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CN115040247B - Femtosecond laser minimally invasive surgery robot system - Google Patents

Femtosecond laser minimally invasive surgery robot system Download PDF

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Publication number
CN115040247B
CN115040247B CN202210723336.5A CN202210723336A CN115040247B CN 115040247 B CN115040247 B CN 115040247B CN 202210723336 A CN202210723336 A CN 202210723336A CN 115040247 B CN115040247 B CN 115040247B
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robot
working end
micro
femtosecond laser
surgery
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CN115040247A (en
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喻俊志
原福松
王巍
王爱民
房居高
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Peking University
Beihang University
Beijing Tongren Hospital
Peking University School of Stomatology
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Peking University
Beihang University
Beijing Tongren Hospital
Peking University School of Stomatology
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2065Tracking using image or pattern recognition
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B2034/302Surgical robots specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Robotics (AREA)
  • Optics & Photonics (AREA)
  • Otolaryngology (AREA)
  • Electromagnetism (AREA)
  • Manipulator (AREA)

Abstract

The invention discloses a femtosecond laser minimally invasive surgery robot system, in particular to an oral pharynx and larynx femtosecond laser minimally invasive surgery robot system. The robot system comprises a robot subsystem, a navigation registration subsystem, a laser cutting subsystem and an operation desk subsystem, wherein the robot subsystem comprises a robot controller, a universal mechanical arm and a special working end, the universal mechanical arm is suitable for multiple operation requirements, the special working end comprises a soft tissue operation working end and a planting operation working end which are detachably connected, different working ends can be installed and used according to specific operation types, and each working end is a double-head integrated working end and comprises two micro robots installed in reverse series. The length, the external diameter and other dimensions of the robot are suitable for the oral cavity and throat, different working ends are skillfully integrated in a single-arm robot system, and the precise operation of various operations such as femtosecond laser automatic cutting, wound automatic suturing, implant automatic implantation and the like of the oral cavity and throat part can be realized.

Description

Femtosecond laser minimally invasive surgery robot system
Technical Field
The invention belongs to the field of femtosecond laser minimally invasive surgery robots, and particularly relates to an oral pharynx and larynx femtosecond laser minimally invasive surgery robot system.
Background
The oral cavity and throat part is easy to be wounded, inflamed, tumor and other diseases. The part has the characteristics of small cavity depth, poor exposure degree of the operation area, adjacent peripheral important nerve vessels and sensitive feeling. At present, the clinic needs to complete the operation by means of an endoscope, a support laryngoscope, a microscope and special instruments, the difficulty is high, the focus is exposed, hemostasis and suturing are difficult, and the operation is easily influenced by objective factors such as doctor state, experience and the like, so that the operation error is caused, and the treatment effect is influenced. However, the existing surgical robots represented by da vinci robots are all non-autonomous, and the cutting and suturing still depend on manual operation of doctors, so that development of a minimally invasive surgical robot system suitable for narrow deep cavities of oral cavities and throats is highly needed.
In addition, oral and pharyngeal operations generally include oral soft tissue surgery, oral implant surgery, and pharyngeal soft tissue surgery, such as three types of vocal cord tumor surgery. Soft tissue surgery typically requires the removal or cutting of soft tissue prior to suturing; oral implant surgery requires cutting soft tissue at the site of the tooth defect to be planted and then implanting the implant.
Different surgical robots exist today, for example a soft tissue surgical robot for soft tissue, a planting robot for oral planting; and the cutting working end and the stitching working end of the existing robot system are erected on different mechanical arms, even different robot systems. This causes the following problems: on one hand, a plurality of robot systems are required to be purchased or at least a plurality of mechanical arms are provided for a hospital, so that the equipment cost of the hospital is greatly increased; on the other hand, a plurality of robots are placed in an operating room, occupy more space and cause more unsafe factors; on the other hand, for dobby robots, there is a significant risk of collision with each other during surgery, even resulting in surgical confusion.
