the positioning of the guide barrel. The guide barrel motion control mechanism can be configured to control the lifting motion, the pitch motion, the left and right translational motion, the horizontal rotational motion, and/or the back and forth motion of the guide cylinder, and the motions in the five degrees of freedom can be independent of each other. The directions of forward and backward movement, left and right translational movement, and lifting movement may be perpendicular to each other.

According to an embodiment of the present invention, the minimally invasive medical robot system may further include a connector disposed on the base for power supply and communication of the working mechanism.

According to an embodiment of the present invention, the outer upper portion of the double-hole protection positioning orifice plate may be a protruding structure including two through positioning holes.

According to an embodiment of the present invention, the lower portion of the protruding structure of the two-hole type protective positioning orifice plate may be provided with a blood groove.

According to an embodiment of the invention, the minimally invasive medical robot system may further comprise an external command triggering device, which may be configured to signal that the positioning of the guiding syringe is enabled.

Further, the external command triggering device may be implemented as a foot pedal disposed at a lower portion of the control mechanism.

According to an embodiment of the invention, the human-machine interaction mechanism is detachably mounted on the control mechanism or independently.

According to an embodiment of the invention, the minimally invasive medical robot system may further comprise a pusher and/or a universal wheel. The pusher and/or the caster can be configured to assist in the transfer and/or fixation of the minimally invasive medical robotic system.

According to an embodiment of the invention, the control mechanism may comprise a space adapted to accommodate the human-computer interaction mechanism and the working mechanism.

According to one embodiment of the invention, the working mechanism can be used in conjunction with a biopsy gun or a radioactive particle implant gun.

According to another aspect of the invention, the aforementioned minimally invasive medical robotic system is used in the fields of prostate biopsy or radioactive particle implantation. To this end, the working mechanism can be used in conjunction with a biopsy gun or a radioactive particle implant gun suitable for the diagnosis or treatment of prostate cancer. Thus, a minimally invasive surgical system that can combine the diagnostic and therapeutic functions of prostate cancer is provided.

According to still another aspect of the present invention, a method of locating an interventional device is provided. The method comprises: positioning a guiding cylinder of the working mechanism such that the guiding cylinder falls on a straight line determined by a hole in the target sampling point and the two-hole protective positioning orifice plate, and the interventional device can pass through the guiding syringe Acting on The target sampling point; or adjusting the positioning of the guiding syringe such that the guiding syringe falls on a line defined by the radioactive particle target implantation path, and the interventional device can pass through the guiding syringe to act on the target implantation path. In both cases, the depth of intervention of the interventional device can be defined by the position of the guide barrel. That is, the spatial position of the guide barrel, particularly the position of its rear end, can define the depth of intervention of the interventional device without the need for additional interventional device depth control components. This design simplifies the structure of the system and avoids the conflict between setting the depth control component and/or the motor that drives its motion in space with other components in the system. For example, during the pre-operative self-test of the system or in the positioning of the guiding syringe, the depth control component placed behind the syringe and/or the motor that drives its movement may be blocked by other components, resulting in the guide cylinder not being able to adjust to The target position, posture, and other components of the system, such as ultrasonic probes, may cause displacement or even damage to the probe.

According to one embodiment of the invention, the interventional device may be a biopsy gun or a radioactive particle implanted gun.

According to an embodiment of the present invention, a method for positioning and positioning a protective positioning orifice plate and a guiding syringe is proposed, and the biopsy sampling can be accurately performed under image guidance. If the positioning of the guiding cylinder is wrong, the guiding cylinder does not fall on the straight line determined by the target path, so the interventional device that passes along the guiding cylinder will not reach the through positioning hole on the protective positioning hole plate as planned. Instead, it is blocked by the protective positioning hole plate, can not pass through the positioning hole and reach the skin of the subject, thereby realizing the self-inspection process of the interventional device before intervening in the human body, and avoiding the positioning of the guiding syringe caused by hardware, software and the like. The damage caused to the subject by mistakes improves the safety and reliability of the system. Embodiments of the present invention visualize surgical procedures, increase detection rates, reduce wounds in the subject, avoid iatrogenic cross-contamination, and reduce labor intensity.

These and other advantages and features of the various embodiments of the present invention will become more apparent from the description of the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

1 is a schematic view showing the overall structure of a minimally invasive medical robot system according to an embodiment of the present invention;

2 illustrates a position of a working mechanism of a minimally invasive medical robotic system relative to a patient's perineum and a puncture point at a perineum thereof, in accordance with an embodiment of the present invention;

Figure 3 illustrates the structure of a working mechanism in accordance with one embodiment of the present invention;

4 illustrates the movement of the guide cylinder in the front-rear direction according to an embodiment of the present invention;

Figure 5 illustrates the movement of the guide cylinder in the pitch, up and down, left and right translation, and horizontal rotation directions, in accordance with one embodiment of the present invention;

Figure 6 illustrates the structure of a two-hole protective locating orifice plate in accordance with one embodiment of the present invention;

Figure 7 illustrates a schematic diagram of a precise positioning of a "positioning hole + guide syringe" in accordance with one embodiment of the present invention;

8 shows a software control flow diagram of a minimally invasive medical robotic system in accordance with one embodiment of the present invention.