In summary, aiming at the problems of limited visual field, poor exposure degree of an operation area, dense peripheral nerve blood vessels, high risk and the like of soft tissue excision operation of oral cavity, throat and the like, the application provides a robot system with the length, the outer diameter and the like suitable for the oral cavity, throat and the like, which skillfully integrates different working ends into a single-arm robot system and can finish various operation operations which do not depend on manual operation of doctors, such as femtosecond laser automatic cutting, wound automatic suturing, implant automatic planting and the like of the oral cavity and throat parts; in addition, due to the proper size, the device can realize accurate cutting of soft and hard tissues in a deep cavity with narrow oral cavity throat, high-efficiency suturing of soft tissue incisions and accurate implantation of implants, shortens operation time and reduces wounds.
Disclosure of Invention
Aiming at two types of operations such as oral cavity and throat soft tissue excision and tooth implantation, the invention provides a design thought of a femtosecond laser surgical robot with a double-head integrated working end, and forms a soft tissue surgical robot subsystem with a six-degree-of-freedom universal mechanical arm and a double-head working end and a tooth implantation surgical robot subsystem. Besides the robot subsystem, the two surgical robot systems also comprise a laser cutting subsystem, a navigation registration subsystem and an operation desk subsystem. The four subsystems cooperate with each other to realize intelligent preoperative planning, intraoperative visual navigation positioning control and postoperative automatic efficient suturing/implant screwing.
The application provides a femtosecond laser minimally invasive surgery robot system, which comprises an operation table, a robot controller, a universal mechanical arm and a special working end, wherein the universal mechanical arm is suitable for various surgery requirements, the special working end comprises a soft tissue surgery working end and a planting surgery working end which are detachably connected, different working ends can be installed and used according to specific surgery types, and each working end is a double-head integrated working end and comprises two micro robots which are installed in reverse series connection.
The femtosecond laser minimally invasive surgery robot system comprises a detachable connection, a clamping connection and a shaft pin connection.
The femtosecond laser minimally invasive surgery robot system is preferably an oral pharynx and larynx femtosecond laser minimally invasive surgery robot system.
The femtosecond laser minimally invasive surgery robot system comprises a soft tissue surgery working end and a throat soft tissue surgery working end.
The femtosecond laser minimally invasive surgery robot system comprises two miniature robots which are installed in series in an opposite direction, wherein one of the miniature robots is a five-degree-of-freedom femtosecond laser cutting robot, and the other miniature robot is a miniature planting robot.
The femtosecond laser minimally invasive surgery robot system is characterized in that a soft tissue surgery working end consists of two micro robots which are installed in series in an inverse mode, wherein one of the micro robots is a five-degree-of-freedom femtosecond laser cutting robot, and the other micro robot is a micro stitching robot.
The femto-second laser minimally invasive surgery robot system is characterized in that a special working end is arranged on a tail end flange of a general mechanical arm, the flange can rotate at least 180 degrees, and a required micro-robot can be adjusted to the front end or towards a patient according to surgery requirements by rotating the flange.
Preferably, the femtosecond laser minimally invasive surgery robot system comprises a five-degree-of-freedom femtosecond laser cutting robot, wherein the five-degree-of-freedom femtosecond laser cutting robot is a miniature laser automatic ablation and cutting robot, three-dimensional movement of light spots, 360-degree rotation of a light knife and 0-110-degree pitching can be realized, a dust collection cooling system and a 3D endoscope vision system are integrated, the diameter of an intracavity part is not more than 10-20mm, preferably not more than 15mm, and the vision system is not interfered by laser.
The femto-second laser minimally invasive surgery robot system is characterized in that the micro-implant robot is an implant automatic positioning/screwing micro-robot, the overall size outer diameter is less than or equal to 40mm, the length is less than or equal to 200mm, and the femto-second laser minimally invasive surgery robot system comprises a tail end adjusting unit, a screwing compaction unit, a force detection unit and an implant clamping unit, and can be suitable for the implantation surgery of 3 implants.
The micro-suture robot system comprises a tail end adjusting unit, a needle pressing unit, a needle storage unit, a drawing unit and a needle pushing unit, wherein the overall size outer diameter of the micro-suture robot is less than or equal to 25mm, the length of the micro-suture robot is less than or equal to 200mm, the number of stored needles is not less than 10, and the suture depth of the micro-suture robot is less than or equal to 5mm.
The femtosecond laser minimally invasive surgery robot system is characterized in that the soft tissue surgery working end designs micro robots into different lengths and outer diameters according to whether the surgery part is an oral cavity or a pharyngeal throat. Aiming at the soft tissues of the oral cavity, the micro-robot can be designed to be 50-150mm in length and 10-20 mm in outer diameter; for throat soft tissue, the micro-robot can be designed to be 100-200mm in length and 5-10 mm in outer diameter.
The technical scheme provided by the invention has at least the following beneficial effects:
(1) The application can cooperatively realize intelligent preoperative planning, visual navigation positioning control in operation and automatic and efficient suture/implant screwing after operation through the cooperation of the four subsystems of the robot system, the navigation registration system, the laser system and the operation desk system without depending on manual operation of doctors.
(2) The soft tissue surgery working end and the implantation surgery working end are detachably connected to the universal surgery mechanical arm, so that the robot is applicable to different departments of the oral cavity, and meanwhile, the robot can finish operation by using one robot system under the condition that a doctor of the implantation department and the soft tissue department of the oral cavity are required to jointly review, so that the cost is saved.
(3) Each working end comprises a double-end integrated working end which is reversely connected in series, and for different operation operations of the same operation, only one needed working end is required to be rotated to the front end of the operation, a plurality of mechanical arms are not required, so that space occupation is reduced, and the risk of collision of the plurality of mechanical arms is avoided.
(4) The flange at the front end of the universal mechanical arm is reliable and stable in rotation, and is provided with the stop piece, so that the operation is safer and more stable.
(5) Aiming at the characteristics of tissues of the oral cavity and the throat, the invention designs the micro robots with different sizes and types respectively, so that the operation is more accurate.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings required for the description of the embodiments will be briefly described below, and it is apparent that the drawings in the following description are only some embodiments of the present invention, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
FIG. 1 is a general construction of a femtosecond laser minimally invasive surgical robot of the present invention;
FIG. 2 shows the state of the femtosecond laser minimally invasive surgical robot of the invention under different surgical operations, a) oral soft tissue excision, b) oral soft tissue suturing;
FIG. 3 is a schematic view of a five degree of freedom femtosecond laser microsurgical robot of the present invention;
FIG. 4 is a schematic view of a single-arm micro-suturing robot of the present invention;
FIG. 5 is a schematic view of a micro-planter robot of the present invention;
FIG. 6 is a schematic view of a universal robotic arm rotary flange of the present invention.
Detailed Description
In order to make the technical problems, technical solutions and advantages to be solved more apparent, the following detailed description will be given with reference to the accompanying drawings and specific embodiments.
Referring to fig. 1, the femtosecond laser minimally invasive surgery robot system of the present invention is composed of four subsystems: robot system, navigation registration system, laser system, console system.
The femtosecond laser minimally invasive surgery robot system uses a femtosecond laser technology, so that the application particularly relates to an oral pharynx and larynx femtosecond laser minimally invasive surgery robot system.
Robot system
The robot system comprises a general mechanical arm and a special working end which are suitable for different operation types. The special working end comprises a soft tissue operation working end and a planting operation working end which are detachably connected, different working ends can be installed and used according to specific operation types, and each working end is a double-head integrated working end and comprises two micro robots which are installed in reverse series.
(II) navigation registration System
The tail end of each micro-robot is provided with an endoscopic navigation sensor. Although the visual navigation sensor is structurally integral with the micro-robot, the image signals it acquires are processed by the navigation registration subsystem. The micro-robot end deviation calculated by the navigation controller is fed back to the robot controller through the operation console main controller.
The robot movements, including the movements of the general mechanical arm surgical platform, the micro femtosecond laser surgical robot, the micro suture robot and the micro planting robot, are controlled by a robot controller. The robot controller is communicated with the operation console main controller in real time and receives the instruction of the main controller, such as initial pose, motion path, deviation adjustment and the like, and the robot controller and the navigation controller feed back the information of the pose, tail end deviation, instruction execution state and the like of the robot to the main controller.