Mode for carrying out the invention

The present disclosure will be described more fully hereinafter with reference to the accompanying drawings in which FIG. However, these embodiments can be implemented in many different forms and should not be construed as being limited to the embodiments described herein. Rather, the examples are provided so that this disclosure will be thorough and complete, and the scope of the disclosure will be apparent to those skilled in the art.

1 shows, in a structural schematic view, the composition of a minimally invasive medical robotic system in accordance with one embodiment of the present invention. The minimally invasive medical robot system includes a working mechanism 3, an adjustment mechanism 4, a control mechanism 5, and a human-machine interaction mechanism 1. The working mechanism 3 is positioned on the adjustment mechanism 4, and the adjustment mechanism 4 is positioned on the control mechanism 5. As shown in FIG. 1, the human-machine interaction mechanism 1 is detachably mounted on a column fixed to the control mechanism 5. It should be understood that the human-machine interaction mechanism 1 can also be set independently.

As shown in FIG. 1, the minimally invasive medical robot system may further include an external command triggering device 6. An external command triggering device 6 is provided at the lower portion of the control unit 5. In this embodiment, the external command triggering device 6 is implemented as a foot pedal.

As can be seen from FIG. 1, the minimally invasive medical robot system according to this embodiment may further include a pusher 2 and four caster wheels 7. As shown in FIG. 1, the pusher 2 is fixedly mounted on the top surface of the control mechanism 5, and the four universal wheels 7 are mounted below the control mechanism 5. It should be understood that in other embodiments, the pusher 2 may be directly attached to the upright on the control mechanism 5 or to the side of the control mechanism 5.

The working mechanism 3 can be used to achieve perineal biopsy of prostate tissue and implantation of radioactive particles. When the working mechanism 3 is used to realize the perineal puncture biopsy of prostate tissue, a biopsy gun can be used, in particular, the surgeon holds the biopsy gun through the guiding syringe of the working mechanism 3 (as described below), and manipulates the biopsy gun to complete the biopsy. sampling. When the working mechanism 3 is used to realize the implantation treatment of the radioactive particles of the prostate tissue, the protective positioning orifice plate (as described below) can be removed, and the particle implantation gun is used, specifically, the operator holds the particle implantation gun through the work. Guide the syringe of mechanism 3 (as described below) and manipulate the particle implant gun to complete the particle implantation.

As shown in Figure 2, it schematically shows the puncture point 8 at the patient's perineum and the position of the working mechanism 3 relative to the human body when working with the minimally invasive medical robotic system.

Figure 3 shows in more detail the structure of the working mechanism 3 in accordance with one embodiment of the present invention. The working mechanism 3 may include a two-hole guard positioning orifice plate 31, a guide syringe 34, an ultrasonic probe 33, an ultrasonic probe moving mechanism 32, a base 53 and a guide syringe motion control mechanism 37. The guide cylinder movement control mechanism 37 is slidably mounted on the base 53, and may include a left control mechanism and a right control mechanism, and the inside of the left control mechanism and the right control mechanism, and the area defined by the left and right control mechanisms may be provided. An assembly that controls the positioning of the guide barrel 34, wherein the positioning of the guide barrel 34 can include its spatial position and attitude. Alternatively, it is also possible to provide a connecting plate for assisting the fixing between the left control mechanism and the right control mechanism, for example, at the top or intermediate portion between the left control mechanism and the right control mechanism.

The double-hole protection positioning hole plate 31 is detachably mounted on the front curved plate of the base 53, the ultrasonic probe moving mechanism 32 is slidably mounted on the upper support plate of the base 53, and the ultrasonic probe 33 can be clamped to the ultrasonic In the probe motion mechanism 32.

According to an embodiment of the present invention, as shown in FIG. 4, the guide cylinder movement control mechanism 37 is slidably mounted on the base 53, and may be configured to control the forward and backward movement of the guide cylinder relative to the base 53, as shown in the figure. The dotted arrow in 4 is shown.

In accordance with an embodiment of the present invention, as shown in FIG. 5, the guide barrel motion control mechanism 37 includes an assembly that controls the positioning of the guide barrel 34, such as a screw drive structure, that can be configured to control the lift movement of the guide barrel 34. , pitching motion, left and right translational motion, and/or horizontal rotational motion, as indicated by the dashed arrows in FIG.

Therefore, the guided motion control mechanism 37 can achieve the aforementioned five degrees of freedom of motion for controlling the positioning of the guide barrel 34, that is, the lifting motion, the pitch motion, the left and right translation motion, the horizontal rotation motion, and the back and forth motion, and can be independent of each other. The directions of left and right translational movement, lifting movement, and forward and backward movement may be perpendicular to each other.