The robot automatic work requires preoperative registration and intra-operative navigation, and therefore, a navigation registration subsystem needs to be developed. From a functional division perspective, the navigation registration subsystem includes an infrared sensor, a vision sensor, and a navigation controller. The infrared sensor detects the surgical mark, the pose registration of the robot and the surgical target is completed, and the working end can reach the vicinity of the target point under the condition of no intracavity visual feedback. In order to further improve navigation positioning accuracy and correct errors introduced by deep cavities, soft tissue changes and the like, vision sensors are arranged at the tail ends of the micro robots, so that the micro robots can extend into the oral cavity along with the micro robots, close-range observation of surgical environments is realized, and positioning in surgery is realized. The infrared sensor and the vision sensor respectively send the pose signal of the operation mark and the multi-view endoscopic image signal to the navigation controller. The navigation controller calculates the pose of the micro-robot relative to the focus in real time and sends the pose to the console main controller. In addition, the navigation registration subsystem also sends the processed results of the sensor information and the algorithm to the operation desk for display. Conversely, the console master controller controls the opening and closing of the navigation registration subsystem and is also responsible for providing the navigation registration subsystem with the required pre-operative scan/planning data. The navigation registration subsystem outputs the positioning result at a frequency not lower than 2Hz, which is raised to not lower than 5Hz while the surgical action is being performed.
(III) laser subsystem
In the cutting process, the laser unit receives control signals of the main controller in real time, firstly, output parameters of the laser are adjusted and controlled according to operation requirements, the output power of the laser is 5W, the pulse width is 400fs, the repetition frequency is 200KHz, the laser is provided with an electric control switch, three signals are used for controlling, one signal is used for controlling manually, the other signal is used for controlling by the laser output parameter monitoring module, and the other signal is used for controlling by the navigation registration subsystem. And establishing a laser output parameter monitoring module to observe the output state of the laser in real time, and if the problem of losing lock is solved, cutting off the optical path and closing the laser. The pulse control module controls the power entering the large-core hollow optical fiber by the navigation subsystem according to the focus part image recognition result. The dispersion compensation module is used for pre-compensating the accumulated dispersion in the optical fiber so as to keep the cutting pulse to work at the narrowest pulse width. The achromatic lens focuses the light beam to a light spot with the size of 30 mu m, couples the light beam into a large-core hollow fiber, and outputs the light beam into the five-degree-of-freedom femtosecond laser micro-robot through collimation of a collimator.
(IV) operating desk subsystem
The operation desk is an interaction platform of doctors and the system and consists of an interaction interface and a main controller. To increase the system integration, the laser unit and the robot controller may be integrated inside the console. The interactive interface displays information such as a focus three-dimensional model, intraoperative real-time video, a visual operation path, various data, alarm signals and the like, and simultaneously provides input interfaces such as operation path, robot pose adjustment, laser adjustment and the like. The operating end is composed of an operating handle, a button and the like, and is used for controlling operations such as starting and stopping of movement, fine adjustment of a robot hand, starting and stopping of cutting and the like by a doctor.
The operation table main controller controls the robot and the laser unit to work in real time according to the operation flow, the robot state, the navigation feedback information and the doctor monitoring instruction. And a plurality of software and algorithm modules are operated in the main controller to realize three-dimensional model display, preoperative auxiliary planning, preoperative registration, preoperative operation planning, intraoperative navigation, real-time motion track parameter adjustment, laser start-stop and parameter control, interactive interface display, operation end signal feedback and the like.
The operating table subsystem is a 6-degree-of-freedom moving platform, the working radius is 1mm, the repeated positioning accuracy is 0.5mm, the mechanical clamping force is 6-10 kg, and the operating table subsystem is provided with a quick interface so as to conveniently and quickly replace surgical instruments.
(V) general surgical procedure
The general basic procedure of surgery is as follows: the method comprises the steps of acquiring CT and MRI data of a patient before operation, acquiring multi-source data, reconstructing three-dimensional, registering and fusing, navigating a route by a robot before operation, planning actions, preparing the patient before operation, anaesthetizing the patient, preparing an operation area (including disinfection, towel laying and opening device exposing oral pharynx and throat), registering and planning and confirming robots, macro positioning by a universal mechanical arm, micro positioning by a femtosecond laser robot, automatically cutting focus/planting cavity, automatically preparing the focus/planting cavity by the aid of the micro-suture robot, adjusting the micro-suture robot/micro-planting robot to the front end by means of rotation of a working end by the aid of an operating arm, and completing positioning navigation, completing automatic suturing/planting, withdrawing the suture/planting robot, and observing the patient after operation.
Acquisition of preoperative patient CT, MRI and dental model data
CT or MRI and dental model data of the operation part of the patient are obtained, and three-dimensional reconstruction is completed through image processing software. Three-dimensional reconstruction, registration and fusion of multi-source data are carried out by leading CT or MRI and dental model images into a main control unit of an operation table, completing three-dimensional reconstruction of data by using an operation image synthesis software module, completing registration and fusion of multi-source data of a patient by using osseous mark points of the head, and generating a three-dimensional model of a patient disease area required by an operation. The focus and registration marks can be accurately reflected in the model and displayed to doctors through an interactive interface.
Surgical planning
In the "preoperative surgical planning module" of the interactive interface, the doctor confirms the focus boundary and completes the surgical path planning, including: macro positioning points of the universal mechanical arm, micro positioning points of the automatic working end, tail end tracks of the automatic working end, man-machine cooperative operation points, laser cutting start and stop points, suture points, planting nest sizes and the like.
Preoperative preparation
The patient is anesthetized, fixed, and the operating table, the lower mouth gag and the registration mark are fixed at the head osseous structure.
Robotic registration and planning validation
Starting a registration navigation software module, detecting the spatial position of the robot relative to registration marks by using an in-vitro registration positioning sensor (such as an infrared navigation system), calculating the spatial pose of the robot relative to the focus, registering the three-dimensional model of the patient to the current pose of the robot in the registration navigation software module, unifying the two models in the same coordinate system, displaying the spatial relationship between the robot and the three-dimensional model of the patient in real time, and running a surgery planning simulation software module to perform parameter adjustment and confirmation of preoperative planning.
General mechanical arm macro positioning
And starting a general mechanical arm macro positioning module in an automatic operation control module, and controlling the general mechanical arm to move to a macro positioning point by using the relative pose of the end of the robot and the registration mark fed back by a registration navigation software module in real time by a robot controller. The doctor monitors the site in real time and accurately observes the relative pose change between the tail end of the robot and the operation channel through a registration navigation software module. The doctor can pause and fine tune the position and the posture of the tail end of the robot at any time.
Laser robot micro-positioning
The "laser robot micro-positioning" operation in the "automatic surgical control module" is initiated. The registration navigation software module utilizes an endoscopic navigation sensor to analyze based on multi-view endoscopic images, calculates the pose of the laser robot relative to a focus starting point or a planting operation starting point in real time, and feeds back the pose to a robot controller. The robot controller controls the laser robot to move in the mouth or throat to the starting point of the automatic cutting path. The doctor monitors the site in real time and accurately observes the relative pose change between the tail end of the robot and the focus or the implantation operation area through a registration navigation software module. The doctor can pause and fine tune the terminal pose at any time.
Automatic preparation for automatic cutting focus or planting pit
The automatic laser cutting operation in the automatic operation control module is started, the robot controller is cooperated with the laser controller according to the position and posture information of the tail end fed back by the endoscopic navigation sensor, so that the actions and the laser control of the laser robot tail end vibrating mirror, the focusing lens and the posture adjusting mechanism are realized, the femtosecond laser focusing light spot is enabled to execute an operation planning path, and the preparation of focus cutting or implantation nest is completed. In the process, a doctor monitors the site in real time, and accurately observes the relative pose change between the tail end of the robot and the focus through a registration navigation software module. The doctor can pause and fine tune the terminal pose at any time. After the focus excision or fossa preparation is completed, the laser robot returns to the path starting point, the universal mechanical arm returns to the macro positioning starting point, and then returns to the waiting pose.