Fig. 5 is a partial view showing the structure of the lifting movement, the pitching movement, the left and right translational movement, and the horizontal rotation movement of the guide cylinder. The first vertical lead screw 61 and the second vertical lead screw 63 are respectively vertically and rotatably disposed inside the left and right control mechanisms of the guide syringe control mechanism 37, and the vertical lead screws are respectively provided with 1 The silk cores are fixed with the first vertical moving member 62 and the second vertical moving member 64 respectively outside the silk core. The first horizontal lead screw 71 is horizontally and rotatably disposed inside the first vertical moving member 62, and the second horizontal lead screw 73 is horizontally and rotatably disposed inside the second vertical moving member 64, the first horizontal wire One end of the bar 71 and the second horizontal lead screw 73 that is not in contact with the first vertical moving member 62 and the second vertical moving member 64 is provided with a bearing (not shown) that supports and rotates. One horizontal nut is respectively disposed on the horizontal screw, and the first horizontal moving member 72 and the second horizontal moving member 74 are respectively fixed on the outside of the female core. According to the principle of the cooperation of the lead screw and the nut, the rotational movement of the lead screw can be converted into the first vertical moving member 62, the second vertical moving member 64, and the first horizontal moving member. 72. The second horizontal moving members 74 each move in a straight line along the lead screw.

A lower portion of the first horizontal moving member 72 is provided with a connecting member 82, and a lower portion of the second horizontal moving member 74 is provided with a universal joint 81. In order to ensure a stable attitude of the guiding syringe 34 during surgery, a guiding syringe holder 83 is provided for mounting the guiding syringe 34, the front portion of which is connected to the universal joint 81, and the rear portion is connected to the connecting member 82 by bearings.

The design of the universal joint and the structure associated therewith optimizes the rotational motion of the guide cylinder in the conventional embodiment. Typically, the rotation of the target component is carried out by attaching it to another rotatable component, such as a rotatable shaft, to which the target rotating component is connected, by means of the component (eg The rotation of the rotatable shaft drives the overall rotation of the target rotating component, that is, the rotary motion under a single point connection (control).

The rotation mode adopted in the present invention is to respectively set a connection point (or a control point) at the front end and the back end of the target rotation component, and control the two connection points (or control points) in the vertical direction and the horizontal direction respectively. The change in orientation controls the rotation of the guide cylinder, that is, the rotational motion under the two-point control. Compared to the rotary motion under single point control, it is more flexible and simplifies the mechanical structure.

In the embodiment of the present invention, the guiding pin holder and the horizontal moving member are connected in a front end universal joint and a rear end bearing. Among them, the rear end selects the bearing to ensure the stability of the position of the rear end of the guide pin holder (the rear end of the guide barrel) in the space, thereby ensuring that the syringe does not slip in the front-rear direction and ensures that the syringe does not slip. Out of the universal joint.

Alternatively, a connecting member may be disposed at a lower portion of the second horizontal moving member 74. The front portion of the guiding pin holder base 83 and the connecting member disposed at the lower portion of the second horizontal moving member 74 are connected by bearings, and the first horizontal movement is performed. The lower portion of the member 72 is provided with a universal joint, and the rear portion of the guide needle holder 83 is connected with the universal joint provided at the lower portion of the first horizontal moving member 72; or in other reasonable designs, the two ends of the guide needle holder 83 can be Set to connect to the universal joint separately.

In addition to the existing ball joints, it can also be a universal joint and the like in the implementation.

When the first vertical lead screw 61 and the second vertical lead screw 63 rotate at the same speed and in the same direction, the first vertical moving member 62 and the second vertical moving member 64 are also along the same speed at the same speed and in the same direction. The linear motion of the bar up or down synchronizes the first horizontal lead screw 71 and the second horizontal lead screw 73 to move up and down, thereby achieving the lifting movement of the guiding syringe 34.

When the first vertical lead screw 61 and the second vertical lead screw 63 are rotated at different speeds and/or different directions, the first vertical moving member 62 and the second vertical moving member 64 are also at different speeds and/or directions. The different directions are linearly moved up or down along the lead screw, and the first horizontal lead screw 71 and the second horizontal lead screw 73 are driven to perform the ascending and descending movement, thereby achieving the pitching motion of the guide syringe 34.

When the first horizontal lead screw 71 and the second horizontal lead screw 73 rotate at the same speed and in the same direction, the first horizontal moving member 72 and the second horizontal moving member 74 are also at the same speed and in the same direction along the lead screw. The step moves linearly to the left or to the right, thereby effecting the left and right translational movement of the guide barrel 34.

When the first horizontal lead screw 71 and the second horizontal lead screw 73 rotate at different speeds and/or different directions, the first horizontal moving member 72 and the second horizontal moving member 74 are also at different speeds and/or in different directions. The screw moves out of synchronization linearly to the left or to the right, thereby achieving a horizontal rotational movement of the guide barrel 34.

The above is described from the process of positioning the guide cylinder. If the description is made from the result of the positioning of the guide cylinder, the principle of the screw drive can be known that the distance = the number of revolutions * the pitch, that is, one revolution of the screw, the lead screw The upper thread (moving part) is the distance of one pitch along the lead screw, the number of turns of the screw is different, and the distance of the thread (moving part) is also different, so that the guiding cylinder (guide pin holder) can be realized. Positioning.

Before and after the positioning of the guiding cylinder, the displacement of each moving part on the screw (including the size and direction of the distance) is:

First vertical moving member 62: A; second vertical moving member 64: B;

The first horizontal moving member 72: C; the second horizontal moving member 74: D.

If A and B are the same, the translation of the guiding cylinder in the vertical direction is achieved, that is, the lifting movement of the guiding cylinder;

If A and B are different, the rotation of the guiding cylinder in the vertical direction is achieved, that is, the pitching motion of the guiding cylinder;

If C and D are the same, the translation of the guiding cylinder in the horizontal direction is achieved, that is, the left and right movement of the guiding cylinder;

If C is different from D, the rotation of the guiding cylinder in the horizontal direction is achieved, that is, the horizontal rotating motion of the guiding cylinder.

The aforementioned various degrees of freedom of motion can be driven by built-in motors and can be independent of each other.

The aforementioned assembly for controlling the positioning of the guide barrel 34 in the area defined by the left control mechanism and the right control mechanism, and the left and right control mechanisms is a screw drive structure, but it should be noted that the inventors have conceived Other forms of components or transmission structures can be provided to control the positioning of the guide barrel 34.

In another embodiment, the guide barrel motion control mechanism 37 can include a first directional motion control module, a second directional motion control module, and a third directional motion control module. As an alternative to the screw drive, each control module can be hydraulically driven with a linear motion device that uses a pressure pump to pressurize or depressurize the pressure oil in the pipe and actuator to push the actuator's pressure rod to telescope, thereby The rotary motion is converted into a linear motion to achieve the positioning of the guide cylinder. The first direction motion control module can be configured to control translational motion and rotational motion in a vertical direction of the guide syringe 34, and the second direction motion control module can be configured to control translational motion in the horizontal direction of the guide syringe 34 and Rotary transport The third, directional motion control module can be configured to control the translational movement of the guide syringe 34 in the direction of linear motion of the ultrasonic probe motion mechanism 32. The translational movements in the aforementioned three directions may be perpendicular to each other and independent of each other.

As shown in FIG. 3 and FIG. 4, the working mechanism 3 further includes a connector 51 disposed on the base 53 for power supply and communication of the working mechanism 3, and can drive the internal mechanical structure to realize the aforementioned 5 of the guiding syringe 34. Movements of degrees of freedom, namely pitching, lifting, left and right translation, horizontal rotation, front and rear. The positioning of the guide barrel 34 can be performed according to a preset program.

Alternatively or additionally, the aforementioned five degrees of freedom of the guiding cylinder 34, ie the adjustment of its own attitude and spatial position (the positioning of the guiding cylinder), can also be achieved manually. Alternatively or additionally, the connector 51 may also be disposed at a suitable position of the guide barrel motion control mechanism 37, such as the lower side of the guide cylinder motion control mechanism 37.

It should be noted that FIG. 4 is a view from a direction in which the guard positioning plate 31 is guided to the direction of the syringe movement control mechanism 37, and FIG. 5 is from the guide cylinder movement control mechanism 37 toward the guard positioning orifice 31. A view within a certain range of viewing angles, so the drawing direction of FIG. 5 is rotated by about 90 degrees with respect to FIG. The "front and rear" direction herein can be understood from the direction in which the ultrasonic probe is linearly advanced or retracted in FIG. 4, and the "left and right" direction is a direction perpendicular to the "front and rear" direction, but it should be understood that the "front and rear" direction and The "left and right" direction is a relative concept, and the "front and rear" direction in one view may become the "left and right" direction in the other view.

When the working mechanism 3 is operated, the ultrasonic probe 33 is pushed into the rectum of the subject by the ultrasonic probe moving mechanism 32. In some cases, a protective device is additionally installed outside the ultrasonic probe to improve the imaging quality, such as the ultrasonic probe cover. To obtain a fan-shaped ultrasound scan image, the ultrasound probe motion mechanism 32 is manipulated to rotate the ultrasound probe 33 that extends into the rectum of the subject within a certain angle. The trajectory envelope of the guiding syringe 34 relative to the two puncture points 8 is tapered, ensuring that the double-cone puncture sampling can avoid the urethra of the subject, reducing injury and complications when the left and right prostates are separately puncture and sampled.