Automatic suturing or automatic screwing of implants
The automatic suturing or automatic implant screwing operation in the automatic operation control module is started, and the universal mechanical arm rotates the working end to convert the suturing robot or the implant robot to the front end. And repeating a procedure similar to laser excision to finish automatic suturing or screwing in the implant. And then, the working end and the mechanical arm return to the standby pose, and the whole operation process is completed.
The construction and operation of the robotic subsystem for different surgical types is described in detail below.
The dedicated working ends of the robotic system are divided into two categories according to the type of surgery: the soft tissue operation working end and the implantation operation working end can be specifically divided into an oral cavity soft tissue operation working end and a throat soft tissue operation working end. In practical use, soft tissue surgery and implantation surgery are two different types of surgery, generally belong to different departments, and have no crossing condition in one surgery. Thus, in embodiments, the detachable connections include threaded connections, snap-fit connections, shaft pin connections, by which different working ends may be configured for a universal robotic arm for different surgical types, thereby completing different surgeries. However, in some cases, there are cases of joint consultation and joint operation in different departments, so that different working ends can be integrated into one robot system, the space of an operation table and a mechanical arm can be saved, and unsafe factors in the operation are reduced.
The special working end is arranged on the tail end flange of the universal mechanical arm, the tail end flange can rotate at least 180 degrees, and the required micro-robot can be adjusted to the front end according to the operation requirement by rotating the flange. Referring to fig. 6, the flange plate is T-shaped, i.e., a T-joint, and serves to connect the general-purpose robot arm and the micro robot. The sewing robot/planting robot and the laser robot are coaxially arranged on the flange, the flange is connected with the mechanical arm, and the rotation, the positioning and the resetting of the micro-robot are completed through the rotation of the mechanical arm. Each working end consists of two micro robots which are installed in reverse series, and when an operation is carried out, referring to fig. 2, the currently required micro robots can be adjusted to the front end by rotating the flanges at the tail ends of the mechanical arms according to the operation flow requirements, so that the soft tissue removal/implantation operation and suture/implant screwing-in are completed.
The following is a specific description of the oral cavity soft tissue surgery, the implantation surgery, and the throat soft tissue surgery, respectively.
1. Oral soft tissue surgery
Fig. 2 shows the working end configuration of the oral soft tissue resection and suture operation and the state of the micro-robot. As shown in fig. 2, the working end of the soft tissue surgery is composed of two micro robots installed in reverse series, one of which is a five-degree-of-freedom femtosecond laser cutting robot and the other of which is a micro suture robot.
When soft tissue cutting is performed, the flange on the mechanical arm is rotated so that the five-degree-of-freedom femtosecond laser cutting robot faces the patient. The five-degree-of-freedom femtosecond laser cutting robot is a miniature robot for automatic laser ablation and cutting, can realize three-dimensional movement of light spots, 360-degree rotation of a light knife and 0-110-degree pitching, integrates a dust collection cooling system and a 3D endoscope vision system, has the diameter of a cavity part not exceeding 15mm, and has no interference of laser.
The oral cavity soft tissue operation comprises the following steps: ① The mechanical arm accurately positions the femto-second laser micro robot to the focus position; ② The femtosecond laser ablates and cuts focus (an additional dust absorption cooling system and a 3D visual servo system) with a spot speed of not less than 5000mm/s, a cutting error of not more than 50 mu m and an angle error of not more than 1 DEG; ③ An automatic suturing micro-robot is used for suturing wounds, wherein the suturing depth is less than or equal to 5mm, and the position error of a suturing nail is less than or equal to 1mm; ④ And resetting the robot and evaluating the operation result.
When soft tissue suturing is performed, the flange on the robotic arm is rotated so that the micro-suturing robot is directed toward the patient. The micro-suturing robot is a soft tissue automatic gathering and suturing micro-robot, the overall size outer diameter is less than or equal to 25mm, the length is less than or equal to 200mm, the number of stored needles is not less than 10, and the micro-suturing robot comprises a tail end adjusting unit, a needle pressing unit, a needle storing unit, a drawing unit and a needle pushing unit, and the suturing depth is less than or equal to 5mm.