The adjustment mechanism 4 is arranged to adjust the horizontal position, the vertical position and/or the pitch angle of the working mechanism 3 according to the position of the patient and/or the position of the operating table. In the embodiment shown in Figure 1, the position adjustment knob can be operated.

The human-machine interaction mechanism 1 is for displaying real-time images collected by the work mechanism 3, receiving external inputs, and is also configured to communicate with the control mechanism 5, thereby controlling the various components in the work mechanism 3 by the control mechanism 5. As shown in FIG. 1, the human-machine interaction mechanism 1 is detachably mounted on the control mechanism 5. In the embodiment of FIG. 1, the human-computer interaction mechanism 1 includes a notebook computer loaded with scanning imaging and calculation software developed for the system for reading, modeling, merging, and registering real-time images. , display, and responsible for biopsy sampling points, calculation, display and adjustment of particle implantation paths, is the surgeon The main source of the surgical information and the main guide for completing the surgical operation are obtained; as the upper computer, a control command is sent to the control mechanism 5, thereby controlling the components in the working mechanism 3. Those skilled in the art can understand that the notebook computer can be replaced with other electronic devices according to actual needs (including but not limited to desktop computers, tablet computers, and electronic control units, remote control devices, etc. designed for the system).

It should be understood that the procedure for positioning the guide barrel 34 can be set by the human-machine interaction mechanism 1. The external command triggering means 6 is configured to signal the human-machine interaction mechanism 1 so that control of the various components in the working mechanism 3 by the control mechanism 5 can be enabled, thereby enabling the positioning switching of the guide cylinder to be enabled.

In the embodiment shown in FIG. 3, the external command triggering device 6 is implemented as a foot pedal provided at the lower portion of the control mechanism 5. When the foot pedal is depressed, a signal is sent to the human-machine interaction mechanism 1 through the control mechanism 5, and control of each component in the working mechanism 3 is enabled only when the human-machine interaction mechanism receives the signal, thereby The positioning switching of the guiding syringe 34 is enabled, and the next sampling positioning or particle implantation positioning can be started. Such a control mode is to protect the patient, avoiding the uncontrolled displacement of the interventional device in the human body and causing a medical accident.

The control mechanism 5 includes a hardware circuit and is interconnected with the human-machine interaction mechanism 1, and can receive the command of the human-machine interaction mechanism 1 or transmit the command signal of the received external command triggering device 6 to the human-machine interaction mechanism 1. The various components in the working mechanism 3 are controlled.

Further, the control mechanism 5 may further include a space for accommodating the working mechanism 3 and the human-machine interaction mechanism 1 for saving the working mechanism 3, the human-machine interaction mechanism 1, the related cable, and the like when the device is not in use.

It should be understood that when the positioning of the guide barrel 34 is achieved by manual adjustment, the functions of the human-machine interaction mechanism 1 other than the image display, and the external command triggering device 6 are optional mechanisms or functions. It should also be understood that the external command triggering device 6 can also be configured to send a signal to the syringe motion control mechanism such that control of the various components of the working mechanism 3 is enabled, thereby enabling positioning switching of the steering cylinder 34 to be enabled.

Both the pusher 2 and the universal wheel 7 can be used for transfer and fixation of the medical robot device. It should be understood that the pusher 2 can be changed to other forms of pulling device according to actual needs, and the universal wheel 7 can also be changed to other specifications or forms of load-bearing structures or moving devices suitable for the surgical site environment, such as a height-adjustable bottom strap. Lifting bracket for the wheel.

As shown in FIG. 3, FIG. 4 and FIG. 6, in a preferred embodiment, the double-hole protection positioning orifice plate 31 is detachably mounted on the front curved plate of the base 53, and the outer upper portion is a protruding structure, including Two through positioning holes 311. The protruding structure (including the positioning hole 311) may be a symmetrical structure. The two puncture points 8 at the perineum of the patient shown in FIG. 2 respectively correspond to the two through positioning holes of the protection positioning orifice plate 31.

It should be understood that in FIGS. 3 and 4, the front curved plate on the base for mounting the protective positioning orifice plate is shown as a direct protruding structure of the front end of the base, but other forms of bending and protruding structures are also feasible. For example, the front end of the base protrudes forward and then bends upward.

Different from the conventional matrix mechanical template method, the two through positioning holes 311 according to the embodiments of the present invention respectively correspond to the puncture points of the left prostate and the right prostate of the operator. At the same time, a blood trough 312 is opened in the lower part of the protruding structure of the protective positioning orifice plate 31 for intercepting the blood of the subject during the operation, preventing the backflow into the device, causing pollution, affecting the surgical progress, and even causing cross infection.

Figure 7 illustrates the principle of a precise positioning of the "positioning hole + guide barrel" in accordance with one embodiment of the present invention. When the external command triggering device 6 is triggered (for example, stepping on the foot pedal), the human-machine interaction mechanism 1 automatically calculates the positioning data corresponding to the next sampling or particle implantation, and controls the working mechanism 3 accordingly, that is, through the guiding syringe motion control. The mechanism 37 moves back and forth integrally on the base 53 to control the front and rear position (spatial position) of the guide syringe 34 in the linear motion direction of the ultrasonic probe to thereby define the depth of intervention of the interventional device; The control mechanism 37, as shown in Figure 5, achieves control of the positioning of the guide cylinders in the vertical and horizontal directions in four degrees of freedom. Through the adjustment of the above five degrees of freedom, the self-attitude and spatial position of the guiding syringe 34 can be adjusted, so that the guiding syringe 34 falls on the straight line determined by the target sampling point and a certain positioning hole 311, and cooperates with the intervention device. Accurate positioning is achieved by intervention depth control. This structure makes the system overcome the shortcomings of the traditional template method in principle and improves the positioning accuracy. The surgeon only needs to hold the biopsy gun, and the orbital guide 34 is inserted into the subject's prostate at a specified depth, and the biopsy gun is operated to complete the sampling. According to another embodiment, without using the protective positioning orifice plate, the positioning of the guiding syringe 34 can be adjusted so that the guiding cylinder falls at a certain position on the straight line determined by the target path of the radioactive particle target, the operator A particle-carrying gun is placed through the guiding syringe to act on the target implantation path.

It should be understood that the above structural drawings or other schematic diagrams only show the system structure and working principle of the embodiments of the present invention, and do not represent the actual dimensions thereof, nor fully represent the actual shapes of the components.

The overall structure of the embodiment of the present invention has been described in detail above, and the working process is further exemplified below.

The surgeon takes the stone removal position and the medical staff completes the preparation for disinfection. Holding the pusher 2, moving the system to the vicinity of the operating table, determining its position and locking the universal wheel 7, adjusting the level of the working mechanism 3 according to the surgical space and the position adjustment knob in the posture rotation adjustment mechanism 4 of the subject Position, vertical position and/or pitch angle. Boot, device self-test and initialization.

8 shows a software control flow diagram of a minimally invasive medical robotic system in accordance with one embodiment of the present invention. As shown in the flow of Figure 8, after the self-test and initialization are completed, enter the main menu and select according to the operation needs. “Prostate biopsy” or “radioactive particle implantation” and input the subject information to create a medical record.

The ultrasonic probe moving mechanism 32 is operated to push the ultrasonic probe 33 into the rectum of the subject, and the ultrasonic probe 33 is moved or rotated forward and backward to realize the fan-shaped scanning imaging. The human-computer interaction mechanism 1 displays the imaging result, and the operator can adjust the sampling according to actual needs. The range of radioactive particle implanted areas.

3D modeling, image fusion and registration through software, as shown in the flow of Figure 8. The display screen of the human-computer interaction mechanism 1 displays the pre-sampling point (puncture sampling plan), and the operator adjusts the position and number of the sampling point reasonably according to the actual needs and the physiological condition of the subject. In the case of radioactive seed implantation, this step adjusts the position and number of particle implantation paths (particle implantation planning).

Puncture sampling was then initiated. The display screen of the human-machine interaction mechanism 1 starts to prompt the sampling points. The operator holds the biopsy gun 35 through the guiding syringe 34, so that it can accurately penetrate the prostate from the puncture point of the perineum according to the preset angle, trajectory and depth of the system, and push the switch on the handle to make a small The block of prostate tissue is removed and sealed in the needle, which completes a single point sampling. When the external command triggering device 6 is triggered (for example, stepping on the foot pedal), the human-machine interaction mechanism 1 automatically calculates the positioning data corresponding to the next sampling or particle implantation, controls the working mechanism 3 accordingly, and passes the guiding syringe motion control mechanism. 37 is integrally moved back and forth on the base 53 to control the front and rear positions of the guide cylinder 34 in the linear motion direction of the ultrasonic probe; and at the same time, by controlling the partial structure of the guide cylinder movement control mechanism 37 as shown in FIG. 5, in four The positioning of the guide cylinder is achieved in degrees of freedom. Through the adjustment of the above five degrees of freedom, the spatial position of the guiding syringe 34 and its own posture can be adjusted, so that the guiding syringe 34 falls on the straight line determined by the target sampling point and a certain positioning hole 311, and cooperates with the intervention device. With precise control, precise positioning is achieved. This structure makes the system overcome the shortcomings of the traditional template method in principle and improves the positioning accuracy. The surgeon only needs to hold the biopsy gun, and the orbital guide 34 is inserted into the subject's prostate at a specified depth, and the biopsy gun is operated to complete the sampling. According to the system prompt, and with the signal of the external command trigger device 6, traversing all the sampling points, the prostate biopsy process is completed. Similarly, if the radioactive particles are implanted, the radioactive particle implantation must be completed according to the particle implantation path suggested by the display and the signal of the external command triggering device 6 until the pre-implantation path and the implantation point are traversed. There is no need to review the positional accuracy and dose distribution of the implant after surgery. Throughout the process, it relies on the system's real-time image tracking of the interventional devices, which greatly enhances the operational visualization and risk control capabilities.