The operation steps of the throat soft tissue operation are as follows: ① The motion platform accurately positions the femtosecond laser micro robot to a target position so that the tumor surface is positioned on a focal plane; ② The laser micro-robot ablates tumors according to a preoperative planning path, wherein the ablation range is 2cm, the accuracy (navigation positioning error and ablation error) is less than or equal to 0.5mm, a suction device is additionally arranged, the 3D endoscope monitors in real time, and if emergency such as massive hemorrhage occurs, the mode is immediately changed into a master-slave mode; ③ An automatic suturing micro-robot is used for suturing wounds, wherein the suturing depth is less than or equal to 5mm, and the position error of a suturing nail is less than or equal to 1mm; ④ And resetting the robot and evaluating the operation result.
2. Implantation surgery
The configuration and state of the working end of the implantation surgery are similar to those of the working end of the oral soft tissue, and the difference is that the suture robot is replaced by the implantation robot, that is, two micro robots which are installed in reverse series at the working end of the implantation surgery, one is a five-degree-of-freedom femtosecond laser cutting robot, and the other is a micro implantation robot.
When soft tissue cutting before planting is performed, the flange on the mechanical arm is rotated, so that the five-degree-of-freedom femtosecond laser cutting robot faces to a patient, and the specific robot configuration and operation are similar to those of the robot for performing cutting of the oral soft tissue operation, and are not repeated.
When the formal planting operation is carried out, the flange on the mechanical arm is rotated, so that the miniature planting robot faces to a patient. The miniature planting robot is an automatic positioning/screwing miniature robot for the implant, the overall size outer diameter is less than or equal to 40mm, the length is less than or equal to 200mm, and the miniature planting robot comprises a tail end adjusting unit, a screwing compaction unit, a force detecting unit and an implant clamping unit, and can adapt to planting operations of 3 kinds of implants.
The oral implantation operation comprises the following steps: ① The mechanical arm accurately positions the femtosecond laser micro robot to the position of the cutting point; ② Laser cutting, wherein cutting wound deviation (navigation positioning error and ablation error) is less than or equal to 0.5mm, cutting depth is less than or equal to 14mm (an additional dust absorption cooling system); ③ The implant operation robot automatically positions and screws in the implant into the prepared implant nest.
3. Throat soft tissue operation
The configuration and state of the working end of the throat soft tissue operation are similar to those of the oral soft tissue, the difference is that the micro-robot is different in size, and the micro-robot can be designed to be 50-150mm, preferably 80-120mm, and 10-20 mm, preferably 14-18mm in outer diameter for the oral soft tissue; for soft tissues of the throat, the micro-robot may be designed to have a length of 100-200mm, preferably 150-200mm, and an outer diameter of 5-10 mm, preferably 6-8mm. By adapting robots with different sizes to the oral cavity part and the pharyngeal part, the operation is more convenient and accurate.
The specific robot configuration and operation for the soft tissues of the throat are similar to those of the cutting and suturing robot for the soft tissue operation of the oral cavity, and will not be repeated.
It should be noted that the throat soft tissue surgical working end and the oral soft tissue hand working end may be two independent working ends of different sizes, or may share the same rear handle portion, but are different from the front extension portion extending into the oral cavity and/or the throat. In the latter case, the front extension portion may be removably attached to the rear handle portion, such as by a threaded connection, a snap-fit connection, a pin connection.
While the foregoing is directed to the preferred embodiments of the present invention, it will be appreciated by those skilled in the art that various additions, deletions, modifications and alterations may be made without departing from the principles of the invention, and such additions, deletions, modifications and alterations are to be seen as a result of the scope of the invention.