It should be noted that embodiments of the present invention may be applied in the fields of prostate biopsy or radioactive particle implantation, for example, the working mechanism 3 may be equipped with a biopsy gun suitable for prostate biopsy or treatment, and a radioactive particle implantation gun. However, it should also be appreciated that the present invention and its embodiments can be modified and applied in conjunction with other medical procedures, positioning other medical devices, and the like, for example, the working mechanism 3 can also be used in conjunction with a cryostat.

The embodiment of the invention provides a method for positioning and positioning a protective positioning hole plate and a guiding needle cylinder, that is, The protective positioning hole plate is in front, the guiding needle barrel is behind, and may not be in contact with the skin of the subject, the posture and position of the guiding needle barrel are adjustable, and one of the positioning holes on the positioning hole plate and the target point are determined. The straight line coincides with the straight line of the guiding cylinder. Since the length of the guiding cylinder is larger than the guiding hole length of the conventional mechanical template, and the positioning hole of the protective positioning hole plate can be engaged, if the positioning of the guiding cylinder is wrong, then The guiding syringe does not fall on the straight line determined by the target path, so the interventional device that passes along the guiding syringe will not reach the through positioning hole on the protective positioning hole plate as planned, but will be blocked by the protective positioning hole plate. Through the through-positioning hole and reaching the skin of the subject, the self-test process of the interventional device before the intervention of the human body is realized, and the injury to the subject caused by the positioning error of the guiding syringe caused by hardware or software failure is avoided. Improve the safety and reliability of the system, and eliminate the positioning deviation of the traditional template method in principle, and overcome the traditional template method for surgical wounds and limitations. , No less than the self-test process and improve the accuracy of puncture, to ensure that the biopsy gun, the gun exact arrival implantation predetermined position, an error can be controlled within 1.0mm, improve the operation reliability.

On the basis of this, some embodiments of the present invention design a blood trough on the protective positioning hole plate for intercepting the blood of the subject, and the components of the guiding syringe which may be contaminated by the blood and other tissues of the operator inside the device are One-time, it basically eliminates the possibility of iatrogenic cross-infection and reduces the maintenance cost of the hospital. In one embodiment, the blood trough can be a slit having a certain width. When the blood flows here, due to the structure and gravity of the positioning orifice, it will flow down the outer surface of the positioning orifice without entering the interior of the apparatus. In another embodiment, the blood trough can be a juxtaposed arrangement of multiple slits. According to an embodiment of the invention, the blood troughs may be arranged laterally or longitudinally.

According to some embodiments of the present invention, the ultrasonic probe moving mechanism can not only move the ultrasonic probe back and forth in the rectum, but also includes a rotating mechanism that can rotate the ultrasonic probe within a certain angle of the subject's rectum to expand the scanning imaging range. Switching the imaging profile and obtaining the position information of the depth, angle and trajectory of the interventional device in real time to improve the reliability of the operation.

According to some embodiments of the present invention, the control software of the minimally invasive medical robotic system can achieve rigid, elastic fusion and image registration of preoperatively acquired magnetic resonance imaging (MRI) and real-time ultrasound imaging. Based on the rigid fusion imaging, the nonlinear information of the elastic fusion imaging is used to accurately combine the lesion information provided by the magnetic resonance image with the ultrasound image through software, regardless of whether the interventional device is horizontal or obliquely inserted. The system can display the trajectory of the interventional device in real time, especially the position information of the needle tip, improve the trajectory tracking accuracy of the biopsy gun/radioactive particle implanted gun, and assist the surgeon to perform biopsy/radioactive particle implantation treatment more accurately, that is, the intervention is realized. Real-time monitoring of the whole process, reducing the risk of misoperation and improving the reliability of surgery.

In addition, in the treatment of prostate cancer, the radioactive particle implantation method has the advantages of convenient operation, small wound surface, high conformity, low recurrence rate, less complications compared with external irradiation and surgery, and easy control of radiation dose. In some developed countries, it has become the standard of treatment. In an embodiment in which the orientation and spatial position of the guide cylinder can be controlled according to a preset program, efficiency, safety, simplicity, and reliability can be greatly improved.

According to some embodiments of the present invention, the complex motion of the medical robot system associated with the positioning intervention device is decomposed into a linear or rotational motion of the guide cylinder in 5 degrees of freedom, so that they can be independent of each other, reducing the operation difficulty and expanding The surgical space between the legs of the subject is convenient for the operator to operate.

According to some embodiments of the invention, the diagnosis and treatment of prostate cancer is integrated into the same system. Among them, the image-guided particle implantation function makes it possible to precisely control the position of each radioactive particle and monitor the particle position in real time in the ultrasound image. It is not necessary to post-check the position and dose distribution of the implanted particles, saving the operation. The energy of the surgeon and the subject.