Claims (10)

1. The femto-second laser minimally invasive surgery robot system comprises a robot subsystem, a navigation registration subsystem, a laser cutting subsystem and an operation desk subsystem, wherein the robot subsystem comprises a robot controller, a general mechanical arm and a special working end, the general mechanical arm is suitable for multiple surgery requirements, the femto-second laser minimally invasive surgery robot system is characterized in that the number of the general mechanical arm is one, multiple mechanical arms are not needed, the special working end is arranged on the tail end flange of the general mechanical arm, and the flange plate is in a T shape; the special working end comprises a soft tissue surgery working end and a planting surgery working end which are detachably connected, different working ends can be installed and used according to specific surgery types, each working end is a double-head integrated working end, each working end comprises two micro robots which are installed in reverse series, the navigation registration subsystem comprises an infrared sensor, a visual sensor and a navigation controller, wherein the infrared sensor detects surgery marks, the pose registration of the robots and surgery targets is completed, the working ends can reach the vicinity of target points under the condition of no intracavity visual feedback, and the navigation controller calculates the pose of the micro robots relative to focuses in real time and sends the pose to the operation table main controller.
2. The femtosecond laser minimally invasive surgery robot system according to claim 1, wherein the laser cutting subsystem is controlled by three signals, one is manually controlled, the other is controlled by a laser output parameter monitoring module, the other is controlled by a navigation registration subsystem, the laser output parameter monitoring module observes the output state of the laser in real time, if the problem of losing lock is solved, the optical path is cut off and the laser is closed, and the pulse control module of the laser cutting subsystem controls the power entering the large-core hollow fiber by the navigation registration subsystem according to the focus part image recognition result.
3. The femtosecond laser minimally invasive surgical robot system of claim 1 being an oropharyngeal laryngeal femtosecond laser minimally invasive surgical robot system.
4. The femtosecond laser minimally invasive surgical robot system of claim 1 wherein the soft tissue surgical working end comprises an oral soft tissue surgical working end and a throat soft tissue surgical working end.
5. The femtosecond laser minimally invasive surgical robot system of claim 1 wherein the implantation surgical working end is composed of two micro robots installed in reverse series, one of which is a five-degree-of-freedom femtosecond laser cutting robot and the other of which is a micro implantation robot; the working end of the soft tissue surgery consists of two micro robots which are installed in reverse series, wherein one robot is a five-degree-of-freedom femtosecond laser cutting robot, and the other robot is a micro stitching robot.
6. The femtosecond laser minimally invasive surgical robot system of claim 1 wherein the end flange of the robotic arm is capable of at least 180 ° rotation, by rotating the flange, the required micro-robot can be adjusted to the front end according to the surgical needs.
7. The femtosecond laser minimally invasive surgical robot system of claim 5 wherein the five-degree-of-freedom femtosecond laser cutting robot is a laser automatic ablation, cutting micro-robot capable of three-dimensional movement of a light spot, 360-degree rotation of a light knife and 0-110 ° pitching, and integrates a dust collection cooling system and a 3D endoscope vision system, the diameter of an intracavity part is not more than 15mm, and the vision system is not interfered by laser.
8. The robot system for the femtosecond laser minimally invasive surgery of claim 5, wherein the micro-implant robot is an automatic implant positioning/screwing micro-robot, the outer diameter of the whole dimension is less than or equal to 40 mm, the length is less than or equal to 200 mm, and the robot system comprises a tail end adjusting unit, a screwing-in compressing unit, a force detecting unit and an implant clamping unit, and can adapt to the implant surgery of 3 implants.
9. The micro-surgical robot system of claim 5, wherein the micro-surgical robot is a soft tissue automatic gathering and suturing micro-robot, the overall size and the outer diameter are less than or equal to 25mm, the length are less than or equal to 200 mm, the number of stored needles is not less than 10, and the micro-surgical robot comprises a tail end adjusting unit, a needle pressing unit, a needle storing unit, a gathering unit and a needle pushing unit, and the suturing depth is less than or equal to 5 mm.
10. The femtosecond laser minimally invasive surgical robot system according to claim 4 or 5, wherein the soft tissue surgical working end designs the micro robot to have different lengths and outer diameters according to whether a surgical site is an oral cavity or a pharyngeal throat.
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