Numerous modifications and other embodiments of the present disclosure will be apparent to those skilled in the <RTIgt; Therefore, it is to be understood that the above are only the preferred embodiments of the present invention, and are not intended to limit the invention, and any modifications, equivalents, etc., which are within the spirit and scope of the present invention, are included in the present invention. Within the scope of protection.

Industrial applicability

The minimally invasive medical robot system of the invention is suitable for industrial production by using existing production equipment, and can be applied to products related to medical technology such as medical diagnosis and treatment. Its structure is used in fields such as prostate cancer biopsy or radioactive particle implantation, which increases the detection rate, reduces the wound surface of the subject, avoids iatrogenic cross infection, and improves the safety and reliability of the operation.

Claims

A minimally invasive medical robot system, comprising: a working mechanism (3), an adjustment mechanism (4), a control mechanism (5), and a human-machine interaction mechanism (1), wherein the working mechanism (3) is positioned On the adjustment mechanism (4), and the adjustment mechanism (4) is positioned on the control mechanism (5),

The working mechanism (3) comprises: a double-hole protection positioning orifice plate (31), a guiding syringe (34), an ultrasonic probe (33), an ultrasonic probe moving mechanism (32), a base (53), and a guiding syringe a motion control mechanism (37), the guide cylinder movement control mechanism (37) is slidably mounted on the base, and the two-hole protection positioning orifice plate (31) is detachably mounted on the base (53) The front curved plate, the ultrasonic probe moving mechanism (32) is slidably mounted on the upper support plate of the base (53), and the ultrasonic probe (33) is clamped in the ultrasonic probe moving mechanism ;

The adjustment mechanism (4) is arranged to adjust a horizontal position, a vertical position and/or a pitch angle of the working mechanism (3) according to a position of the patient and/or a position of the operating table;

The human-machine interaction mechanism (1) is configured to display a real-time image collected by the working mechanism (3), receive an external input, and is further configured to communicate with the control mechanism (5), thereby passing the control The mechanism (5) controls the components in the working mechanism (3).
A minimally invasive medical robotic system according to claim 1 wherein said guide barrel movement control mechanism (37) includes a guide barrel seat (83) for mounting a guide barrel (34), wherein said At least one end of the guide pin holder (83) is connected with a universal joint (81) for assisting the adjustment of the posture of the guide cylinder (34).
The minimally invasive medical robot system according to claim 2, wherein said guide cylinder movement control mechanism (37) includes a left control mechanism and a right control mechanism, and said left control mechanism and said right control mechanism And/or in the region defined by the left control mechanism and the right control mechanism, means for controlling the positioning of the guide cylinder (34), for example, the control of the guide cylinder (34) The component that is positioned is the screw drive structure.
A minimally invasive medical robotic system according to claim 3, wherein the positioning of the guide barrel (34) comprises one or more of the following movements of the guide barrel (34): lifting movement, Pitch motion, left and right translational motion, horizontal rotational motion, and back and forth motion.
The minimally invasive medical robot system according to claim 1, wherein the outer upper portion of the double-hole protection positioning orifice plate (31) is a protruding structure, and includes two through positioning holes (311).
The minimally invasive medical robot system according to claim 5, characterized in that the lower portion of the protruding structure of the two-hole protection positioning orifice plate (31) is provided with a blood channel (312).
The minimally invasive medical robot system according to any one of claims 1 to 6, characterized by further comprising an external command triggering device (6) configured to emit a signal to cause guidance The positioning switching of the syringe (34) is enabled, and preferably, the external command triggering device (6) is implemented as a foot pedal disposed at a lower portion of the control mechanism (5).
The minimally invasive medical robot system according to any one of claims 1 to 7, characterized in that the human-machine interaction mechanism (1) is detachably mounted on the control mechanism (5) or independently.
The minimally invasive medical robot system according to any one of claims 1-8, further comprising a pusher (2) and/or a universal wheel (7), the pusher (2) and/or a universal The wheel (7) is configured to assist in the transfer and/or fixation of the minimally invasive medical robotic system.
The minimally invasive medical robot system according to any one of claims 1-9, characterized in that the control mechanism (5) comprises a device for accommodating the human-machine interaction mechanism (1) and the working mechanism (3) )Space.
Use of a minimally invasive medical robotic system according to claims 1-10 for prostate biopsy or radioactive particle implantation.
A method for locating an interventional device, comprising:

Positioning the guide barrel (34) of the working mechanism (3) according to claims 1-10 such that the guide barrel (34) falls on the target sampling point and the two-hole protective positioning orifice plate ( 31) a line defined by a hole, or causing the guide barrel (34) to fall on a line determined by the target path of the radioactive particle target,

Wherein the interventional device controls the depth of intervention according to the guiding syringe (34), and acts through the guiding cylinder on the target sampling point or the radioactive particle target implantation path.